Sea sickness pills cause a medical emergency! :huh:

An OCC boat left Denmark this summer bound for Inverness and the Caledonian Canal. Strong westerlies had stirred the North Sea making for a lumpy passage so out came the sea sickness pills. One of the crew, a man in his early 60 's succumbed quite quickly and retreated to his berth. Only later did it emerge that this guest crew was taking a drug called alfuzosin to control his prostate symptoms. Within 24 hours he found that he could no longer pass urine and was becoming increasingly uncomfortable.

As his distress increased the skipper tried to contact any Coastguard for advice on the ship 's VHF but was unable to raise anyone. Eventually a passing helicopter picked up their call and relayed it to Aberdeen who recommended the yacht divert to there where they would be met by an ambulance. By now the crewman was in acute urinary retention and extreme discomfort. As this had been a relatively short passage the yacht was not equipped with urinary catheters and strong painkillers so there was no option but to forge ahead as fast as possible.

The story ended happily. The poor guy was transferred to hospital where the insertion of a catheter gave instant relief. He was treated for urine infection but has not been back on a boat since!

So a few questions for discussion.
Is everyone aware that most sea sickness remedies (including patches) have, what are called, parasympathetic side effects? This means they can cause a worsening of certain conditions such as urinary retention and glaucoma. Men with pre-existing prostate problems should be wary as they may tip the balance and result in acute urinary retention.
My guess is that most boats on passages of less than 500 miles would not routinely carry the equipment and skills required to catheterise a man. Should they do so if they have male crew on board above the age of 55?
My guess is this man got into trouble because he had a mixture of infection and parasympathetic drug side effects conspiring together to exacerbate his already precarious prostate. Do we all carry antibiotics and if so which ones?
If you are someone susceptible to urinary retention which sea sickness remedies should you use and which should you avoid?

Good Points. I agree. Even for a physician getting into an unknown medical emergency situation is no fun at all. I 've been the one on the plane forced to respond - even once when the casualty was the main pilot - believe me we 'd rather not.

But back to the suggestion of the skipper being abreast the crew 's medical history; I think that is crucial. When I skippered my own boat in the Vic-Maui race recently (Victoria BC, to Maui - about 2500 nm), each crew member had to give me a detailed account of any medical issues. It was easier for them knowing that I am a physician, but even if not, at least one person on the boat and in the abscence of a physician crew member I would suggest the skipper - or maybe someone with the most first aid training, should know each crew member 's history, medication list and allergies, sensitivities, etc. Preferably in writing so that nothing can be forgotten in a pinch. This way the medical bag can be stocked in specific preparation for any likely scenario. For instance, if someone is very allergic to a specific antibiotic, either make a LARGE note of that in the med bag, or better yet, don 't even have that particular type of antibiotic on board if there are good alternatives.
Oh and just one comment - the airlines ' medial bag is pretty pathetic, sorry to disillusion you...

Magnus