Thursday, September 25, 2008

TechTip - Mal de Mer

Readers asked me to provide more detail about our Counter Sea Sickness Offensive, also known as Operation Ocean Ack. First off... I am not a doctor. I do not play a doctor on T.V. I do not even own a T.V. Do not take anything I say as medical advice. More importantly, do not even think about suing me if you decide to try any of these medications. This is just what is working on s/v Don Quixote.

Short Answer - We use a combination of first level homeopathic remedies and pretty powerful anti-nausea drugs to beat back mal de mer.

Long Story - Sea sickness hits everyone eventually. As with so many salty issues of nautical accomplishment, there are those who have done it, those to whom it will happen soon, and those who lie. This truism holds for everything from running aground to spending 24 hours vomiting in the head. Some day, you will meet a sea condition that will take you down. It doesn’t have to be big sea, choppy sea, or windy sea. It just has to be the sea with your name on it.

Let's start with the most important bit about sea sickness. Once you get sick, it is damn near impossible to stop throwing up. So with every fiber of your being, you need to prevent yourself from getting sick in the first place. And of course, it really appears that all the best 'remedies' for sea sickness start with the recommendation, "Take the day before you go to sea." Gee thanks. So in addition to everything else you must contend with prior to departure, you need to make sure you drug the entire crew.

Because there is an escalating scale to how much you need to intervene to address sea sickness, it is challenging to figure out where you should start your intervention. We like to begin with a highly advanced, pharmaceutical approach and then gently taper back until the boat is running on ginger snaps and Top Ramen. With experience, you’ll know at what point on the escalation path you need select with each crew member.

Open Air Cures - The simplest cure for queasiness is visibility and fresh air. Stop what you’re doing, look up, look around, go out into the cockpit. Take the helm. Put on some really bouncy music that makes you want to dance. Dance on the deck while you stare around. Alternatively, just go to sleep.

Food - Some foods that settled the tummy are ginger snaps, ginger ale, saltines, and graham crackers. My girls also do well pretzels. Think bland, dry, and gentle. Top Ramen and macaroni and cheese are good for hot foods. Stick to non-caffeinated, low sugar, and low acid beverages.

Berkeley Ideas - There are many, many natural and homeopathic methods to stave off sea sickness. I have had a great deal of success with acupressure bands. There are those that swear by the press-on acupressure dots. Papaya enzyme is good as an antacid. You might also try other homeopathic or natureopathic supplements. I haven’t tried any other than papaya so I can’t speak to their efficacy.

Meclizine HCl - DrGeorge recommends an over the counter anti-emetic called meclizine. Look it up. It's good stuff. It doesn't make you drowsy, which is key. You can take 25 mg twice a day starting the day before, and it does a really good job of keeping the beast at bay. DrC and I took it throughout our passage, and neither of us experienced a moment of sea induced queasiness. I did have that one hour of wanting to toss my cookies in sheer unadulterated terror, but I don't think that counts.

More Meds - Crew that have never been sick are recalcitrant and will not take their meclizine in advance. You'd think the stuff was nasty like that grape antibiotic we feed our kids. It's just a small blue pill, for gods sake. But crew will balk and then proceed to get violently ill. At which point you have to go all macho captain on them and law down the medical law. People who do not get better within about 24 hours can actually start doing themselves some pretty serious harm.

Even at this juncture, you have several options. You can try dramamine crushed under the tongue, the meclizine they should have been taking all along, or a club to the head. But if the boat is really rocking and you've got a true sicky aboard, these measures might be too little too late. The problem is that nothing is staying down your boat's victim. Now you need to start getting really personal.

Suppositories - When there is no other way to get meds into a crew member, we intervene with a suppository dose of prochlorperazine 25 mg. It's available by prescription only so you'd need to get this from a doctor in advance. You can probably get some by taking an emergency medicine course and getting the prescription from the instructor. It's very good to have aboard and should only be taken when you simply can't get the crew member to stop vomiting and start sucking down fluids.

Let Me Think
Let Me Think
Originally uploaded by toastfloats.
Points Beyond
- After that, the problem goes beyond my ability to even speculate what you should do. Dehydration can kill so this isn't just an unpleasant problem. Land is your best bet, but if not land you can look at evacuation off the boat, enemas, and other more serious interventions. Fortunately, we have not as yet made it to this step and are unlikely to do so in the near future. Coastal cruising at least ensures that you can generally drop a really sick crew member on to a rock within 48 hours of any location.

Now someone please give me a cure for land sickness.


Al Thomason said...

I always remember the phrase when it comes to Sea Sickness: At first you are afraid you are going to die, then later you fear you might not. . . .

Anonymous said...

This is great information Toast! The methods that you use on Don Quixote helped a lot on our recent trip down the coast even though it was much calmer I think for us.
Thanks for this information as to what worked for you.