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How to keep those rolling waves from ruining a boating excursion

Posted: Wednesday, May 29, 2002

ANCHORAGE, Alaska (AP) -- Want a quick cure for seasickness?

Sidebar: A Guide To Seasickness Remedies

In the backpack:

- Chewing gum. Try ginger or peppermint.

-- Rolaids. Usually helps those who are just slightly sick. Can help neutralize the stomach acid so it doesn't burn so much on the way up.

Alternative medicines:

-- Ginger. The root of this plant has been used for centuries to curb seasickness. Suggested dose is two 500 mg tablets twice a day, and it can be added to other remedies without conflict. Popular forms include tablets called ''Queeze-Eze'' and ''Smooth Sailing,'' a carbonated beverage.

-- Acupressure. Put pressure on the Nei-kuan (P6) acupressure point on the wrist. The spot lies between two tendons on the underside of the wrist, two finger widths past the main crease where the hand meets the arm. There are no known side effects and some say acupressure even works for morning sickness. Several types of elastic or adjustable bands are available that have a plastic or metal button on the inside designed to put pressure on the spot. They can be added to other remedies without conflict. Most popular brands include, ''Sea-Bands'' and ''Acu-Bands.'' More recently, an electronic version has been marketed called ''ReliefBand'' that emits a low-level adjustable current. They are expensive, $50 to $165, but some studies show they are 80 to 90 percent effective.

Over-the-counter:

These medicines are basically antihistamines and are thought to dry up the sinuses, thus having an effect on the inner ear. They need to be taken several hours before you set sail. Generally, they cause a varying degree of drowsiness. There are several brands with different active ingredients including:

-- Dramamine (dimenhydrinate)

-- Benadryl Allergy (acrivastine)

-- Bonine, Dramamine II, Antivert (meclizine) -- less sedating than Dramamine;

-- Marezine (cyclizine) -- causes less drowsiness than others

-- Stugeron (cinnarizine) -- commonly used in Europe, less sedating.

-- VitaMotion-S Oral Spray (dimenhydrinate) -- four quick sprays to the mouth, includes same active ingredient as Dramamine, plus ginger and vitamin B6.

Prescription drugs:

-- Scopolomine -- This comes in a patch that you wear behind your ear for up to three days. Common side effects include dry mouth, drowsiness, blurred vision, memory loss and dizziness. The most common brand name is ''Transderm Scop.''

-- Promethazine and Ephedamine -- Often prescribed in combination, the Promethazine attacks the seasickness while the Ephedamine counters the drowsiness brought on by the first.

-- Phernergan -- Stops vomiting in its tracks but also may put you to sleep.

HOW TO MITIGATE SEASICKNESS

1. Keep your eyes on the horizon.

2. Apply cold packs or ice to the neck.

3. Avoid greasy, heavy, and spicy foods and alcohol before setting sail.

4. Take slow deep breaths.

5. Eat light, starchy foods. Drink lots of water.

6. Stick to the center of boat and get fresh air.

7. Keep your head steady.

8. Avoid smells, including diesel.

9. Stay on deck.

''Drink beer and eat cold fried chicken.''

''Stand in the middle of the boat and let your knees flex like you are skiing. It helps keep the fluids in your brain level.''

''I once saw a ginger-based beverage called Smooth Sailing' perform miracles -- by raising the dead -- on a halibut charter.''

''Cheez-Its.''

''Place a cold can of beer right behind your ear.''

''Those wrist bands with a metal disc that pressure point.''

Those are the kinds of answers you get when you ask for advice on the best ways to prevent seasickness. And the range of answers should be the first clue that there is no easy solution.

There is no foolproof, single cure for seasickness that works for everybody, every time, say the people who've spent decades studying why people get sick in boats and on airplanes.

Instead, there seem to be a handful of remedies that work for some people some of the time, according to interviews with researchers, pharmacists, doctors and fishing charter captains and information garnered from informal surveys and the Internet.

The problem is scientists haven't been able to pinpoint what causes seasickness, although ''it definitely has to do with the inner ear,'' said Joel Ventura, a researcher at Brandeis University's Graybiell Spatial Orientation Laboratory near Boston. The center conducts research for NASA.

Seasickness, he said, appears to be the result of a conflict between messages delivered to the brain, which gets visual signals from what we see, sensory signals from pressure receptors of the skin and joints, and balance signals from the inner ear.

When the signals get too confused, you start feeling flush. Then you're sweating, your face has turned halibut-belly white, and finally the brain tells the stomach to purge.

Most of us think we have only five senses, but in reality we have a dozen or more, Ventura said. One of these senses covers angular acceleration, which is something detected by the cilia in the vestibular system of the inner ear. Certain antibiotics can destroy that cilia. A person with destroyed cilia doesn't appear to get motion sickness.

That might make this seem like a motion sickness solution, and it was once even considered, though not seriously, for astronauts. But there is a problem: People can't walk after the cilia are destroyed. They have to learn to walk all over again using visual clues for balance.

This has discouraged researchers from pursuing the treatment and sent them off to find other remedies. The problem with most of those is that they work for some people but not for others. The success of treatments appears as variable as the susceptibility of various people to seasickness.

''There are tremendous individual differences,'' Ventura said. ''There are certain people I can put in the (rotating) chair and make pitch motions and they can do that all day.''

There are, however, some clues as to who is likely to have problems.

If you are prone to car or air sickness, your are a good candidate for seasickness. The Imperial College of Science Technology and Medicine in London reports that sufferers of frequent headaches, especially migraines, as well as lactose-intolerant individuals also seem especially vulnerable.

Meanwhile, there's good news for aging boomers: Adults over 50 are least likely to suffer from seasickness. But it appears that Asians, women in particular, get sick almost every time.

Some studies suggest up-and-down motions are more likely than side-to-side motions to cause motion sickness. Most people also appear to acclimate in one or two days, and there is some indication that cumulative exposure to rolling seas over years pays off.

And while there is no one drug that works for everyone every time, study results suggest some drugs, as well as some alternative medicines and other precautions, are worth a try. Studies show as much as 80 percent of all seasickness can be alleviated or avoided with some sort of treatment. A big part of this might come from people simply finding something they believe in. Research here has shown the placebo affect may account for as much as 40 percent of the cure.

Believing in a remedy appears to be the best way to maximize the chances of that remedy working. Here are some of those remedies:

Alternative medicines

Anything with ginger in it -- ginger snaps, ginger ale, ginger gum -- has been found to calm the stomach. Eat it or drink it.

A pressure on a point on the wrist is also believed to be effective. Several companies make elastic wrist bands with plastic tabs for $10 or less that are worn snugly on the wrist. Electronic versions are available but are more expensive, $50 to $175. Some reports suggest the effectiveness of the electronic system could be as high as 90 percent.

''How it works is that there is a meridian, or energetic line, that travels from (the wrist area) to the middle part of the stomach,'' explained Rande Lucas, a local licensed acupuncturist and registered nurse. There are points on the outer ear that make the same connection. Lucas said she can tape small pellets to the ear that can be pressed while someone is at sea for similar stimulation.

The nice thing about both ginger and acupressure is that they can safely be used in conjunction with other remedies.

Over-the-counter medications

The active ingredient in Dramamine, Bonine and Marezine, all over-the-counter medications, is an antihistamine, which is thought to dry up fluids in the sinuses effecting the inner ear. The different medications each have a different antihistamine, and that can change the drugs' affects.

Dramamine causes considerable drowsiness for many people. Bonine, Dramamine II and Marezine also cause drowsiness but reportedly not as severe. The key with these drugs is to start taking them before you board the boat.

''They are fairly effective for most people,'' said Harry Vance, a pharmacist at Fred Meyer on Abbott Road. But they need to premedicate and repeat it about every four to six hours.''

Prescription medications

The breakthrough in prescription drugs is scopolamine. It comes in a patch form called Transderm Scop that is effective for up to three days. Side effects, however, include dry mouth, drowsiness, blurred vision and memory loss. Test results show scopalamine is 50 percent effective, Ventura said, but when you add the placebo effect, which is about 40 percent, you find that about 70 to 80 percent of people will respond favorably to the drug.

Scopalamine first came on the market in 1990 but was off the market from 1994 to 1997 for further testing. It's back on, and while it doesn't work for everyone, it ''is the drug of choice,'' Ventura said.

''The patch was the last big breakthrough,'' pharmacist Vance said. ''It was quite a big improvement above Dramamine and Bonine.''

But the ultimate remedy?

Go sit under a tree, British maritime hero Admiral Nelson is quoted as having said in the late 1700s.

''That's what I do,'' said Larry Voelk, office manager for Lucky Pierre's charter boat operation in Seward. ''I don't go on the water. That's the cheapest solution.''



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