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Sailing Totem: Medical Checkups, And A Crisis

Life still happens, even when cruising. How do you handle routine medical care when far from home?

May 18, 2021
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Doctora Ocha reviews pictures of Jamie’s nose carcinomas.
Doctora Ocha reviews pictures of Jamie’s nose carcinomas. Behan Gifford

This story originally appeared on Sailing Totem.

Routine dermatology checkups occupied our morning, although they’ve felt anything but routine since Jamie’s basal cell and squamous cell carcinomas were sliced out in Puerto Rico a few years back (thank you to the awesome Dr Jaime “Coco” Villa!). Stepping into the sterile clinic today, a trio of uniformed staff offers greetings as the door jingled closed. Muted tones of the room temper my concerns about that rough spot on Jamie’s nose that the doctora didn’t like a few weeks ago.

We’re expecting the outcome of today’s appointment to be travel plans for Guadalajara or Mexico City, two of three places in Mexico with a clinic that offers the specialized Mohs surgery to cut out this next round of cancerous cells.

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Xpression crew reunited in Washington
Xpression crew reunited in Washington Behan Gifford

During much of 2020, one of my concerns was that an incidental need for medical care – whether it was a public hospital or private clinic – would put us at risk for COVID. It was a trip to the dentist where a cruiser caught the virus earlier this year, and didn’t survive.

Fortunately, our medical needs tended to more mundane and managed in the fleet. Actually – we can blame any 2020 trauma on the fauna! Jamie and another cruiser were hit by a stingray, a painful jab that sends toxins flooding through your body for a short time. Bee stings plagued most of our buddy boats cruising in the Sea of Cortez. One particularly bad day, the third sting was on the left butt cheek after unknowingly sitting on a bee – not to be outdone, another bee flew up my shorts and stung my upper inner thigh. Ouch! I might have lost it a little – and then lost it giggling in empathy when not one but two kid boat moms reported being stung in, well, an intimate location!

Gofundme fundraiser
This fundraiser has been organized to pay to get Xpression back to Puget Sound, and provide financial cushion for the journey ahead. Behan Gifford

The only problem emerged was when a bee sting on my foot turned into cellulitis. Always good to know the medical professionals in the fleet: we had several in our group of bubble boats! The infection needed antibiotics, but restocking our antibiotics was among the last items on the pre-South-Pacific-departure list. No need to let them age on board when they’re so readily accessible on shore… until you have a pandemic, don’t have the right one, and can’t go into town! But the fleet provides (the dude abides?), and another boat had a course of the meds I needed.

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Our crew is finished with covid vaccination jabs, so we’re following up on postponed care. Siobhan had a new retainer made; she’s in the last stages of orthodonture. Her invisible aligners (Invisalign is a brand name) ran $1,500 for the complete treatment with the awesome Dr Felix here in town (excellent care; Starbucks machine in the waiting room a bonus). Niall fast tracked to get his molds and trays made here last December, and is already almost finished. I went in for cleaning, and to deal with a filling that had been bothering me – and left with that fixed and two additional fillings (total cost, $175).

Max leads a knots class for kids in Mexico.
Max leads a knots class for kids in Mexico. Kat Liana

Next up are eye exams. Most recently we went to an optometrist here in Puerto Peñasco, about a year and a half ago; the method was accurate if dated. I don’t think even there was a fee when we bought a pair of glasses. We’ll get more comprehensive tests up in Arizona, and have that scheduled for a couple of weeks from now. Contacts for Siobhan may be in order.

Meanwhile, other friends from the Sea of Cortez fleet are facing down a bigger medical challenge. The crew of Xpression was floating around the Sea this summer; they fund cruising through periodic jaunts stateside by mom, Steff, a travel nurse. She’s been up in Washington for some weeks on a nursing locum gig when she felt some shortness of breath, then trouble swallowing. The symptoms finally got a diagnosis: stage 3B lung cancer. I’ll save you Googling: this is really bad.

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Navigation class for kids
Navigation class for kids, courtesy of Xpression crew. Kat Liana

“We are now a cancer family and everything looks different.” Max’s news hits in the gut. The news had to be broken to their daughters over a video call. I can’t imagine it, but a part of me feels the injustice: there is zero reason this nurse, triathlete, mother with octopus arms, and never-smoker should have lung cancer.

Right now, Steff’s up in Washington state for treatment, and the boat is down in Mexico. One of the tribe has already driven from the Seattle area, to La Paz, and back again – to reunite the family – while in the midst of his own family’s health care challenges. But Max and Steff’s boat, Xpression, is the family’s only home—it’s where she would like to live for the time she has ahead with her family. This fundraiser has been organized to pay to get Xpression back to Puget Sound, and provide financial cushion for the journey ahead (Steff is her family’s breadwinner). They face a very difficult road.

Steff leaves a donation for the local orphanage in La Cruz.
Steff leaves a (contactless!) donation for the local orphanage in La Cruz. Kat Liana

Max and Steff are Those Cruisers: you know the type – if there’s a need in the fleet, they step up and help. Like running planning meetings for the South Pacific bound boats departing from La Cruz last year. Teaching a navigation class for kids, or another on tying knots. So the fleet here is stepping up with the fundraiser, and I hope some of our readers will be moved to contribute as well.

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Going cruising doesn’t mean going without a safety net. We have travel health insurance that isn’t useful for everyday expenses, but is in place should an emergency or serious illness occur. But being ready for all the repercussions: is it even possible? Meanwhile, we keep up with routine checkups and pay out of pocket for all our needs—because outside the USA, it’s generally just a few hundred dollars per year for our family.

Man with a skin graft on his nose.
The last time Jamies’ nose went to a Mohs clinic; 2017 Behan Gifford

We prepare with first aid and CPR. We prepare with maritime medical training classes. We have our safety nets of catastrophic-coverage insurance. But there’s just no way to prepare to face down the big C as a family.

Back in the lobby of the dermatology clinic, our problems feel small. We had good news from the doctora: in fact, Jamie’s basal cell carcinomas don’t warrant traveling to a clinic for Mohs, after all. A second installment of his asymmetric facelift is put off for now. We’ll watch it, and follow-up with her again in two months. Consultation, $35.

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