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The time for seasickness advice is before the head is in the bucket

2013 November 1

Never offer a feel-good suggestion to a green-faced crewmate. It's a sure way to make a bad situation worse. One vomiter somehow becomes many. It's one of the many mysteries of the malady.

Instead, let's tackle the sour subject of seasickness, and what to do about it, in the safe confines of this fine, stable magazine.

The literature on seasickness is disappointingly thin. Most medical experts will say that it's a response to the eyes seeing one thing and the body feeling another, or vice versa. When there is a conflict, the primitive brain thinks it is hallucinating and assumes that the body has been poisoned, so it sends the purge command. Some say that the only cure is to eliminate the conflict and that means staying home. That doesn't help folks who want to learn to sail.

I have sailing friends who seem to have found a fix. Here's what they're doing:

1. They trick the trick.

2. They carry an ounce of prevention.

3. They learn to breathe.

Seasickness seems to be closely related to the natural stress response, and might be manageable in much the same way. Dr. Walter Cannon of Harvard Medical School observed increased heart rate, respiration, blood pressure, and even cholesterol in situations of stress, and coined the phrase "fight or flight" early in the last century. It's the panicky pounding chest you feel after a near-miss fender-bender
or when your teenage daughter is late coming home.

Studies seem to show that both too little stress and too much are bad for our health. When we have too little, we don't learn how to cope with it and don't develop resilience and sufficient immunities. When we have too much, our body wears down too quickly. Stress, therefore, is good in moderation, but even then, we need to be able to understand it to manage it.

The first rule in stress management is to control your perception of the event. For example, whereas a homeowner may panic if fire breaks out in their house, a firefighter is trained to handle the fire calmly and professionally. The fire isn't less serious for the firefighter; he or she simply has the training and tools to cope with the event and the homeowner doesn't.

But how do you change the conflicting perception between what you see and what you feel when you're on a rocking boat? It starts with detachment: not trying to control the conflict and instead, tricking the body into not being tricked. The premise is that the conflicting movement isn't created by the boat, but by the body. Think of it this way: you see waves lift and turn, the boat lifts and turns in response. Your body sits or stands on the boat, and tries to settle the movement by compensating. Your legs, arms and back become shock absorbers to keep your head steady. But when you resist in this way, your body feels something that your eyes don't see and seasickness ensues.

Some people are prone; they can't seem to stop fighting the motion. They're often the ones clinging to a shroud with two white-knuckled fists. Others seem to be in sync with it, and rarely get sick. Often, they're the ones who grew up on boats, or they're blessed with instinctive balance. And they have another advantage: since they don't waste energy gripping and fighting it, they have more energy to remain healthy and calm.

The cured will tell you that they learned to trick the trick by moving with the boat, not against it. When they do, they can often prevent seasickness from starting. It's like agreeing to be led while dancing.

But it's not a perfect cure. Sometimes more stressful things happen, like breakdowns, storms or angry mark roundings. Being cold, hot, tired, hungry or thirsty makes us far more susceptible. An ounce of prevention includes dressing in layers and actively adding or shedding clothes to regulate temperature. It's a good idea to sail after a good night of sleep and rest on board in good weather. It's also vital to drink water and snack.

Even then, one ugly cold wave can get it going. So can it be fixed on the water? Some sailors regularly fight it off. How?

They've learned about homeostasis, or the body's balanced state, and know how to get it there. The goal is to lower your heart rate, blood pressure and slow the release of endorphins at the very onset of symptoms. The way to do that is to force your breathing to be more regular and paced.

Sailors have been doing it for hundreds of years. At the first sign of nausea, you'll see an experienced sailor sit quietly, suck on a lollipop and look at the horizon. The underlying effect of these actions is to focus on something other than the queasy feeling. The heart slows naturally, pressure is relieved and the stress reduced. A more direct approach is to use a yoga technique and focus on the breath itself, timing and lengthening inhalations and exhalations and listening to the breath pass through the head, esophagus and in and out of the lungs. It's a natural remedy supported by strong physiological evidence. And it seems to work, more often then not.

The problem, of course, is that it's too late to talk about these techniques when someone's head is in a bucket. Better to give a person the basic tools before they need to use them.

So here's an idea. If you're going to take a newcomer sailing, preface your trip with your regular safety talk about PFDs and ducking for tacks and jibes, and then say something like, "if you start feeling funny, you can work through it by taking 10 long full breaths, and then another 10 if you need to." Then eat, drink, dress and go sailing.