A Close Call in the Caribbean

A medical emergency becomes even more serious when out at sea — far from land and the nearest hospital.

After my wife, Sandy, and I retired from the federal government in 2013, we began spending the winter months aboard our 42-foot sailboat, Sandy Sea, cruising and diving in the Bahamas. As part of our departure preparation, we always plan for what to do in the event of a medical emergency on board. Our preparations include having a well-stocked medical kit and not putting ourselves or our boat at undue risk.

On Wednesday, Feb. 4, 2015, we were anchored off George Town's Sand Dollar Beach in the Exumas. Sandy began to experience excruciating lower back pain on her left side that left her nauseated and bent over on the floor. I feared she had a kidney stone because I had experienced two episodes with them in the past. A Percocet helped to relieve the pain, but she could not keep down any fluids, and the pain was getting more intense. We agreed it was likely a kidney stone and decided to wait and see if it would pass. I radioed the friends we had been cruising with, and they came over in their dinghy. One of the friends is a nurse, and she agreed it was likely a kidney stone. Another dose of medication helped to relieve the nausea, so Sandy was finally able to sleep.

Even after a full night's sleep, however, Sandy was unable to keep down any fluids, and the pain was getting worse. At this point we knew we had to get to a medical facility, but none were in the area. Getting to the closest hospital in Nassau — approximately 130 nautical miles away — would take three days by sail.

I was wondering who to reach out to when I thought about the dive insurance we've had for years and an article that I read noting that Divers Alert Network® (DAN®) is not just for dive emergencies. We have been scuba divers for many years; I am an instructor, and Sandy is my dive buddy. We have been DAN members since 2006. After locating our DAN insurance cards among our important papers, I used Skype to make the call, and a representative answered immediately. The whole process seemed to go into hyperdrive. The medical information specialist on the other end of the line assessed the situation, brought an expert onto the call and concluded that Sandy needed to be evacuated to a medical facility. Then the representative said they would call us back within the hour with a plan of action.

True to their word, DAN called back with a flight reservation to Nassau and said a car would be waiting for us at the airport to take us to the emergency department of Doctors Hospital in Nassau. By this time news of Sandy's medical emergency had already spread through the cruising community, and our cruising friends assisted us by reaching out to the St Francis Resort to get a mooring ball. They also helped by watching our sailboat while we were away, getting a water taxi to pick us up and having a taxi waiting at the dock to take us to the airport.

DAN insurance covers more than just dive accidents, and our medical staff will
make arrangements for whatever is necessary to save a life.
We flew into Nassau and went straight to the emergency department. The hospital would only accept cash or credit card, not our insurance, so we feared the bills would add up quickly. We discovered Sandy had a 10 mm kidney stone that would likely not pass on its own, so we spent the night in the hospital. The urologist that the hospital called in gave us a concise assessment and recommended a course of action, but he also advised us of the hospital's limited capabilities and informed us that he was an independent contractor and as such could only accept cash or a credit card for payment. The staff at the hospital was wonderful and very professional, but neither of us felt comfortable about our options.

We had been getting follow-up calls from DAN asking how things were proceeding and to keep them updated. At around 7 a.m. we called to update DAN, share our concerns and inquire about the option of flying Sandy to Miami, Florida, for medical attention. DAN's medical supervisor agreed that Sandy would likely get better medical care in Miami and arranged to fly us to Miami that day. DAN even spoke to the hospital in Nassau about an authorization to fly, which the hospital would not provide. Because of her condition, we were flown first class to Miami, and DAN had a car waiting at the airport to take us to the emergency department at Mount Sinai Medical Center.

When we arrived at Mount Sinai, the doctors examined Sandy; it was immediately apparent to them that emergency surgery was necessary. Sandy's blood pressure had dropped to 65/35 mm Hg, and the kidney stone was blocking her ureter. The surgeon told me that she had developed sepsis, an infection in the bloodstream, and that her organs were starting to shut down. After the surgery Sandy had to remain in the intensive care unit for three days to get the infection under control. After the successful procedure, I learned from the surgeon that if we had been delayed another 12 hours Sandy likely would not have survived.

Three weeks after the incident, Sandy was cleared to fly, and DAN made arrangements for us to fly back to our sailboat in George Town. In the interim, DAN continued to reach out to us to see how both Sandy and I were doing.

We are so grateful to have received such excellent care, and we appreciate DAN being so helpful in getting us to the right place in time. The service, genuine concern and professional expertise DAN provided is something rare in today's environment of automated answering systems. We are also grateful to our wonderful friends for their assistance in our time of need; they made all the difference in the world helping us through this medical emergency.

We look back now and think about what we could have done differently. The following are some lessons we offer from our experience:
  • When traveling, know the area and what medical capabilities exist.
  • Talk to your insurance provider before you leave, and get information about what to do if an emergency arises.
  • Have a well-stocked medical kit on board.
  • Have a way to communicate: a cell phone, internet access or a VHF or single-sideband radio.
  • Carry with you copies of your passports, identification and
  • insurance cards.
  • Always have DAN insurance. They were there for us.
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Has DAN been there for you? Tell us about it at ThereForMe@dan.org.

© Alert Diver — Q4 Fall 2018