Epi-sailor

Pukers United – For those that have

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This one is going to be long - grab a beer or just scroll down to “My Solution”.

From my first offshore passage I was a puker.  Not a one and done puker but I can puke for days and this can be dangerous.   I am also an ICU nurse and help patients work through nausea and vomiting (N/V) daily.  So, while I’m absolutely no neuro expert on the subject, I have read a fair amount of primary, textbook, and popular literature trying to solve my motion sickness which has dramatically improved in recent years.

So, at the encouragement of my sailing friends, I thought I would share what has and has not worked.  And maybe help someone trying to solve this same equation. This has been covered extensively on SA but b/c solutions to the problem are varied I thought I would add my random 2 cents.

As most folks know, motion sickness (ms) is generally thought to be caused when there is a conflict between vestibular (ears), visual (eyes), and somatosensory (neurological body balance) information. “When these three sensory cues are not congruent, a sensory conflict is generated in the brain, and hypothesized that this conflict underlies the symptoms of motion sickness” (1). This uncertainty is why I think it is hard to have one solution.

Over the years I have tried almost every conceivable evidenced based and and non evidenced based medical and complimentary approach to solving ms including various antihistamines, scopolamine (patch), pressure point wrist bands, ginger, etc.  Below are the common ones I have tried and found in the literature.

Medications I have tried: 

Diphenhydramine, chlorpheniramine, cyclizine and cinnarizine are all antihistamines.  This group has been a bit too sedating  - making me feel sleepy - so I sit on the rail, get tired, shut my eyes and start to puke.  I have also tried these with pseudoephedrine (Sudafed), it is thought the pseudoephedrine counteracts the sedative qualities of the antihistamines but this simply made the whole experience worse.

Promethazine (Phenergan) - also an antihistamine - this is often our go to at work when other options have failed. But it is very sedating.   Years ago I tried it with pseudoephedrine and it worked well, but not great.  But it also put me to sleep for half a day.  We now carry it in oral form on our boat in case someone gets scary sick.  It also comes as a suppository, which we need to add to our med kit.

Meclizine- also an antihistamine -the literature suggests it is a bit less effective than the above meds but it is also less sedating so it has become part of my answer.

Scopolamine (scop) patch - Scop is an anticholinergic and for some people it works great and if your trying to deal with ms you may want to give it a try BUT  I am not a fan.  Its side effects can be absolutely awful and include hallucinations, anxiety, and severe dry mouth. I personally have seen leprechauns dancing on the foredeck. And, I have cared for many patients that have had frightening episodes of hallucinations and anxiety.  If you want to give this med a try, chat with your Dr. and do it at home well before departure.  This is not a unique heads up – but I have seen the stuff work and I have clinically seen it be a complete disaster. You have been warned.

Ondansetron (Zofran)  - a serotonin blocker, this medication often works great for N/V related to oncology and post operative treatments but the evidence suggests it is not effective for motion sickness. However, for me, it has become part of my solution. Yes I believe in evidence – but whether placebo, confounder or an N of 1, I use it.

Complimentary options I have tried include:

Pressure point wristbands – I know people who swear by them (including my mother) but for me they have not been very helpful when used alone, with no other interventions.   The evidence suggests they have limited effectiveness. But when I combine them with other interventions they may be helping. 

Ginger: pills, candied, and cookies. I now use pill forms and have these awesome triple ginger cookies in bulk for offshore sails.  They are like ginger crack. I think they settle my stomach. Why they work I have not researched but I believe they help 

Diet:  The popular literature, friends, and colleagues have all suggested staying away from fatty foods, alcohol, caffeine, etc.  I have tried all these things and what I now believe is sticking to my normal diet before and during trips works.  I also think - what if the stuff comes back up.  Better soft foods like pasta than 40 grit Doritos.

Posture/Sea legs:  Sea legs are for real.  Standing (not sitting) and looking at the horizon is for me super helpful. We now have our own boat and when we leave port I will stand and drive the boat as long as my legs will let me. We sleep on the boat the day or two before going out. If you’re crew and feeling green ask the skipper if you can stand while you get your legs. 

My Solution.  

Medications: I take meclizine b/c its less sedating than other antihistamines and ondansetron b/c it’s a different mechanism of action and I’m trying to approach from many directions 

Pressure bands: b/c I respect my mother and anecdotally they work for some people and I paid for them. 

Diet: stay with the normal foods I eat every day including caffeine, alcohol, and normal bowel process. Ginger, particularly the triple ginger cookies from Trader Joe’s, and oral ginger pills appear to help. 

Sea Legs:  sleep on the boat, stand as much as possible and stay on deck for as long as reasonably possible. 

 FYI when I couldn’t remember a few details I used the resource below.  I think you have to pay to access unless you access through your library.   

1.         Priesol, A.J. (2018). Motion Sickness. UpToDate  Retrieved from http://www.uptodate.com

Some links I found on SA that helped me sort it out 

 http://forums.sailinganarchy.com/index.php?/topic/23455-the-best-sea-sickness-medication/

http://forums.sailinganarchy.com/index.php?/topic/12263-sea-sickness/

http://forums.sailinganarchy.com/index.php?/topic/58738-bonine/

http://forums.sailinganarchy.com/index.php?/topic/90899-sea-sickness-remedies/

 

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Sitting under an apple tree works. 

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oak tree

the only sure cure for seasickness is sitting under an oak tree.

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The patch has worked for me. It has become less effective as I've aged. Dry mouth is the only side effect for me.

Nothing else worked and I want to race and race hard.

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Your best bet might be to be born immune, like I was. Or reborn, if you swing that way. Of course, you take your chances that you might actually come back as a cat with a nasty hairball problem.

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I puked once when my daughter ate a bag of cheetos and left an orange rainbow on the leeward side of the boat.

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For those who use TransdermScop, don't touch your eye after touching the patch unless you wash your hands. I freaked out my wife once - she thought I had a stroke because one pupil was way dilated. That will also contribute to blurred vision.

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Weed works. I got relief at the helm once by toasting English muffins with ganja sprinkles. Curious whether anyone has studied whether THC or CBD is the best?

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Don't drink milk or have it on cereal for breakfast on the day.

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TL;DR, can someone give me a Cliffs Notes version?

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Having watched helpless lumps of humanoid lay in misery for days... I’d never go through that just to get to the accustomed side.. I’d find another pursuit 

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I always bring Bonine, if it appears to be rough will take one or 2 when leaving.  Only sick once, was below, warm, busy, washboardy still able to race but felt like crap for 24 hours.  Big +1 on being on deck, driving is excellent but just staying busy, trimming is another good one.  Going below if questionable just go to sleep.  I was deep sea fishing once, flat calm summer - squall came up, 3 or 4 of the other 5 fishing getting sick, I went forward got in a pipe berth and had a nice nap.  woke up, fished, fun.

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3 minutes ago, SailBlueH2O said:

Having watched helpless lumps of humanoid lay in misery for days... I’d never go through that just to get to the accustomed side.. I’d find another pursuit 

20 years of persistence plus a healthy dose of  short term memory loss is helpful

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13 minutes ago, hobot said:

TL;DR, can someone give me a Cliffs Notes version?

Completely fair - in original post see “my solution”

or maybe this

1.  If you get sick there is no one solution so try a shot gun approach particularly with things that can’t hurt you ie wrist bands, ginger cookies, drive the boat, stand, look at the horizons, one less beer etc.

2. Meds- most common OTC meds used for ms will make you sleepy but they often help. I use meclizine bc it is often considered to be the least sedating of all the antihistamines. 

3. This is the most unique thing I do and have not seen in other places - I combine meclizine(antihistamine)with another med that works in a very different way called zofran (serotonin blocker).  Zofran works great to stem off or reduce puking but not really indicated for ms.   This combo seems to work for me.

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Epi-Sailor, this’ll sound silly, but I’m convinced. I think a big reason the pressure bands don’t work for you is because of your medical training, or at the very least, the internet. When I used to work on a charter fishing boat way back in the day, we’d give everyone a rubber band to wear on their wrist and told them it’d prevent sea sickness. It was absurdly effective. Obviously quite silly, but worked. 

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6 minutes ago, Monkey said:

Epi-Sailor, this’ll sound silly, but I’m convinced. I think a big reason the pressure bands don’t work for you is because of your medical training, or at the very least, the internet. When I used to work on a charter fishing boat way back in the day, we’d give everyone a rubber band to wear on their wrist and told them it’d prevent sea sickness. It was absurdly effective. Obviously quite silly, but worked. 

I completely agree with your entire post and believe your story.  As much as I try to be open to things less rooted in my training  it can be tricky..

What I do believe about the bands is they absolutly work for a lot of people including my mom who’s ms sickness is far more severe than mine.  

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There are some where it's "mind over matter", I think...

I hired a stewardess once on a 50m schooner, a private super-yacht, we left FTL and she was throwing up as we left the seaway, didn't stop until we got to Antigua some 8 days later...

A few days after we arrived, I called her into my office as I had to let her go because she couldn't do her job, i.e. serving the owner and guests, cleaning cabins, laundry etc if she was puking constantly. She begged for another chance, bawling her eyes out... (I'm a sucker when chicks cry...) Against my better judgement, I gave her another chance on the proviso that I didn't care if she had to serve him, as well as all the other duties even if  holding a bucket under her arm... I let her know if she was going to let me down, I'd likely lose MY job. She promised she'd NOT let me down.

The boss showed up in Antigua, we cruised for 2 weeks down island to Trinidad, she performed flawlessly. Absolutely flawlessly, not one moment of seasickness, I was so proud of her, and relieved for myself.

The boss and guests got off in Trinidad and we were heading back to Antigua... within 15 minutes from raising the anchor, she had her head in the bucket for the next 5 days solid... She resigned when we got back to Antigua...

I've always wonder why when she HAD to perform she could, when the pressure was off, if Olympic Chucking was an Olympic sport, she woulda won gold!

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1 hour ago, Epi-sailor said:

 

I completely agree with your entire post and believe your story.  As much as I try to be open to things less rooted in my training  it can be tricky..

What I do believe about the bands is they absolutly work for a lot of people including my mom who’s ms sickness is far more severe than mine.  

I don’t think there’s any real value in the bands other than the classic mind over matter. In the grand scheme of things, sea sickness is largely a brain game.  Your eyes say the world isn’t moving, but the rest of your body knows it is. The bands probably still work for those that believe in them. Unlike real illnesses, I still believe many of the snake oil cures are actually quite effective on sea sickness.  It’s just a matter of finding one you believe in  

That’s all just guessing though. I’ve only been sea sick once in my life. We were in a heavy leftover sea with the thickest fog I’d ever seen. I’d guess 10-15 feet of visibility. All I could see was about half the cockpit of the boat. I kept driving til I was ready to puke. Went down below for a few minutes and all problems gone. I’m going with the theory that my brain, being used to a life on boats, had no issue down below, but expected movement when on deck. 

I fully understand that some people are just screwed by motion sickness. 

Edit:  And please don’t think I’m some goofy hippy. My old man’s a doctor and mom’s a nurse. I just have my own theory based on a lot of time on the water with ignorant test subjects. 

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17 minutes ago, Monkey said:

 

I fully understand that some people are just screwed by motion sickness. 

 

I was this type and my friends would agree and exactly why I thought I would beat an old topic once again. 

 

Btw at least half the Drs and Rns I work with are hippies. 

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As an oceanographer who goes to sea often, I have been using promethazine AND pseudoephedrine ("navy cocktail") for the last 30 years with 100% effectiveness. More significantly, I have had many others on the same trip expedition use it when they got mal de mer with the same 100% effectiveness, and I am talking about >75 individuals; statistically significant. I've kept whole ships running in bad weather, it's that good. If you get sleepy, take an additional sudafed...easy. Now, here's the part I like. If you are getting sick, take the meds, lie down and take a nap and when you get up..poof, all better. As long as you can keep it down for ca. an hour. Can't do that with the patch, and then there are the pink elephants too. For me I take it (25 mg of each every 5 hours) on the first day and then I get my sea legs, so I stop taking it. This is the same for most people, but some are the ones who can't adapt; they just continue the regime.

On this topic, what I think is interesting is the sea sickness response - barfing! Why don't we just get a headache or such? The theory I prefer is one of simple evolution: animals that ate something poisonous/bad, which in many cases causes hallucinations, spinning head, etc, and threw up survived; those that didn't barf, died. So, the mixed signals from a moving 3-D world is like eating some bad stuff, so barf. Simplified description for this thread, but could explain many people's response to going to sea.

I'll leave you with that thought,

Greg

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33 minutes ago, gcutter said:

As an oceanographer who goes to sea often, I have been using promethazine AND pseudoephedrine ("navy cocktail") for the last 30 years with 100% effectiveness. More significantly, I have had many others on the same trip expedition use it when they got mal de mer with the same 100% effectiveness, and I am talking about >75 individuals; statistically significant. I've kept whole ships running in bad weather, it's that good. If you get sleepy, take an additional sudafed...easy. Now, here's the part I like. If you are getting sick, take the meds, lie down and take a nap and when you get up..poof, all better. As long as you can keep it down for ca. an hour. Can't do that with the patch, and then there are the pink elephants too. For me I take it (25 mg of each every 5 hours) on the first day and then I get my sea legs, so I stop taking it. This is the same for most people, but some are the ones who can't adapt; they just continue the regime.

On this topic, what I think is interesting is the sea sickness response - barfing! Why don't we just get a headache or such? The theory I prefer is one of simple evolution: animals that ate something poisonous/bad, which in many cases causes hallucinations, spinning head, etc, and threw up survived; those that didn't barf, died. So, the mixed signals from a moving 3-D world is like eating some bad stuff, so barf. Simplified description for this thread, but could explain many people's response to going to sea.

I'll leave you with that thought,

Greg

Your response reminded me of this article.   https://www.cntraveler.com/stories/2016-07-21/the-nasa-space-treatment-that-will-cure-your-seasickness

 

I love promethazin at work.  The stufff works period.  Older Dr once told me that we use it less frequently bc RNs were frequently inappropriately  helping pts “sleep”.  When zofran came along the Drs cut Rns off.   It’s now our second line med and I can’t think of a single instance where it failed to work.  

 

Have you ever given promethazine  in PR or IV  form as a rescue option for someone already sick?

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Do what most of them sadly have to do here. Take a few little blue pills 

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I am partially immune, good genes maybe, or just killed those particular brain cells early in life.

But "partial immunity" is a funny thing, like every other Thing-That-Goes-Wrongtm, it chooses the best (worst) time to strike. The first time I sailed a charter with group of fellow dinghy racers, I was the one most familiar with navigating and was given the task..... of course weather deteriorated, our RDF could not give me a reliable fix, I was doubtful of both the boat's compass -and- dinghy sailors' ability to follow a compass course...... and sometime in the wee hours, hunched over the nav desk, as the boat lurched thru a building chop approaching a lee shore, I was trying to figure out where the fuck we were, and the closed-in space combined with lack of sleep etc etc just made my guts explode..... a blessing in disguise, kinda, because it woke me up and cleared my mind...... we were on a shelving coast and knowing the depth within ten feet would resolve the basic problem of "how long until we hit the bricks."

I was also hit by seasickness while in the Navy, loitering around in the boiler room of a tin can watching the bilge water slosh back and forth, back and forth, back and forth, back and forth, back and forth, back and forth......

My full and sincere sympathy goes out to those more affected. It's a horrible feeling.

-DSK

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Only time I ever puked on a boat was after waking up with a really bad hangover, never suffered motion sickness.  I can read a book, while riding in a moving vehicle.  Missus BB OTH, used to get it.  She was delivery crew on the well known yacht "Symphony" going from New England, down the coast and through the Panama Canal.  Once offshore, she was sick.  One time, as she was suiting up to go on watch, she puked into her bib overalls and it ran down into her boots, but she clipped up the bib, and went on deck to stand watch.  She refused to eat for a while, but the Captain told her she had eat.  "If you don't eat, you don't shit, and if you don't shit, you die!!' was his line......
 

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I've never been seasick to the point of puking in thousands of offshore miles, but what I keep on board is a drug called Sturgeron.  The advantage to it is it works after people get queasy. Seems to have few side affects, at least from the people I've given it to.  I travel abroad and it's available over the counter in Europe. I have taken it once on a southern delivery in terrible weather on a Catamaran. The motion was weird to me, one hull rising and the other diving so I felt a bit queasy.  I took one pill and felt fine.

I know it's available in Germany and Bermuda. I didn't look for it in Canada. I'd give it a try if you can get it, it;s worked wonders on very sick crew in a few situations.

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Rolaids or similar are simply magic. Chew one when you are on the weather side about to head for the leeward rail, and by the time you get there, its all calmed down. Repeat as necessary.

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5 hours ago, billy backstay said:

Only time I ever puked on a boat was after waking up with a really bad hangover, never suffered motion sickness.  I can read a book, while riding in a moving vehicle.  Missus BB OTH, used to get it.  She was delivery crew on the well known yacht "Symphony" going from New England, down the coast and through the Panama Canal.  Once offshore, she was sick.  One time, as she was suiting up to go on watch, she puked into her bib overalls and it ran down into her boots, but she clipped up the bib, and went on deck to stand watch.  She refused to eat for a while, but the Captain told her she had eat.  "If you don't eat, you don't shit, and if you don't shit, you die!!' was his line......
 

This,   Leaving the bar at 3 in the morning after a night of beer, rum and jagermeister isn’t a good idea, trust me on this!:lol:

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5 hours ago, DrewR said:

I've never been seasick to the point of puking in thousands of offshore miles, but what I keep on board is a drug called Sturgeron.  The advantage to it is it works after people get queasy. Seems to have few side affects, at least from the people I've given it to.  I travel abroad and it's available over the counter in Europe. I have taken it once on a southern delivery in terrible weather on a Catamaran. The motion was weird to me, one hull rising and the other diving so I felt a bit queasy.  I took one pill and felt fine.

I know it's available in Germany and Bermuda. I didn't look for it in Canada. I'd give it a try if you can get it, it;s worked wonders on very sick crew in a few situations.

Had a guy in the UK hallucinating on those at night, reckoned he could see something swimming in the cockpit. No, he hadn’t been drinking. 

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My wife and I both get seasick, me on the first day out but she gets the same marathon episodes you mention.

we once did a three day offshore passage where she laid on the cabin floor the whole way, it worked but not much use on a two person crew.

She seemed to have some symptoms of gastritis once she started up, so she now starts a course of ranitidine before we head out and sucks on antacids at sea.

no problems at all the last two long trips, which involved  crossing Bass Strait, or sailing along it’s length.

we also spent two summers aboard in the PNW with no problems, but that really doesn’t count, it’s a millpond there compared to Tasmanian waters.

For me, I look forward to the first puke, it gets better from there, the trick for me is to think I am part of the boat, and not fight it’s motion. I also stay on deck, even sleep in the cockpit if I can.

my impression on most cases of sea sickness is it relates to fighting the motion of the boat, we generally stop fighting and settle down after the first 24 hours, which is when the sea sickness settles down.

so I just consciously move with the boat as soon as we get into a swell, seems to work.

as usual in most things medical, the big mistake is to assume that one size fits all,  it’s never that simple, work out what suits you.

i am attracted to that promethazine and sudafed recipe, as an old PCP and ED Director, I like old, tried and true meds...

 

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One key thing is to avoid "triggers" - by these I mean don't try and refuel the diesel tank at sea, also make sure the inside of the boat doesn't smell of it either. Keep the boat clean and tidy inside, ensure that whoever has the responsibility for meals can do it quickly and is not stuck in the galley preparing a cordon bleu meal at sea etc. Great if you can do something active like steering that allows you to keep your eye on the horizon, and never ever have full on meal just before you depart with several beers.... leave that for when you have finished your voyage.

I also find having something to suck on really helps that has some sugar in it - take your pick from essential aids

 

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1 hour ago, mad said:

Had a guy in the UK hallucinating on those at night, reckoned he could see something swimming in the cockpit. No, he hadn’t been drinking. 

Really? Interesting. I've given it out many times. I;ve never had anyone have anything near that reaction. 

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17 minutes ago, DrewR said:

Really? Interesting. I've given it out many times. I;ve never had anyone have anything near that reaction. 

Only seen it with one guy. 

Personally, there’s no way I’d have done offshore if I suffered from sea sickness like some do! Fuck that!

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2 minutes ago, mad said:

Only seen it with one guy. 

Personally, there’s no way I’d have done offshore if I suffered from sea sickness like some do! Fuck that!

 

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Candied ginger, start before journey.  It works because it is a dispersant, sending blood out of the ear canal and stomach.

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I often get seasick the first couple of days, especially if I'm doing things like chartwork below. . Other than staying hydrated I don't do anything special - I find that taking any drugs just delay the transition from sick to OK.  My wife gets quite severe seasickness even in millpondish Maine cruising conditions. The patch helps, but once she's off it, she feels sick for a day or two.  

4 hours ago, carcrash said:

Rolaids or similar are simply magic. Chew one when you are on the weather side about to head for the leeward rail, and by the time you get there, its all calmed down. Repeat as necessary.

Hmm... interesting. Never tried that. If you eat too many you might find yourself creating bricks?

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Some awesome info here. A few things I haven’t tried such as the navy concoction. I’ll give that a go next time I head OS.

i had a vast improvement when taking zofran and the patch. I went from getting sick nearly every trip offshore  (inc days with little or no swell) to doing Hobart with only 1 quick spew.

the only problem was the fatigue. I had to fight it  and it was tough when drugged up and on day 3 of the race.

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Another thing to remember, if you have any old blokes on the crew, is a lot of these meds are anticholinergics and can cause urinary retention.

make sure you read the side effects labels, and don’t give anything like this to any bloke over 65, or someone with prostate issues.

acute urinary retention three days from help is a medical emergency, unless you have a silicone catheter lying around in your first aid box ...

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20 hours ago, Elegua said:

Hmm... interesting. Never tried that. If you eat too many you might find yourself creating bricks?

Not that I have seen. Never needed to eat a million of the things, just a few seem to do the trick.

I don't often get seasick, but when I do, this antacid trick works, and seems to work for anyone aboard who tries it.

Of course, combined with the normal behaviors: avoid diesel fumes, have roles that require paying attention to the horizon, stay on deck, easy to digest and quick to prepare meals, etc.

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Eat oranges. They taste the same coming up as going down.

Ginger biscuits work for me.

Tried scopolamine patches back in the late '80s: Never again! Couldn't lie to my wife about a little affair I had.

Standing and doing something is the best cure.

Fear is also remarkably efficacious in curing seasickness. 

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On 1/12/2019 at 3:04 PM, gcutter said:

As an oceanographer who goes to sea often, I have been using promethazine AND pseudoephedrine ("navy cocktail") for the last 30 years with 100% effectiveness. More significantly, I have had many others on the same trip expedition use it when they got mal de mer with the same 100% effectiveness, and I am talking about >75 individuals; statistically significant. I've kept whole ships running in bad weather, it's that good. If you get sleepy, take an additional sudafed...easy. Now, here's the part I like. If you are getting sick, take the meds, lie down and take a nap and when you get up..poof, all better. As long as you can keep it down for ca. an hour. Can't do that with the patch, and then there are the pink elephants too. For me I take it (25 mg of each every 5 hours) on the first day and then I get my sea legs, so I stop taking it. This is the same for most people, but some are the ones who can't adapt; they just continue the regime.

On this topic, what I think is interesting is the sea sickness response - barfing! Why don't we just get a headache or such? The theory I prefer is one of simple evolution: animals that ate something poisonous/bad, which in many cases causes hallucinations, spinning head, etc, and threw up survived; those that didn't barf, died. So, the mixed signals from a moving 3-D world is like eating some bad stuff, so barf. Simplified description for this thread, but could explain many people's response to going to sea.

I'll leave you with that thought,

Greg

Which promethazine drug in particular do you recommend? Avomine, Phenergen....??

Also, here in Aus, we have a million types of Sudafed. Is there a specific one you have used with great effect??

TiA

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With the scourge of seasickness you eventually reach a state where you are scared you're actually going to die. But then comes the next, more advanced stage where you become scared that you're not going to die.

If you haven't actually upchucked by this stage then you really need to "get it out of your system". There is a sure fire way to make that happen. Firstly, you need to stick your right hand index finger as far down your throat as you can possibly reach. Next, you need to stick your left hand index finger as far up your arse as you can possibly reach. Usually, that will do the trick. In the rare circumstance where that still doesn't work, simply change hands.

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When I was in my twenties, the only times I ever got seasick was when I went below while underway.  As I’ve gotten older, I’ve become more sensitive. For awhile, I would take Bonine before every outing.  I gradually weaned myself off, and now, I generally don’t t need anything.  But when I do, I use this:

Www.reliefband.com

im surprised no one has mentioned this yet.  It is FDA-approved, so unlike those terrycloth wrist bands with the little nubs, they can actually advertise that it relieves nausea.  This was originally developed to help chemo patients, and it’s made it’s way to the boating community.  

This thing works.

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On 1/14/2019 at 6:19 AM, Hukilau said:

When I was in my twenties, the only times I ever got seasick was when I went below while underway.  As I’ve gotten older, I’ve become more sensitive. For awhile, I would take Bonine before every outing.  I gradually weaned myself off, and now, I generally don’t t need anything.  But when I do, I use this:

Www.reliefband.com

im surprised no one has mentioned this yet.  It is FDA-approved, so unlike those terrycloth wrist bands with the little nubs, they can actually advertise that it relieves nausea.  This was originally developed to help chemo patients, and it’s made it’s way to the boating community.  

This thing works.

That deserved a few clicks on the Googlewebs:

https://www.ncbi.nlm.nih.gov/pubmed/8747609 (impressive results, I love the experiment design but wish the sample size were a bit larger, somebody's gonna need a bigger boat)

https://www.ncbi.nlm.nih.gov/pubmed/15018290 (less promising but what in the hell is "optokinetic drum rotation"?)

 

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Take mescaline, got it.

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I found this interesting...not sure how the Skipper would feel about me standing up at the shrouds while everyone is hiking on the rail, though.

https://www.abc.net.au/news/science/2017-01-11/why-do-we-get-seasick-and-how-do-we-get-sea-legs/8134890

The only time (on the small number of offshores I've done) I wasn't sick we were on split watches and not expected to hike - so I was either on deck and busy trimming, etc, or horizontal.  Getting horizontal always works for me but it doesn't seem fair if the other crew are getting hosed on the rail or they have to draw straws to see who gets to go forward  when the bow is cuddled up to a kite in a berth.  Even though they tell me they don't care as long as I keep moving to the high side.

I tell people it seems you don't know if something works (or if you just got lucky) - you only know if it doesn't, which sucks.  I have been given some Stugeron (which we can't get here) so I guess that'll be the next thing to experiment with. 

Can we even get 'proper' Sudafed here in Oz now, without having to convince a pharmacist to hand it over?  Years ago I was giving small doses to an elderly and incontinent dog on the vet's advice...got to the point I went back to the vet for an alternative because I got sick of trying to convince the pharmacist I wasn't manufacturing something more potent with it!  

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On 1/15/2019 at 12:49 AM, Hukilau said:

When I was in my twenties, the only times I ever got seasick was when I went below while underway.  As I’ve gotten older, I’ve become more sensitive. For awhile, I would take Bonine before every outing.  I gradually weaned myself off, and now, I generally don’t t need anything.  But when I do, I use this:

Www.reliefband.com

im surprised no one has mentioned this yet.  It is FDA-approved, so unlike those terrycloth wrist bands with the little nubs, they can actually advertise that it relieves nausea.  This was originally developed to help chemo patients, and it’s made it’s way to the boating community.  

This thing works.

But it's only 'splashproof'?  Might not stay dry long enough to find out if it works.  Or maybe I need to change boats.  :-)

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14 hours ago, Teener said:

That deserved a few clicks on the Googlewebs:

https://www.ncbi.nlm.nih.gov/pubmed/8747609 (impressive results, I love the experiment design but wish the sample size were a bit larger, somebody's gonna need a bigger boat)

https://www.ncbi.nlm.nih.gov/pubmed/15018290 (less promising but what in the hell is "optokinetic drum rotation"?)

 

Interesting, thanks.  I said earlier that the device was "FDA approved"; I relooked at the website and saw that it actually claims "FDA-cleared technology".  Hmmm.  Not sure what the difference is.  What I do know is that those pressure point wrist bands pointedly do not claim to or advertise that they relieve nausea; they aren't allowed to here in the good ol' US of A unless those claims have been verified in a prescribed manner.  In contrast, Reliefband does specifically advertise that it relieves motion sickness and nausea.  It even goes so far as to claim some kind of FDA benediction.  I don't know what kind of vetting it went through to be able to make these claims, but I am assuming that it either went through some kind of approval process, or they have enough scientific studies to back up their claims such that they are confident they can defend themselves if the FDA gets in their grill.  At least more confidence than the makers of those pressure point wrist bands have.

Regardless, a personal story on the Reliefband:  one night, my wife woke up, seriously nauseous from some unnamed bug.  I put the Reliefband on her wrist, and within 10 seconds, she looked at me in amazement and said the nausea was almost all gone.  She was back to sleep within a few minutes.  I don't have my reliefband anymore, as I gave it to my sister in law when she needed to get chemo treatments.  I don't think she used the band then, and although she's fine now, I never saw the band again...

btw. if you want more studies to look at, the Reliefband website lists these:

  • Yoo SS, Teh EK, Blinder RA, et al. NeuroImage. 2004; 22: 932-940.
  • Koch KM. Dig Dis & Sci. 1990;44(8):53S-7S.
  • Hu S, Stern RM, Koch KL, et al. Gastroenterology. 1992; 102(8):1855-58

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11 hours ago, PITA said:

But it's only 'splashproof'?  Might not stay dry long enough to find out if it works.  Or maybe I need to change boats.  :-)

It looks pretty robust to me.  I would think that the bigger issue is that a lot of water could wash away the conductive gel it needs to work properly.

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I'm a chronic sufferer first day out on a long trip.  All excellent advice above.  Personal commentary:

1. Ensure you're well-fed and well-slept for at least 3 days before you're off, and drink gallons of water.  Your body will thank you for this once it gets dehydrated..
2. For the same 3 days, keep off the booze.  Same result.
3. Again try to de-stress for those last 3 days.  A late night in the office finishing that "essential project" will completely fuck up plans 1 and 2 above.
4. Stay on deck and upright for as long as possible, a horizon view is a must to coordinate brain signals.  Facing the wind is an advantage.
5. When below, get into a bunk as fast as possible, and most importantly hang your head over the side of it. Something funny happens in the ear canals when your head is lower than the rest of you, so it may be that they stop transmitting distress messages.  In any event it keeps your head closer to the bucket.
6. Ginger is the king.  I make my own crystallized ginger and keep a handful in my foulie pocket.  A side benefit is trading lumps of it to a fellow sufferer in return for drinks post-race.

YMMV.  But for 200,000+ miles, those have worked for me.

Drugs didn't.

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On 1/11/2019 at 5:46 PM, Epi-sailor said:

I personally have seen leprechauns dancing on the foredeck. 

You say this as if its a bad thing 

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The way I look at it is like this. Motion sickness was a big issue in the psace program. NASA never found a solution to my knowledge. Drugs don't work aside from mild anesthesia, which detracts from the sailing experience. So you either get over it or you suffer. 

Aside from one time I NEVER get sea sick. Don't know why, whereas I  saw a person complain of sea sickness from standing on floating dock.  You got the gene(s) or you don't. 

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30 minutes ago, HuronBouy said:

You say this as if its a bad thing 

 

Missus Backstay saw kittens in the gas log fireplace, and mice in the sink, one night a couple weeks ago, after taking a Flexeril on top of a Xanax!!   No more Flexeril for her!!

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1 minute ago, billy backstay said:

 

Missus Backstay saw kittens in the gas log fireplace, and mice in the sink, one night a couple weeks ago, after taking a Flexeril on top of a Xanax!!   No more Flexeril for her!!

Ok that's a bad thing 

Zolpidem is not prescribed in Canada because it seems to make you do crazy things and have no memory of it.  Xanax and Zolpidem are the same class of drugs so may be it was the Xanax?  

 

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2 minutes ago, HuronBouy said:

Ok that's a bad thing 

Zolpidem is not prescribed in Canada because it seems to make you do crazy things and have no memory of it.  Xanax and Zolpidem are the same class of drugs so may be it was the Xanax?  

 

 

No she has been taking Xanax rarely in small doses from time to time, but never had a Flexeril added....

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Phenergan(promethazine) plus pseudoephedrine if available. Most countries won't sell medicine containing pseudoephedrine any more so I use caffeine instead. I am a delivery skipper and use it myself and on seasick crew. I would estimate 95 % of people I have given this to get a good result.

I have tried everything else on myself and crew but they all have drawbacks with side effects like hallucinations. Not ideal.

The big deal is to keep hydrated properly. I let crew eat or not as they please but there is compulsory drinking if water on every change of watch. 

 

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Never been sick on the boat, but the closest I've come was getting a face full of someone elses vomit as they yacked off the rail.... not fun.

I always tell my crew to take ginger pills if they are uncertain about seasickness. This is sometimes enough, but also carry meds, which they are to take the second they start to feel any sort of motion sickness.

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+1 for ginger cookies -  they work for me too (especially if they're home made) 

During the Van Isle 360 in 2017 a crew on one of the boats tried to beat sea sickness by eating a bunch of weed edibles. She ended up puking for 8+ hours and being "rescued" by the coast guard.  

 

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7 hours ago, HuronBouy said:

You say this as if its a bad thing 

Only sometimes but Wife and friends that were there agree with you (topic seems to come up  when we are two or three drinks in).  And it make for a great story to share with patients when they see Umpa Loompas, Hobits, or Tinker bell.  I tend not to share stories of pink elephants with yellow spots - a bit to scary for the actively altered.

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The OTC meds like dramamine and meclizine work quite well.....when taken far enough in advance.  Combos like phenergan and pseudophed are probably pretty good, and close to the mixture we were givng space shuttle astronauts too.  Zofran works to shut off the part of the brainstem that allows you to vomit, so if you need that in your combo, it means your vestibular surpressant.....isn't surpressing the vestibular!

Try starting meds like dramamine or meclizine (or preferably dramamine at night, and meclizine during the day) for up to 48 hours prior to travel.....most will find that they aren't sedated any more and they are much more resistant to Mal de Mer.......For a days sail, just take take a dramamine the night before and meclizine in the morning before travel

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We did the '80 Victoria to Maui yacht race.  Our navigator was a NOAA commander and got us the NASA cures for motion sickness that were used by the astronauts.  I don't remember the downers, but we used Dexedrine to bring us back up to function reasonably.  I remember being hungry and thirsty during the ups and downs, it was a roller coaster.

In the '82 Vic-Maui we used Scopolamine patches, which seemed to be a more reasonable approach.  I usually do not have a problem, but on that race, we had some initial issues going out the strait in rough conditions, and then again 4 days later when the trade winds kicked in with a new motion.

During the '96 Sydney-Hobart, my son was not feeling well and asked how best to discreetly puke over the side in seriously rough conditions.  He apparently did not heed all of my advice, and when he puked some of his unpleasantness planted itself on my cheek, and I also lost it.  I keep trying to teach him important things about the world.

 

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Regarding promethazine, that's the generic/real name and it doesn't matter which commercial version, but 25 mg. Regarding sudafed, in the US you just have to fill out the paper work and show identification, but yeah, the "chemists" out there have made it hard to get. And in this respect, I just use the 4hr, 30 mg version since it matches the promethazine duration. But, any stimulant can do the same, so I guess caffeine could do a reasonable job given enough.

I was a bit surprised not to see any comments on the why barf hypothesis.

cheers, Greg

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There are some interesting articles on Stugeron and Parkinson's.  I can't find the article but I read it on the internet so it's true.  Something about a high rate of Parkinson's in the Royal Navy and the link that kept coming up was Stugeron.

We had some Stugeron from fellow cruisers in Mexico when my now ex-wife was dealing with motion sickness.  Didn't really work for her.  What did work some of the time was dark chocolate and Zofran with one ear plug in.  She is a weird woman...

I also had her close her eyes while going to the head while underway.  She couldn't last more than a few seconds going down below with her eyes open.  She knew where every handhold was.

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I like Coca-cola or a piece of bread and an apple to settle my stomach when it gets rough. But the best cure will always be steering or just standing behind the helmsman and enjoying the view.  

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I've been sailing and boating all of my life 50+ years, and have puked in big boats, small boats, fishing boats and sailboats. The worst case i ever had was at age 16, paddling a canoe. We were in huge groundswells on Hudson Bay.  With sailing it only happens in snotty conditions. (The fucking gulf stream in a strong northeast blow.... uggh)

Bonine has been my go to for years and years along with ginger capsules. I typically start a day before race or cruise and it manages it pretty well. If i feel sick i do my best to not show it, if there is an odd motion or giant swell i try to limit time working at the nav station to short bursts. I am worried that the problem is getting worse as i get older. Beating into big seas is much harder on me than down wind in a following sea.

2016 Bermuda Race i was sick. 24 hours of puking and sleep. I doubled on the meds and couldn't keep my eyes open. I fucking hate not pulling my weight. Being incapacitated like this was unusual in that i can and have puked while reefing, driving, navigating etc. Try not to puke into the galley sink, it is a PIA to clean. Normally, if I'm taking the meds I puke and go back to work. I"m not incapacitated. At one point i was looking miserable puke running down my chin, just sort of moaning, and one of the new to the boat crew looked at me and said, "he really must love sailing cause that looks fucking miserable."

2018 Bermuda race, I asked my dr. to prescribe me the necessary components of the coast guard cocktail, he declined saying that a 54 year old aging athlete with slightly high blood pressure shouldn't be taking speed 300 miles from land. Fuck him. I did try Sturgeron for the first time along with "5 hour energy" every time coming on watch. I felt fine the whole race. Weather was not anything rough so I cant say that i truly tested the combo. The delivery home was pretty sporty and i puked once and was exhausted during a 30 hour stint trading off on the wheel every 30 minutes, but all in all I am pretty pleased with Sturgeron. I did enjoy some mild hallucinations, mostly a feeling like we had someone right behind us through the whole storm... just the big breaking seas.

I"m very curious about possible help from pot related treatments as well as the anti nausea meds mentioned above.

I would literally try anything to eliminate this affliction. It can be the worst feeling in the world, but I cannot live without sailing... i'm fucked.

 

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The worst it ever was for me on a sailboat was when the tiller snapped on my Oday 23.  I had a spare, but had to hang over the transom in some rough weather to replace the thing (transom-hung rudder).  I ralphed at least twice:  once while fitting the new tiller, again while pulling up to the dock.  At least my neighbors got a show.

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BONINE- take one an hour before going out and take a second when you get on the boat..[for really big wave days].. then one every 12 hrs.....no issues...works great.

Sturgeron- cinnarazine- from canada pharmacy OTC -15-30 mg   take 2  but need to take them every 6 hrs....if you forget it is not good.

 

Patch... makes you hallucinate in your sleep...but does keep you from getting sick.... wash hands after for sure... or wear gloves... clean skin off with alcohol before applying.

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a surgeon  can cure it, but you may have to relearn how to speak ;-)

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Good evening,

Thanks for the frank discusions. I suffered from sea sickness. I called myself a first night outer, but it often extended to three days.  

After a lifetime of offshore sailing I finally called it a day shortly before I turned 60. Having done something like 10 Atlantic crossings (one which was solo) racing and deliveries, I loved my ocean passages but eventually found that the motion sickness became unbearable and I was no longer willing to subject myself to the suffering.

NOTHING worked for me. What did help was to immediately hit the bunk when leaving port and to have a good, deep sleep. When I then woke up, I would find that I am in tune with the ocean and the boat and would be 100% okay for the rest of the passage. I could then bleed the diesel engin, cook or navigate no problem. However, I would normally be in command, so going for a snooze immediately was not always viable.

Never mind how sick I was, I would always stand my watch, but it sucked. And then there would be those guys in the crew, first time out ever, having a whale of a time, the tougher the going, the better, joking and having fun doing all the stuff I could not do. How I envied them!

My last ocean passage was a two-up race on my little 9 meter trimaran. Seasick for the first three days of a nine day race. After that I sold the boat and hung up my boots.

I now make a point of flatly turning down all offers to go and sail offshore and have bought a racing dinghy for my wife and I to sail on inland waters.

Regards.

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I was sick most of the way down the coast from BC to Mexico this summer, as detailed in this thread, although once past point conception the seas got a lot smaller and I didn't feel ill anymore.

Sturgeon didn't work at all for me, neither did Meclizine.  The bands may have helped (they helped a lot when I was flying planes) but I was still sick using them but it may have delayed the onset a bit. It's way worse in thick fog when I can't see the horizon.

I didn't puke with the patch on, but that leg had calmer seas so I dunno if it was that or the patch. 

In desperation at one point I ate raw ginger, that gave 20 mins or so relief. The thing that really seemed to help was to lie down in the cabin on the settee, but not always able to do that when solo. but that really helped.

Taking Gravol a day or two before I leave and keeping it going for the first day or two also seems to work - though again I've had calmer seas for a while now so it's hard to tell.

Seasickness really fuckin' sucks though, especially when you are by yourself so you still have to function.

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Have you guys found that on longer passages that seasick crew tend to get better after a few days?  Or not so much?

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2 minutes ago, BrickTopHarry said:

Have you guys found that on longer passages that seasick crew tend to get better after a few days?  Or not so much?

It completely depends on the individual person's metabolism.  Some never get it, some get over it pretty quickly, and some just never get over it, and eventually become a medical emergency.  I had to offload one guy mid-Atlantic onto a passing RN warship.  Not an easy operation, but he'd been upchucking for 8 days and was going down fast despite our efforts at hydration.

Personally I'm bad for the first 18-24 hours, then I get my sea legs. The first day ashore after a crossing I get bad again.  But that could be the drink.

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On 1/12/2019 at 11:18 AM, DrewR said:

I've never been seasick to the point of puking in thousands of offshore miles, but what I keep on board is a drug called Sturgeron.  The advantage to it is it works after people get queasy. Seems to have few side affects, at least from the people I've given it to.  I travel abroad and it's available over the counter in Europe. I have taken it once on a southern delivery in terrible weather on a Catamaran. The motion was weird to me, one hull rising and the other diving so I felt a bit queasy.  I took one pill and felt fine.

I know it's available in Germany and Bermuda. I didn't look for it in Canada. I'd give it a try if you can get it, it;s worked wonders on very sick crew in a few situations.

I picked up some sturgeron in St Martin I think and in the UK.. or someone in those places gave it to me to give to my gf, it worked well for her when nothing else did. She got sick about 30 seconds after we left the dock in any conditions. Gratefully, I have never been sick on a boat except the one time I caught someone elses hurl across the face.

 

having said all that, I sometimes wonder why I don't get sick. could be numb inner ears or something. and I've heard a few times that as one gets older their susceptibility to motion sickness decreases. I started sailing later in life than most people.

the last few years, i've been doing a lot more offshore sailing, and even though I don't get sick, before we leave for a passage I'll pop a meclizine or two and continue that for a day or two into the passage. Better safe than sorry. The dreams get a little weird!

 

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On 1/11/2019 at 8:40 PM, VWAP said:

Do what most of them sadly have to do here. Take a few little blue pills 

and after 4 hours ?

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On 1/11/2019 at 8:26 PM, charisma94 said:

There are some where it's "mind over matter", I think...

I hired a stewardess once on a 50m schooner, a private super-yacht, we left FTL and she was throwing up as we left the seaway, didn't stop until we got to Antigua some 8 days later...

A few days after we arrived, I called her into my office as I had to let her go because she couldn't do her job, i.e. serving the owner and guests, cleaning cabins, laundry etc if she was puking constantly. She begged for another chance, bawling her eyes out... (I'm a sucker when chicks cry...) Against my better judgement, I gave her another chance on the proviso that I didn't care if she had to serve him, as well as all the other duties even if  holding a bucket under her arm... I let her know if she was going to let me down, I'd likely lose MY job. She promised she'd NOT let me down.

The boss showed up in Antigua, we cruised for 2 weeks down island to Trinidad, she performed flawlessly. Absolutely flawlessly, not one moment of seasickness, I was so proud of her, and relieved for myself.

The boss and guests got off in Trinidad and we were heading back to Antigua... within 15 minutes from raising the anchor, she had her head in the bucket for the next 5 days solid... She resigned when we got back to Antigua...

I've always wonder why when she HAD to perform she could, when the pressure was off, if Olympic Chucking was an Olympic sport, she woulda won gold!

my dad gets viciously motion sick on boats. I've seen him turn green on training flights in relatively benign weather with relatively benign maneuvers. Yet, when he flies, it can be the most miserable shit you can imagine - like having the seatbelt so tight its cutting off circulation to your thighs because  the alternative is hitting your head on the ceiling (possibly, hard enough to blind yourself). He'll just truck right along like nothings happening. The difference? In that last situation, if you get sick you'll die! So yeah, in short, i agree, mind over matter can help a lot. 

Personally, i get sick to the point that i might puke after about a day of offshore sailing in 20kts. A few hours in and i'll usually feel it coming on when its #4 weather - but i can always hold it together (that time in Charleston doesn't count, fuck all of you) for WL racing since there is always something to do. have definitely thrown up in my mouth packing a kite once or twice though... My desire to offshore sailing is definitely tempered over the years. I'd like to do some races, but no interest in another NPT-BDA, for example... Maybe i need to get more experience with sturgeron .  

 

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On 1/18/2019 at 11:45 PM, BrickTopHarry said:

Have you guys found that on longer passages that seasick crew tend to get better after a few days?  Or not so much?

Personally, depends on the circumstances. I've been between no issue in the slop, a one and done, and incapacitated without meds. Never been an emergency, though. 

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On 1/18/2019 at 2:28 PM, dacapo said:

a surgeon  can cure it, but you may have to relearn how to speak ;-)

now where have i heard that (btw, i think it was relearn how to walk... although maybe the relearning how to speak would be a specific thing for you...) 

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31 minutes ago, mustang__1 said:

my dad gets viciously motion sick on boats. I've seen him turn green on training flights in relatively benign weather with relatively benign maneuvers. Yet, when he flies, it can be the most miserable shit you can imagine - like having the seatbelt so tight its cutting off circulation to your thighs because  the alternative is hitting your head on the ceiling (possibly, hard enough to blind yourself). He'll just truck right along like nothings happening. The difference? In that last situation, if you get sick you'll die! So yeah, in short, i agree, mind over matter can help a lot. 

Personally, i get sick to the point that i might puke after about a day of offshore sailing in 20kts. A few hours in and i'll usually feel it coming on when its #4 weather - but i can always hold it together (that time in Charleston doesn't count, fuck all of you) for WL racing since there is always something to do. have definitely thrown up in my mouth packing a kite once or twice though... My desire to offshore sailing is definitely tempered over the years. I'd like to do some races, but no interest in another NPT-BDA, for example... Maybe i need to get more experience with sturgeron .  

 

Did you puke on a BDA Race once?

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1 hour ago, mustang__1 said:

now where have i heard that (btw, i think it was relearn how to walk... although maybe the relearning how to speak would be a specific thing for you...) 

well, more for the puker on the boat..........;-)  

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4 hours ago, jackolantern said:

Did you puke on a BDA Race once?

that was a one and done for the most part. I mean, it was a lot of puke, i certainly didn't need the second helping of lasagna, but it was only once. 

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On 1/17/2019 at 12:21 PM, Lono said:

I've been sailing and boating all of my life 50+ years, and have puked in big boats, small boats, fishing boats and sailboats. The worst case i ever had was at age 16, paddling a canoe. We were in huge groundswells on Hudson Bay.  With sailing it only happens in snotty conditions. (The fucking gulf stream in a strong northeast blow.... uggh)

Bonine has been my go to for years and years along with ginger capsules. I typically start a day before race or cruise and it manages it pretty well. If i feel sick i do my best to not show it, if there is an odd motion or giant swell i try to limit time working at the nav station to short bursts. I am worried that the problem is getting worse as i get older. Beating into big seas is much harder on me than down wind in a following sea.

2016 Bermuda Race i was sick. 24 hours of puking and sleep. I doubled on the meds and couldn't keep my eyes open. I fucking hate not pulling my weight. Being incapacitated like this was unusual in that i can and have puked while reefing, driving, navigating etc. Try not to puke into the galley sink, it is a PIA to clean. Normally, if I'm taking the meds I puke and go back to work. I"m not incapacitated. At one point i was looking miserable puke running down my chin, just sort of moaning, and one of the new to the boat crew looked at me and said, "he really must love sailing cause that looks fucking miserable."

2018 Bermuda race, I asked my dr. to prescribe me the necessary components of the coast guard cocktail, he declined saying that a 54 year old aging athlete with slightly high blood pressure shouldn't be taking speed 300 miles from land. Fuck him. I did try Sturgeron for the first time along with "5 hour energy" every time coming on watch. I felt fine the whole race. Weather was not anything rough so I cant say that i truly tested the combo. The delivery home was pretty sporty and i puked once and was exhausted during a 30 hour stint trading off on the wheel every 30 minutes, but all in all I am pretty pleased with Sturgeron. I did enjoy some mild hallucinations, mostly a feeling like we had someone right behind us through the whole storm... just the big breaking seas.

I"m very curious about possible help from pot related treatments as well as the anti nausea meds mentioned above.

I would literally try anything to eliminate this affliction. It can be the worst feeling in the world, but I cannot live without sailing... i'm fucked.

 

Lono, this image popped into my head when I read your post,

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22 hours ago, dacapo said:

well, more for the puker on the boat..........;-)  

that was jamie that regatta i think. Aside from the delivery i kept my shit together the rest of the time on that boat. Including that clusterfuck of a vineyard race in 2010. 

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