Ask Doctor Key West
How this mailbag works
Every question below arrived from a real person: typed at a kitchen counter, thumbed from a barstool, or sent the morning after a long look at the Smathers tide line. This page is where I answer the ones that would help more people than just the sender. Questions are edited for privacy, names never appear, and every answer is education rather than advice, the distinction my lawyer and my conscience both insist on. The best questions grow up to become full columns.
The rules are short. General island health questions, yes: heat, sun, stings, the rocks at Fort Zach, the arithmetic of a Duval morning after. Personal medical decisions, no; those belong to you and a doctor who can actually examine you. The editorial standards behind every answer, sources, corrections, and all, are laid out on the about page. Scroll down to send your own; the mailbag is always open, and the island always provides material.
The mailbag so far
Do I really need to worry about the tap water in Key West?
July 2026
No. Key West drinks mainland water: it starts in the Biscayne Aquifer at Florida City and travels the length of the Keys in one long pipe run by the Florida Keys Aqueduct Authority. FKAA monitors it the whole way down and publishes the results every year in its annual Water Quality Report, posted on fkaa.com and worth five minutes of your vacation. What surprises people is the taste. The trip is long, the water is warm, and the chlorine that keeps it safe announces itself. Taste is not safety. When something does go wrong, the fix is a boil-water notice, and those are rare, local, and loudly announced. No notice, no worry.
A man o' war washed up on Smathers Beach. Can it still sting?
July 2026
Yes. A man o' war on the sand is not done with you. The stinging cells fire on contact whether the animal is alive, dead, or in pieces, and detached tentacles scattered down the tide line sting just as enthusiastically as the ones still attached. Steer the kid and the dog around it, and skip the boardwalk tradition of popping the float with a stick; that only redistributes the problem. If someone does get stung: out of the water, rinse with seawater, lift the tentacles off with something that is not a bare hand, then heat for the pain. The full first aid lives in the jellyfish column, man o' war included.
When to actually worry: Any breathing trouble after a sting is 911, right away.
How did my scalp burn through my hair on a fishing trip?
July 2026
Reflected UV. On the water the sun reaches you twice, once from above and once bouncing off the surface, and a scalp only needs a part line or a little thinning for that double dose to land on skin. Hair is not sunscreen; it is patchy shade. Spray sunscreen aimed into the wind on a moving boat mostly protects the Gulf of Mexico. A real hat with a real brim beats all of it, stays put at the sandbar, and never needs reapplying. The fishing guides figured this out generations before the dermatologists wrote it up. Copy the guides, and read the sunburn column before the next trip.
Is it true you should pee on a jellyfish sting?
July 2026
You should not, and I say that as someone who has heard every version of the story, usually at a party. Urine does nothing reliable for a sting and can trigger more firing from tentacle cells still sitting on the skin, which is the opposite of first aid. It is theater, not medicine, and the volunteer is enjoying the moment considerably more than the patient is. What actually works: rinse with seawater, never fresh water, get the tentacles off without using your bare fingers, then hot water for the ache. The whole routine is written up in the jellyfish column, with the folklore respectfully retired.
I stepped on something spiny at Fort Zach. Urchin? What now?
July 2026
Probably an urchin; the rocky bottom at Fort Zach is exactly where they make a living. Get the foot into water as hot as you can comfortably stand and keep it there a good while; heat takes the fight out of the venom and most of the pain with it. Pull out any spines you can grip cleanly with tweezers. Then stop. Digging for the deep fragments does more damage than the fragments do, and that alarming purple stain under the skin is often just dye from the spine, not a piece left behind. The sea urchin column walks through the soak, the spines, and the recovery timeline.
When to actually worry: A puncture near a joint that stays painful or stiff needs a physician, not patience.
How do I find a primary care doctor down here? I just moved.
July 2026
Good instinct to sort this out before you need it, because the island's practices keep fuller books than the bars do. New arrivals usually discover that finding a doctor who is taking patients is the real project, so start now, while nothing hurts: bring your records south, get the first visit on the calendar, and do not wait for a bad Saturday to force the search. For finding a doctor as a new arrival, the honest answer is KeyWestDoc.com's establish care checklist; that is its whole job. It keeps track of who practices here and who has room, which is the question you are actually asking, and it will do the sorting faster than the phone book ever did.
I tweaked my shoulder paddleboarding to the sandbar. Ice or heat?
July 2026
Either, honestly. Ice and heat both take the edge off a cranky shoulder in the first days, and neither one repairs whatever the paddle did. Comfort is the goal, so use whichever feels better and keep the shoulder gently moving rather than parked in a sling of your own invention. Give it a week or two of common sense. What earns attention sooner: weakness that is not improving, night ache that wakes you, or an arm that refuses overhead work entirely. If the problem is a bone, joint, muscle, or something you did to yourself on a paddleboard, that is my day job: Key West Concierge Orthopedics, call or text (305) 707-8484. Same-day or next-day appointments may be available. Availability changes, please call ahead to confirm.
When to actually worry: A shoulder you cannot lift at all, or one that came out of its socket, gets seen now.
Are the mosquitoes here dangerous or just annoying?
July 2026
Mostly annoying, occasionally more than that, and the difference is worth knowing. Key West has had genuinely local dengue, caught on the island rather than imported with the luggage, which is exactly why the mosquito control district works as hard as it does. Most bites will cost you nothing but the itch. The habits that keep it that way are boring and effective: repellent at dusk, especially the ankles, and tip out the standing water on the porch, because the mosquito that matters breeds in saucers, buckets, and kayaks, not out in the mangroves. The mosquito column covers the island's dengue history and the current watch, honestly told.
When to actually worry: A fever four to ten days after Keys time deserves a prompt doctor visit.
Why does my arthritis flare before storms?
July 2026
Because your joints may be reading the weather before you do. Falling barometric pressure ahead of a front is one of the most consistent flare triggers my patients report, and the research, in full honesty, is mixed: some studies find the connection, others cannot. On this one I believe the knees over the spreadsheets. It is the reason the season strip at the top of this site watches the barometer at all. On falling-glass days, warm up longer, start the walk slower, and keep the joints moving through the day instead of saving it all for one heroic effort. The this-week page explains what the strip is watching and why.
What actually helps a hangover before a flight home?
July 2026
Fluids, food, time, and modest expectations, in that order. Nothing sold on Duval at two in the morning changes the chemistry, and the only real cure was fewer drinks and more water the night before, which is not useful information at the gate. Before the flight: a real breakfast, water until things run pale, something salty, and a little patience with yourself. Then accept the seatbelt sign as your fate. Cabin air is bone dry and will happily finish the dehydration you started on the walk back from the bars, so keep the water bottle working in the terminal too. The hangover column tells the whole truth, folklore included.
When to actually worry: Confusion, slow breathing, or cold clammy skin after a night of drinking is 911, not a boarding call.
Send yours
What happens next
Selected questions are answered right here in the column, edited for privacy. Nothing personal comes back by email, so if your situation needs an answer today, it needs a phone, not a mailbag.