Home Medical Care and Equipment

[Tommy T.]

@Old55

As you requested, here is a new topic. Your naming idea was just about perfect! I just added "and" to make it more properly descriptive.

I am not quite ready to tackle the details tonight, as it could be a bit involved and I will need to think it through for Phiippines vs. USA and Australia, which were my previous sources of information and medicines.

I will begin by stating a very important caveat here: I am NOT a medical professional. Anyone reading here should just accept it - or not - as ideas and possible suggestions that either worked for my ex and I while sailing in remote areas, or that I think may now be salient here in the Philippines. Anyone interested in following up on anything should visit with a health care professional - doctor or RN - and NOT rely on any of this information.

Please feel free to criticize, add, subtract or augment my ideas - I've got big shoulders and this is not a pride thing - someone asked for assistance and I will try to help, if I can, okay?

Also, I hope there are some professionals who are members of the forum willing to speak up and share their expertise.

So... with that aside, I will also state my experience just so you may not think I am just blowing smoke out my a**. If  this history might seem boring to you...just skip to the next post by me or whomever?

Before setting sail, my ex and I took a course in Mountaineering first aid in Seattle. It involved all the normal things taught in standard "First Responder" courses.... Except - they added many things that aren't part of a normal course and concentrated on how to care for someone who becomes ill or injured when hiking or climbing in remote areas. The whole concept centered on - "You cannot dial 911... so here's what you do...."

We did the usual classroom training then would go outside at night and practice what we learned. It lasted for several weeks and culminated in "Real Scenarios" in a rugged park, in the fall and well after dark. It was VERY realistic (we had equipment with us and flashlights) - with stage make-up blood, sucking chest wounds people acting quite well as if they were in need of assistance. It was scary and a wonderful experience to prepare for travelling alone, 1,000's of miles from any land or other assistance.

Prior to setting sail, I prepared a comprehensive list of equipment, books and medicines that I reckoned should be carried on board. I luckily encountered a physician who also had a yacht in our marina and she invited me to come to her office to discuss this. I asked the price - $50.

When I met her at her office, she immediately came around to my side of her grand desk to look over the list with me - what a shock! As we went item by item, she offered suggestions and I made notes. More than once we came across a medicine that she actually said, "I am not familiar with that... I will get back to you." How many of you have seen a doctor who admitted knowing less than God? She also offered suggestions for several books to buy (now-a-days this would all be online books) - everything from tropical medicine guides to easy-to-follow medical manuals. The most complex was the Merc Manual - which, though woefully out of date, is still valid for a number of situations and interesting to read if you are not squeamish.

Over an hour later, we finished and I got up to leave asking her - gee, this has been a long time, whatta I owe you, "I said fifty bucks, so it's fifty bucks!" I was thankful and very embarrassed to return to the waiting room that was packed with patients...

I am a certified Rescue SCUBA diver. Yeah... most of what I learned concerned assisting other divers in distress. But some of it also addressed illnesses such as heart issues, breathing problems, panic attacks, administering oxygen, using a small defibrillator, poisonings, allergic reactions and non-invasive examinations of ill persons. It was a great course too. CPR was, of course, top of the list too.

I apologize for my always long-winded comments here. But I think health is - at least for me - just about the most important thing there is as I steadily advance in age and regress in strength, mind and abilities. So that's how I am beginning. I will try to list some equipment and concepts of things that I feel are important to learn and that I also need to review anyway because I forget so much these days...

Cheers all! 

Edited September 8, 2019 by Tommy T.

[nor cal mike]

Excellent post regarding an important subject. While I am only minutes away from the best hospital where I live, I am always concerned about evening and holiday staffing. I have seen 2 close friends suffer fatal heart attacks that may have been survivable had emergency care been available more quickly. I am eager to read what members have to offer.

[Tommy T.]

This is how I suggest anyone begin to gather their tools for self-help in case of emergencies or situations that crop up that cause concern. See about obtaining a guidebook or reference book(s). Then look through it (them) while sipping a cold one. Try to educate yourself a bit more than you already have.

These are images from one of the medical books in my library. I considered this probably the most helpful book for over 20 years sailing in the tropics. It is probably long out of print but, even today, I still refer to it and it still has mostly good information. I just checked online and Amazon carries the 1992 version of this book. I would seriously consider getting it if I didn't already have a copy. There may be a newer version, but I did not look very far...

I included a page I picked at random to show how this book is organized. It actually has a chapter about ear issues and describes them in detail - for @stevewool. Then, at the end of the chapter, it has this quick reference guide which I really like. Every chapter is like this and covers just about everything you can imagine and explains it all in easy to understand, yet professional terms.

What I really like about it is that it also includes suggestions about medications to use for specific situations and lists them in order of preference. So, if you have, for instance, an infection somewhere, the authors will suggest, perhaps penicillin as #1 choice, followed by tetracycline as #2..., etc.

So, I consider getting a reference book to be something to consider. Otherwise, you can Google any ailment, symptom or concern and get more hits than you can imagine.

There are many fantastic online references. I prefer Mayo Clinic because it is considered one of the premiere medical care centers in the world. But there are many others. Just try to choose the ones that have some history - been around a while. And, like talking with a physician, don't be afraid to look at more than one site - some offer more or less information.

[Jack D]

7 hours ago, nor cal mike said:

Excellent post regarding an important subject. While I am only minutes away from the best hospital where I live, I am always concerned about evening and holiday staffing. I have seen 2 close friends suffer fatal heart attacks that may have been survivable had emergency care been available more quickly. I am eager to read what members have to offer.

Automated external defibrillators: Do you need an AED?

An AED may save your life during cardiac arrest.

By Mayo Clinic Staff

If you've watched a TV medical drama, you've probably seen someone whose heart stops beating and then is suddenly shocked back to life by a doctor who yells "clear" before delivering a jolt of electricity to the person's chest.

This type of procedure isn't limited to the hospital. It can be done at home if you have an automated external defibrillator (AED), a lightweight, portable device available without a prescription. If you have severe heart disease, you're at risk of sudden cardiac arrest.

AEDs can resuscitate you only if you have a specific type of heart rhythm problem. Talk to your doctor about whether owning an AED could help save your life.

MANILA-- The Philippine Heart Association (PHA) on called on the government to increase awareness and training on cardio-pulmonary resuscitation (CPR) and automated external defibrillator (AED) as a way to save the lives of persons with heart disease.

[Tommy T.]

I cannot think of a good way to organize this to not forget anything, so will try to do this by situation in alphabetical order. I may end up adding things out of order if I remember later. And please feel free to ammend or correct these comments!

Remember, you need to consult a professional with anything regarding your health. Do not rely on these thoughts and opinions because that's all they are!

I include over-the-counter medications that I know are available here, but there may be many more that members can mention or suggest, please?

With any medications, you MUST check either online, with a medical professional or at least the insert information regarding efficacy, side effects, problems with interactions with other meds, alcohol or foods, or any pre-existing conditions.

Virtually all medications have expiration dates one year out from manufacture date. I believe this is mandated by law. However, many drugs work fine for much longer. I have some drugs left over from my yacht med kit that are over 20 years old and they work fine. Maybe not as well as when purchased, but good enough. Check with your doctor or online to verify if it's okay to take an old med - do not rely on my words!

Aches and Pains - There can be all sorts of causes of aches and pains - from simply sleeping in an odd position to kidney or liver issues that present as backaches or heart conditions resulting in arm, jaw and/or chest pain.

Paracetamol is the most readily available med here. There are different versions but all have the same basic ingredient. I suggest to avoid some brand name versions that include caffeine claiming to be more effective (and they are more expensive too)... Just the basic paracetamol should be enough... Check with your doctor! Don't even think about taking this to help with a hangover or while drinking alcohol. Paracetamol mixed with alcohol is toxic to the liver - this much I know for an absolute fact. Don't do it!

Aspirin is the original pain reliever. It can upset your stomach because it is acidic. As someone recently suggested, it is a MUST med to keep if you have history or chance of heart attack or stroke because - I believe - it thins the blood. As many of you know, it can be taken daily in child doses as a preventative. However, if you are injured, cut and bleeding or expect to undergo surgery, do not take aspirin as it will make your bleeding more difficult to control.

If drinking or feeling poorly the next day as a result, I try to take aspirin. I have not asked so don't even know if that is available here? Please, members, help me out? I have some remaining from my med kit and it still works, but I am running out...

Tramadol with or without paracetamol is a fairly effective pain killer for OTC. The tramadol seems to have a bit of a relaxing effect.

Ibuprofen is the powerhouse of OTC pain meds. It can cause stomach upset if taken alone, so best with some food. It may not be good for all people because of that. It is also known to cause heart issues, especially with strong dosages or prolonged use. Be careful with it. I have used it for tendonitis as a doctor suggested - 800 mg, four times a day. That's a hefty dose, but it eliminated the pain after the first two doses. I kept that up for two weeks and it allowed the damaged tissues to heal. I did this on three separate occasions. Check with your doctor!

Those are the only OTC pain meds I am aware of here... members please?

For sore muscles or if your back spasms (as mine sometimes does because of lifting something or moving in an unusual way or because of stress) ibuprofen works great. A doctor friend of mine also suggested (not with ibuprofen) that alcohol is a great muscle relaxant (music to my ears!). So, if I feel a back spasm developing, I hit the bed or set up cushions in my chair, take a few good slugs of Tanduay (or whatever is at hand), sometimes take some ibuprofen (I know that's not a good idea, but it helps and has not caused problems to me for over 40 years now) and rest. And I get out the heating pad.

Electric heating pads are great for easing pain caused by muscle spasm, cramp, over-use. Amesco sells two versions - long and short and they produce "moist" heat. I consider that essential equipment. I don't remember what I paid, but I think it was less than P2,500? I am sure you can order them online cheaper or find them in other stores.

If you experience sore muscles or impact injury, then pack it with ice (wrapped in towel or T-shirt to prevent skin contact damage) for about 20 minutes, let it rest for 20 minutes, then repeat. The cold reduces the blood flow to the injured area which reduces the amount of bruising and swelling.

After 24 hours or so, switch to heating pad. There are also arguments for alternating heat with cold, but I am not familiar with those. Again, maybe members have suggestions?

[Tommy T.]

37 minutes ago, Jack D said:

Automated external defibrillators: Do you need an AED?

An AED may save your life during cardiac arrest.

Excellent information, Jack!

I was going to include that later, but why not now?

I just researched them online a little bit ago and was a bit shocked (pun intended) at the price. I saw a range of US$1,200 up to $2,500 and beyond. But, hey, if a person has a condition or history of heart problems that an AED could treat, how much is your life worth? If EMT service is unavailable or far away, this might be the only thing to make the difference.

I have been trained in their use and they are so simple even without training. They are totally automatic - as the name implies. Just do as you are told.

But check with your doctor before hand to see if it might be a good idea.

Edited September 9, 2019 by Tommy T.
Fix spelling

[Tommy T.]

Allergy - A professional medical doctor allergist sailor I met was so kind to consult with L and me for several hours one evening for the cost of some beers and an S & R pizza... Thanks Doctor Rob!!! So many people suffer from allergies that I think they might be one of the most common maladies and can have terrible consequences.

Verlix is a low grade antihistamine that works for 24 hours and does not make a person sleepy. There are other medications virtually identical with different names and other formulations that work in similar fashion. Benedryl or other stronger meds can be taken with it if it does not do the job alone - but check with a professional before you do that. It helps relieve hives, nose congestion, slight asthma.

Benadryl is the heavy-weight of OTC antihistamines. It works very well to ease many allergic reactions including asthma, nose congestion, hives, itching, etc. But it will make most people very sleepy. Only a minimal dose is required (I don't remember now, but I think only 50 mg. dose will do most things), but all that seems to be available here is strong dose. Do not take alcohol with this - don't even think about it!

I have suffered from allergic rhinitis most of my life. I had prescriptions years ago for a med in USA that worked great but was expensive. It used to be available here, but is not longer available. So I asked one of the pharmacists and she suggested something called Nasonex (Mometasone). It is apparently a drug similar to cortisone but without the side effects or possibility of addiction (due to reversal of symptoms through lack of use). It desensitizes the sinus and nose tissues so they do not react and produce all the mucous for self-protection. For me it is a God-send. I use a spray in each nostril each morning. Instruction say a spray in each nostril morning and night. I find I don't need that so much. If I miss a few days, it does not matter as the effects last. There are times I can just use it once every several days and my nose remains clear. If you start with it, it will take several days before it actually takes effect - up to a week or more. I think it costs something like P400 for about 1 month's supply.

For asthmatics, an emergency inhaler can be a life saver. There are a few different versions out there. I picked Ventolin (Salbutamol) and have one because I can get asthma from exposure to cats and some plant pollens. They are not expensive. Be careful about drinking alcohol because I understand there may be a bad interaction with this med.

I have no idea if these are available here in Phils... If you really want them, you might have to import them and I don't know if that is possible?

Epi-pens are the top of the line for allergic reactions. They are also super expensive - the brand name version shows online for over US$500 for a set of two. I just now found this online but know nothing about it: 

Patients can purchase the authorized generic for Adrenaclick® at the low cost cash price of $109.99 for a two-pack. This authorized generic is a Food and Drug Administration (FDA)-approved device with the same active ingredient as other epinephrine auto-injector devices.

If you are allergic to bees or peanuts or shellfish or whatever, one of these may save your life because they work almost instantly and are so simple to use. So you need to decide if the cost is worth your life or not? I have a set of two that is a couple years old and cost me around US$250 at the time.

Edited September 9, 2019 by Tommy T.
Fix grammar mistake

[Tommy T.]

12 hours ago, nor cal mike said:

Excellent post regarding an important subject. While I am only minutes away from the best hospital where I live, I am always concerned about evening and holiday staffing. I have seen 2 close friends suffer fatal heart attacks that may have been survivable had emergency care been available more quickly. I am eager to read what members have to offer.

Thanks for your comments, Mike.

They reminded me of the most important concept in First Responder training. I quote here from Wiki Encyclopedia:

The golden hour, also known as golden time, is the period of time following a traumatic injury during which there is the highest likelihood that prompt medical and surgical treatment will prevent death.

Let's hope none of us or anyone else we know requires this sort of aid...

Edited September 9, 2019 by Tommy T.
Additional comment

[Tommy T.]

And, here's a brief anecdote that happened late last year.

L and I drove to Mati, then on to Dahican and a beach shelter to attend the annual family reunion.

Papa was almost 90 years old and was just sitting at a table observing and enjoying. Suddenly, he just went blank and sort of collapsed. Several people came over very concerned but nobody had a clue about what to do. As the only foreigner there I felt a bit awkward, but was sitting right next to him when this occurred. He was totally unresponsive, but breathing okay and heart okay, so I felt that he might have fainted. I directed the relatives - including L and her sister, to lay him down, head up, legs up and cover him with jackets to keep him warm. That's it. L - the only one there besides me with any training - kept an eye on him and checked his pulse frequently. We debated transporting him to the nearest city for treatment, but he did not seem worse, so we decided to just wait and see. 

After maybe 20 minutes, he started to become responsive again and was mostly back to normal within about 90 minutes. L and I didn't leave his side for the rest of the afternoon.

What this experience did for me was to really shock me that nobody knew anything about what to do - we're talking over 60 people there with no training at all.

[RBM]

One of the common issues for us seniors appears to be stroke and heart attacks. Of course monitoring BP and life styles are very important.

I purchased a inexpensive BP monitor on Lazada, was a tad high, but after trying a few home remedies settled on apple cider vinegar which has been very successful in my case.

There are some simple steps for a carer to follow which are on GOOGLE  to identify a stroke, plus what not to do and what to do. Perhaps and idea to print out and and frame. Sounds perhaps negative how ever could be a life saver, next will take a look at heart attack, perhaps members can comment here.