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Medical Care




Preventing and treating seasickness

It Can Happen to Anyone…
• Anyone can get seasick. It won't kill you, but for a while you may wish it would.
• If you've had motion sickness before, plan ahead and take an OTC drug before embarking. Or get a prescription for The English words "nautical" and "nausea" derive brain incorrectly interprets the distress caused by scopolamine or another powerful antiemetic (antinausea) drug.
from the same Greek root naus = ship, and for good this motion as the result of poisoning, and causes • Use an alternative remedy, if you think it will work.
reason. People have been getting seasick for stomach disturbance leading to vomiting.
• If you take a drug you have not had before, "test drive" it thousands of years.
Seasickness has two components: the dis- ahead of time for effectiveness and side effects.
While seasickness is miserable and can be tress (dizziness and nausea) experienced by On the boat, position yourself to minimize the effects of debilitating, it can be prevented and even the brain, and the stomach's reaction to it. boat motion.
and Treating
treated. Researchers at universities, You can have one without the other. Folk • If you start to get sick, be considerate of others. If a companion gets sick, protect him/her from injury or falling research institutes, and navies of remedies that soothe the stomach do overboard. Give fluids.
many nations have studied seasick- not stop the nausea's root cause, which • If seasickness strikes, try the chew-but-don't-swallow ness and motion sickness, and reliable is in the brain.
technique to treat symptoms.
information from those studies is presented in this Some believe that seasickness results References for Further Reading
from a conflict between what the inner ear detects Gahlinger, P.M., M.D. Ph.D. 1999. How to help your patients avoid travel travail. Postgraduate Medicine and what the eyes see. If this were the whole prob- Jacobs, M.E., M.D. 2001. Survival at sea: Seasickness. In: P.S. Auerbach (ed.), Wilderness medicine, 4th What Is Seasickness?
lem, it could be prevented or cured by keeping an edn. Harcourt Health Sciences Company, pp. 1530-1531.
Money, K.E., J.R. Lackner, and R.S. Cheung. 1996. The autonomic nervous system and motion sickness. eye on the horizon outside the boat. This works for In: B.J. Yates and A.D. Miller (eds.), Vestibular autonomic regulation. CRC Press, pp. 147-173.
Seasickness is an unpleasant condition that may Onan, C. 1991. In search of a cure for seasickness. Cruising World, December. some people, but not for the majority.
Scavone, J.M., B.G. Luna, J.S. Harmatz, L. von Moltke, and D.J. Greenblatt. 1990. Diphenhydramine include dizziness, tiredness, acid stomach, and kinetics following intravenous, oral, and sublingual dimenhydrinate administration. Biopharmaceutics and Drug Disposition 11(3):185-189. (Abstract accessible at http://www.ncbi.
nausea/vomiting. It usually comes from rhythmic How to Predict Seasickness
Weinstein, S.E., and R.M. Stern. 1997. Comparison of Marezine and Dramamine in preventing motion of sea waves. People rarely get seasick from symptoms of motion sickness. Aviation, Space, and Environmental Medicine 68(10):890-894. Wood, C.D., Ph.D., and A. Graybiel, M.D. 1968. Evaluation of sixteen anti-motion sickness drugs under bouncing as a small boat skips over the sea—it's the Seasickness can strike anyone, including seasoned controlled laboratory conditions. Aerospace Medicine 39:1341-1344.
slower motion of natural waves that does it.
professional mariners. Most people get over it in a Written by Terry Johnson, Marine Advisory Agent, University of Alaska Fairbanks, Homer, Alaska 99603. NOAA National Sea Grant NA16RG2321, projects A/161-01 and A/152-20. UAF is an AA/EO Seasickness occurs when the visual, vestibular
few days if they are at sea that long, but knowing employer and educational institution. (inner ear), and proprioceptor (receptors in the
this is little comfort if your fishing trip is spoiled.
Alaska Sea Grant College Program muscle and joints that signal locomotion and pos- Try reading, while riding as a car passenger in stop- University of Alaska Fairbanks ture) systems are in conflict with each other or not and-go traffic or on winding roads. If you get carsick Fairbanks, Alaska 99775-5040 consistent with past experience. The subconscious in this test, there's a good chance you'l get seasick.

dimenhydrinate or meclizine tablets. If you find that you're starting to feel sick, take a couple of the tablets and chew but To Prevent Seasickness
OTC Drugs
don't swallow. Instead, hold the "mush" under your tongue or Ease Symptoms
Most over-the-counter (OTC) drugs for prevention of motion or against the inside of your cheek, where the drug can be sickness are based on antihistamines. They work by depressing absorbed through the lining of the mouth. Research shows that The night before:
the brain's emetic or vomiting center. They are moderately the drug passes into the bloodstream, although it still takes a effective and have minimal side effects, including drowsiness couple of hours to reach full strength. Some sufferers report • Eat and drink moderately.
and dry mouth.
excellent results from this approach.
• Take an advance dose of medicine (see "OTC Drugs" section).
Drugs based on meclizine (Bonine, Antivert, Dramamine II) cause less drowsiness than the old standard drug, The morning of the voyage:
dimenhydrinate (original Dramamine, Triptone, Gravol). Common Medications for
• Eat only a light breakfast, avoiding rich or fatty foods.
Diphenhydramine (Benadryl), an antihistamine also used as a Alternative, Folk, and
Go easy on the coffee.
sleeping pill, can cause significant drowsiness.
• Take a second dose of drugs.
Over the countera
Many people don't want to use drugs to prevent or cure Using OTC Drugs Effectively
On the boat:
seasickness, so they use alternatives. Most of these alternatives Tablet, chewable, liquid have not proven effective in clinical trials, but some users report Most dimenhydrinate- and meclizine-based drugs are sold as Capsule, suppository • Take a position with a good outside view, low and near the pills or as chewable tablets. They should be taken at least two center of the boat if possible.
hours before boarding so the drug can go through the digestive Avoid smells of exhaust, fuel, the galley, and the head (toilet).
Ginger, as powdered or candied root, cookies, tea, or ginger
ale, soothes the stomach of many sufferers.
system and into the bloodstream. A person already nauseous • Avoid reading or work requiring close-up focus (like • Acupressure, on the nei kuan or precordial #6 position
or vomiting will get no benefit because the tying gear).
drug will be expelled in the next bout of on the inside of the wrist, prevents nausea in many people. Move around and get fresh air.
vomiting, or will be trapped in the stressed Dramamine IId
Elastic wristbands with plastic beads that press on the wrist digestive system. OTC drugs are useful • Avoid alcohol and tobacco.
are sold for this purpose. for preventing seasickness, but not for • An electronic device that resembles a wristwatch and sends If you start feeling sick:
a mild, user-variable, electric current into the wrist (at the nei It is essential to get the drug into • Acknowledge the situation and tell the captain or crew.
kuan position) can prevent seasickness or stop it after it has your system in a sufficient amount, • Avoid going below or into enclosed spaces which varies with a person's size and Tablet, capsule, liquid There's no harm in trying alternative remedies, and they may body chemistry. Some people need to If you think you're going to throw up:
be all you need. But most seasick-prone people need drugs to exceed the recommended dose, while • Vomit over the side, on the downwind side, or in the head. prevent the symptoms.
others cut it in half. Further, some OTCs lose effectiveness in 4-6 Tablet, injection, hours. You might want to "test drive" a drug ahead of time (well suppository, liquid Be considerate of others on the boat. • Many people feel much better after vomiting.
before you go boating) for effectiveness and side effects.
Capsule, injection, A second component of drug effectiveness is faith in the suppository, liquid If your companions are seasick:
drug. Studies show that as much as 40% of all seasickness can The transdermal scopolamine patch, sold by prescription, is very be alleviated by the belief that the drug is effective, even if the • Protect them from injury or falling overboard.
popular among recreational boaters and professional mariners. For patient has taken a sugar pill (placebo) instead of the real thing.
Prescription drug combinations
• Encourage them to drink water or sport most people the side effects are minimal, the patch is convenient, Scopolamine + dextroamphetaminef
drinks to avoid dehydration and to keep and it lasts up to three days. Scopolamine works wel for most Promethazine + ephedrine or
people, but should be used only under a doctor's supervision.
up essential electrolytes. Children are Here's Something to Try
especially susceptible to dehydration.
Most other prescription drugs for seasickness are used Too often people don't think they will get seasick until they get only by the severely affected. They are taken as a pill, injection, May also be available c Antivert is a prescription f Dexedrine is suppository, syrup, or salve. Some are quite potent, and side out on the water, and then it's too late to take an OTC drug as prescription forms.
d Dramamine II causes a preventative. If you're one of those, here's something you can effects can be serious or even life-threatening. Gravol is not available in less drowsiness.
try. Next time you go out, take along a package of chewable e Cinnarizine is not available in the U.S.


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