By BitMED Provider: William Jantsch MD

Well, it’s finally the day to begin the trip you have been planning for almost a year. You will be flying to Europe to begin a 2-week cruise on a luxury yacht sailing in the Mediterranean. However, you remember that the last time you were in a boat you got very sick from the water motion, and the last thing you want is a repeat of this. What can you do?

Motion sickness is a disorder caused by many factors, but is primarily due to a difference in the movement you feel, and the movement you see. When the brain receives conflicting signals, the result is clammy, cool skin, dizziness, nausea, and vomiting. 

People can get motion sickness on airplanes, automobiles, boats, or carnival rides. Some people can get waves of “sea-sickness” just by watching boats bob up and down at a dock. Some lucky people seem immune to this form of disorientation, but others are highly susceptible. 

If you know that you have the capacity to get motion sickness, there are several measures that you can employ to try to avoid experiencing symptoms that would otherwise spoil a nice vacation. 

Step 1- Planning
Start your journey well-rested and comfortable. Wear loose-fitting clothes, and do not eat or drink a large amount just before travel. Avoid caffeine, spicy foods, or alcohol just before the trip. If possible, try going for a short jaunt in the plane or boat you are going to spend time in, to get used to the surroundings. 

Step 2- Positioning
If in a car, try to sit in the front seat, and keep the back of your head rested against the seat with your eyes gently closed. You may find that you will not get motion sick if you are the driver of the car (but do not drive if you feel the least bit sick!). In an airplane or boat, try to be situated in the middle of the craft so that you do not feel the maximum motions. Again, by keeping you head rested against a solid surface and keeping your eyes closed, you will limit the amount of “confusion” that your brain feels during the journey.
Try to keep your head tilted back about 30 degrees, with your eyes focused on the horizon straight ahead. Lying flat may also be of benefit. Try to avoid enclosed spaces without a reference to the horizon, and avoid close work such as reading, knitting, or typing.

Step 3- Specific Treatments
There are many medical and non-medical treatments for motion sickness, that can be employed if you get sick in spite of optimal positioning. Non-medical treatments are generally based on the theory of counter stimulation of an acupuncture site in the wrist. You can find “Sea-sickness Bands” that put some mild pressure on a nerve in the wrist, and some people find these to be helpful. There are also bands that will stimulate the wrist area with electrical current or with pepper cream (capsaicin). Please be warned that medical researchers have tried to determine how effective these devices might be, and so far, such studies have not been able to show any measurable benefit from wrist bands of any sort in the treatment of motion sickness

There are many medications, however, that are very effective in treating motion sickness. There are both prescription and non-prescription medications for this indication, and these are in the same general class of medicines (anticholinergic antihistamines).

A commonly used medication is meclizine (e.g. Bonine), but diphenhydramine (Benadryl) may also be used. Perhaps a bit more potent is promethazine (Phenergan) or scopolamine (available in a patch worn behind the ear called Trans-derm Scop). The use of any of these medications is generally safe in otherwise healthy young people. These medications are all mildly sedating, and sometimes are used to help induce sleep. Do not drink alcohol while using motion sickness medications. These medications should be used in limited amounts if at all in people with chronic medical conditions such as heart disease, strokes, circulation problems, or people in advanced age. 

If you have any question as to whether a medication is safe for you, please ask your doctor, or consider a telehealth chat with a service such as BitMED. Most of the medications for motion sickness are available without a prescription in the United States. 
Here’s to hoping that your vacation trip is pleasant and healthy!