Seasickness remedy

[Old Jim]

While reading Dem's post about fishing outside the bar and his mention of taking motion sickness pills the night before it occurred to me that in the gazillion posts I have read on this site I have never seen the issue of seasickness addressed.

Back in the early eighties, the USCG did some research on seasickness; it's causes, ways to minimize it and medication to either prevent its onset or stop it once you're afflicted.

As a result of that study, they came to recommend what some now call "The Coast Guard Cocktail" as a way to treat seasickness after it has begun.

The "cocktail" is a combination of 25mg of Phenergan (also called Promethazine) and 25mg of Ephedrine, both in tablet form and taken together.

I swear by this stuff. We had people, including my wife, get violently ill while sailing on Mary Flower and every time the stricken person took these meds, the seasickness disappeared within minutes! And I mean DISAPPEARED, not just reduced. In over ten years of carrying these medications on board the treatment never failed to work. And unlike most motion sickness meds such as Dramamine and the like, this doesn't have to be taken in advance. It can be taken after the person is already ill. And unlike Dramamine, it tends not to make the person drowsy.

If you'd like to learn more about this subject in depth, just Google the phrase "phenergan ephedrine seasickness". You'll find a ton of information as to how and why it works.

I suppose this isn't technically a C Dory subject but if it helps someone on a C Dory tolerate a rough weather outing, I guess it's ok to post it.

Jim

Here's a photo of my wife happily reading while crossing Lake Michigan in 4 - 6' waves with a 25 knot wind forward of the beam. Before we started using the "Coast Guard Cocktail", she would have been lying in her bunk experimenting with new colors of green on her face in these kinds of conditions.

[B~C]

Reading! now that would have to be the true test for sea sickness medication. I take some folks out that get sick and take meds and then spend the rest of the morning in the V-berth passed out. The USCG cocktail sure sounds like just the stuff to have on the boat for those prone to chumming......except for my brother in law, who I will continue to tell we have no sea sickness drugs on board.

[Dora~Jean]

Good information Jim, never heard of it before, could cure my wife's problems! Are they over the counter or by prescription only?

[thataway]

I probably have not commented on motion sickness on this site. Many of my patients were boaters, plus I also had to deal with racing crews, and medcial kits for cruising boats (including our own). I get sea sick on occasion (never on a C Dory or Tom Cat --yet) I tend to rely on simple remedy's first--and Phenergan/Ephedrine prescription combination is way down on my list--actually below Scopolamine patches. I have tried it in recalcifant patients and found it not to be much better than other remedies. It is an offshoot of a potentially more dangerous group of drugs which were used in some of the early NASA motionsickness studies. (Compazine and Pheneragan are still part of the anti motionsickness program for NASA, but in suspository or injectable form--and with specific instructions what to do if the serious side effects occur)
Please understand that I have looked carefully at this combination from a medical standpoint and reached the conclusion that it is not a first line combination of choice for the average person.

Phenergan (Promethazine) is an antihistimine--but does have some specific side effects which can be dangerous--beside causing drowsyness (which is a reason that ephedrine is added to the "cocktail) it can cause extrapyramidal movements like parkenson's disease. It can definately impair thinking and reaction time. It can be dangerous in causing respiratory arrest in young children.

Ephedrine has quite a bad rap--having been used with some weight loss regimes. It is a central nervous system stimulant, and in susceptable people can cause an increase of strokes and heart attacks. Both of these products can be purchased in pharmacies in other medications but not as a combination for motionsickness. Note that Ephedrine was withdrawn from a number of common remedies in the last 5 years. Be certain that you discuss your medical needs with a physician who is knowlegable in the treatment of motionsickness.

Simple solutions:

First: eat lightly before sailing and while sailing. Avoid alcohol before and while boating if you tend to become seasick. Get adequate rest before leaving. Ginger is a natural product which has good reviews in prevention--both as a powder and in foods. Wrist bands--either passive pressure points or electrostimulation seem to work for many people.

For medication I like the across the counter Bonine chewable. The beauty of this is that it will work in the person who is alway sick. You disolve the pill under the tougue and it will be absorbed into system in half an hour or less. It does not have to be swallowed with water--and thus will not start the vomiting reflex. (Meclizine is the name of the drug--also called by Dramamine II). It is less likely to cause drowsyness than Dramamine. Any drug can have side effects--and Bonine should be taken with caution (consult your physician) if you have asthma, prostatic enlargement or glaucoma.

Other simple techniques help with motion sickness--stay in fresh air, keep in a place where you can fixate on the horizon. Stay busy--including steering the boat. Some will feel better lying down. The type of boat will definately affect different people different ways. I don't do well in a rapid quick motion boat, but do fine in a slow motion boat. I almost always got sick in rough weather in one very fast racing boat we sailed--and never did in the slow roll cruising boat we took to Europe.

Transdermal scopolamine patches are the ultimate motion sickness cure. But again there are potentially serious side effect. There are the eye side effects with dialation of the pupil, blurring of the vision, drowsyness, difficulty urinating, dry mouth, disorientation and the worse is psychosis. On several occasions I have had radio calls when at sea from a boat where a crew member has become psychotic from the patch.
Something you don't want on a small boat is a crazy person!

There are a number of other drugs you will hear about-used for nausea prevention in cancer chemotherapy etc--there is no good study that these expensive drugs are any better for motionsickness than the tried and true drugs. Also you will hear about "Sturgeron" a brand of Cinnarizine. Fortunately this was never approved by the FDA in the US--and this year was banned in the UK because of its calcium blocking effects. Do not use this drug--especially in high doses you may see in some web sites.

I am not practicing medicine and none of this advice should be construed as the practice of medicine, but general advice which is readily available from many sources. I will be happy to answer specific question about motion sickness.

[CAVU]

I would have to go along with Mark Twain; the only surefire cure for sea sickness is to sit under a tree. :D

[Old Jim]

Bob,

Thanks for your thoughtful comments from your medical perspective.

Back then (20 years ago) not as much was known about the side effects of these drugs. Although we, or anyone else we knew who took them, never experienced any problems, it's good to have more current information and to know that there are newer motion sickness remedies that have eliminated many of the problems associated with the older stuff.

I would certainly look at these drugs differently in light of the new information but I don't think I would hesitate to take or offer them in a case where severe seasickness caused someone to be so incapacitated that it endangered the crew or the boat and nothing else was effective.

One thing is for certain; I would never again allow someone on board who was using a Scopolamine patch. I had a crew member standing a lone watch in the wee hours of a dark night who scared the living crap out of the two of us who were off watch and sound asleep below. All of a sudden, he began screaming "Get off! Get off!" When I bolted up the companionway I found him pressed back against the lifeline looking like he was about to jump overboard. He was pointing aft and yelling "She's trying to get us!"

When I shined a light at where he was pointing, I saw only the MOB horseshoe buoy hanging from the stern rail. From the general shape of it, he had hallucinated the buoy into an old woman with long, stringy hair who was trying to climb over the stern. It took about 20 minutes to get him calmed down. Pretty scary couple of minutes.

Jim

[bcarli]

My wife and I have spent a lot of time sailing off-shore and found very good results with using Sturgeron, we would cut the pill in half and never felt any side effects. I was surprised to read the above post about the dangers of Sturgeron, I will have to research this problem more. But it sure worked for fighting sea-sickness

[flapbreaker]

I take one meclazine at bed time and one about an hour before leaving port if I'm going in the ocean. This has worked great for me.

One interesting thing is that I used to fear getting sick but after several times of going out and not getting sick I'm not focused on it and don't feel the least bit concerned about it.


Mythbusters did a test of common motion sickness remedies and to their surprise the only thing that worked for both the testers was Ginger.

[C-Hawk]

[thataway]

Stugeron (Cinnarizine ) has never been a legal drug in the United States. It has never had FDA approval. It is a class of antihistimines, but has many properties like Scopolamine (including the blurred vision, dryness of the mouth, difficlty urinating). It has been recently varified that in moderate doses (like some recommended by non medical professionals in various cruising blogs and publications)--it acts as a calcium channel blocking agent. The mechanism of the calcium channel blocking--is that calcium is necessary for smooth muscle contraction--with it blocked, the perpheral vessels dialate, and decrease perhperal resistance--dropping the blood pressure and pooling blood. Calcium channel blocking agents have their use--but as an unwanted side effect of a drug this is not desirable and can be risky for certain individuals.

Stugeron has also been reported to cause extrapyramidal effects as I mentioned for Phenergan: (Abnormal movements of the hands, legs, face, neck and tongue, eg tremor, twitching, rigidity). As many of these drugs the warnings include: "Patients should not operate hazardous machinery or drive motor vehicles or perform potentially hazardous tasks where loss of concentration may lead to accidents".

I have been aware of Stugeron for about 25 years and know that a fair number of cruisers take it. I have never recommended that patients take Sturgeron. In S. Calif. most folks got their supply from Mexico--at times one is not entirely sure that drugs there have the quality control that US drugs have. I have found that most sailors do well with with either modalities or drugs with minimal side effects and have not wanted to expose patients to potential risks. Now that it is confirmed that there are risks enough to take it off the market in UK, this only affirms my feelings about not using the drug.

I understand that people who have taken a drug in the past will say "I have taken it for years with no problems"--but as we age, we develope conditions which increase the risk from some drugs.

[Gene Morris]

The most effective remedy that my wife has used is a compounded Scopolamine. My understanding is that the patches had problems with regulating delivery of the drug. The compound is contained in a applicator. One CC on each wrist rubbed in seems to do the trick.

Gene Morris

[Captains Cat]

Won't make anyone feel any better but am reminded of one of my trips across the North Atlantic on a destroyer on the tail end of a hurricane when, out on deck, I came across a young seaman hanging on the lifelines over the side. He had long since lost breakfast and anything else he had had for the last day or so. I said, trying to be sympathetic, "What's wrong son, weak stomach?"

He looked at me somewhat greenish and said, "Hell no Sir, I'm throwing it as far as anyone!".

Glad it's never happened to me!

Charlie