How to relieve seasickness

Mark Rothfield | Volume 29, Issue 6
Some say the best cure for sea sickness is to lie under a tree. We look at ways to 'ease the quease' when you're on the high seas...

He was a fearless, peerless fast bowler for Australia, famous for skittling English and West Indies batsmen with pace and derring-do, yet Merv 'The Swerve' Hughes is also a 'chucker'.

You wouldn't say it to his moustachioed face, of course, but it's true - the 1.93-metre colossus with an unquenchable appetite for food and XXXX is prone to seasickness. Barfs like a breastfed baby when the seas and fumes get too much during a day's fishing.

His mates think it's hilarious, offering barely a carrot-sized morsel of sympathy for this bastion of Ockerdom and Club Marine columnist.

"Everything's funny when it doesn't happen to you," Merv laments, "but I've tried just about every remedy and old wives tale there is to beat it. I've loved fishing since I was a young bloke, but as I get older I really can't handle it physically any more. Being seasick knocks me around for days afterwards".

"I suppose my boat legs aren't that great. People tell me to stay agile and light on my feet... but it's not easy when you're 130 kilos!"

Hughes is far from alone in his mal de mer misery. Lawrence of Arabia, Lord Nelson, Charles Darwin and Julius Caesar are among the celebrated sufferers. Trans-Tasman kayak adventurer James Castrission and Volvo ocean-racing skipper Chris Nicholson are more recent additions to the casualty list.

Research suggests that only one per cent of people are fully immune to motion sickness, while 10 per cent suffer only seldomly. That leaves 90 per cent of us exposed to getting ill every time we board a boat. Women are more susceptible than men, particularly after giving birth - why is not known.

The safety implications are concerning, and not just for those bent precariously over the gunwale and contemplating swimming 20 miles to shore. Virtually 100 per cent of liferaft occupants will vomit in rough seas, adding dehydration and despondency to their long list of perils. Bluewater vessels battling gale conditions can be left dangerously undermanned as green-gilled crew lie comatose in their bunks.

While there are no official economic impact stats, it would likely run to billions based on lost patronage for the global pleasureboating, cruise and defence industries.

Surprisingly, the issue hasn't even blipped on the Boating Industry Association's radar, according to NSW marketing manager Domenic Genua: "Based on market research of one - me - I don't believe it's a deterrent that has hindered recreational boating in any way," the 20-year industry veteran, says. "I would suggest that, like other ailments, people deal with it rather than avoid participation."

That's easier said than done, for seasickness can scar people mentally - like the Texan tycoon rendered violently ill during a fishing charter off Pittwater some years ago. He resorted to offering $10,000 cash for a rescue helicopter to come out and 'save' him. He never went boating again.

For every person who suffers seasickness, there's often a spouse and offspring denied the chance to venture onto the high seas.

In evolutionary terms, motion sickness is relatively new. It didn't exist on a mass scale before the invention of the wheel or the first sea voyages, so there has been insufficient time for the body to develop an appropriate response.

The scientific theory is that there's a clash between the visual inputs from our eyes and the equilibrium sensor in the middle ear, which don't tally with what's sitting in our memory.

But that doesn't explain why some people are more susceptible than others. It's also poorly understood why levels of control can affect the severity of sickness - why the driver on a winding road is less likely to be ill than a passenger, or why people get sick when reading in a boat or car or focusing on the compass.

Every boat moves through the water in its own way. Some may affect occupants more than others, and only trial and error will tell. Catamarans have the advantage of cutting through waves rather than riding the swell, but can be more skittish in beam seas.

As Merv Hughes touched on, it helps to synchronise your movements with those of the hull to help your brain adjust to the sensory information it's receiving. After a day or two, you will generally get your sea legs naturally.

Sufferers can console themselves with the fact that nausea is a subjective experience requiring higher brain levels than mere vomiting. It disturbs the body's thermal regulation, making victims sweat as a means of losing heat, whereas most other stress triggers cause the body to heat up.

University of Newcastle neuroscientist, Professor Eugene Nalivaiko believes nausea is our defence against toxic shock. "Somewhere in the brain a sensor triggers a hypothermic response - it's an evolutionary benefit because it slows down metabolism and allows toxin to be purged," he says. "It seems that, purely by accident, stimuli which cause motion sickness act via the same sensor."

Dampening this tendency is difficult as existing drugs that work well for vomiting are rarely suitable for nausea, and vice versa. And because it's not life-threatening, seasickness isn't high on the medical research agenda, nor are funds forthcoming from the industries affected.

Merv Hughes finds that being flat on his back is the only way he can feel better. Some hypothesise that lying down prevents histamine from reaching the brain and it also 'unweights' the stomach.

"I've heard other remedies, like jumping in the water, but that's not really smart when you're out fishing for sharks," comments Merv.

He refrains from taking seasickness tablets because of the side-effects and limited efficacy. Staying ashore is his only guaranteed solution, but this obviously limits his catch.

"A mate of mine uses his barometer more than weather forecasts," he adds. "I've looked out at glistening flat seas and begged to get going, but he says 'let's have a coffee and see what happens'. By the time we've finished there's waves that you wouldn't surf in Hawaii."

James Castrission, along with fellow paddler Justin Jones, successfully managed to cross the Tasman in a kayak despite encountering seas up to 10 metres and winds over 100km/h.

"Getting ready for the Tasman I tried 17 different kinds of potions and remedies in all," James says. "Unfortunately, you have to go out and test if they work, and if they don't you come back and try something else.

"It took 12 months for me to find the combination of medication and remedies that made life bearable. I ended up with three things - a tablet normally used for chemotherapy patients, acupuncturing myself in the wrists and hypnotherapy exercises."

When paddling with air on his face and the horizon ahead James was fine, but he relied on Justin to do the big tasks inside the cabin like fixing electrics or sending a detailed email. "Going into the cabin I had a whole lot of negative thoughts. In the end I'd spend 20 minutes meditating to calm myself down before sleeping."

Sydney angler Marcus Malouf says he's tried everything from Kwells to Travacalm, ginger tablets, acupressure bands and elastic stomach straps while fishing the turbulent waters off Australia's East Coast, Papua New Guinea, the Middle East, Mexico, New Zealand and elsewhere. He has developed a ritual that covers all the bases, including a bathroom stop to purge the system.

"The day before, and the morning before we leave, I try to eat clean, wholesome food," Marcus says. "Don't be having orange juice or milk because that will simply curdle in the stomach.

"The best tip I've had from a Cairns game skipper was Chupa Chup lollies. I religiously take these or barley sugars to suck on and chew.

"Another trick is to allow myself a treat towards early afternoon - something like a finger bun that I can look forward to - and on the way in I enjoy a cold rum and coke."

There are a few other simple techniques to try in the absence of medication:

  • Position yourself low down and amidships where you'll experience the least motion.
  • Don't face backwards from your direction of travel; keep your gaze on the horizon or a fixed point.
  • Isolate yourself from others who are suffering because it can be a psychosomatic trigger.
  • Keep your head still, resting against a seat back.
  • Get fresh air from a window or air-conditioning. Even going barefoot has been shown to ease the quease in about one-third of cases.

Ginger has its fans among those preferring drug-free solutions, be it in tablet, biscuit or beverage form. However, scientific data shows there's very little difference from a placebo. At best the aromatic root slightly prolongs tolerance, but won't prevent the eventual onset of sickness.

If ginger isn't to your taste, peppermint can also calm the stomach - take it as a lolly, tea or essential oil. Among the herbs people try are fenugreek, fennel, marjoram, rosemary, basil, raw parsley, cloves, nutmeg and chamomile.

Vitamin B6 deficiency is sporadically blamed for motion sickness so it can't hurt to down some Vegemite, a Berocca or good old meat, fish, poultry and cereals a day or two beforehand.

Wristbands are in the same boat in that some people swear by them - and scientific papers do regard them more positively than ginger. The plastic nub on the inside of the band applies acupressure to the median nerve, although the jury's still out as to exactly how they work.

A derivative of acu-bands is acupuncture, which has supporters among those who've tried bands and bracelets with varying success.

One of the stranger products on the market is Boarding Ring eyewear, which uses tinted fluid in the frames to create an artificial horizon, replicating a 'visible internal ear'. The idea is that the fluid's self-levelling tendency enables the wearer's eyes to transmit the same data to their brain as to their inner ear, thereby removing sensory conflict.

The manufacturer claims French Navy tests have shown, in 95 per cent of cases, that just six minutes is effective in the treatment of seasickness symptoms. They can be worn over existing glasses, with no side-effects other than fashion criminality.

Another treatment being trialled by NASA scientists involves wearing LCD shutter glasses that create a stroboscopic vision "of 4Hz with a dwell of 10 milliseconds". It was found to reduce the severity of symptoms, but surely would erode whatever skerrick of pride remained.

The US Air Force favours a program called 'habituation', in which flight crews are placed in simulators. They gradually increase the motion until people become desensitised. Problem is, the effect is only temporary.

Along similar lines, Eugene Nalivaiko is exploring Oculus Rift technology - the virtual reality headsets designed for immersive 3D gaming. Facebook recently purchased the Oculus company for $2 billion, which means new gadgetry should shortly be available. Professor Nalivaiko believes that simulating the boating situation in 3D prior to going offshore would help acclimatise people to the experience.

A product called ReliefBand claims to be the only Australian Government-approved medical device guaranteed to treat nausea. It generates electrical impulses that apparently regulate the nausea signalling process between the brain and stomach, via the vagus nerve.

The Nevasic Program, developed in the UK and available as an iPhone/iPad app, claims to stabilise the balance receptors via "precisely engineered stabilising audio pulses and frequencies" presented in "a jacket of music". You must listen to it on headphones.

The pharmaceutical frontier is inundated with drugs bearing scary, multisyllabic titles like Hyoscine Hydrobromide or Scopolamine (as found in Kwells and Travacalm HO), Dramamine and Stugeron. None is completely efficient, and what works on one person may not on another.

Regardless of what medicine you choose, it's best to take it well before your voyage because sickness impedes digestion.

Hyoscine/Scopolamine works by blocking some of the nerve signals sent from the inner ear to the brain's vomit centre. It can also induce blurred vision and dizziness, along with dry mouth, constipation, problems urinating, and confusion. It's available as a patch placed behind the ear, or a tablet.

Antihistamines are a gentler alternative, being commonly used to treat allergies, but also nausea symptoms. Over-the-counter medications like Dramamine can be effective for short trips or mild cases of seasickness. They tend to cause drowsiness and shouldn't be mixed with alcohol.

Also look for names like promethazine, cyclizine and cinnarizine among the ingredients list. Stugeron (cinnarizine) was originally developed for improving blood flow to the brain so it's not a specialty drug.

Personally, I've taken a cyclizine-based tablet known as Marezine over the years, which prevents vomiting if not nausea. This pill dates back to 1965 and was used for the first manned moon missions, but is now hard to find locally.

Phenergan is a well-tried medication available in pill form, suppository or intramuscular injection - as administered aboard cruise ships. The main side effect is drowsiness for 24 hours or so.

In the juggling act between not being sick and not being drowsy, Sydney pharmaceutical company Bova Compounds has developed ET's Escape Travel Sickness Capsules containing a cocktail of scopolamine, an antihistamine called chlorpheniramine maleate, ginger and caffeine.

Marcus Malouf genuinely swears by them, albeit he also works as financial controller for the company, and thousands of customers agree.

James Castrission reckons Kiwi paddlers rave about a bespoke product called Paihia Bombs formulated by a pharmacist in New Zealand. It is a two-pill system, one containing an antihistamine known as polaramine and the other being a caffeine derivative.

As Australian authorities soften their stance to medicinal marijuana, scientists are also ramping up development of cannabis-based nausea therapies. The human body naturally produces cannabis-like chemicals called endocannabinoids, which moderate physiological processes like appetite and pain sensation. A German study has shown that participants with elevated levels of endocannabinoid in their blood had higher tolerance levels for motion sickness.

"Anecdotally, quite a few merchant sailors have told me that cannabis is the best therapy," Professor Nalivaiko says.

There have been no new motion sickness drugs developed in the past 25 years, but the good news for the next generation of anti-nausea pills is that Professor Nalivaiko and Co have just discovered the first-ever biomarker of nausea. It's the aforementioned temperature drop found in animals that's also inherent in humans. By measuring and tracking the temperature change, it will finally allow animal modelling to be conducted quickly and cost-effectively.

"Virtually all new pharmaceutical agents are tested and developed this way, but animals, of course, can't say when they're feeling nauseous," Professor Nalivaiko says.

"Brain pathways for controlling temperature are quite well understood so from this new knowledge we can find where nausea-related influences tap into the thermal-regulatory circuit."

For now though, in the absence of a one-size-fits-all medication or technique, it's every man and woman for themselves when it comes to finding an individualised solution. As Merv Hughes would agree, seasickness is just not cricket.

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