Mar 19, 2013

Doctor Recommended: Medical Kit for the Travelling Angler

"Put the lime in the coconut drink them both together, Put the lime in the coconut, then you feel better, Put the lime in the coconut, drink them both up, Put the lime in the coconut, and call me in the moooooorning!"  -Harry Nilsson

Ah, if only medicine could be so easy especially given the over the counter availability of limes. I must confess a bias towards the Western Hemisphere as evidenced to my lack of any journeys to Europe or Africa. The blame lies in my obsession with Mexico and Alaska which leaves me no vacation time to travel to other destinations where I can ponder old buildings, historic art and overpay for espresso. On one of these excursions to Mexico, a friend began to suffer from gastrointestinal issues and having a medical background, I felt obligated to explore the pharmaceutical stock of Punta Allen, Mexico. Interestingly, the local clinic had medications that were free to the public, but I’ve seen better supply in my wife’s purse. From that point on, I made sure to be well supplied for future fishing trips. These supplies I keep in a waterproof near-indestructible box that you can get at any camping supply store. A few of the things that are rarely used, I vacuum seal and keep in the box as well. I can remove and add items depending on how remote the location. Here’s my suggestions:

Nearest clinic?  Not Near
None of the following should be taken internally, I suppose you could but it would be most unpleasant. I keep a varied supply of band aids, especially ones fitted for fingers and finger tips. Coban self adherent wrap is fantastic for line cuts. In fact, I keep a roll of this stuff in my sling pack, boat bag and first aid box. For larger cuts, I usually keep in a vacuum bag: a few gauze 4x4’s as well as gauze bandage rolls to make a pressure dressing. Some triple antibiotic ointment, Hexachlorophene, or Iodine can be useful to decrease local infections. For sunburns, an ample supply of aloe based lotion is always wise. Silver Sulfadiazine (you’ll need a prescription) is a topical ointment that even with a limited supply can be applied to burns to reduce the risk of infection as well as decrease the symptoms. In the case of blisters, I keep a couple of sheets of moleskin.

Internal Use - Nonprescription
Nothing gets more use on a trip than Acetaminophen and nonsteroidal anti¬inflammatories (NSAID), e.g. Naprosyn and Ibuprofen. I keep a couple of bottles of each in several locations. The Acetaminophen is best for fever or headache. Whereas, the NSAID’s can be used for muscle-joint aches and pains as well as fever and headache. On a prior trip to Christmas Island, my guide made a quick visit to the brush because he ate something from a banquet that didn’t “agree with him”. Turned out, he had consumed a local oily fish that though quite delicious was like a bull in the china shop with that shop being housed in his colon!!! Fortunately, most of my travel partners do not consume such adventurous fare but more times than not, someone is stricken by similar malady. Therefore, an ample supply of Loperamide can make someone very popular and present the opportunity to sell to the highest bidder. For heartburn, a supply of antacid comes in handy. A decongestant (Pseudoephedrine) or antihistamine (Diphenhydramine) can be a nice convenience for someone with upper respiratory symptoms or an allergic reaction.

Chances are, one of these characters is not feeling 100%
Internal Use - Prescription
Okay for this category, you are going to have to rely on your personal health care provider. In most cases, they will be willing if you explain the purposes of these meds and don’t make the request too regular. First and foremost, a prescription pain reliever is always good to have available. A friend of mine spent the better part of a fishing trip trying to pass a kidney stone. A few tablets of Codeine or Hydrocodone would have rendered his pain somewhat tolerable. In the case of someone trying to throw up their entire gut, Promethazine suppositories are quickly effective. Yes, I know the thought of suppositories are reprehensible but what good are tablets if you can’t keep water down? I’ve saved a couple of trips from rendering me immobile by having a muscle relaxant available for back spams. Try standing on the bow of a panga while double hauling into a wind with your back as flexible as the local parking ticket officer. Depending on your comfort level, a limited supply of broad spectrum antibiotics can be useful if you are traveling to areas with limited health care resources.

Of course, with all the above you must take into account if you or your party have any medical conditions that would contraindicate the use of some of these meds. Make sure to check your supplies on a regular basis. As luck would have it, if you forget to restock an item, guaranteed on your next trip, you will need it. Also, never hesitate to seek medical attention when the situation warrants. One last bit of advice, emergency medical evacuation insurance, learn about it, and buy it. By the way, thanks to my buddies Joe and Harvey, I found that rum makes a better additive to fresh coconuts than lime.

-Charlie Chambers is a physician living in Hood River, Oregon

"Fly Fish the World with Us"

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