Medical information
for living and cruising
on a boat

    Dr. Nick     Contact me.

This page updated:
May 2013

Injuries / Conditions

Use the following at your own risk; I'm not a doctor; this is not medical advice; no liability accepted.


Dr. Mark Anderson's "Cruising Medical Kit"
SailNet - Randy Harman's "Cruiser's Medical Plan"
SailNet - Liza Copeland's "Medical Issues for Cruisers Part One"
Survival quiz
Kit list and 3 kits reviewed in 1/15/2002 issue of Practical Sailor.
Ship Captain's Medical Guide
"Tools for Treatment" article by Jeffrey Isaac in Ocean Voyager 2001 from Ocean Navigator magazine
Article by Pnina Greenstein in Oct 2001 issue of Blue Water Sailing magazine
"Making the Most of Telemedicine" article by Michael Jacobs in 5/2002 issue of Cruising World magazine

Good book: "Medicine For The Outdoors" by Paul Auerbach.
Good book: "Medicine For Mountaineering" edited by James Wilkerson.

Medical advisory services:
From John Harper at Medical Advisory Systems 1/2001:
1. Medical Advisory Systems, Inc. (MAS, for short) does have a medical advice hotline, available to our subscribers on a 24/7 basis.

2. The annual subscription is $400 per year. This entitles you to contact with our duty physician within a minute of the time you call, again, on a 24/7 basis. Also included for the $400 fee are: medical record storage for two persons; a quick communications guide; a radio drill manual; and advice about stocking your vessel's medical locker.

3. Yes, the hotline can be contacted by radio. Many of our clients use single sideband radio or a relay through a shore/marine radio station.

World Clinic
MedAire / MedLink
HealthForce Partners

From Jeanne Pockel's "Cruising Dictionary":
If you need medical care outside of Western Europe, USA, Australia, NZ, we strongly urge that you do not go to the local hospital. In major towns and cities find the private clinic that treats the well-to-do (applies to every South American country, every Caribbean island, and most Pacific islands). If you can find it, read a book called "Sitting Ducks".

Free medical/dental clinics in USA

Internet is cancer


Hopkins Medical Products, 800-835-1995

Overseas prescription drug suppliers:
Imported Drugs.Com (generic drugs; high shipping cost)
Pharmacy International Inc (moderate shipping cost)

From John / truelove on World-Cruising mailing list:
My doctors say that most prescription drugs are good for 2 years, despite expiration dates. Do *not* photocopy your prescriptions - it's illegal to do so. Ask your doctor to give you 2 originals - get one filled and take the other with you. Prescriptions should be understood by pharmacists worldwide.
From John Titterton on World-Cruising mailing list:
Some prescription drugs are like colour (color in the US) photographic film - it loses sensitivity and stability before the expiration date when in humid and/or hot conditions. I keep film and prescription drugs that are not stable or deteriorate quickly in the refrigerator. They do not take up much space, and it will normally extend their useful life well beyond the expiration date. There are exceptions to this, such as compounds or medications made from animal extract or ones with a high natural content in cream form. My wife also uses some special drops for her eyes to treat enzyme infections once in a blue moon - she wears contact lenses. This small bottle has a very short shelf life (6 months from manufacture) and once opened should be thrown away after two days, before the infection has cleared up. We experimented keeping the unopened bottle (you can fit two into a matchbox) in the refrigerator and found that it was still 100% effective after a year. Also, once opened and kept in the refrigerator, it lasted approximately a week instead of the two days.

A pharmacist once told me to not only keep the cream he had made up for me in the refrigerator, but to keep a small plastic film on the surface of the cream to prevent air reaching it. He informed me the cream would deteriorate quickly if exposed to the air and become ineffective. It cured my ailment quickly and thus I was never able to see how long it would actually last.
From John / truelove on World-Cruising mailing list:
You make some good points. I had not thought of compounds -- of course you are right. I recall when the Trans-Derm Scop patch was temporarily banned and I was able to get topical syringes filled with Scop gel -- it had to be constantly refrigerated. When I quoted my doctors, I was referring to caps like Vioxx and Cephalexin and also BP meds, which I should have clarified. It's true that cooler and less humidity is better.

You can buy frames and lenses very cheaply through the internet (although customer service can be bad if anything goes wrong). The process is explained at Glassy Eyes' "Online Eyeglasses: How it works". Use store links on Glassy Eyes to get extra discounts.

But you still need to visit an optometrist to get an eye examination and prescription (make sure it includes your Pupillary Distance and Near Pupillary Distance). This costs $50-$100 (try Walmart or CostCo for cheapest ?), and really should be done every year or two.

And you need the frame measurements, best taken from an existing set of your frames. The measurements will be in the form "Lens Width - Bridge Width - Temple Width (earpiece length) - Lens Height", in MM. Often the first three numbers are stamped on the earpiece.

My experience 7/2009:
I had an eye-exam done and a prescription written ($35), then ordered progressive bifocals from 39dollarglasses through glassyeyes.

Price ($85 including shipping) and speed were great. I ordered grey frames and received brown frames with "gray" stamped on the inside of the earpiece !

I'm not happy with the progressive bifocal lenses: the lens size is too small and the near-distance field of vision (in focus) is much too narrow, but that seems to be a common complaint about progressive bifocal lenses, and nothing to do with ordering through the internet. Someone suggested that more expensive lenses may have wider fields of vision (in focus).

At exam time, the optometrist looked at my old with-line bifocals and said "you won't be able to get big lenses like that any more", so maybe I couldn't have done any better on the "too small" issue either, buying off-line.

"I know a man who gave up smoking, drinking, sex, and rich food. He was healthy right up to the day he killed himself."
-- Johnny Carson

Injuries / Conditions

From Beth Leonard's "An Apple a Day When the Doctor's Away":
Allergy and infection can give same symptoms: heat and swelling.
Rub area with cortisone cream.
If it works, you have an allergy: take an antihistamine.
If it doesn't work, you have an infection: take an antibiotic.

Always follow instructions from doctors: pic


CDC travel info
Judy Lamar's "Illnesses Related To Water"
International Association for Medical Assistance to Travellers (IAMAT)

Some of this from CDC and Travel Health Online:
Immunizations, summarized from "Medicine For Mountaineering" edited by James Wilkerson:
From Donal Philby on the SailNet liveaboard-list:
I just received $500 worth of vaccinations and other health medications prior to an upcoming trip this month to Thailand, Cambodia and Laos. Holy smokes! And another $300 for hep A and B boosters on return.

Included in this is Malarone, an anti-malarial which you take a couple days before and all during and for a week after returning. At $5.75 a pill/day (some pharmacies sell this for up to $13/pill), this is no small investment. It was $170 for a three-week trip. But after watching my father suffer recurring bouts of malaria contracted during WWII in the Pacific, I'm not interested in sharing that experience.

It made me realize that planning a cruise through malaria-prone areas of the tropics could prove wildly expensive unless one can find a cheaper source of such medications. The source I found seemed less than other places. I'm going to check to see if these could be gotten via VA hospital (I just got my records to apply for services, if needed).

I expect that the health precautions are going to cost more than our on the ground travels, since we are going where things are cheap.
From Franz Karl Byars on the SailNet liveaboard-list:
As one who prescribes Malarone for travelers, I'm pretty sure that you don't take the med on a daily basis but once a week. You should start the med prior to leaving and then continue the med for at least 3 weeks after you leave the infested area. You should double-check on the prescription.

From Rick Kennerly:
Re: Getting vaccinations:

Not a lot of doctors carry these vaccines because they expire before they use them all, so they will order them or send you where you can get them. Most hospitals do have a vaccinations nurse. Some county health departments do some or all vaccinations for free. But any county health department will know where to get the shots in your local area.

Prices of vaccinations (11/2004 at Marathon FL health clinic):
Cholera: 1 shot $36.
Hepatitis A: 2 shots $68 each, at least 6 months apart.
Hepatitis B: 3 shots $60 each, over a 6- to 8-month period.
Typhoid: 1 shot $70, or four-pill regimen ($???).
Tetanus booster: 1 shot about $36.
Yellow Fever: 1 shot $90.

My experience:
I decided to get hepatitis A and typhoid vaccinations before my Caribbean cruise, on the theory that you can get those diseases from contaminated water. I think my tetanus is up-to-date.

[Later, got a Tetanus booster in Salinas PR for $10.]

From article by Bernadette Bernon in 11/2003 issue of Cruising World magazine:
We met one crusty coot who'd had such a wicked toothache on a transocean passage that he finally wrenched it out with vise-grip pliers, "leaving only one damn tooth on top," he crowed, "What the hell good's that ? I pulled it out, too."

"Lucky he didn't have a urinary-tract infection," Douglas whispered to me.

Taking medicine

From "Mr. Monk and the Two Assistants":
"You can't catch scurvy," Julie said. "You get it from not eating enough oranges."

"That's an old wives' tale," Monk said. "From wives who later died of scurvy."