Sea (motion) Sickness

Questions relating to medical issues and treatment. Where possible and appropriate, we will request comment from qualified and reputable NZ-based diving doctors. If your query relates to a personal medical issue, we recommend you contact your GP or relevant medical specialist.

Re: Sea (motion) Sickness

Postby NEMES1S » Sat Feb 14, 2009 7:33 pm

Scuba Sam wrote:I do almost all of my diving on boats. A couple of sea-sickness tips I have gleaned other than those above, which might be worth trying -

Small frequent meals so the stomach acid has something to churn on other than itself - up to every hour, and as little as a couple of crackers.

Paihia Bombers - magic sea sickness preventative. Combination antihistamine, caffeine to combat drowsiness, and an anti nausea additive. They seem to be far superior to Sea Legs and other tablet remedies. I have used them on offshore liveaboards in the Coral Sea and to Three Kings. I have buddies who are far more prone to sea sickness than me who use them on every boat trip, but still survived the Coral Sea journey without sickness. I recommend taking them for a day on shore first, and trying them on a familiar dive first before using them on a liveaboard in extreme conditions, and there are also medical questions which the place selling them asks to see if you are a suitable candidate for them. PM me for details on how to get them.

Not sure how that helps you in Oz sorry Vampire, but maybe next time you are over diving at the Knights...

Cheers,

Sam

I was told by some Military Doc's to steer well clear of anti-histamines and diving period...weird..
Sfish did some research into this and according also to DAN anti-histamines are also a no-no.
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Re: Sea (motion) Sickness

Postby Jason » Sat Feb 14, 2009 8:31 pm

Hmmm?
The Paihia Bombers sounds impressive but I'm unsure if there is a strong disagreement with antihistamines and diving :?:
(will be flicking through all the Medical pages in Mags like Dive Pacific & Diver Training tomorrow)

I do know that if I dive the Three Kings without a retch, then I have finally passed my first Certification in Sea Legs
Just drifting along with whatever is current.
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Re: Sea (motion) Sickness

Postby DiveDiva » Sun Feb 15, 2009 7:54 am

NEMES1S wrote:
Scuba Sam wrote:I do almost all of my diving on boats. A couple of sea-sickness tips I have gleaned other than those above, which might be worth trying -

Small frequent meals so the stomach acid has something to churn on other than itself - up to every hour, and as little as a couple of crackers.

Paihia Bombers - magic sea sickness preventative. Combination antihistamine, caffeine to combat drowsiness, and an anti nausea additive. They seem to be far superior to Sea Legs and other tablet remedies. I have used them on offshore liveaboards in the Coral Sea and to Three Kings. I have buddies who are far more prone to sea sickness than me who use them on every boat trip, but still survived the Coral Sea journey without sickness. I recommend taking them for a day on shore first, and trying them on a familiar dive first before using them on a liveaboard in extreme conditions, and there are also medical questions which the place selling them asks to see if you are a suitable candidate for them. PM me for details on how to get them.

Not sure how that helps you in Oz sorry Vampire, but maybe next time you are over diving at the Knights...

Cheers,

Sam

I was told by some Military Doc's to steer well clear of anti-histamines and diving period...weird..
Sfish did some research into this and according also to DAN anti-histamines are also a no-no.


As I understand it, (and I am no medical expert) a reason antihistermines are not recommended for divers is because taking them can make you drowsy. Although you're unlikely to fall asleep while diving (though I have come close on a night dive once...seriously...I was that relaxed), I suppose they do have the ability to impair judgement and therefore your ability to make the 'right' decision at the moment you may need to during the dive. Note that Pahia Bombers include caffine to help combat the drowsiness. I would, however, guess their affect (like all of the sea sickness medication we have mentioned) differs in each of us, so, as Scuba Sam says, I would see how they affect you on land first. If they make you feel drowsy and you would be unhappy diving in that state, then don't dive. If you find the caffine kick sufficient to overcome the drowsiness, then consider getting wet. At the end of the day it's up to you.

From another thread.
Gregv wrote:When considering using any medication underwater, you want to consider the following (using antihistamines as an example):
1. Will antihistamines make me more susceptible to DCI? Older sedating antihistamines could exaggerate the effect of nitrogen narcosis in a diver. There is no obvious physiological effect of their action that would make DCI more likely. Poor decision making as a result of impaired cognition however clearly can lead to an accident.
2. Will diving make any side effects of antihistamines worse? Other than potentially exacerbating nitrogen narcosis, no.
3. Will my exercise tolerance or thought processes be affected by use of antihistamines? If using a non sedating antihistamine, probably not.


Personally, I only take ginger which I have had mixed success with. I don't tend to get sea sick too often (thank goodness!) and so have every sympathy for those who do.
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Re: Sea (motion) Sickness

Postby justsimon » Sun Feb 15, 2009 8:08 am

There's always the old rocking horse story. Don't know if it's an urban myth or not.

A bloke made himself less susceptible to sea sickness by rocking on a rocking horse (in a garage with curtains on the windows so nobody saw him) for an hour or so a day. Apparently he got used to being in motion and less likely to hurl on boats.
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Re: Sea (motion) Sickness

Postby Jason » Sun Feb 15, 2009 11:43 am

justsimon wrote:There's always the old rocking horse story. Don't know if it's an urban myth or not.

A bloke made himself less susceptible to sea sickness by rocking on a rocking horse (in a garage with curtains on the windows so nobody saw him) for an hour or so a day. Apparently he got used to being in motion and less likely to hurl on boats.


That might be it JustSimon! Reckon I will upgrade my computer chair to one that rocks, it can't hurt to try.

The big worry over pharmeceutical drowsiness is when diving in the nitrogen-narcossis zone as it can enhance the effect. I also found that taking such medication brings more chance of nightmare or disturbing sleep wave patterns which awakens me although the medication is a subtle form of sleeping pill agent.

Taking such medication upon land before underwater is a wise act indeed, never thought of this and will do so from now on.
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Re: Sea (motion) Sickness

Postby Scuba Sam » Mon Feb 16, 2009 1:59 pm

This is turning out to be a really educational topic for me!! Cheers guys!! I should have pointed out in my earlier post that we (my buddies and I who use Bombers) are recreational divers, diving within recreational limits. Tech diving/decompression diving, where the limits are potentially being pushed further is a different type of diving - I have not used bombers in this situation.
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Re: Sea (motion) Sickness

Postby NEMES1S » Mon Feb 16, 2009 2:52 pm

Diving without going past 40m I have had some odd after effects from taking anti-histamines,hence my previous thread on the meds.
It was actually after the dive I found the odd sensations occurred,I stopped them and after that I have had no ill effects since,that was when Sfish got on the subject and referred to the DAN crew and also some UK military doctors...all of which as I mention said ... Steer well clear..

And the Doctors actually said it wasnt the "drowsying" effect it was that some people have had hallucinations and similar odd effects,mine wasnt that bad but it certainly concerned me to look into it,I was taking the big ones 180mgs...so in lesser doses maybe all good..I dont know.

That said a fellow diver Shane takes Anti-histamines for hay fever as I do and has no trouble at all (not sure on how many Mg's)....so yeah...its all about how we are made up as well,some may not be as prone to any effects...but the question is do you want to risk it..?

I just have to pull the dives now when I have a bit of hayfever or do what Andy told me and snort salt water up both nostrils....sound mad but it works,the initial sensation for me is like getting a red hot poker shoved up your nostril right to your brain...so yeah quite painfull but when the pain subsides its all good!!.
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Re: Sea (motion) Sickness

Postby Jason » Thu Feb 19, 2009 11:12 pm

Ok, I have a x2 (double) Boat Dive amongst the islands just out from Wollongong this Sunday.
I only lifted a finger, ever so slowly, to fill the last place. Obviously the Club Chairman has worked at auctions and a few people were astonished that 'I' would put myself upon another boat dive.
May the (dark side of the) Force be with me.
Just drifting along with whatever is current.
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Re: Sea (motion) Sickness

Postby Michelle » Fri Feb 20, 2009 7:45 am

Good Luck - I'm sure you'll have a great time. If you do get a little queasy the best thing to do may well be to get in the water. I know that diving if you're not feeling 100% goes against the grain, but if you know it's motion sickness, then you may well start to feel better as soon as you get in the water.
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Re: Sea (motion) Sickness

Postby Jason » Fri Feb 20, 2009 9:13 pm

Yes well, I'm thinking if I'm sick, might as well enjoy the dives while I'm at it anyway and get me money's worth. Reckon Leon (skipper - United Divers) will probably just kick me overboard anyway rather than listen to me retch (like a Walrus marking his territory) for the umptinth time. Once I got a handle upon being sick and diving, then I'll feel a bit better (pun?) doing Deep Dives and being sick.
Just drifting along with whatever is current.
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Re: Sea (motion) Sickness

Postby Jason » Sun Feb 22, 2009 4:59 pm

Well x2 Dives via boat today and I wasn't sick (instead my Buddy was - though due mostly from viral infection) though conditions were flat and of good viz.
Mind you, as another Diver hopped into the boat while still moored, the boat rocked and I felt a subtle wave of nausea and I nearly said "you're effin kidding me" to myself.
Just drifting along with whatever is current.
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Re: Sea (motion) Sickness

Postby Michelle » Sun Feb 22, 2009 10:21 pm

Now you know you can do it, you need never shy away from a boat dive again - a whole new world of dive sites have just opened up.

Well Done
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Re: Sea (motion) Sickness

Postby Peter the Eel » Tue Feb 24, 2009 12:14 am

Hi All,

Whilst Sfish is unwell and otherwise engaged, she has asked me to join in the forum to provide an entry of this particular topic.
I have been working and diving with Sfish on many occasions before she moved to New Zealand. When I don’t dive, I work as a Medic in the British Army.
Recently I provided Sfish with some info and advice to assist of her buddy on the subject of “antihistamines”. Sfish always has that extra bit of care and attention for her buddies! 

Right now for the serious stuff:
Most of our research has been done on army personnel, though I suspect the same effect would be observed on civilians.
We advise to steer clear of antihistamines for various reasons many of you mentioned in the forum.
Pharmacologically, many antihistamines are closely related to the psychiatric drugs and share a common side effect, sedation (In extreme case followed by hallucinations).
In addition, in cases were antihistamines are taken to treat hay fever, there is a strong possibility of the diver developing ear or sinus barotrauma. Other drugs are less sedative (usually the most recently developed), but they may provoke cardiac arrhythmias or bronchospasm (asthma).

The best advice is always to stay in good health and dive only if you feel healthy and up for it, as for long term allergies or conditions do consult your physician and dive medics, as they should be the best professionals to assess your risks.

Best wishes to one and all, Pete.
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Re: Sea (motion) Sickness

Postby NEMES1S » Tue Feb 24, 2009 12:19 am

Peter the Eel wrote:Hi All,

Whilst Sfish is unwell and otherwise engaged, she has asked me to join in the forum to provide an entry of this particular topic.
I have been working and diving with Sfish on many occasions before she moved to New Zealand. When I don’t dive, I work as a Medic in the British Army.
Recently I provided Sfish with some info and advice to assist of her buddy on the subject of “antihistamines”. Sfish always has that extra bit of care and attention for her buddies! 

Right now for the serious stuff:
Most of our research has been done on army personnel, though I suspect the same effect would be observed on civilians.
We advise to steer clear of antihistamines for various reasons many of you mentioned in the forum.
Pharmacologically, many antihistamines are closely related to the psychiatric drugs and share a common side effect, sedation (In extreme case followed by hallucinations).
In addition, in cases were antihistamines are taken to treat hay fever, there is a strong possibility of the diver developing ear or sinus barotrauma. Other drugs are less sedative (usually the most recently developed), but they may provoke cardiac arrhythmias or bronchospasm (asthma).

The best advice is always to stay in good health and dive only if you feel healthy and up for it, as for long term allergies or conditions do consult your physician and dive medics, as they should be the best professionals to assess your risks.

Best wishes to one and all, Pete.

Welcome and thank you for that...

Very interesting indeed...
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Re: Sea (motion) Sickness

Postby Peter the Eel » Fri Feb 27, 2009 1:11 am

Dear Pete,

This is a very good point. Thanks for bringing it up.

First of all it is very important to remember to treat the cause and not the symptoms.

My comment on taking antihistamines to treat hay fever and risk of developing ear or sinus barotrauma is because antihistamines seldom completely cure the nose and throat congestion, it’s the Hay fever or Common pet allergy effect on the diving, rather than the drugs you want to worry about.

The sedating effect of anti-seasickness medications will affect judgment and aggravate nitrogen narcosis.
Short acting anti-seasickness tablets will last about 4 hours, the dosage 25mg.
Antihistamines tablets vary in dosage but I can say a standard pill would be 180mg (Hay fever one a day dose but you'll find stronger one and weaker ones, depending on country and conditions).

One advice I can give is to take the sea sickness tablets the night before so as to have the least effect on the diver's abilities.
This can not be done for allergic reaction as the tablets needs to be taken on the onset.
By taking sea sickness pills or even 25mg of standard antihistamines the night before at bed time, sedation will occur during the night. This will still provide resistance to sea sickness for the early part of the following day. However I would like to emphasis that if doing so the depth of the diving should be limited to 100ft (30m) and even 60 ft (18m).

We always suggest that medicines are tried outside the water first to check any side effect, even if you never had side effect with any medicines before.
And if alcohol is ever involved, this will induce more side effects due to the additives involved. So if you always have taken a mild sea sickness remedy and the day before your dive you end up consuming alcohol you might experience all sorts of side effect you wouldn't otherwise have.

As for Transdermal skin patches (Scopoderm), the are not recommended for diving (but it is not mentioned on the leaflet!) due to its side effect.
One of my best friend uses them for diving (rough seas only though), but it was an educated decision and a personal choice. She has learnt managing the side effect in a way that works for her and does not affect her diving abilities.

History of motion sickness can interfere with safe diving, in such case it is essential to seek medical advice and use remedies in line with safe diving practices ( always read the label, minimise dosage, take it the night before, keep hydrated, think caffeine boost (just the one coffee though).

Greetings.
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