Features July 2017 Issue

Strategy to Fight Seasickness

 

Getting over seasickness as quickly as possible must be the focus and responsibility of all on board. Having dealt with 400 seasick sailors (out of 1,200 sail-training students) on ocean passages over the past 42 years, I have become very experienced at prevention and treatment. The following steps to avoid or lessen the severity of seasickness has served well over those years.

Stugeron
One of the more effective remedies, Stugeron (cinnazine) isn’t sold in the U.S., but you can buy it online.

Prior to Sailing

Avoid coffee, black tea, colas and alcohol, fatty foods including tuna, tomatoes, salami, hard cheeses and sauerkraut at least 2–4 days before the passage.

Increase your water intake to two liters per day. Give each crewmember their own one-liter water bottle labeled with their name. Start appropriate seasickness medication at least 24 hours prior to departure: 2-3 grams of Vitamin C, Berocca, Stugeron tablets, Compazine suppositories or TransDerm Scopolamine patches.

Whether or not you feel any symptoms of seasickness, it is essential to maintain a steady fluid intake of one liter per 2- to 3-hour watch ensuring a total of 2 to 3 liters per day. As soon as seasick symptoms appear (mild headache, queasiness, sweating, drowsiness, depression) a more disciplined response is required.

Add Emergen-C, (available online) Berocca or a similar electrolyte replacement vitamin-mineral drink mix to your drink bottle. The electrolyte replacement helps your cells absorb fluid more quickly and completely. Gatorade and similar sports drinks lack Vitamin C, which counteracts histamine production that causes seasickness.

Eat small amounts of food on a regular basis: crackers, cookies, crystallized ginger, canned fruit or hard candies. Bananas provide potassium and are an excellent first choice if available.

Stand your watches no matter how you feel, as this will speed your recovery faster than lying in your bunk.

Effective Seasick Medication

Stugeron (cinnarizine) 15 mg tablets are only available by mail order from www.CanadaDrugsOnline.com in the U.S., but are readily available in many countries including the United Kingdom. Stugeron, an over-the-counter antihistamine has consistently proven to be one the most effective anti-seasick medication causing less drowsiness than other antihistamines. Avoid Stugeron Forte 75 mg tablets, which are unnecessarily strong.

Compazine (prochlorperazine) 5, 10 or 25 mg. suppositories (not oral) have, from my experience proven to be the most effective prescription anti-nausea and anti-anxiety medication that causes the least drowsiness. As anxiety can cause nausea and since Compazine treats both it is an important drug to carry aboard. Suppositories are far more effective than tablets once vomiting has started.

Transderm Scopolamine 1.5 mg. patches may work when no other drug does, but one MUST first test this drug out on land as documented side effects can be severe. Avoid using for more than three days. Scopalamine is also available in tablet form (Scopace 0.4 mg.) but this is much less effective once vomiting has started.

CAUTION! With any drug, prescription or over the counter, there are published side effects. For more on prescription and homeopathic remedies see “Cures for Seasickness,” January 2009, and “Drug-free Seasickness Solutions,” December 2009.

Feeling Queasy?

Take the helm and steer the boat, focusing on the horizon. If the boat is overpowered, reduce sail. If you are sailing close-hauled, ease sheets and fall off.

Minimize time working below if possible. When going below, take your foulies off in the cockpit rather than below decks. The faster you either get back on deck or lie down, the better you’ll feel. Avoid lying down in your foulies for an extended period of time to lessen the chance of hyperthermia.

Maintain medications and review whether additional or different medications are required. If you feel like vomiting do not lean over the lifelines to vomit; use a 2-liter plastic container with tight-fitting lid that you can use on deck and below.

Most people feel considerably better after vomiting, but it is essential to maintain a steady fluid-electrolyte intake. Take small sips, stay hydrated, and keep your blood sugar level up.

Prolonged vomiting causes dehydration surprisingly quickly, hypothermia (even in the tropics) anxiety, confusion, depression, and shock. Once in shock, an enema or intravenous is the next step to rehydration and your survival.

After departure, coastal wave refraction and associated choppiness are frequently followed by more regular ocean swells, so do not be initially discouraged by seasickness. In almost all cases sailors recover from seasickness within 1 to 4 days if they follow the above advice.

John and his wife Amanda Swan Neal, a former Whitbread racer and author of The Galley Companion, have more than half a million miles at sea combined. Through their company Mahina Expeditions they conduct sail-training expeditions aboard their Hallberg-Rassy 46, Mahina Tiare III in oceans around the world.

Comments (32)

Well I don't get seasick much, but I wouldn't recommend eliminating caffeine completely, if one is used to drinking tea or coffee. Surefire way to bring on a withdrawal headache leading to queasiness and an overall long dreary day. Also I recommend ginger chews or raw ginger, and/or hard candy or chewing gum. Another thing, face forward into the motion, we are acclimated since childhood riding in cars facing motion. Also, contrary to above, IMO if you can lie down forward and close your eyes, it breaks the confusion between seeing and feeling, which is triggering the seasickness. Now get back out there!-Scow

Posted by: ScowHound | May 8, 2019 11:57 AM    Report this comment

Rather than a plastic bucket to vomit into, I issue paper paint pails which can be thrown overboard in the ocean. They will dissolve quickly enough.

Posted by: Tango | May 5, 2019 12:34 PM    Report this comment

Sailing from NY harbor to Annapolis MD several years ago on a 47' ketch, I became sick after rounding Cape May. Miserable over night, I decided if I was going to throw up, I would throw up something good. I downed a pint of vanilla ice cream and a 1/2 lb. of M&Ms. Cured!

Posted by: Stuart | May 1, 2019 7:34 PM    Report this comment

I have been sailing offshore for about 35 years and have never once succumbed to the dreaded mal-du-mer. I'm told everyone will experience it sooner or later and it takes about 72 hours to recover. Meanwhile, I'll anticipate my time. I have read that it's cause is an incongruity between your inner ear and your vision. Distractions (wristbands, manning the helm, etc.) are reported to be effective. Another distraction used by Irish fishermen, so I've read, is to put a wad of well chewed tobacco sufficiently far into your dominant ear to inhibit hearing. I personally would prefer to use a Home Depot bought foamie which I keep a supply aboard my SV Jalapeno. Since I can't vouch for it's effectiveness, yet, please give this a try and let me know the results. It certainly seems to be preferable to drugs and a bunch of other wives tales.

Posted by: Jalapeno's Skipper | April 30, 2019 11:18 PM    Report this comment

I have been sailing offshore for about 35 years and have never once succumbed to the dreaded mal-du-mer. I'm told everyone will experience it sooner or later and it takes about 72 hours to recover. Meanwhile, I'll anticipate my time. I have read that it's cause is an incongruity between your inner ear and your vision. Distractions (wristbands, manning the helm, etc.) are reported to be effective. Another distraction used by Irish fishermen, so I've read, is to put a wad of well chewed tobacco sufficiently far into your dominant ear to inhibit hearing. I personally would prefer to use a Home Depot bought foamie which I keep a supply aboard my SV Jalapeno. Since I can't vouch for it's effectiveness, yet, please give this a try and let me know the results. It certainly seems to be preferable to drugs and a bunch of other wives tales.

Posted by: Jalapeno's Skipper | April 30, 2019 11:15 PM    Report this comment

As a physician I want to point out the problems with the higher dose of Compazine, which is probably no longer available under this brand name. It is identical to the generic name, prochlorperazine, and was mentioned in 5, 10 & 25 mg. It is very effective to treat nausea and vomiting and is available in both oral and rectal suppository form. I keep several of the 10 mg. rectal suppository form in my on-board first aid kit to treat severe nausea and vomiting but not for prevention, because it commonly has side effects of drowsiness, blurred vision and urinary retention. And, by all means, stay away from the 25mg. dose which often times will cause rigidity and spasm of the muscles, including involuntary muscle contractions of the facial muscles.
As for prevention, I agree pretty much with what physician TimC has already noted, and want to emphasize avoidance of the scopolamine unless a person has previous experience with it, keep the stomach filled frequently with water, consume minimal amounts of food at any one sitting, try sucking on a ginger candy, keep your eyes on the horizon, stay busy on top side to conquer fear, and it really helps to imagine you are sixteen years old again with your favorite friend on a fun-filled roller coaster ride!

Posted by: Tayana 37 | April 30, 2019 3:15 PM    Report this comment

I have found that Rolaids is almost instant relief. If you feel like you are about to barf, chew a Rolaids, and by the time you make it to the leeward rail, you will feel OK.

Posted by: David Smyth | July 24, 2018 8:44 PM    Report this comment

I have found that Rolaids is almost instant relief. If you feel like you are about to barf, chew a Rolaids, and by the time you make it to the leeward rail, you will feel OK.

Posted by: David Smyth | July 24, 2018 8:43 PM    Report this comment

Just finished ordering a new supply of Stugeron from www.CanadaDrugsOnline.com moments ago. No problems. Have ordered from them in the past. Fast and great pricing. I have used Stugeron for years based upon John and Amanda's recommendation and have found it very effective. My crews have used it as well and I would say it is 80 - 85% successful. When it gets really nasty I add the electric Relief Band and it seems to really help when the going gets really rough. I also follow a pre-sail dietary regimen, refined over 50 years of sailing offshore, very similar to John's suggestions and have come to believe that a proper diet is a help to delay seasickness in very rough conditions but is not a complete preventative. Certainly what works for me is not perfect for everyone but may help you develop your own strategy.

Posted by: TXMarineRepair | July 23, 2018 11:11 PM    Report this comment

I am a physician and have sailed extensively in San Francisco Bay and off the California Coast and internationally. Ginger does work as well as any medication as investigated by the British Navy and published in the New England Journal of Medicine. All antihistamines will work whether or not they are labelled for motion sickness except the non sedating antihistamines such as certrizine, loratadine, etc. The non sedating antihistamines are not as complete at blocking receptors and the lack of sedation lessens their effectiveness. So you can choose meclizine (Bonine), chlorpheneramine (Chlortrimeton), diphenhydramine (Benedryl) or another of your choice. I have used chlorpheniramine because it is available as 4, 8, and 12 mg and the 12 mg dose works for 8-12 hours. There is no reason to start these more than 1-2 hours before boarding as they are all rapidly absorbed and acting in the central nervous system within that time. They can worsen urinary obstruction in men and so you may want to experiment with this before you get onboard ship. Scopolamine patches also work but there are many reports of confusion and disorientation with this medication, more commonly as one gets older. You should notify someone on board if you are using the patch so that they can remove it if you start acting stranger than usual. These can also cause urinary obstruction so you may want to try one before leaving your trip. These need to be applied about 4 hours before boarding. The wrist bands seem to also work for some people but their effectiveness is less predictable. If you dislike all the ingested and medication choices try it. Hydration with electrolytes is important but I do not believe that you need additional vitamin C. I do believe that avoiding a full stomach and foods that are hard to digest is very important. In general foods higher in fat are harder to tolerate but there is tremendous individual variation in this. Choose wisely and start out with as empty a stomach as you can tolerate. And above all try to stay out on deck and stare off at the horizon if possible. Finally I do believe that there is a psychological component to motion sickness. The fear induced by the vessels rocking motion and "big seas" makes this worse. I don't really know how to predict this but I personally just accept this as the natural movement of our planet earth and avoid thinking that I am about to die. To date I have never been seasick even in a couple of full storms off of the California coast but I expect my time will come. I carry Phenergan suppositories (you need a prescription in the U.S.) and frequently have injectable Phenergan for those that are vomiting excessively and cannot take any medication by mouth and are facing severe dehydration. Mr Neal's advice is well taken.

Posted by: TimC | July 23, 2018 1:39 PM    Report this comment

I would like to endorse S/V Harmonie. There is some really silly stuff in this article. Take this: "Avoid coffee, black tea, colas and alcohol, fatty foods including tuna, tomatoes, salami, hard cheeses and sauerkraut at least 2-4 days before the passage." Hate to break it to you but tomatoes and sauerkraut are essentially fat free foods. Either this is a very poorly written sentence or the person just doesn't know what they are talking about. Even the tuna suggestion is dubious - canned tuna packed in water has only about 1 gm of fat. Tuna in oil can have a goodly amount of fat (which shouldn't surprise anyone). But fresh tuna is also quite low in fat. This list looks suspiciously similar to a list of foods high in tyramine, but I know of no relationship of tyramine to seasickness.
In general, one has to get health advice from people who have genuine knowledge. Otherwise, it is just the passing around of gossip, folklore, and urban legends. I recommend you find a reliable health source like the Mayo Clinic Online - a good site written by people who actually know what they are talking about.

Posted by: lesliegb | July 22, 2018 8:19 PM    Report this comment

I'll second the ginger recommendation. I've used Sailor's secret ginger capsules and ginger gum, both worked very well and don't have the side effects of meclizine or the other 'medical' remedies.

Posted by: JLuValle | July 22, 2018 6:17 PM    Report this comment

John Neal summary covers it all for the average or outliers needs. So much is personal anecdotal evidence- worthwhile but not always generalizable to most people in variable
conditions. My own anecdotes - advance dosing well before departure, no fatty foods am of departure, scopolamine patch has worked great for 10 sailors over 60 years old without significant side effects and usually only need one 3 day patch. Test it out before your trip is best. Getting marezine or Stugeron is near impossible but I recently sent for Stugeron from Canada Drugs Direct.
Frequent hydration is necessary. OTC drugs like Dramamine or meclizine work less effectively and cause excessive drowsiness making staying on deck keeping busy less likely. Don't go below much or for long periods. For most once through the first 24 hrs you are in the clear unless really stormy.

Posted by: Youmans | July 22, 2018 10:14 AM    Report this comment

My $.02. Lots of sailing experience.
I had such a bad time with Scalpolomine, I won't try that again. My way of dealing with mal de mer, has worked well for other novices who have followed my advice. If getting under way early, no red wine, and no more than one beer or highball the evening before. Eat a normal type of breakfast, not heavy or greasy; Oatmeal is ideal, but lots of other similar morning foods are OK. No morning coffee.
No meds unless its your first time at sea for the last month or so, then 1/2 an OTC antihistamine dose. I usually get nauseous if the seas are over about 4', or confused, after about 3 hours out. I continue to do whatever, I am supposed to do, even if I "heave". Drink lots of water sips, even if it comes right back up. I take a small swallow every minute or so.
My center cockpit boat allows me to puke over the cockpit side, and if it is rough enough for me to feel sick, the deck wash will keep things clean. First safe, convenient chance, I take a nap of an hour or two, and when I come back up, sea legs have grown, and I am able to eat, sleep etc in my normal fashion. It has worked for many other guests both experienced, and inexperienced. It is important that they focus on doing their job in spite of sickness; I think it gives a feeling of "I can do this" and bests the psychological component. You don't feel at "mercy".

I am a heavy drinker, but I don't drink alcohol under weigh until I see the lines attached to the dock. Water and G-2 become the beverages of choice while in motion, but after my nap, I can resume normal coffee consumption.

Posted by: Capt Chetco | July 15, 2018 1:33 AM    Report this comment

My $.02. Lots of sailing experience.
I had such a bad time with Scalpolomine, I won't try that again. My way of dealing with mal de mer, has worked well for other novices who have followed my advice. If getting under way early, no red wine, and no more than one beer or highball the evening before. Eat a normal type of breakfast, not heavy or greasy; Oatmeal is ideal, but lots of other similar morning foods are OK. No morning coffee.
No meds unless its your first time at sea for the last month or so, then 1/2 an OTC antihistamine dose. I usually get nauseous if the seas are over about 4', or confused, after about 3 hours out. I continue to do whatever, I am supposed to do, even if I "heave". Drink lots of water sips, even if it comes right back up. I take a small swallow every minute or so.
My center cockpit boat allows me to puke over the cockpit side, and if it is rough enough for me to feel sick, the deck wash will keep things clean. First safe, convenient chance, I take a nap of an hour or two, and when I come back up, sea legs have grown, and I am able to eat, sleep etc in my normal fashion. It has worked for many other guests both experienced, and inexperienced. It is important that they focus on doing their job in spite of sickness; I think it gives a feeling of "I can do this" and bests the psychological component. You don't feel at "mercy".

I am a heavy drinker, but I don't drink alcohol under weigh until I see the lines attached to the dock. Water and G-2 become the beverages of choice while in motion, but after my nap, I can resume normal coffee consumption.

Posted by: Capt Chetco | July 15, 2018 1:32 AM    Report this comment

CanadaDrugsOnline closed their website on July 13, 2018 following a plea agreement with the US DOJ. If you are interested in the story PharmacyCheckerBlog.com has it.
There are numerous other Canadian pharmacies still doing business with US customers, at least for now. CanadaDrugsDirect is one and they have the product listed as 'Sturgeon'.

Posted by: Pelican5077 | July 14, 2018 11:37 PM    Report this comment

CanadaDrugsOnline.com always comes back as a failed connection when I try. Also searched for Stugeron and Marezine online with no usable results. Anybody know a non-sketchy website someone in the US can use to purchase Stugeron or Marezine?

Posted by: 365Lusso | July 14, 2018 10:03 PM    Report this comment

Be cautious using scopalamine patches, especially if you are over 60. My husband had tested them twice for short periods of time (12 hrs) prior to our passage to the Bahamas with no side effects other than dry mouth. During our 4-1/2 day passage to the Bahamas he hallucinated badly beginning about 12 hours after starting the patch. This included seeing and talking to several imaginary people (including a rock band), seeing things that weren't there, turning us around twice and then denying it, and stating that he was going up to the clubhouse to get a shower when we were 150 miles offshore. It was a very stressful sleepless passage for me, but thankfully we arrived safely. Nowhere in the literature does it state this is a possible side effect of the patch but when I later had surgery and was discussing alternatives to help my nausea from the anesthetic, we relayed my husband's experience and the anesthesiologist stated that everyone knows "not to give patches to men over 60". My husband will never use a patch again.

Posted by: S/V Regina Maris | July 14, 2018 9:06 PM    Report this comment

a couple of things I have found helpful managing mal de mer, Generally, most effective if you use them at first hint of symptoms and until you get sea legs, your experience will vary.
- avoid going below
- get comfortable and keep your eyes closed, on deck or below
- when hit be wave of nausea, relax, close eyes, breath steadily
- try not to give in to urge to vomit, not always pleasant or easy, but can work, still have a bucket handy
- take something in advance if you expect initial rough conditions
- Stugeron can help even after onset
closing your eyes tends to mitigate symptom onset caused when your ears sense more or different motion than what your eyes sense.
a shipmate says, anyone who has never been seasick has never been to sea.
fair winds, ~A

Posted by: asailor | July 14, 2018 1:10 PM    Report this comment

That should be check out wikipedia article on "cyclizine".

Posted by: ValR | July 14, 2018 12:27 PM    Report this comment

I have found Marezine (cyclizine) to be very effective, with minimal side affects and producing much less drowsiness than many other medications. This is why it was selected by NASA. Please check out the article on cyclizing on wikipedia.

However, although OTC, it is almost impossible to find in the US. Does anyone know of a good source for Marezine? Thanks.

Posted by: ValR | July 14, 2018 12:23 PM    Report this comment

That's called 'Land sick'.
I get it even after a weekend on a choppy lake.
once after a day on choppy water, we went out for dinner,
I kept missing my mouth with the fork :)
I have seen people fall down or stagger like they were drunk when getting off the boat to a solid dock.

Posted by: sailing Jack | July 14, 2018 11:44 AM    Report this comment

As once a commercially head boat captain I second the relief band suggestion. Used it with similar (80%) results even after rail hugging had begun. Afterall it was invented to assist chemo patients.

Posted by: pbbrican | July 14, 2018 10:44 AM    Report this comment

The article says, "In almost all cases sailors recover from seasickness within 1 to 4 days if they follow the above advice."

What it should say is: "In almost all cases sailors recover from seasickness within 1 to 4 days no matter if they follow the above advice or not."

This is a subject full of advice that is useless, or even potentially dangerous. Every suggestion works for somebody (there is a mental component to it, even though it is not "all in your head"), but nothing works for everybody. It might be a good idea to talk to a real doctor about dosages and treatment plan if you suffer a severely or regularly from seasickness. Some of the drugs recommended here are serious and not to be taken without real knowledge.

Posted by: S/V Harmonie | July 5, 2017 6:39 PM    Report this comment

I am a physician who rarely gets queezy while at sea. I often have guests aboard on passages who do. There is a Relief Band which is battery powered and delivers a slight shock to the wrist which I have had aboard for several years which has been nothing short of miraculous for 8 out of 10 guests who've developed mal de mer while sailing with me. I learned about them when they were written up in a medical journal as the only thing that would stop motion sickness after it started, and that they are effective for treating post operative nausea and the severe nausea that sometimes accompanies early pregnancy. I purchased mine on line at West Marine for about $100 8 years ago. The button batteries can be purchased at your local drug store and last about 3 days. I recommend that people who are susceptible also get scopolamine patches (put on 6-8 hours prior to setting sail), and use the Relief Band before shoving off. In my experience, the other remedies mentioned have little effect once it starts, and it takes a few days of misery to recouperate.

Posted by: S/V Kristy | June 26, 2017 11:16 AM    Report this comment

Many, including moi, find ginger an effective remedy. Either ginger capsules, ginger ale, or ginger snaps.

Posted by: KMan | June 25, 2017 6:00 PM    Report this comment

I get what we call "mucky stomach" in the beginning of a bumpy passage - loss of appetite, very slight nausea when below decks. I have found that Sea Bands - the knit elastic wrist bracelets with that put pressure on an acupuncture point on the inside of your wrist - work for me as long as I put them on before it gets rough. I get over the mucky stomach within a day so these have been very helpful to get me through that first difficult bit. Make sure to take them off when you lie down off watch. I woke up with swollen hands once when I forgot to take them off. I wouldn't count on the Sea Bands for really rough weather. Certainly have the good drugs with you at all times.

Posted by: Gene %26 Molly | June 25, 2017 12:04 PM    Report this comment

One thing I found with my offshore program, John, was that getting the mess into your system for a few days (3 is what I recommend) before departure is the single best thing one can do to avoid getting seasick. It doesn't seem to matter what medication, as long as you follow that advice. I had 54 newbies leave Newport one November and not one got sick.

Posted by: ABurton | June 25, 2017 9:18 AM    Report this comment

That should reads "meds"

Posted by: ABurton | June 25, 2017 9:18 AM    Report this comment

That should reads "meds"

Posted by: ABurton | June 25, 2017 9:18 AM    Report this comment

One thing not mentioned was if you have prostate problems antihistamine can make it worse so consult your physician if you do.

Posted by: Frankco | June 21, 2017 7:31 PM    Report this comment

I have bad allergies and already take Claritin every day.. Will Claritin work or should I switch to Sturgeon 15 and if so how many days in advance? What do you recommend for feeling like you are still on the boat once you reach land. I don't know if there is a name for this but it sometimes lasts four or five days?

Posted by: Frankco | June 21, 2017 7:26 PM    Report this comment

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