Seasickness Medication in UK

[salad]

slapping the captain with a flounder 3 times.

Does self flagellating with a flounder count?

 

[Adios]

Seasickness
What causes it? There are three systems in the body that control where we think we are in space. 1. Vision/Eyes (E). This is the dominant sense. 2. Vestibular System(V). Those 3 semi-circular canals of the inner ear. 3 Proprioception (P). The neurological feedback from our muscles tendons and joints. This 3rd one is often overlooked but important in sailing. These 3 systems are brought together in the brainstem. We feel sick (the body telling us to stop doing this) because the brain is trying to resolve the conflict mainly caused by the eyes saying “We are stationary in respect to our surroundings” (The Boat) and V and P saying “No we are moving”. This is called Conflict Theory. It is just that at present as so far there are no Functional MRI studies that show where in the brain this occurs, but it certainly does. The very first sign that you will all have seen is the person going quiet.

How to we treat it? A) Non-drug interventions immediate. There are two ways to do this. 1 Resolve the conflict and 2 Distract the brain from the conflict. For 1 the absolute best thing is to get it early and put the three systems EVP back together. For the E get the person to look out rather than in, particularly good if that view is in relation to the boat ie looking over the boat at the horizon. For the V there is nothing you can do. For the P get the person on the helm. Their whole body will now be moving in time with the boat and even better their E will be perfectly placed to see the boat and the horizon. For 2 distract the person by telling them about something interesting or get them to tell you about something. (Side note. Virtually all of us get some form of seasickness when we have to go below and particularly if we have to read something forcing E into absolute conflict, however when I used to race I was more often than not the navigator and had to spend lots of time looking at tides and weather and charts. Even in force 8’s I was never seasick down below because I had to do complex brain work that distracts the conflict model. In vestibular labs they use this distraction to test nystagmus suppression but that is getting technical!) Finally, if all else fails going below somewhere warm preferably near the keel with eyes shut will partially resolve the conflict, oh yes being sick can give some temporary relief.
B) Non Drug interventions long term. The obvious one is habituation. The brain does eventually give up trying to resolve the conflict and almost always goes back to the E sense as its primary. The trouble is this can take 6 hours or 6 days. This is characterised by Susceptibility. Susceptibility can be increased or decreased by a number of factors. Genetics is one. If your parents got seasick you are likely to. Age. Babies do not get seasick but old age people, children between 10 and 16 and women do. We know this habituation is true because patients with bilateral vestibular failure do not get seasick as the brain has long since given up resolving the conflict. You can be trained out of it but would you want to!!! This is called specialised habituation training. In essence it is putting you in motion simulator and presenting you with the conflict. Boy is it grim. You will be sick and sick and sick for most of the 7 days it takes. It is usually only used in very specific situations for example Military Pilots in the middle of training who suddenly develop motion sickness. Lots of money has been spend so specialised habituation training is justified. (For the military at least but maybe not for the poor pilot who has to endure it.)
C) Drug interventions. Drugs do work mainly by suppressing the nausea Anticholinergics. eg Scopolamine, Antihistamines. Eg Cinnarizine. This is a complex subject and too detailed to go into here but the two widely used are Scopolamine patches (Prescription in the USA and not easily available in the UK and Europe) and Stugeron (Cinnarizine) (Not available in the USA)
D) Non Drug interventions the Placebo!!! So there are magical cures, sitting on brown paper, wrist bands, copper bracelets, eating pumpkin seeds, sliced apple and finally slapping the captain with a flounder 3 times. All but the last will work. The Placebo effect is massive here. If a skipper tells you to try something and you believe in it or him/her it will likely have an effect. I never stop people believing in those costly wrist bands. The more they cost the better they are likely to work because the more you have invested in the idea.
E) Diet/Foods. There is no doubt that you are less likely to feel sick if you keep hydrated, have light fairly bland food before starting, avoid alcohol. Ginger actually works! In randomised control trials there is an effect but unfortunately not quite enough to prove statistically significant but an effect non the less. I always have ginger biscuits on board.
Finally, this is my take on the subject and only that. Do what works for you.

Excellent post thanks! I always wondered why I've never come close on my own boat, can hang upside down changing a fuel filter drifting beam on if needed, but have succumbed a few times on other peoples boats where I had less to do. It puts me off crewing for other people TBH and I wonder if many people suffer it doing RYA beginner courses and are put off so never find out that they wouldn't have an issue at all if they were master in command of their own vessel where seasickness isn't an option.

 

[Adios]

Loratadine (antihistamine) is surprisingly effective and doesn't make you drowsy.

Anyone else tried this?

 

[Adios]

Does self flagellating with a flounder count?

without blubbing?

 

[st599]

How is this for causing drowsiness?

It's the main ingredient in night nurse and prescribed for short term insomnia.

 

[stuartwineberg]

I always use ‘Stugeron’, the first couple of times out each season I can’t go down below without them, once the season is underway I can manage without, but still carry them just in case. It’s available from pharmacies over the counter.
I feel for ‘Nelson’ apparently he was a severe s/s sufferer and it took about 6 weeks for him to overcome it.

+1 for Stugeron, for most people is non sedating.

 

[debenriver]

I have always found that you can't be sick whilst singing! So being at the helm and singing was 100% effective. Getting down below and laying flat when off-watch. Navigation and cooking a bit more tricky but singing definitely helped. Mid you the rest of the crew were no so impressed with the singing ....

 

[auditdata]

I have always found that you can't be sick whilst singing! So being at the helm and singing was 100% effective. Getting down below and laying flat when off-watch. Navigation and cooking a bit more tricky but singing definitely helped. Mid you the rest of the crew were no so impressed with the singing ....

Yep the good old "Distract the brain from the conflict"

 

[Spirit (of Glenans)]

Stugeron makes some people sleepy. There are non-medical things that help, ginger being very popular. I usually keep a bottle of sports drink onboard to help anybody recover after a bout of sickness. I don’t suffer but I like to graze and keep my stomach working.

Once on a delivery, I took Stugeron. The initial dose is meant to be two tablets, followed by a single one at the recommended intervals. Unfortunately I forgot that I was only supposed to follow up with single tablets, taking two each time, with the result that my time on the voyage consisted entirely of being on watch alternating with sleeping?

 

[Salt'n'shaken]

Patches are available from pharmacies (worn behind the ear like a mini nicotine patch). Very effective if applied before you even get on the boat rather than when you start to feel dodgy. I think more effective than tablets but also has the added advantage that if you are sick (nothing works 100% - if you need to deal with something in the engine bay in a big swell) then they keep working whereas if you’ve just chucked the tablet up you don’t know if you lost it but shouldn’t take a second dose.

in my view ginger does work but not like some people say! It’s not a magic cure - but if you are feeling off, ginger (eg ginger nuts) will be better than other foods at getting energy into you without making it feel worse. I’m not a fan of ginger beer but I expect if you like it this would be very good. Everytime I’ve actually spewed on a yacht I’ve been a bit cold/tired/dehydrated to start with. Helming helps focus on the horizon and I find standing up let’s the legs damp the motion.

Second for the patches

 

[Leighb]

Second for the patches

Just a word of caution about the Scopoderm patches. It is advised that you try it at home before using it in anger. They can produce quite unpleasant side effects in some susceptible individuals, one such being my missus. She put one on at home before going to bed, within a short while she had nasty vertigo making it difficult for to get to the loo!! Feeling of dizziness and light headedness lasted many hours. Back to Stugeron, wrist bands and ginger.
I had no trouble with the patches, but they didn't seem to help much with the nausea, perhaps I am too thick skinned?