Not everyone on the boat was all smiles….

Recently, Nurse Amy and I took a trip to Key West, Florida, for some deep-sea and reef fishing. I’d like to say a good time was had by all, but on every boat in moderate seas, there are those that suffer what the French call “mal de mer.” You know it as motion sickness or seasickness.

Don’t be embarrassed if you’ve been seasick or suffered other kinds of  motion sickness before. It’s pretty gosh-darn common, so much so that the Centers for Disease Control (CDC) report that almost everyone has experienced it. Indeed, Admiral Lord Nelson, British naval hero of the Battle of Trafalgar during the Napoleonic Wars, complained of having it. Even some of your favorite reality stars from “Deadliest Catch” suffer from it.

(Aside: The “medical-ese” for seasickness is “kinetosis.” You now know a medical term that the grand majority of physicians don’t. Ask yours “what should I do for kinetosis?” and get a blank stare!)

Some survival scenarios require water travel or a bumpy road trip. If your only route to your bug-out destination is by sea, you may suffer during the voyage. There are, however, a number of strategies to reduce or eliminate seasickness.

WHY PEOPLE GET SEASICK

Dr. Bones with a remora fish stuck to his arm 

Travel involves moving, but motion can make you sick. You get seasick when one part of your balancing system (for example, eyes, sensory nerves, and the inner ear) notes movement but other parts don’t. Let’s say you’re inside the cabin of a vessel at sea. Your inner ear senses the motion of the waves, but your eyes don’t detect it. This contradiction of sensory inputs confuses the brain and causes a processing failure that leads to motion sickness.

Who gets seasick? It appears that women are more likely to experience it than men. Also, people who are very sensitive to smells may be especially vulnerable. Where you are plays a part: The Atlantic Ocean has rougher seas than the Pacific Ocean or the Caribbean Sea. A small ship is less stable than a large one. Newer ships have more stabilization tech than older ships. If you’re on an old, small ship in the North Atlantic, be prepared.

SYMPTOMS OF SEASICKNESS

There are a number of symptoms seen in victims of seasickness. They include:

• Headache
• Dizziness or vertigo (a spinning sensation)
• Nausea and vomiting
• Cold sweats
• Paleness

Some confuse it with the flu or eating contaminated food, but seasickness is specifically related to motion. If you feel better when you get off the boat, it’s seasickness.

TREATING AND PREVENTING SEASICKNESS

There are a number of strategies to prevent seasickness and others that treat an ongoing case. It’s important to know that everyone reacts individually to meds and natural remedies. Always have more than one way to deal with the problem and don’t be shy about asking your physician for options. Here are some:

PRESCRIPTION AND OVER THE COUNTER DRUGS

In normal times, you have access to various drugs and supplements that can help. Some are by prescription and others are over the counter.

SCOPOLAMINE: The most popular prescription medicine for seasickness and other forms of motion sickness comes in the form of a skin patch with scopolamine (brand name: Transderm Scop). Placed on the skin behind the ear, it works for up to three full days. Scopolamine is most effective when applied four hours before boarding the vessel. These patches work similarly to antihistamines by interfering with the communication between nerves and the part of the brain that controls vomiting. Scopolamine patches last longer than antihistamines, however, and many insist they have fewer side effects. Wear only one patch at a time and avoid alcohol when wearing one. Also, make sure to remove the patch after three days, as withdrawal symptoms can occur that are very similar to…seasickness!

ANTIHISTAMINES: A number of over-the-counter antihistamines such as Dramamine and Bonine (Dimenhydrinate) have ingredients that calm down the brain’s nausea and vomiting mechanism. They are taken once on the night before the trip and then again an hour before boarding.

Scopolamine and antihistamines both have the possible side effect of causing significant drowsiness in susceptible individuals.

HERBAL AND OTHER NATURAL REMEDIES

A number of natural remedies have been reported to help with motion sickness. Although the hard data is not yet in, some might be worth a shot:

GINGER: Ginger is a popular remedy used to treat seasickness for centuries. Some studies suggest that a gram of ginger works as well or better than Dramamine. Ginger is available as chews, lollipops, or in teas.

VITAMIN C: Vitamin C may possibly work against seasickness. In one study, subjects were given either two grams of vitamin C or a placebo, then placed on a raft in a wave pool. Those taking vitamin C reported less symptoms.

WRIST BANDS: Based upon the practice of acupressure, these bands apply pressure on the underside of the arm about 1 ½ inches above the wrist. Some newer versions deliver a mild electrical pulse to the area instead.

AROMATHERAPY: Products like “Quease-Ease” contain a combination of several herbal essential oils and are meant to be inhaled to relieve symptoms of motion sickness.

OTHER STRATEGIES TO TREAT OR PREVENT SEASICKNESS

In survival settings, you may not have any of the above products. Here are some options:

GET REST: Not enough rest leads to sleep deprivation, which magnifies the occurrence of seasickness by interfering with the inner ear’s ability to habituate to turbulent motion.

EAT WELL BUT NOT TOO MUCH: Enduring rough seas on an empty stomach is a recipe for disaster, but it’s just as bad to be full. Eat some starches before leaving and nibble on snacks throughout the day. Beware of greasy, spicy, or fatty foods as they can worsen the symptoms. Consider bread, crackers, or pretzels instead. Others swear by hard candies or chewing gum to avoid feeling sick.

STAY HYDRATED (THAT’S WATER OR ELECTROLYTE DRINKS, NOT ALCOHOL): Dehydration is bad enough, but seasick and dehydrated is worse. If you’re on the ocean, make sure to bring water or sports drinks and sip frequently. Don’t sip, however, on a martini or other alcoholic beverage! This can initiate or worsen a bout of seasickness.

GET SOME FRESH AIR: Staying in the closed cabin of a ship in rough waters can cause or worsen seasickness. Getting out on deck in the fresh air often helps relieve symptoms. Practice controlled breathing to avoid hyperventilating.

FIND THE BEST PART OF THE SHIP: The front and back of the boat will experience the most wave motion. Look for a spot in the center of the boat where the movement is at its lowest level. The helm (steering wheel) is often right at this spot, so taking over the wheel might also give you a sense of control that helps ease the discomfort.

AVOID STRONG ODORS: Strong smells like exhaust fumes or cooking odors can increase sensations of nausea.

LOOK AT THE HORIZON: In addition to getting out on deck for fresh air, look at the horizon. The horizon will likely be more stable than near views.

TAKE A NAP: Sleeping often eases seasickness. Staying low on the boat, towards the center, and on your back all work to mitigate motion and get you through the voyage. Closing your eyes prevents your brain from being on the receiving end of signals that can lead to seasickness.

STOP READING: Reading, texting, or otherwise concentrating on books, screens, or phones is liable to make you sick on a boat.  This happens because focusing your eyes on an apparently stationary target convinces your brain that your balance is off.

INSERT AN EARPLUG: Seasickness is caused by the brain receiving mixed signals from the inner ear and the eyes. If you insert an earplug into one ear, this causes your brain to believe that your inner ear isn’t working quite right, so it ignores it in favor of your eyes, making the movement of the ocean correlate well what your eyes are seeing, thus decreasing motion sickness. Tradition suggests placing the earplug in the opposite ear from your dominant hand.

STAY OUT OF THE SUN: Long hours in the sun will hasten dehydration and worsen seasickness. If there’s no shade, consider a large hat to give you some protection.

AVOID OTHERS WHO ARE SEASICK: Sounds cruel, but seeing a lot of other people vomiting can trigger the same response in you. Don’t let the idea of getting seasick get into your head, or you might talk yourself into it!

GIVE IN:  Once you’re seasick and you really feel like vomiting, just go ahead. You’ll feel a lot better afterwards. Remember, you’re not the first and you won’t be the last.

Heckuva haul, even after throwing 80 percent back!

HOW LONG DOES SEASICKNESS LAST?

Here’s a little good news: Surveys reveal that the grand majority of the seriously seasick recover within 48 hours, even if they stay aboard ship. Try several of the strategies mentioned, and you’re likely to prevent or, at least, lessen the misery.

Joe Alton MD

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