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ADVANCE Perspective: Physical Therapy & Rehab Medicine

Sick at Sea

Published September 6, 2011 10:55 AM by Rebecca Mayer

I spent my Labor Day Weekend sailing Buzzards Bay and Vineyard Sound on a gorgeous 38-foot sailboat with teak decks and billowing sails. Each day began and ended in a different spot from watching the sunrise on Cuttyhunk in the Elizabeth Islands to admiring a starry night at Lake Tashmoo on Martha's Vineyard.

Sounds perfect, doesn't it? Well, it was except that nearly 24 hours later, the earth is still moving under my feet. I was dreadfully sea sick the whole weekend.

Motion sickness occurs when the body, the inner ear, and the eyes send conflicting signals to the brain. Individuals who experience motion sickness on a regular basis need to learn to control-and eventually prevent-these symptoms. Motion sickness is common with about one-third of the world's population experiencing symptoms during routine travel.

I have learned how to deal with, and somewhat control, my lifelong issue with motion sickness by car, train and plane. But boats are the wild card. Experts recommend that you stay on the deck and look at the horizon when sailing. You also can take prescription and nonprescription medicine before travel to prevent or reduce symptoms of nausea and vomiting.

The problem is that I packed in such a hurry that I forgot my medication and my PSI bands. Psi bands are acupressure wrist bands for the relief of nausea due to pregnancy, motion sickness/ travel, chemotherapy, and anesthesia. Although approved by the FDA, there is little scientific evidence that the bracelets work but they may have a placebo effect. Either way, I wish I had had my bracelets and my meds.

People often try alternative methods of preventing motion sickness such as taking ginger or wearing acupressure bands. A physical therapy clinic with a specialty in vestibular therapy may help individuals who have significant problems with motion sickness. Vestibular therapy consists of exercises involving head and body movements which are designed to decrease dizziness, increase balance function and increase general activity levels.

Because I am still dizzy and nauseous and have a headache, I'm in the process of getting a referral from my physician for physical therapy so that I may undergo a vestibular evaluation to determine the appropriate course of treatment. I want to be better prepared before my next journey and I hope PT is the answer. Do you have experience in vestibular therapy for motion sickness? What can I expect?

 

2 comments

Thanks for the feedback, Dean. Believe me, I'd love to travel to England for my therapy! I will be doing a follow-up post once I've gone to rehab. Here's hoping for some relief on my next outing.

Rebecca Mayer September 6, 2011 1:27 PM

Rebecca, the reason "old salts" tell people to get up on deck and look at the horizon is to reconcile the conflicting messages being sent from the eyes (nothing is moving in the cabin so your eyes don't perceive movement) and your inner ear (which is telling you that the whole world is moving). This conflict creates that lovely sensation of mal-de-mer.

The vestibular occular reflex (VOR) is how the eyes and inner ear are tied together. In motion sickness, the inner ear is telling the eyes to refocus  but the eyes say "we're already in focus, thank you very much". A vestibular therapist will most likely prescribe exercises of adaptation which may initially actually bring on your symptoms. With practice, your vestibular system will make long term changes in the neuronal response to head movement. Eventually your eyes and inner ear will get into sync if you are diligent with the exercises. In th end, no more symptoms.

Of course, this is based upon your short history. Your therapist will take a complete history, give a thorough examination, and prescribe accordingly. I'd invite you to our vestibular clinic, but traveling to the UK is probably more than your plan will pay for.

PS. that used to be one of my favourite areas to sail before moving to the UK. I'm glad you had good weather and neither Irene nor Katia ruined your plans. Good luck with your rehab and let us all know how it turns out!

Dean Metz September 6, 2011 12:04 PM

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