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A seaman’s life is full of challenges. They face the peril of the raging waters
of the ocean as they sail for days and months. But the real challenge is
how to keep both body and mind healthy, sane, and able while on board.
Fit on
Board
By Dr. Benedicto D. Dorado
T
here are so many problems that a seaman
on board must face. The number one
problem is psychological. If you are a
first timer it is very difficult to face the
realities of life. So many questions come to
your mind. Why do you have to leave the
comfort of your family and friends on land. Seafaring is a
vocation. It is not just like sailing and learning the ropes
of seamanship. You are out on the sea to earn a living,
support your family, and eventually save for the future
when the time comes for you to retire. Acceptance of
the reality that you are away from your loved ones for
months on end, for at least six to ten months is a reality.
You may enjoy the work at sea for a month or so, but
being away out on the sea for the longest time in your
life for the first time can be nerve wrecking.
Seamen have to prepare themselves psychologically.
The first rule is acceptance. Depression may come
but you have to deal with it. It’s fortunate that the
information technology called the internet is here. The
social media has helped a lot in doing away with the
loneliness, the longing for the security and comfort of
the home, and the loving presence of the family and
special ones. In this time of social media, the depression
that lead to psychoses has been in a large way been
addressed.
The number two problem is diet imbalance due to
faulty eating habits. A seafarer patient told me that most
of the times they have no choice but to eat whatever is
available in the ship. They have to consume whatever
food is available on board due to budgetary constraints.
Metabolic diseases is common like diabetes, gouty
arthritis and hypertension.
I encountered the worst gouty arthritis in a patient
20
who was about to go on board but could not due to
a severe case of chronic gout. The tophi is formed by
the deposit of uric acid in the blood. Tophi is a rounded
mass located at the metatarso phalangeal (toes) or
metacarpo phalangeal (hands)joints making the
affected hands and toes deformed. Tophi can form in all
joints of the body like elbows, knees and lowback. Tophi
however occurs in joints where there is more ligaments
like the toes and fingers and wrists. Tophi when excised
by surgery is a powdery crystal composed of uric acid.
Because of the tophi , there is chronic pain and during
severe arthritic attack, ankylosing deformity happens
where the joints cannot be moved anymore. There is
severe pain on the affected joints and is aggravated
when you move the joints. In the late stages of disease,
the patient may be disabled as he can no longer move
his deformed hands and feet due to the tophi or
rounded masses on his joints. Once the uric acid crystal
in the blood cannot be eliminated through the kidneys
by urination, it will be deposited in the calyxes (tubes) of
the kidney itself forming kidney stones. Kidney stones
hinder the flow of urine and the kidney will enlarge
because the urine cannot be eliminated completely.
Since there is poor elimination of urine through the
kidney, there is increased ammonia and blood urea
nitrogen in the blood. In worst cases, creatinine is also
increased causing edema or manas of the patient. When
this happens the kidney is in failure. If the kidney stone
or stones will not be removed , there is accumulation of
waste product and will cause uremia or kidney failure.
Once uremia sets in the patients can die unless the
patient undergo dialysis.
A balanced diet is very important. Most foods eaten
on board has high levels of cholesterol and high purine
content which when processed in the liver produces uric
acid. When you consume these foods, gouty arthritis ,
high blood pressure and heart diseases may develop.
Arteriosclerosis (hardening of the blood vessels) is one.
Foods commonly consumed on board are high in
cholesterol content and high in uric acid. Examples of
food items high in uric acid are: alcoholic drinks; fried