Health Issues

Severe Hand Cramps

Dan and I both experienced severe hand cramps early into our trip. Because we were gripping our paddles for hours upon hours day after day, our hands wanted to remain in that clenched shape. After a night's sleep we often woke to discover our hands balled into fists so tight we were unable to open them. We had to pry our fingers apart!


Our solution to this problem was to change our paddling stroke. Instead of pulling the paddle back, which requires one to grip the paddle, we pushed the paddle forward, which allowed us to palm the paddle, keeping it in place with just our thumb and forefinger. I little play and experimentation will show you what I mean and while it felt strange at first I quickly became accustomed to it.

Foot Problems

As would be expected, my feet were constantly wet during my circumnavigation of Florida. As a result, all the hard rough skin on the bottom of my feet slid off. It was gross, but not a major health hazard. Be aware this might happen.


The other consequence of constantly wet feet is of course, trench foot. During the prime thru-paddling season, the water is cold and neoprene footwear is great for keeping feet warm. However, neoprene boots should be taken off during the day to prevent fungal growth. Keep a tube of athlete’s foot cream with your toiletries just in case.

Chafing/ Saltwater Rashes

Upper Body

Even the best rashguards don’t eliminate the problem of rashes, only mitigate it. Your nipples might bleed; your armpits, waistband, and inner thighs will chafe. Be prepared. When your nipples start to bleed, put a band-aid over them and then duct tape the band-aid in place (seriously). Some people recommend rubbing susceptible areas with coconut oil or lotion each morning. I've never done it, but it couldn't hurt.


Lower Body

Wear underwear (non-cotton of course) under your boardshorts, hiking pants, or whatever you decide to wear when paddling. Why? Because as you shift and move throughout the day while wearing underwear + shorts, the friction takes place between the underwear and the shorts, rather than the shorts and your skin. There is an old hiking trick to wear two pairs of socks to prevent blistersit's the same principle.



Avoid swimming in the sea when a freshwater shower will not be available later that day.The salt will dry on your skin and then begin to cut into you. Imagine all those sharp crystal edges rubbing against your skin. You shouldn't take a bath in the ocean, in other words.

Oral Herpes / Cold Sores

click for lip balms at REI
click for lip balms at REI

If you've ever gotten a cold sore then you have herpes. It's not a big deal. However, exposure to prolonged or intense UV light can trigger the herpes simplex virus and cause cold sores. Mountaineers know this and wear high spf limp balm as a resultUV radiation is stronger at high altitude than at sea level. A thru-paddle in Florida will expose you to weeks or months of subtropical sun, and so applying lip balm everyday is important (in addition to preventing sunburn and windburn).

Kidney Infections

Dehydration combined with hours of confined sitting make you susceptible to kidney infection. So while they are possible, infections are unlikely if you drink lots of water. Symptoms are painful or difficult urination, discharge in urine, and fever. An infection needs to be treated with antibiotics, so always drink lots of water!


Seasickness may seem like a ridiculous item to include on this list. After all, if someone suffered from seasickness, would they voluntarily undertake something like a thru-paddle? Well, even the saltiest seadogs get sick sometimes. So take seasickness seriously since it can result in dehydration, which can cause hyperthermia in warm months and the aforementioned kidney infections.


To prevent and treat seasickness eat bland, non-acidic foods and drink plenty of fluids. There are over-the-counter and prescription anti-seasickness drugs as well, but I prefer to focus on prevention and behavior changes before resorting to medication. After all, we demand a lot from our bodies on these trips, and metabolizing and expelling medications taxes our bodies further. In other words, don't pack a lot of dramamine and start popping it at the first sign of trouble.

Severe Dry Eye

During my circumnavigation of Florida, I suffered severe dry eye and irritation after about 1000 miles. It began after paddling all day into a headwind. Despite my sunglasses, the wind dried out my eyes and they never recovered. They remained painful and red the rest of the trip. I worried I had permanently damaged my eyes until I returned home and my ophthalmologist gave me a topical steroid. It was only severe dry eye.


This problem confronts everyone who spends a lot of time outdoors: construction workers, snowboarders, landscapers, paddlers, et cetera. There are a number of preventative measures one can take to avoid my fate.


First, have lubricant eye drops and use them often, before redness and irritation appears. Do not use Visine or any other product that contains vasoconstrictors—they constrict blood flow to the eyes and cause rebound redness. Visine makes the problem worse! Instead, choose brands like Refresh that are strictly lubricants.


Second, always wear polarized sunglasses that block 100% of UV rays. If you face a daylong headwind as I did, wear a pair of ski/snowboarding goggles. Goggles are great because they fit snuggly around the face, blocking sunlight and preventing wind, sea spray, salt, and dust from blowing into your eyes.

Overheating / Heatstroke

On a hot day there is a simple and easy way to bring your body temperature down. Of course drink plenty of fluids, but due to the humidity (discussed in the Weather section), heat may not be carried away from your body fast enough. Also, when layered up on a cold day, you will work up a sweat and can become very hot. Taking off a layer of clothing or opening zippers lets in cooling wind, but then your sweat can freeze, leaving you with a persistent chill.

As seen on National Geographic

Instead, stop paddling, dunk your hands into the cold water, and let them soak. Blood carries body heat from your core into the many capillaries in your hands. Because there is so much blood flowing through your hands, your body quickly cools down.


This is so effective, a product called the AVACEN marketed for the military and fire departments uses it to cool soldiers and firefighters. I saw this device on a NatGeo special watch the clip by clicking on the link above.


While this effect is an asset, it is also a dilemmacold wet hands will steal your warmth and keep you chilled despite a sprayskirt, fleece jacket, and dry top. A good pair of gloves is the answer, but I've yet to find satisfactory cold-weather paddling gloves. If you have any suggestions, please let me know.

Hypothermia / Dealing with the Cold

The paradox of Florida in winter is that you can be threatened by hypothermia and heat stroke on the same day, which presents an interesting challenge to paddlers.


The key to staying warm when paddling is to stay dry, but do not wear a wetsuit or drysuit. Standard practice for sea kayakers in places like the Pacific Northwest or Alaska is to wear wetsuits or drysuits but in Florida these clothes can lead to overheating. During Florida winters, while the water and air may be frigid, the sun nevertheless remains bright. The ability to layer up and down easily without leaving the kayak is essential, which is why I recommend using pull-on cycling fleece on the gear page.

For an in-depth review of hypothermia's symptoms, effects, treatments, et cetera, visit this page from Princeton University. I think it is important for paddlers to know the symptoms for each stage of hypothermia. Page 167 of Cold: Adventures in the World's Frozen Places by Bill Streever has a great mnemonic device for remembering the signs of each stage, The Umbles:

    First you mumble,

    then fumble,

    then grumble,

    then stumble,

    and finally tumble.

Cotton Kills

The expression "cotton kills" has been around for decades and I probably do not need to mention this, but do not wear cotton while paddling.


Cotton is cool and comfortable against the skin, but it also dries very slowly. Because of this, when you sweat or become wet while wearing cotton, that moisture remains against your skin and draws heat from your body. Wearing cotton in damp conditions can lead to hypothermia, even in mild temperatures like the 60s.

Dead Air

The key to warmth is to make sure air does not flow across your body. You do this by trapping air in small places close to your body to create "dead air." Your body warms this unmoving dead air and it keeps you warm. So in effect, it is not the clothing that keeps you warm but the air trapped by the clothing.


Unlike cotton, synthetic fibers such as fleece create dead air, even when wet, and they dry very quickly.


Because of Florida's latitude, you can become sunburnt even in winter, even on a cloudy day. I have been sunburnt on a cloudy day many times!  So put on SPF 50 sunscreen every day before you leave camp.


The sun is so intense, and you will be exposed to so much of it every day during a thru-paddle, that you will still tan despite wearing SPF 50.  Dan and I wore sunscreen every daythick stuff that coated like Elmer's glueand nevertheless we became deeply tan. We never burned, but that doesn't mean we were not still receiving large doses of ultraviolet radiation.


If you have already suffered from skin cancer or melanoma, you will need to be extra cautious on a thru-paddle. Long sleeves and big hats should be worn at all times in addition to SPF 50 sunscreen.

Ass-to-Mouth Disease

You are your own biggest health-hazard in the backcountry. Outdoor novices worry about poison ivy, jellyfish, et cetera, but if you get sick in the backcountry, you probably did it to yourself through poor hygiene.


Tips for keeping clean are discussed on the Sanitation page.

Insect-Born Diseases

Mosquitoes aren't just annoying, they spread two diseases that, despite decades of eradication programs, still persist: West Nile Virus and Dengue Fever.  Mosquitoes and all the other unfriendly insects you'll encounter in Florida's backcountry are discussed on the Insects page.