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Preventing and Treating Seasickness


Even the most enjoyable day on the water will turn miserable if you or members of your crew get overwhelmed by seasickness, a.k.a. mal de mer. From annoying discomfort to safety hazard, seasickness can have dramatic impact on a voyage, especially when crew becomes impaired and as a consequence makes bad decisions or can’t perform assigned duties. Once they are lining up three deep at the leeward rail to transfer lunch over the side, big trouble is here. But with a little preparation, some discipline and a positive mindset you can avoid joining them. “ Prevention or early intervention is the best medicine for seasickness,” recommends Dr. Michael Jacobs, a lifelong sailor and frequent speaker at Safety-At-Sea Seminars, who also provides medical advice for the participants in offshore racing events like the Pacific Cup and the Newport-Bermuda race.

What is it?

Seasickness is a form of motion sickness, which constitutes a stressful disagreement between the senses that help us maintain our balance and position in a moving environment. The eyes may tell the brain the world is stable while the inner ear reports rolling, pitching and yawing. This confusion is the indirect cause for queasiness.

Who gets it?

Anyone who is susceptible to other forms of motion sickness could be subject to mal de mer, which means about 90 percent of us, including pilots, astronauts and old salts. Different individuals experience motion sickness differently or not at all. Symptoms include fatigue, nausea, vomiting, dizziness, headache or cold sweat. Experienced sailors and physicians agree that preparation helps lessening the intensity of the effects or preventing them outright.

Effective tips to prevent seasickness

  • Eat a healthy, low fat diet, consisting of lighter meals, avoid excessive alcohol intake 48 hours before departure
  • Get a good rest prior to departure and try to get enough sleep while you are underway
  • If your eyes see what your inner ear senses you have a better chance to keep mal de mer at bay
  • Don't stare at any one point for extended periods, especially when using binoculars
  • Obtain good broad view of horizon in your peripheral vision
  • Don't read books, papers or magazines
  • Minimize time below deck and in cramped, badly ventilated spaces
  • Drink enough water as dehydration exacerbates seasickness
  • Chewing antacids at the onset of queasiness may help
  • If you are at the helm, steer by reference to oncoming waves, clouds, horizon and distant marks
  • “Ride” waves with your whole body
  • Medication is most effective when taken before symptoms begin
  • Monitor the weather report, and avoid or prepare for rough conditions
  • Keep a positive attitude and don't focus on becoming sick

What if seasickness hits?

  • Symptoms: yawning, sighing, dry mouth, belching, drowsiness, lethargy, dizziness, headache; cold sweat, pallor, nausea, dry heaves, vomiting, anxiety, apathy
  • Fight back and act quickly with additional medication
  • Lie down on your back
  • Put your head as close to the boat’s center of gravity as possible, which means low and in the center both laterally and longitudinally, where pitching and heeling have the least effect
  • Eat savory crackers, bread or non-acidic fruit. Honey may help, too
  • Chew ginger tablets, ginger cookies, or candied ginger
  • Avoid dehydration; drink plenty of water or ginger ale

Remedies

Available remedies fall into three categories: herbal treatments, drugs and wristbands. Ask 10 different boaters about the most effective cure to mal de mer and you’ll get 10 different answers. All products claim to offer relief for motion sickness even though they may have been developed for other primary uses. Check dosage, known side effects and contraindications. We recommend you read the instructions and talk to a pharmacist or doctor before taking over-the-counter or prescription drugs.

Herbal treatments are most convenient to take—in gel caps, gum or drops. The most popular ingredient is ginger because it helps calm the gastrointestinal tract. While it may not be as effective as other methods, ginger has few or no side effects. Products to research: MotionEaze, Sailors Secret Ginger Caps and Ginger Anti-Seasickness Gum offered by West Marine.

Motion sickness drugs are also called antiemetics and come in prescription or over-the-counter (OTC) strengths. If they contain antihistamines, they most likely will cause drowsiness. However, there are non-drowsy formulas available. Very popular with hard-core bluewater sailors is a drug called Cinnarizine (Stugeron), which is also used to treat epilepsy. Stugeron is not FDA approved and therefore unavailable in the U.S. Many boaters report success with the Scopolamine Transdermal Therapeutic System (TTS), which works like a nicotine patch and has to be worn well before seasickness commences. Dr. Jacobs cautions of possible side effects such as drowsiness, and problems with urination for men. It lasts for three days but offers only a fixed dosage of the medication, which may not suit all individuals equally well. Some antiemetic drugs to research: Antivert, Bonine, Dizmiss, Dramamine, Meni-D, Ru-Vert-M, Phenergan, Stugeron and Transderm Scop. Bonine and Dramamine are available from West Marine.

How some of the most popular seasickness drugs compare

Medication Dose Effective
OTC Dramamine 50mg liq/cap/chew 4-6 hrs
OTC Marezine 50mg caps 4-6 hrs
OTC Bonine 25 mg chew 6-12hrs
Rx: Antivert 12.5/25/50 mg tab 6-12hrs
OTC Stugeron * 15mg tabs 6-12hrs
Rx Transderm-Scop 1.5mg patch 3 days
Rx Phenergan + Ephedrine 25mg tabs of each 6-12hrs
Rx Phenergan (alone) 12.5,25,50 mg tab 6-12hrs

supp, injection

* not available in US

Acupressure wristbands apply constant pressure or electrical impulses to a spot on the underside of the forearm, approximately 1.5 inches up from the wrist crease, between the tendons. They can be worn for extended periods without causing any side effects. Other applications for wristbands include the reduction of nausea caused by morning or post-operative sickness, or during chemotherapy. Products to research: Queaz-Away, available from West Marine.

Electronic wristbands are an FDA-approved variation of the acupressure band. They are worn around the same spot on the wrist but send gentle, adjustable electric signals that help control nausea. The ReliefBand Voyager is a non-drug treatment, resembling a wristwatch, that uses programmed electrical pulses to treat motion sickness. It is safe and clinically proven to be effective before or after symptoms start. The ReliefBand Voyager begins working within minutes of activation rather than hours as seen with commonly used medications, and provides the added benefit of being controlled by the user; sufferers can simply turn the device on or off as needed and get immediate relief. Products to research: ReliefBand Voyager, offered by West Marine.

Conclusion

Dealing with seasickness is not a mystery as long as you leave the dock prepared. If you are like 90 percent of the population, it is very likely that you or some of your crew will be subject to some symptoms of mal de mer. Once you accept that, preventing or minimizing the negative effects should be a priority. It will increase the enjoyment of the trip and contribute to the safety on board. There are a myriad of remedies out there, some available over the counter, some requiring prescription. But not everything works equally well for all individuals. Talk to other boaters who have experience with different remedies and consult a physician or pharmacist. “Try medications on land to find which one works best and has the fewest side effects for you,” Dr. Jacobs recommends. The good news about seasickness is that body and mind learn to adjust. Individuals who wobble when stepping ashore after an ocean passage are proof positive. They have developed sea legs.