What Causes Seasickness — And What to do About it

Washington Post
By Melanie D.G. Kaplan
November 2, 2018

“Can you get seasick in a kayak?”

Years ago, AdventureSmith Explorations founder Todd Smith worked as an expedition leader in Alaska, and one day he fielded that question from a participant on his paddling excursion.

“We were in Icy Strait outside Glacier Bay National Park, and there was a little wind and a little chop,” Smith said. “I told the guy, ‘Oh no, you can’t get seasick. You’ll be fine. Just keep paddling!’ ” Smith laughs about it now that he answers the question differently, but the story doesn’t end well for the inquiring kayaker.

When Smith shared this with me recently, I wasn’t the least bit surprised to hear that a paddler was looking peaked. In fact, in the I-will-out-seasick-you game, I think my story of getting queasy while swimming across the Chesapeake Bay is the winner. Not that I’m keeping score, of course, but I’ve been a little green around the gills — or worse — on whale-watching boats, car ferries, sailboats, kayaks and cruises ships large and small. Don’t get me started on Imax films with water scenes.

For generations, experts have generally agreed on the cause of mal de mer: “The affliction arises from a sensory conflict between the eyes and inner ear which triggers a guttural reaction,” wrote André Sobocinski, a historian for the U.S. Navy’s Bureau of Medicine and Surgery. When this happens, and the motion sensors in our inner ear perceive that something is out of whack, we can suffer symptoms that include nausea, drowsiness and yawning, mild headache, dry mouth, clamminess, perspiration and paleness.

A newer theory centers on a person’s postural activity, or their body sway. Thomas Stoffregen, a kinesiology professor at the University of Minnesota, published research in 2013 that shows seasickness happens more frequently and to a greater degree in people whose bodies sway more — albeit, a tiny, imperceptible movement — even on land. By studying undergraduates in a program called Semester at Sea, before and during the voyage, Stoffregen accurately predicted who was going to get sick and to what degree.

In addition, Stoffregen’s research looked at the data for mal de debarquement, the sickness that can occur when a seafarer returns to land. More recently, he has turned his attention to how and why motion sickness affects the sexes differently. (He said women are twice as likely as men to vomit on ships.)

We also know that pregnant women are more susceptible, and kids 2 to 12 are most vulnerable. The lucky ones grow out of it, although smooth sailing for them might feel like rough seas for those who still suffer as adults. A cure remains elusive, but until that day, let’s celebrate what we’ve learned about prevention and treatment since the 19th century, when the Navy proposed measures such as eating smoked herring and administering seawater enemas.

By sea and season

Benjamin Shore, chief medical consultant for Royal Caribbean Cruises, said seasickness generally isn’t a problem for the company’s passengers. “A large part of it has been eradicated because ships are very large and stable,” he said. Indeed, these modern vessels use stabilizers — sophisticated fins that are deployed to counteract the roll of the vessel. They don’t, however, prevent all motion, and in the roughest conditions, even hardened sailors and veteran voyagers on the most technologically advanced ships can surrender to the seas.

Smaller vessels, like the ones that AdventureSmith books around the world, have stabilizers, too. And while they make the experience more comfortable, Smith doesn’t talk about them for fear of giving people a false sense of security. Small boats inherently move around more than big ships, so if you’re quick to feel queasy but still want a small-ship experience, talk to the company about avoiding notoriously rough crossings.

“Every place is a little different,” Smith said. “In the Mediterranean, you get winds that pick up at end of summer and into fall; in Baja, you get winds in November and December. We take all that into account and talk to people about the time of year and destination.” If you want to cruise Alaska’s calm and protected Inside Passage, for example, you can start in Juneau (rather than Seattle or Vancouver, B.C.) to bypass the choppier Pacific. In the Galápagos, fly to the islands to avoid taking a cruise from mainland Ecuador, where the sea will be rougher (although you still might encounter chop when you’re cruising between islands). Even places that seem like they’d be tranquil — Australia’s Great Barrier Reef, for example — can get rough, depending on the trade winds.

If you’re seeking the roller -coaster experience, consider Antarctica; the Drake Passage is known for some of the world’s roughest seas. Smith suggests going in January, the middle of their summer. During that time, you’ll have a greater chance of experiencing calm waters during the two-day crossing from Ushuaia, Argentina. “I don’t want to scare people, but sometimes you have 30-foot swells in a 200-foot boat,” he said. “Some people feel like this is part of the experience.” If a Drake mistake isn’t on your bucket list, you may opt to fly into Antarctica with AdventureSmith’s eight-day Antarctica Air Cruise.

For those prone to seasickness, don’t forget to reserve a window cabin toward the center of the ship, which moves around less than cabins too far fore or aft.

Be prepared

Having a positive attitude is important, “versus feeling like you’re going to succumb to something terrible,” said Michael Jacobs, a lifelong sailor and medical consultant for the U.S. Sailing Association, the sport’s national governing body. Jacobs, who co-authored “Marine Medicine: A Comprehensive Guide,” said some people lose confidence that their condition is going to be temporary and panic. In the worst cases, he has seen passengers airlifted from small boats because they consider seasickness a medical emergency. “If you just learn some simple measures,” he said, “there’s hope to get your sea legs.”

If you know you have a tendency to suffer on the seas, it’s best to take preventive measures — ideally before you embark.

Jeff Whittall, the medical consultant for Semester at Sea, said before the ships leave port, students hear a spiel about seasickness prevention. “We try to emphasize that most people will get seasick at some point during the semester, and you have nowhere to go,” Whittall said. “We recommend prophylactics for everyone, because there’s not a lot you can to do once you start feeling sick.”

One of the most effective medications is the prescription scopolamine patch , which lasts three days. Like many nausea drugs, it can cause drowsiness, blurriness and other side effects. Soon, we may have an even better treatment: The Navy has studied the use of a fast-acting intranasal scopolamine spray that also reduces the drug’s negative side effects.

Cruise ships typically dispense over-the-counter antihistamines such as meclizine and dimenhydrinate without charge at the medical clinic or reception desk, but if you’re on a smaller vessel or even out boating with friends, you may want to bring your own. Again, make sure you take it before you feel out of sorts (or when the captain announces angry seas ahead) and don’t overmedicate.

If you want to avoid the side effects of medication, head for the alternative aisle, where you’ll find acupressure wrist bands, magnet bracelets and aromatherapy, which some people find effective. But Whittall said the side effects are a small price to pay, especially on an extended voyage. “What’s worse,” he quipped, “heaving over the side or experiencing some blurriness when you read?”

No to nausea

Prevention is worth “999 times more than any treatment,” Stoffregen said. Once you’re feeling symptoms, you’re often past the point of no return. He said ginger stands alone as the only thing scientifically proved to help alleviate nausea from seasickness without drowsiness. “Get yourself some ginger candy, ginger chews, ginger snaps, and have some ginger in your stomach before you head to sea,” he said. “Nobody knows why it works, but it works.”

Jacobs recommends capsules of powdered ginger root. You can also consume your ginger in ale or tea. Some sailors use pilot bread — a thick, crackerlike item similar to Colonial-era hardtack, which doesn’t go stale — to settle their stomachs. According to Shore, some people even sniff fresh newsprint (Google it) to help relieve nausea, a tactic sometimes used for morning sickness.

Starting on the day before you depart, drink lots of water, get enough sleep and avoid heavy meals, alcohol and caffeine. Continue this regimen until you acclimate, which can take several hours to a week.

When you begin to feel woozy, go to the deck, breathe some fresh air and look out to the horizon. Keep your head still — a deck chair with a headrest works great. The worst thing you can do is go below to your cabin and, say, read a book. Stoffregen recommends putting your electronic devices away, although listening with ear buds is okay. If you’re on a friend’s boat during a calm stretch, ask if you can get behind the wheel.

“I don’t care how sick you are,” Jacobs said. “Balance your head over your shoulders and knees, take the helm and steer. Your brain will automatically recalibrate to the movement.” Even if you can’t take the wheel, remembering to look at the channel ahead can make all the difference. Jacobs’s rule is simple: “If your eyes are seeing what your ears are feeling, you’re likely to have a great day at sea.”

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