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Old 06-13-2018, 07:06 PM   #21
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Regarding allergic reactions to sting rays at least, attached is a picture of my foot from last Summer in the ER. My foot was red hot, itchy, swollen and needed constant ice. I finally went in after four days and they drew the line shown to monitor. It was my third sting, and every one has gotten worse so some people will get hit harder than others. I am also allergic to bee stings for what this is worth. I have always been told Benadryl is a good way to control it. Also, if you get stung, make sure the stinger is not in your foot. Most times the Ray will retract it, but the ER Doc said they do break off on occasion which can pose even more risk to a person predisposed to an allergic reaction. Shuffle your feet.
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Old 06-13-2018, 09:32 PM   #22
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Greetings,
A question for the "medicos" or those in the know...What are the chances of anaphylactic shock? Would it be prudent to put an epi-pen in the medical kit or are there OTC medications that might lessen the symptoms pending medical treatment?

Anyone can experience anaphylaxis. It can be life threatening. In the office, we alway have an Epipen handy. Ive never had to use it on a patient yet in 35 years of practice. It likely will happen.

I think it would be prudent to have one on board as part of your medical kit. I do not at this time, but it is time to review and refresh our kit. You can buy a two-pack of Epipens. If you have a relationship with a physician, they can prescribe it for you.

Allergies are odd things. You can have a mild reaction to something once, and the next time you are exposed you can experience anaphylaxis. Having an Epipen on board can protect you and your family, as well as any guests you have on board.

There are risks to using an Epipen for certain patients with some types of heart disease or taking certain medications. However, unless you know you have one of those risk factors, I would use it.

Often folks are concerned about not knowing when/if they should administer it. Im no expert obviously but my attitude is to use it at the first sign of life threatening symptoms. This could include swelling or tingling of the mouth and throat, shortness of breath, or light headedness and nausea. The risks of anaphylaxis are greater than unnecessary use of the epinephrine.

The Epipen has gotten stupidly expensive. You can now get other automatic epinephrine injectors that are much less expensive, particularly if you shop around.
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Old 06-14-2018, 07:15 AM   #23
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Anyone can experience anaphylaxis. It can be life threatening. In the office, we alway have an Epipen handy. I’ve never had to use it on a patient yet in 35 years of practice. It likely will happen.

I think it would be prudent to have one on board as part of your medical kit. I do not at this time, but it is time to review and refresh our kit. You can buy a two-pack of Epipens. If you have a relationship with a physician, they can prescribe it for you.

Allergies are odd things. You can have a mild reaction to something once, and the next time you are exposed you can experience anaphylaxis. Having an Epipen on board can protect you and your family, as well as any guests you have on board.

There are risks to using an Epipen for certain patients with some types of heart disease or taking certain medications. However, unless you know you have one of those risk factors, I would use it.

Often folks are concerned about not knowing when/if they should administer it. I’m no expert obviously but my attitude is to use it at the first sign of life threatening symptoms. This could include swelling or tingling of the mouth and throat, shortness of breath, or light headedness and nausea. The risks of anaphylaxis are greater than unnecessary use of the epinephrine.

The Epipen has gotten stupidly expensive. You can now get other automatic epinephrine injectors that are much less expensive, particularly if you shop around.
As a physician (medical doctor), I am frightened by the way you posted on this particular topic, Mr Dhays. In a public place you cannot make that kind of statement into which you can just post anything you want. So, judgment was necessary in determining what to put in and what to leave out. This is too important to people here, and risk are too high.

I think it would be prudent to have one on board as part of your medical kit.
You said that without giving the temperature much thought to people here. Are you aware about the importance of keeping epinephrine temperatures regulated at room temperature of 64.4-78.8F ( 18-26C) ? Do you know that epipen instructions say to keep epinephrine at an ideal temperature of 77 degrees, also to never leave epinephrine in a car since closed vehicles reach extreme temperatures in the summer and winter which is the same for boat. ? Why didn't you say that althought this was a crucial point ?

If you have a relationship with a physician, they can prescribe it for you.
Yes, but for you and you alone.

Having an Epipen on board can protect you and your family, as well as any guests you have on board.
Are you serious ? How can you make sure epinephrine (EpiPen) is safe for them ? Even if you have an official medical prescription from your health specialist, this does not, however, give you the right to take decisions for your family or guests or anyone else. Not only you may allow people to be in danger or hurt in this particular situation but you put yourself in danger as well to the law relating to the illegal practice of medicine.

There are risks to using an Epipen for certain patients with some types of heart disease or taking certain medications. However, unless you know you have one of those risk factors, I would use it.
How can you know whether your relative or guest is at risk of heart failure, possible cardiac sensitization, or not ? Many individuals are sick without knowing it. I see that in my practice daily.
If you want to run this risk, do so. But do not advise people here of the forum to run a risk which they perhaps cannot afford to take.

Professional help can be found through your family doctor, talk this over with him or her. Only if you get an individualized official medical prescription for yourself alone or others, keep the auto-injector for epinephrine in its carrier tube at all times aboard, at room temperature in a insulated lunch bag, do not refrigerate, protect it from light. Epinephrine can’t have ice directly on it, but wrapping ice and/or the epinephrine in a towel creates the perfect buffer. Then I place the epinephrine and towel into an insulated pouch which I never leave aboard when I am away from the boat.
Take a close look at the auto-injector and its instructions, be sure to ask your doctor a training session during your appointment. Also keep aboard a fully automatic wrist blood pressure cuff monitor with extra batteries which is a modest amount of extra expense for a valuable aid.

I have been a member of the forum for just 19 days after enjoyed it for six years as a guest. I was not here to criticise you neither to fight with anyone then I trust that my post would be deleted by the TF team. But the question as to how far to go in playing the sorcerer's apprentice with the very core of the health of others had, at some point, to be raised.
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Old 06-14-2018, 07:53 AM   #24
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Greetings,
M. LM. Thanks for the education. I actually thought that an Epipen was a general "cure-all" for any toxic shock victims. I know better now and will NOT pursue the matter any further. Hopefully I will never be in a position to regret my decision.



We know folks with bee/wasp sting allergies and they always have these devices close at hand during the appropriate seasons although I never asked them any particulars about usage.


So. Vinegar it is and a sharp eye out for...





As an aside...A few years back we were transiting the ICW and ran through a "school" of jelly fish. Not quite as dense as the above gif but there must have been dozens upon dozens over a 4 or 5 mile stretch. Big 'uns as well. Some upwards of 10" in diameter...


Oh ya. Shuffle for rays.


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Old 06-14-2018, 09:16 AM   #25
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Thank you Sir but I did not express a real opinion - in that public place - about to carry or not to carry epipen. I just rectified significant inaccuracies or omissions.

What I meant to say:
Seek medical advice, consult a physician, get an individualized prescription.
Get trained. Epinephrine auto-injectors are sold in two-packs for a good reason.
Keep the auto-injector for epinephrine at room temperature (77F) 24/24.
As well, seek emergency help after use.

Jelly fish is a growing problem in the Mediterranean also, as it is in the rest of the world. They say that at least 150,000 people were treated for jellyfish stings around the Mediterranean each summer. Still talking of Mediterranean species of jelly fish, some says that the best protection against stings may be suncream, which prevents the venom released by the tentacles from penetrating the skin, I do not know whether it's useful or not.
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Old 06-14-2018, 09:27 AM   #26
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Jelly fish is a growing problem in the Mediterranean also, as it is in the rest of the world. They say that at least 150,000 people were treated for jellyfish stings around the Mediterranean each summer. Still talking of Mediterranean species of jelly fish, some says that the best protection against stings may be suncream, which prevents the venom released by the tentacles from penetrating the skin, I do not know whether it's useful or not.

Could you clarify on this? Are saying jelly fish populations are increasing or more people are coming into contact with jelly fish?
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Old 06-14-2018, 09:50 AM   #27
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Originally Posted by La Mer View Post
As a physician (medical doctor), I am frightened by the way you posted on this particular topic, Mr Dhays. In a public place you cannot make that kind of statement into which you can just post anything you want. So, judgment was necessary in determining what to put in and what to leave out. This is too important to people here, and risk are too high.

I think it would be prudent to have one on board as part of your medical kit.
You said that without giving the temperature much thought to people here. Are you aware about the importance of keeping epinephrine temperatures regulated at room temperature of 64.4-78.8F ( 18-26C) ? Do you know that epipen instructions say to keep epinephrine at an ideal temperature of 77 degrees, also to never leave epinephrine in a car since closed vehicles reach extreme temperatures in the summer and winter which is the same for boat. ? Why didn't you say that althought this was a crucial point ?

If you have a relationship with a physician, they can prescribe it for you.
Yes, but for you and you alone.

Having an Epipen on board can protect you and your family, as well as any guests you have on board.
Are you serious ? How can you make sure epinephrine (EpiPen) is safe for them ? Even if you have an official medical prescription from your health specialist, this does not, however, give you the right to take decisions for your family or guests or anyone else. Not only you may allow people to be in danger or hurt in this particular situation but you put yourself in danger as well to the law relating to the illegal practice of medicine.

There are risks to using an Epipen for certain patients with some types of heart disease or taking certain medications. However, unless you know you have one of those risk factors, I would use it.
How can you know whether your relative or guest is at risk of heart failure, possible cardiac sensitization, or not ? Many individuals are sick without knowing it. I see that in my practice daily.
If you want to run this risk, do so. But do not advise people here of the forum to run a risk which they perhaps cannot afford to take.

Professional help can be found through your family doctor, talk this over with him or her. Only if you get an individualized official medical prescription for yourself alone or others, keep the auto-injector for epinephrine in its carrier tube at all times aboard, at room temperature in a insulated lunch bag, do not refrigerate, protect it from light. Epinephrine cant have ice directly on it, but wrapping ice and/or the epinephrine in a towel creates the perfect buffer. Then I place the epinephrine and towel into an insulated pouch which I never leave aboard when I am away from the boat.
Take a close look at the auto-injector and its instructions, be sure to ask your doctor a training session during your appointment. Also keep aboard a fully automatic wrist blood pressure cuff monitor with extra batteries which is a modest amount of extra expense for a valuable aid.

I have been a member of the forum for just 19 days after enjoyed it for six years as a guest. I was not here to criticise you neither to fight with anyone then I trust that my post would be deleted by the TF team. But the question as to how far to go in playing the sorcerer's apprentice with the very core of the health of others had, at some point, to be raised.


La Mer, thank you for your post. Your concerns are completely valid and I appreciate your participation.

There likely is a difference in how Epipens are viewed and handled between France and the US. Even in the US, the laws vary from state to state.

As for the specific concerns you expressed;
- I generally think that TF members are reasonably intelligent and can, and will make their own decisions.
- specific information and training about the use and storage of an epinephrine autoinjector would be given with the prescription.
- Yes, a prescription is given for an individual, not any guest or other family members. However, we are talking about an emergent situation where there may not be EMS services at hand. What supplies one keeps on a boat in a remote location are going to be different than what one keeps on hand in ones home, a few minutes away from EMS services.
- Using a epinephrine on the wrong person, at the wrong time could kill them. However, anaphylaxis can also be fatal. If I am hours away from any type of medical aid and a family member or guest is having an anaphylaxis reaction, with an airway closing and heart rate dropping, I would choose to use an Epipen rather than watch them die. That is my choice but everyone will make their own choice.

Again, I agree with your concerns but not necessarily with your ultimate conclusion.
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Old 06-14-2018, 09:52 AM   #28
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Could you clarify on this? Are saying jelly fish populations are increasing or more people are coming into contact with jelly fish?
Yes Sir, jellyfish populations in the Mediterranean is rather extensive. Different factors might have caused a recent increase of jellyfish populations whose higher sea temperatures which benefit jellyfish development and reproduction.

Also through the Suez canal, new jellyfish species have reached and established themselves in the Mediterranean still due to higher sea temperature.

As a result, more people were treated for jellyfish stings around the Mediterranean each summer.
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Old 06-14-2018, 10:25 AM   #29
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La Mer, thank you for your post. Your concerns are completely valid and I appreciate your participation.

There likely is a difference in how Epipens are viewed and handled between France and the US. Even in the US, the laws vary from state to state.

As for the specific concerns you expressed;
- I generally think that TF members are reasonably intelligent and can, and will make their own decisions.
- specific information and training about the use and storage of an epinephrine autoinjector would be given with the prescription.
- Yes, a prescription is given for an individual, not any guest or other family members. However, we are talking about an emergent situation where there may not be EMS services at hand. What supplies one keeps on a boat in a remote location are going to be different than what one keeps on hand in ones home, a few minutes away from EMS services.
- Using a epinephrine on the wrong person, at the wrong time could kill them. However, anaphylaxis can also be fatal. If I am hours away from any type of medical aid and a family member or guest is having an anaphylaxis reaction, with an airway closing and heart rate dropping, I would choose to use an Epipen rather than watch them die. That is my choice but everyone will make their own choice.

Again, I agree with your concerns but not necessarily with your ultimate conclusion.

In reviewing my post, I recognize unequivocally that my tone was entirely inappropriate also I have gone too far in my last conclusion. There was certainly no justification for it, even if I was very concerned with some of your views.

I wish to sincerely apologize and I thank you for your last post.
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Old 06-14-2018, 10:54 AM   #30
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In reviewing my post, I recognize unequivocally that my tone was entirely inappropriate also I have gone too far in my last conclusion. There was certainly no justification for it, even if I was very concerned with some of your views.

I wish to sincerely apologize and I thank you for your last post.


La Mer, no reason to apologize. I did not think that your tone was inappropriate at all. I appreciate your contribution. Im assuming that English is not your primary language, and yet you expressed yourself clearly and respectfully. :-)
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Old 06-14-2018, 03:38 PM   #31
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Thats the "Sea Ray shuffle" The sea jellies are not ableto swim away from you.
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Old 06-14-2018, 04:09 PM   #32
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30 years ago plus, the recommendation for jelly fish 'troubles' was, if not close to medical help, 'piss on it.' I guess that is no longer valid?

My luck, everyone around me would be either shy or empty.
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Old 06-14-2018, 05:03 PM   #33
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30 years ago plus, the recommendation for jelly fish 'troubles' was, if not close to medical help, 'piss on it.' I guess that is no longer valid?

My luck, everyone around me would be either shy or empty.
Good question. Perhaps because urine is warm could be effective method of restoring blood flow to burned areas? Just wondering.
It was more popular after a Friends TV episode in which one person applied urine to a jellyfish sting.

Urine is sterile but my concern is that it has to pass through the germ-laden urethra to get out, and can lead to a bacterial infection of the sting wound.

As auskiwi rightly posted vinegar is usually the way to go just the plain white stuff.
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Old 06-14-2018, 05:10 PM   #34
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I was swimming in the surf on Cumberland Island, GA two years ago. All the doctors can figure is I got into an area filled with microscopic sized jellyfish. I was a giant welt on my entire body except above my neck and head. It took a month's worth of high powered prednisone to deal with it. It as misery. I'm from Florida. I thought I knew what a jellyfish looked like. I have since discovered that they come in all sizes.
Very sorry for you but an interesting point. Indeed the smallest jellyfish in the world is the creeping jellyfish. It has bell disks from 0.5 mm to a few mm in diameter.
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Old 06-14-2018, 05:33 PM   #35
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Surfing in Florida in the mid 60’s I got lots of exposure to jellyfish, they blow shoreward in long windrows, thousands of them.
In those days we all rode longboards, knee paddling, so unless you fell, your upper body was seldom immersed.
The trick to protecting your lower body was to wear pantyhose under your shorts, the tentacles cannot adhere to the slick plastic they are made of, so they harmlessly wash away.
At the time, that was a jealously guarded secret that almost guaranteed I could have the surf break all to myself, and of course, I didn’t want my friends to know what I was wearing!
They all thought I was Superman, few others would chance it when the jellies were in.
Treating jellyfish stings can be accomplished handily with a paste of meat tenderizer and warm water, or green papaya is one of the best remedies, at least in the tropics where such things abound.
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Old 06-14-2018, 06:08 PM   #36
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I have heard of a sting suit and these are popular down under.
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Old 06-14-2018, 08:02 PM   #37
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Treating jellyfish stings can be accomplished handily with a paste of meat tenderizer and warm water, or green papaya is one of the best remedies, at least in the tropics where such things abound.

Many meat tenderizers use an enzyme extracted from papaya's.



The enzymes break down protien, I don't see how that would help with the sting...?
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Old 06-14-2018, 08:51 PM   #38
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I have read the whole thread and hoped that someone else would report this so I could just lurk. But many years ago in SoCal I was body surfing and scooped up a "Portuguese Man O War" right down the front of my bathing suit. It was NOT enjoyable as those tentacles thrashed around. But I did not have a reaction........at least not an allergic reaction. I was done surfing for the day, however.
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Old 06-14-2018, 08:55 PM   #39
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I have read the whole thread and hoped that someone else would report this so I could just lurk. But many years ago in SoCal I was body surfing and scooped up a "Portuguese Man O War" right down the front of my bathing suit. It was NOT enjoyable as those tentacles thrashed around. But I did not have a reaction........at least not an allergic reaction. I was done surfing for the day, however.
Interesting.

Do you believe that you were somehow not stung or that in some way you did not react to the venom?
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Old 06-14-2018, 09:04 PM   #40
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I think the "pee on it" rationale is that there is a very effective product called "Sting-eez" ( or something like that ) One of its main ingredients is urea. The urea breaks down the sticky stuff that attach the tentacles to your body. While urine has urea in it, it is not strong enough to break down the sticky stuff.

I suppose the warmth of the urnine would help some....but you are supposed to soak in warm water for 30 minutes......I don't want to meet the guy that can pee for 30 minutes !
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