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post #1 of Old 06-12-2003 Thread Starter
William Mahaffy
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Dealing with Seasickness

When your inner ear is telling you one thing and your eyes are telling you another, the discrepancy can leave wooziness in the wake.

Motion sickness, mal de mer, "vestibular malfunction resulting in gastric dysrhythmia"—whatever term you use for seasickness, everyone who has experienced it will try anything to avoid a recurrence. While most of us believe that sailors are the primary target for motion sickness, the majority of the research on this problem has been developed for the space program. For those who saw the movie Apollo 13, it is clear why motion sickness could rapidly become a lethal illness.

For anyone who has gone through seasickness, the situation is not only uncomfortable, but it can affect the ultimate safety of the passage, such as when a crew member is incapacitated on a shorthanded boat. And, typically, it is when the boat is in rough weather and extra hands are needed that motion sickness strikes.

Motion sickness, or MS, is a normal physiologic response and is caused by repeated rhythmic stimulation of the vestibular system. Basically, this means the motion of the boat (especially the vertical motion encountered in a head sea) will lead to these well-known symptoms: nausea, vomiting, sweating, fatigue, malaise, and vertigo. MS is worsened when there is conflict between the visual and vestibular cues. For example, reading will give the visual cue of stability while the body will sense the motion of the boat. It is best to match the visual cues to the environment.

Most researchers agree that acclimation to the motion (which takes from 48 to 72 hours) will decrease the incidence of MS by up to 90 percent. Research performed during the 1992-93 British Steel Challenge (the wrong-way, around-the-world race) showed a correlation between increased MS while beating and decreased MS while running or reaching. Cooking, writing, chart table and navigation work were found to increase symptoms, while being on deck helming or lying down decreased symptoms.

Several days at sea usually cure most cases of seasickness. Beware, cooking, reading, and other activites down below can exacerbate mal de mar.

Pharmacologic and non-pharmacologic methods exist that can be effective; the important thing to remember is that different remedies work well for different individuals. You must find the one that works best for you.

The majority of the literature you'll encounter indicates that the most effective preparation to combat MS is a combination of scopolamine and amphetamine. This has resulted in the popular Transderm-Scop, or "the patch." This system delivers one milligram of scopolamine slowly over a three-day period. After that, acclimation should have occurred and the patch should no longer be needed. While this solution has been found to be successful, dizziness, drowsiness, ringing in the ears, blurred vision, urinary difficulty, and skin rash are among the potential side effects. The use of Transderm-Scop, which is only available by prescription, should be discussed with your health-care provider.

The most common over-the-counter preparations are antihistamines such as Dramamine (dimenhydrinate), Marezine (cyclizine), Bonine (meclizine), and Benadryl (diphenhydramine hydrochloride). Another preparation, Stugeron (cinnarizine) is available in Europe and Canada and is reportedly very popular.

The over-the-counter preparations are generally less effective than scopolamine, but they are also associated with fewer side effects. The most common side effect from antihistamines is drowsiness. While the overall decrease of symptoms is similar with Dramamine and Marezine, according to a recent study comparing the two, Dramamine seemed to affect the central nervous system more directly and caused increased drowsiness. Marezine seemed to lessen gastrointestinal complaints with less drowsiness. These differences may help individuals choose the best preparation for their specific symptoms.

For those who prefer to avoid medication, there are a number of natural remedies available. Ginger root has been found to be effective in decreasing post-operative nausea as well as MS symptoms. It is available in liquid, tablet, or natural form.

Blasting conditions, especially upwind when pitching and yawing are at their maximum, will likely  make even the most iron-stomached sailor clamber on deck for some fresh air and a trick at the helm.
Many sailors have heard of the wristbands. These bands are designed to stimulate the P6 (Neiguan) acupuncture point. There are several studies showing the efficacy of P6 stimulation in lessening the nausea of pregnancy, post-surgical, and motion sickness.

A 1995 study evaluated the "Relief Band," a device that actively stimulates the P6 point with a small electrical pulse. Results indicate that this form of active stimulation is effective in preventing and/or lessening existing symptoms of MS. In addition, there were no side effects reported by the subjects in this study.

Regardless of your outlook, for anyone planning to sail in the open ocean for more than a day, seasickness is a serious concern. It has earned itself the following unflattering description: "First you are afraid you are going to die, then you are afraid you won’t." Many people shy away from sailing after experiencing a bout of seasickness. For those who venture out on the water frequently, seasickness can, at best, ruin an otherwise pleasant sail and, at worst, put the vessel and crew at risk. It is important to acknowledge each crew member’s susceptibility to MS and take preventative measures.

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