Skipper's Seasickness Prevention and Treatment Guide
No other illness seems to cause so much misery as fast as seasickness. Even in the high tech world of today, it remains one of the most mysterious maladies on earth...
Medical experts estimate that 33% of all US citizens are prone to seasickness, even in mild conditions. 66% experience symptoms in rougher weather. And a whopping 50% of our astronauts get space-sick from the combined effects of atmospheric pressure changes, weightlessness, and gravitational pull. Unlike the "pop-a-pill-and-you're-good-to-go" crowd, John Neal has done lots of trial and error research over the past 250,000 miles of offshore sailing. He and his wife Amanda--both multi-time circumnavigators--run the offshore cruise training program "Mahina Expeditions" (http://www.mahina.com/).
The Neals take sailors of various experience levels on extended offshore cruises for weeks at a time. Each crew member receives his step-by-step program several weeks in advance of the cruise. Those that follow his program have been almost 100% symptom free! John has found that the closer the crew member follows his methods the better their chances of being symptom free. Pass this information on to your crew at least two weeks prior to a coastal or offshore cruise. This will give them plenty of time to finish the preparation steps before they come aboard.
Before you read further, look over this quick guide. It will help you recognize the symptoms of seasickness in another person.
| Seasickness Stage and Symptom Guide |
| Stage I |
Stage II |
Stage III |
anxiety |
vomiting |
severe dehydration |
headache |
low blood pressure |
depression |
cold sweats |
low blood sugar |
shock |
yawning |
drooling |
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dizziness |
shortness of breath |
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fatigue |
vertigo |
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nausea |
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Causes that Lead to Seasickness
Histamine is a chemical that our body releases to correct for shortages of elements, such as water, salt or potassium. Vomiting causes your body to lose a lot of these three substances.
Histamine rushes to the brain to try to correct the imbalance, but in fact, this adds to the problem. To control seasickness, you need to lower your body's histamine levels. Many of John Neal's methods target this key point through a combination of natural and traditional seasick remedies.
Other factors that add to sickness include fear, motion changes, navigation duties (chart work), reading, pitching, rolling, choppy seas, fatigue, cooking or head odors, and eating.
Pre-Departure and Underway Recommendations
 It should be the focus of everyone on board to help their seasick crew members recover as quickly as possible 
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-- John Neal
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Most crew members experience moderate queasiness over the first 24 to 48 hours of a passage. Make it your goal to control seasickness from the first day of the passage.
Get all hands aboard involved to help sick crew members recover. You need all of your crew healthy so that they can stand watches, change sails, cook, and maintain the boat.
Get with each crew member several weeks before your cruise. Show them the five-phase program below. Not all methods work for everyone, but these steps will help your crew lower their risk of sustained seasickness in any marine weather.
Pre-Departure Recommendations
Two weeks prior:
- Drink 2 liters of water every day.
Several days prior:
- Avoid alcohol, coffee, colas, and fatty foods.
24 hours prior:
- Start seasickness medication.
- Catch up on sleep to remove histamine from the bloodstream.
2 hours prior:
- Drink one quart of water mixed with one packet of **Emergen-C.
Make these preparations to shorten time spent below:
- put together small bags of high energy snacks.
- develop quick-meal plans (one-pot meals).
- organize clothes in bundles.
- complete navigation preparations.
If flying overnight or into a different time zone:
- Arrive one day early and book into a hotel.
- Continue to hydrate with water.
- Rest and sleep. Do this to avoid fatigue--a primary trigger of seasickness.
**Recent research from Germany indicates that 1-3 grams of vitamin C disrupts histamine production. Emergen-C packets (common in health food stores) contain 1 gram of vitamin C, and multiple vitamins and minerals that replace electrolytes.
Underway Recommendations
1 hour after getting underway:
- Drink one quart of water mixed with one packet of Emergen-C.
Maintain hydration and blood sugar:
- Drink Emergen-C or other mineral replacement drinks.
- Snack on potassium rich fruits like bananas or apples.
- Eat crackers, ginger snap cookies, or hard candies.
If you feel queasy:
- Steer the boat. Focus on the horizon. Stay outside.
- Fall off to a reach if close hauled (if possible).
If you have to go below:
- Remove foul weather gear in the cockpit.
- Lie down to prevent histamine from reaching the brain.
- Use a large bowl with a tight lid to vomit.
- Allow yourself to vomit. This will make you feel better.
Natural, Non-Prescription, and Prescription Treatments
The incidence of sustained seasickness aboard Mahina Tiare, even in heavy weather has dropped to nearly zero
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-- John Neal
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Use natural treatments first. Then progress to non-prescription, and--if necessary--prescription drugs. Consult with your physician first before you use any of the treatments below.
John Neal emphasizes that "no one method or drug works for everyone". Often, you will need to combine methods to produce the best results.
Natural Treatments
Natural remedies:
- Relief Bands.
- Acupressure wrist bands.
- Fresh ginger or ginger candy.
- EFT (Emotional Freedom Technique).
Non-Prescription Treatments
**Antihistamines:
- Check with your physician.
- Can cause drowsiness.
- Start 24 hours prior to cruise.
**Stugeron (cinnarizine 15 mg tablets) has an excellent reputation among sailors as the most effective non-prescription drug. Available only in Europe, Mexico, and Canada. You can order on-line at www.CanadaDrugsOnline.com
Prescription Treatments
With John's permission, I have extracted his recommendations on prescription treatments from his underway prep package. This is sent to crew members several weeks prior to departure. Nothing below has been summarized or edited...
"Compazine (prochlorperazine) in 10 or 25 mg. suppositories is the most effective prescription drug from our 30 years of research. Phenergan, a similar drug, does not work nearly as well.
Suppositories are far superior to tablets once vomiting has started. This drug is used to treat anxiety as well as nausea, and since anxiety causes nausea in many instances, this is an important drug to have aboard. 10 mg suppositories, more widely available in Canada are our preference to 25 mg suppositories. Compazine occasionally has side effects; do your research.
Zofran ODT (ondansetron hydrochloride) 4 mg wafers appear to be very effective with minimal side effects. This is a relatively new drug (10 years) and a generic version is not yet available so it is VERY expensive. Unless your insurance covers it, you'll probably choose to wait until the generic equivalent reaches the market.
Scoplalamine available as Transderm Scop 1.5 mg patches has many side effects including hallucinations, psychosis, extreme drowsiness, blurred vision and anxiety; so many knowledgeable physicians will not prescribe it. For some seasick sailors Transderm Scop patches can be very effective when no other drug is working, but it is not a drug we are keen to recommend. You MUST first try this drug out on land.
"Navy Cocktail" consists of 50 mg. ephedrine and 25 mg. phenergan taken orally, used by the US Navy and NASA astronauts. We DO NOT recommend this drug combination."
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"To become an accomplished sailor, one of the disciplines you must master is seasickness response; if not for you, perhaps for your fellow crew members. You will need to stand your regular watches and join the crew at mealtime, even if seasick. This is very important for a speedy recovery."
- John Neal
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