Go­ing green around the gills isn’t black and white

Sea­sick­ness af­fects each per­son dif­fer­ently. Pick­ing the right ship size, dates and lo­ca­tion can help limit queasi­ness on the water.

The Washington Post Sunday - - THE CRUISE ISSUE - BY ME­LANIE D.G. KA­PLAN travel@wash­post.com

“Can you get sea­sick in a kayak?”

Years ago, Adventure Smith 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 whale­watch­ing 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 Adventure Smith 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 Adventure Smith’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 un­til you ac­cli­mate.

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.”

“Bal­ance your head over your shoul­ders and knees, take the helm and steer.” Michael Ja­cobs, a life­long sailor and med­i­cal consultant for the U.S. Sail­ing As­so­ci­a­tion, on what he con­sid­ers a sure­fire way to ease the ef­fects of sea­sick­ness if your stom­ach starts to turn

Ka­plan is a free­lance writer in the Dis­trict. Her web­site is melaniedgka­plan.com. Find her on Twit­ter: @melaniedgka­plan.

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