Family Trip to Health Clinic for Yellow Fever and Typhoid Vaccination Costs + Advice

We received a call from a worker at a health clinic that Val had befriended. The clinic had just gotten in a batch of Yellow Fever vaccinations and that we had better get there soon. First thing the next morning, we were all on our way, the entire clan. The clinic opened at 8:15, and we were there at 8:10.

Lesson 1: The quantities of the Yellow Fever vaccinations are very limited. First dips always goes to the military, and then the rest is dolled out to clinics in a region. Make friends with someone at the clinic so they will call you when doses arrive.

As the first people in the vaccinations portion of the clinic, we thought it would be fairly quick event. Alas, it wasn't. We proceeded to wait for 1 hour before being called back! Yes, 1 full hour and we were not only the first, but the only people there!!!!

Lesson 2: Be ready to wait a long time .... even if you are the first and only people there.

When we finally made it back, we met with the travel nurse. We shared with her that we were in to get some Yellow Fever vaccinations. She proceeded to ask us a serious of questions. The first one, "Where are you going?" Ah, that was easy, "We are going around the world." She gave a queer look. "I need a specific place please." I knew this was going to be an experience, but I wasn't ready for how mechanical it was going to be.

I looked at the world map on the wall and started reading off all the countries along the coast of Central and South America. The nurse dutifully typed them all in. With each one, she would pull back out sheets of information. At about country 5, I finally let the futility of the situation carry the next step. I said, "Look, we are just going to Brazil ... let's just do that one please." "Where in Brazil?" Ugh. So I looked at a map and named a city. "You don't need Yellow Fever for that one." Ugh. "Well, that is just our starting point, we plan on venturing deep into the Amazon river, and spend months and months there." "ohh, well then you definitely need Yellow Fever", she stated, "and you should get Typoid" (BONUS! We wanted that too, but were very focused on the limited quantity of the Yellow Fever vaccination).

Lesson 3: Find a specific place that requires you to have the shots you need, and simply go in with that on your agenda. Don't list every place.

Then she asked, "When are you leaving and when are you getting back?" At this point, I just made up dates. She was going by her script, and she was going to be very through (just as one would want a health care professional).

Val paid the fees: $110 per Yellow Fever shot, $60 per Typhoid shot, and $100 for the entire family consultation giving a grand total of $780.

I went first. KJ held my hand to comfort me watching everything close up. Next up was Val, KJ holding hands again. Then KJ. I had to hold her very still, and KJ braved the shots like a trooper. Next up Dy, she too did great. Sure, there were tears, but it was all good.

2 hours 30 minutes later, we were all done. The reality of the trip was made physical as all our arms were sore the entire day!

Oh, once we were done, there was only 1 Yellow Fever vaccination left for someone else and the clinic manager told us that another shipment wasn't due for 30 days.

Hepatitis A& B and Yellow Fever Vaccinations

I recently went in for the I'm almost 40 years old physical. While talking to my doctor, I shared our adventure plans. The doctor) asked about my vaccinations and if they were up-to-date. After a little discussion it was determined that I needed a tetanus booster and that the doctor would order blood work to determine if I had any immunity to Hepatitis A &B.

The tetanus booster ended up being Tdap (tetanus-diphtheria-acellular pertussis). My blood work showed that I had no immunity to Hepatitis A nor Hepatitis B. So, this past Thursday, I started my Hepatitis A and Hepatitis B vaccination series. I received two shots, one in each arm. I was a real trooper, the girls watched. To our good fortune, the Hepatitis A & B vaccinations were provided by our health insurance company for free. We love Kaiser!

I've also been searching for a provider for the Yellow Fever vaccination. The local travel clinics want $250 per person, for the vaccination. I thought, "WOW! That's a lot of money for a vaccination". After a little more research, I discovered that our local health department also offers the Yellow Fever vaccination. The health department's price to vaccinate our entire family is $540, which includes a $100 consultation fee. I guess the extra $460 that the travel clinic would have charged us was for the convenience. We will not be paying for the convenience.

Baking Soda

A couple of days ago, Val shared one of her favorite, simple living, boat voyaging friendly substances, White Vinegar. Today is my turn. I nominate Baking Soda as the stuff. It is a natural mineral that has whatever number of uses White Vinegar has plus 1!

Baking soda can be used for cleaning, fire extinguishing, and deodorizing because of its chemical composition (blending of carbonic acid and sodium hydroxide) and its physical properties.

In the case of deodorizing, it doesn't just mask odors, it neutralizes them chemically. It is for this reason that you will find baking soda in deodorant body powers and bath salts.

Of all the uses, here are 10 to show the variety of ways baking soda can be used:

1. Toothpaste (always a classic use of baking soda)
2. Underarm deodorant (can be patted onto the skin)
3. Helps relieve sunburn sting and insect bite pain
4. Antacid (1 teaspoon plus 10 oz of water mixed ... great for heartburn)
5. Cleans fruits and vegetables well
6. Put in as laundry detergent in our clothes washing bucket
7. Stainless steel polish (when mixed with water the resulting paste is super)
8. Battery terminal cleaner (super when slightly corroded)
9. Shampoo (1 tablespoon to 20 oz of water)
10. Grease remover

Take that, Vinegar pusher! Heck, between Baking Soda, Vinegar, Hydrogren Peroxide, and Super Glue, we should have everything covered!

Dentemp - Cavity Filling Stuff

Last week, the day before going up on stage before 400 people, one of my fillings came out. There I was, with big hole in my tooth, and it was Sunday. My tongue would not stay out of it, and was being cut by the tooths exposed sharp edges.

I called the dentist office, and was offered the opportunity to call my dentist at home and ask her for a referral. I thought about it, then asked myself, "Well, what would I do if we were out on the boat?" Hmmm .... another normal life happening that could happen while we are out on the boat. My immediate answer was, "I'd put gum in the hole until we got to shore." Then Val remembered some stuff called Dentemp, it is a temporary filling substance that you can buy from a pharmacy. Once put in, it will hold for 3 or 4 days. Perfect! So, we went out and bought some Denttemp. It even has a pain reliever in the material.

It took me 3 different tries to get it put in right. The directions said to leave a bit of moisture in my mouth before putting the stuff in. Alas, each time I did that, the damn temporary filling fell out within a few hours. When I totally dried out my mouth and put it in, the stuff stayed. In fact, when I did go see the dentist 2 days later, she commented on how good of a job I did putting it in!

The nice commentary from my dentist was offset by the end result, I need a root canal. The filling fell out because there was a cavity underneath it, and the cavity was eating away at the tooth. The cavity ate right to the top of my tooth's nerve (hence the pain). This will be my 3rd root canal.

Dentemp is now another part of our boat medical kit.

Don't sail away without Dentemp!

Water Strategy and Needs, Jerrycans, and Sailboat Voyaging

There are 3 basic survival needs: shelter, food, and water; water provides the largest challenge in our upcoming lifestyle.

As the official Water Buffalo, Water Master, and Water Transporter for our family, all watering needs and ensuring we are adequately stocked is my responsibility. As such, I've broken down the water concerns into 2: quantity and quality.

Quantity-

On the quantity front, our Gemini 3200 is equipped with two 30 gallon holding tanks making for a total of 60 gallons. These are plumbed into the boat such that we have water from the tap on the sinks (kitchen and bathroom) and a shower head.

Based on our usage patterns from the summer, it looks we are averaging about 12 gallons of water per day (coming out to 3 gallons of water per person per day). This is an all inclusive number to include water ingested, used for cooking, and washing things like dishes as well as our bodies.

This rate of consumption implies that the holding tanks give us a total of 5 days before replenishing is required. As the water master, that isn't a comfortable number for me. I want at least 8 days of water for the entire family. With 8 days of water, I feel comfortable that we would be able to find a suitable water source for refilling. Consequently, we plan on adding supplemental stores for water, and we will do so in the form of water Jerrycans.

There are 2 reasons for taking the Jerrycan approach, as opposed to installing more, or larger, plumbed in holding tanks. First, water acquisition will be easier. Second, cross contamination will be less likely.

At 8.3 lbs per gallon of water, identifying the right size and easy to carry Jerrycan will be important (remember, I'm the water transporter). The current working plan is to acquire six 5 gallon Jerrycans. Fully topped off, this implies 250 lbs of water, plus the weight of the container itself. This is a figure that must be carefully considered with respect to our load capacity.

Our plan is to use Jerrycans as our source for daily drinking water. That is, a Jerrycan will be out and easily accessible so that anyone can tap into it throughout the day to get some water for drinking. If we allocate Jerrycans as the daily drinking source, and we are completely topped off, at 1 gallon of water per day per person for drinking, we can make our 8 days. Clearly, if we suspect that we are running low on water, and the odds of finding any are low, we can also use water out of our main holding tanks for drinking. If we used all water sources (holding tanks plus Jerrycans) exclusively for drinking, we could make 22 days.

In addition to the static mode of being topped off with water from public sources along our journey, we plan on leveraging 2 other sources for refilling: rain and seawater.

We plan on taking advantage of what falls from the sky whenever we can. We will be adjusting our Bimini such that it is optimal for catching rain water. It will be fitted with an elephant trunk so that the rain water pooled on the Bimini can be routed to our holding tanks. It will be KJ's job to make this connection once it starts to rain.

We will also have a mechanical (as opposed to electric) water maker that will desalinate and purify sea water. Since it is mechanical in nature, it doesn't create mass volumes of water without tremendous effort so its usage will be mainly for generating drinking water.

The last commentary to offer on water quantity is that we plan on acquiring a water bladder for the dingy. This is basically a large balloon that can be pumped full of water. The idea is that we can bring the dingy laden bladder to a water source, fill it up, then dingy back to the boat and pump out from the bladder into the boat.

Quality-

When obtaining water from untried sources, especially in third world countries, one must be very careful. We will be using the Clorox Bleach method of water purification. In general, you use 8 drops of Clorox per gallon of water, or 1/2 a teaspoon per 5 gallons of water. There are some other particulars about this, and if your interested I encourage you to do some research.

The mechanical water maker we will be using on the boat will have both a 10 micron filter and a 5 micron filter. These filters provide filtration capabilities on par, or better than, most water treatment plants in the USA.

As you can probably tell, we are giving water a lot of thought. It is back to the basic needs: shelter, food, and water. If we can keep these 3 covered, we can go indefinitely. Water appears to be the most tricky of the group.

Wellness Checkups

As you may know, we have two girls. KJ just turned 4 years old and Dy is 18 months. Wednesday we went to the doctor for their wellness checkups. The girls had been feeling fine and received their immunizations like real champs. All was well, until 6:30 pm. Dy started acting different. I picked her up and kissed her head. She was hot! Really hot! I immediately gave her a dose of infant Tylenol, then a dose of infant Motrin to break the fever. It did the trick.

Around midnight, Dy woke up. She was running another high fever (103) and she had vomited. I immediately put her in the shower to cool her body temperature and then give her another dose of Tylenol and Motrin. This brought her fever down substantially, but did not break the fever. Bill and I decided to take her to the emergency room. Fortunately, we live near Children's Hospital. What a GREAT place. Everyone was super nice, even at 1:30 am in the morning. The hospital was quiet, we had missed rush hour by 2 hours. Within 30 minutes of getting to the hospital, Dy had been seen by a PA and our fears had been mitigated. Again, what a GREAT PLACE!!

Bill and I thought that Dy was having a reaction to one of the immunizations that she received on Wednesday, but the experienced staff at Children's said that was highly unlikely. It was much more likely that she picked up a virus, at the doctor's office. So the Wellness Checkup ended with a run to the emergency room. Some wellness checkup.

I'm aware that most people at the doctor's office are there because they are sick. I did take extra precautions by wiping the girls hands with antibacterial wipes several times. Just goes to show that some viruses are very persistent.

It just hurts my heart to see my sweet little girl sick.

Stinky Sailor

Living on a boat is a physical challenge, one that provides a fantastic, continuous, workout. Consequently, sweat and body odor become a real issue. What do you do? Take a shower right? Sure, when there is plenty of water but on our boat we won't have hundreds of gallons of water so taking a shower each day is simply not an option. Hygiene, however, is critical and there are many ways one can take a "field" shower and avoid being nasty smelling.

Some sailors bathe in the ocean. They take their soap, shampoo, and conditioner and plunge in. This, however, can be rough on the skin if done too frequently (salt water is abrasive). Once a week is almost too frequent.

Some sailors do a towel bath. They jump in the ocean, get wet, jump out and take a towel soaked in fresh water and clean off. This one you almost get anyway each time you go for a swim in the sea. Just be sure to focus more on the washing part than drying.

Some sailors do a region wipe down. They take a soapy towel and simply wash the parts of their body that require a good scrub. I employed this technique a lot when I was in the Army.

Some sailors take a rain bath. Each day that it rains, they go out on the deck of the boat with shampoo and soap and shower in the rain. This is a favorite of mine and I look for excuses to do this. There is something exhilarating about showering in the rain.

Some sailors take baby baths. This technique isn't eco friendly, but it works well. Buy packs of baby wipes, and wash up using them. This one makes me feel refreshed.

While talking about showering, most folks don't think about it but there is a "best practice" when showering. Always do your wipe downs starting from your head, and end at your feet. That is, wash your head first, then neck, then chest, then upper back, then arms (and arm pits), then stomach, then lower back, then frontal stuff, then rear stuff, then thighs, then calves, and finally feet. This keeps moving the germs/filth away from your head where ingestion of such things can be detrimental.

Hydrate your way to health and weatlh

With the Ironman entry complete, it is time to begin the process of training. My training plan is 40 weeks long and 1 of the key components is hydration. Why is this relevant here? Well, proper hydration results in optimal physical performance AND costs less than drinking soda.

Here is an interesting rule of thumb used by elite athletes: for every 1% of under full hydration your body is, the resulting loss in physical performance is 2%! Put another way, for all the hours you exist and you are under hydrated by 1%, you will have to expend 2% more effort than you would if you had simply remained properly hydrated. 5% under equates to 10% more effort! More effort requires more fuel, more fuel requires more spend. Plus, more effort makes you tired sooner.

Being under hydrated also puts your immune system at risk. Water is a key component of antibody manufacture. Without them to fight off a bug, you get sick. If you get sick, that puts you behind on your goals and also puts you in a bad mental state.

Water is also cheap. The bottled water is so overrated. When we eat out, we always ask for tap water (unless we are outside the US).

Taking steps towards being fully hydrated are simple. For example, you could begin replacing your non-water beverage intake with water. If you drink 4 cans of soda, cut to 3 and replace that 4th one with the equivalent water. Another simple first step is to create a routine wherein each morning, the moment you wake up, you drink a glass of water. Viola! you've increased your water intake.

Over hydration is also a risk. Listen to your body. Do you need gallons of water? No. (unless you are racing accross a hot environment). There are plenty of formulas out there to help you gauge how much water you should be taking in. Find out how much you should be taking in and be sure you're doing it.

Red Bean Ragout Recipe

One of our favorite one-pot-meals is Red Bean Ragout.
This recipe not only taste GREAT, but is really good for you, very versatile, and cooks in less than 30 minutes. What more can you ask for.

2 T - Olive Oil (good quality)
2 C - Tomato(diced) or 1 can of diced tomatoes
1/2 Med - White or Yellow Onion (chopped)
2 to 3 - cloves of Garlic (crushed)
1/2 C - Scallions (chopped)
2 C - Chicken Stock
1 t - Kosher Salt
1 t - Black Pepper
1 can - Red Kidney Beans (drained)
8.8oz - Couscous (Israeli)
Parsley or dry parsley flakes

Heat olive oil, add onion and scallions and saute for a minute or two until the onion starts to turn brown. Add garlic and couscous and brown for 30 seconds. Add tomato, beans, chicken stock, salt, and pepper, bring to a low boil and cover. Cook for 10 minutes (covered). Uncover and add fresh parsley and let cook a little longer until liquid is almost gone.

Total Cost: $3.67 (less if use Rice as substitute for Couscous)
Servings: 4 adult


Tips:
Use a good size frying pan with lid.
If you use dry Parsley flakes, add it when you add the salt and pepper
For heavier meal serve with steamed Asparagus, Broccoli, or grilled Chicken
Other beans that work well: Chickpea, White Northern, and Cannellini
Rice can be substituted for Couscous, just make sure to adjust Chicken Stock (in general, 1 C of Rice to 2 C of liquid)

Speed of Eating

With the weekend almost here, we've decided to make this weekend the weekend of slow eating. Previously an entry covered the cost of speed, and eating certainly fits this category as well. In a frenetic life, we race to get food, we race to get it down, and then we race off to spend more money somewhere. If we spend money our on the food in the first place, why not make the food preparation and consumption an event? Why not take our time and get every penny out of the experience? This weekend, we will not hit any restaurants, fast food joints, or whatever. Every meal will be cooked by us and slowly consumed.

As an added benefit, I recall reading once that it takes the body some 20 minutes to signal its full after it really is full, so if you eat an entire meal in less than 20 you run the risk of eating more than you really needed in the first place.

Walk King

2 years ago, we sold our house and moved into a small 2-bedroom apartment near my office. There were 4 reasons for doing this. First, we wanted more family time. Second, we wanted to use our cars less. Third, we wanted to lower our cost of living. Fourth, we knew we needed some mental preparation for smaller living spaces (the boat). While all of these outcomes were achieved, the one that continues to change our lives is the reduction in our car usage.

We ensured that where we moved not only put my office in walking distance, but so were grocery stores, sit down restaurants, movie theaters, fast food joins, and so on. As a consequence, we walk … we walk a lot. If the weather is accommodating, the shoes get put on and we walk. All 4 of us.

While I love cars (I’m a man after all), I find that we all actively look for excuses or reasons to not drive the cars. We want to walk. At first, we were looking for reasons to drive and not walk, but that has now changed and we are the opposite. Not only is this cheaper, and we have a chance to find money, but this is more healthy.

Keep mind that we walk as a family. A 1 year old, a 3 year old, and my wife and I. No stroller. We all walk.

Walking is slower, so there is more time spent doing that … and less time spending money.