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Thursday, April 3, 2008

Dealing with seasickness

I have done a lot of small boat sailing in my life. I love it, yet I get very seasick. I am often asked how I deal with it, so here is what works for me.

The knowledge that you will get seasick can be daunting. You may already know if you are susceptible to seasickness; if you got car-sick as a kid or if you find it nauseating to read a book on a bus or in a car, you will probably get seasick in a small boat. For everyone else, there will probably be times that you get seasick. There are a few robust individuals who appear immune, but even Don has been known to spew in the cockpit (admittedly immediately after chugging an entire can of soda pop).

Preparation: before the trip
Do not eat a hearty, rich, fatty meal before a voyage. Not even the night before. The stereotypical sailor's meal of pizza and beer is exactly the kind of thing that will ensure a "Roman incident". Have a light meal of some bread and fruit. Drink water or watered fruit juice.

Do not drink alcohol at all before or during a trip. After you have the hook down, fine. Same for any other recreational drugs. You want your head clear and your balance to be as normal as possible.

Get lots of sleep. It's a very busy time provisioning, loading, doing last minute repairs, weather routing, chart planning and so on. Try to build up a "sleep surplus" - even if you are not seasick it will help out on those first night watches as you get used to life at sea.

Prevention is way easier
There is a theory that explains seasickness thus: your brain detects signals from your ears (balance) and eyes that disagree and thinks that you have been poisoned, thereby triggering a vomiting reflex to remove the toxic substance that it thinks you have eaten. Whether this is so I don't know. However, it is certain that seasickness is the cause of a lot of anxiety and unhappy crew members. For some reason, in my experience, women are more susceptible than men.

Take your medication for seasickness well before you start sailing. Usually two hours before. Follow the directions. It is a lot easier to stop seasickness before it starts than to interrupt it once it has got hold, in my experience.

Types of medication:
Dramamine - available as pills, liquid and suppositories, branded as Gravol in North America, this is quite good, although it does make me a bit sleepy.
Scopalamine - this is available as Transderm Scop, the famous transdermal patch that has helped a lot of sufferers. It is also available as Scopace, which is in pill form. I have found it quite effective, although the side effects of extremely dry mouth and weird giddyness are disturbing. It is a very strong drug and smaller people (especially women) report many weird psychological effects. The 3-day patches do stick well but in a very warm climate (where you sweat even behind the ears) they may come off.
Meclizine - branded as Bonine/Antivert, in the form of pills. Didn't help me much but it may help you. It is said to have fewer side effects.
Cinnarizine - branded as Stugeron these pills are very effective for me. Unfortunately they are not sold in U.S. You can get them in Europe and Canada.

Other remedies:
Chewing very hard. Funnily enough, although I am not an alternative remedy kind of person, I do find chewing ginger helps. I am not sure if this is because of the strong flavour or the chewing action, or because it has some drug-like action. I find that chewing beef jerky or anything really salty also helps. I have not tried chewing gum. The very strongly flavoured bright red salted semi-dry ginger slices sold in Chinese food shops are very good. Or Tamarind. I've been addicted since childhood.

Bracelets - some people swear by the elasticated bracelets with so called "accupressure" plastic knobs on that press into the the tendons on the inside of the wrist. I think "Sea Bands" was the brand name. Hey, I wore them, and a scopolamine patch, and chewed ginger, and didn't get seasick so they obviously work...

Aromatherapy - on occasion a strong whiff of a pleasant perfume or essential oil has appeared to avert the start of seasickness. I keep a few vials of the stuff around. It worked one time for me and not another time. Although I'm sceptical, it can't hurt.

During the trip
If the weather is calm, many folk do not get seasick. However the long gentle swells that come from a distant storm are actually worse for me than more violent waves. For example, I was fine over the course of many hours with the 3 metre waves we encountered on Lake Ontario probably because they were close together. A long 2 metre swell in the Atlantic made me feel sick within an hour.

Avoid leaning down below, or being out of sight of the horizon unless you are lying down. Try to keep in a fresh flow of air. Get something to do, like navigating or steering the boat. Sit on deck in the wind and look at the horizon (fasten your safety harness to the boat. You are wearing your safety harness above deck, aren't you?) Avoid strong greasy smells (like lasagna cooking on the stove, or diesel fumes). Try to avoid listening to other people puking as this can set you off as well.

Once I start to get seasick, the first signs for me are a headache and mild nausea. Then immediately before the first vomiting attack, a rush of saliva in the mouth. You must get to the rail or over something impervious to fluid or you will be wiping up puke from the carpet. If you make someone else do it you will not be popular. (Fortunately no serious cruising boats have carpeting.)

If you are like me, you will vomit a number of times until you have emptied your stomach. Then you will vomit some more. And more. For me it's every 10-20 minutes. It is exhausting, but do not give up, try to serve your watches. The danger here is of dehydration. Once my stomach is empty, I carry around a bottle of water and a large cup. The cup is for vomiting into (nothing much left inside so it is big enough) the bottle is for taking a few swigs whenever I can bring myself to. With practice you can almost work normally for 19 minutes out of 20. Not pleasant (for others either), but it will pass.

The seasickness stops in one of two ways, for me. Either I get my "sea legs" and it just stops (after about 2-3 days), or I get tired and dehydrated and collapse into a whiny, incapable, self-pitying mound of misery and lie down in a corner to die. Warn the other crew members that this is to be expected, tell them to bring you a cup of water once in a while (every couple of hours) and perhaps a slice of fruit to suck on. You will probably reject their offerings with hideous moans and curses. If they are really good friends tell them to bring you anti-nausea medication in the form of suppositories and get them to make sure you use it.

Keep taking your medication even if you are constantly vomiting. Pills or suppositories.

After the trip
You will live. You will at some point want to die, and this will continue, but you will be OK if you are sensible and the crew help you. It is like magic; as soon as you sail into calmer waters or as soon as you get off the boat you will be cured! You will feel fragile but relieved to be alive. Drink plenty of fluid and get some sleep - unless you have just made Port of Spain and have an appointment with Carnival!

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