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That Queasy Feeling

You hadn’t eaten much this morning, but suddenly you’re aware that you’re not hungry any more...You hadn’t eaten much this morning, but suddenly you’re aware that you’re not hungry any more. It feels like you’re sweating; though you are feeling cold. You’re aware that you seem to be swallowing more frequently, and you’re finding it harder to concentrate. At first you’d attributed the slight feeling of fullness (and those few discreet burps) to the increased altitude, but now you’re feeling a bit disoriented, and, somewhat abruptly, it feels like you have a headache. Carbon monoxide? Hypoxia? You realize you’re feeling more than a little weak and dizzy, and unexpectedly, nauseous. Suddenly, you know. You look around for a container -- any container...

MOTION SICKNESS AND PILOTS
Yes, motion sickness -- in response to unfamiliar movements and conflicting sensory inputs. It can happen aboard ship, on an amusement park ride, or in planes, trains, and automobiles. It happens in space, and it can even occur in a simulator. More common among passengers and student pilots than those folks wearing epaulets, it does occasionally happen to experienced crewmembers, particularly when illness, stress, fatigue, or other factors increase susceptibility. Sure, it’s uncomfortable, but it can also jeopardize the safety of a flight -- often when peak performance matters -- such as during strong turbulence in instrument conditions.

Stay focused -- distraction kills pilots. If the worst happens, fly the airplane... and land soon.

THE HARDWARE
Dizziness, vertigo, and motion sickness all have to do with the vestibular apparatus, its orientation and equilibrium. Your vestibular 'system' comprises at its core three circular canals, nestled in your inner ear. The rings are set at right angles to one another to monitor motion -- whether it’s forward-backward, up-and-down, or side-to-side. Working in concert with this system, are pressure receptors in the skin, as well as muscles and joints, and your eyes. Your central nervous system processes all this information, and tries to make sense of it all.

Complications: Problems such as vertigo are common after an ear injury, infection, or circulatory disorders, to which the inner ear is very sensitive. Allergies, even the common cold, can make trouble.

WHAT CAUSES IT?
While the abrupt and unwelcome results get all the publicity, what goes on in the background, unannounced (and regrettably, often unshared, until it’s too late) is where the battle lies. There are several scenarios that increase anyone's susceptibility to possible nausea:

  • When your body is moving, or thinks it is, but the eyes say otherwise, stress builds up, and stomach muscles tighten.
  • Periods of low workload during exposure to unfamiliar motion.
  • Outside influences such as medication or tension, and other psychological factors.
  • Predisposition of gender: Studies have shown that women tend to be more susceptible to the ill effects of motion sickness than men -- that finding stands for all age groups.
DEFENSE
The most practical and effective method is avoidance -- stay occupied. An idle mind plus and active vestibular system is a recipe for a most unpalatable offering. If it happens to you, and you’re the one flying, open the air vents -- you may need to anyway, later, but open the vents at the first sign of symptoms. Keep your head against the headrest if you have one, loosen your clothing, use supplemental oxygen if you have it, keep your eyes outside and land as soon as possible. After that get back in the saddle sooner than later. Repeated exposure increases tolerance.

Warning: Anti-motion sickness medication isn't the answer, as they frequently either cause drowsiness or include 'do not operate heavy machinery' on the packaging. That latter part is indicative of the drug's ability to adversely affect your navigation and decision making skills.

MOTION SICKNESS AND PASSENGERS
If you’re a passenger, and you’re prone to feeling airsick, add this to your preflight list of don'ts. (If you're a pilot, be wary of the items on this list):

Five Anti-Airsickness Do's

  • Sit over a wing (this is where the effects of turbulence are less) and look out the window at the horizon.
  • Open up that air vent.
  • Minimize your exposure to stress.
  • Being well-rested and wearing loose clothing stack the odds in your favor.
  • Drugs -- so long as it's not your heavy machine... For mild discomfort, herbal remedies and over-the-counter products can help. Dramamine or Scopolamine are options.

    Note: The topical “patches” tend to provide a fixed dose, whereas in pill form they can be titrated as needed, and are actually more effective, as they are absorbed much more quickly. Any such medication may make you drowsy and give you a dry mouth.

Eight Anti-Airsickness Don'ts
  • Stay away from cigarette smoke, and avoid alcohol, caffeine, and salt.
  • Avoid greasy or spicy food, and strong odors, whether from food or fuel.
  • Don’t eat a heavy meal or drink alcohol the night before.
  • If you’re not taking off or landing, reclining your seat will help.
  • Do NOT read.
  • Avoid rear-facing seats.
  • Avoid rapid changes in position.
  • Avoid rapid head movement. Effervescent drinks (in particular, ginger ale) have been found to be helpful, as has ginger in other forms.
Important: Above all, do not watch or talk to another traveler who is experiencing the same problem you are! Most cases of dizziness or motion sickness are self-treatable or self-perpetuating... depending on the sufferer's mental disposition.

UNCONVENTIONAL REMEDIES
Scientists still don’t know just why, but stimulating the median nerve on the inside of the wrist seems to block the nausea reflex. (A relatively new product that exploits this effect has in fact been on the market for several years. Marketed as the “ReliefBand” and worn like a wristwatch, its battery-powered electrodes provide a small current to those same nerves and the results have been, apparently, excellent. Results have been so successful that the devices have found use by chemotherapy patients and by women during pregnancy to stave off “morning sickness”. Getting further out there, biofeedback has actually been studied by the Air Force and there's always acupuncture.

PILOTS -- SPECIAL CONSIDERATION
As a pilot, you want to make your passengers as comfortable as possible -- mentally and physically. Be considerate. Communicate with your passengers before taking off -- are they feeling okay, nervous, and have they ever flown in a small airplane before? Asking not only provides you with important information, but also generally makes you appear more caring and -- if properly done -- sets a passenger at ease. A passenger who is comfortable is less susceptible to motion sickness and more likely to share potentially damaging information should they begin to succumb. (Also, remember: just as a pilot who suddenly feels awful still needs to keep flying the airplane, if despite your best effort to sound like Mr. Rogers, a passenger springs this surprise on you, keep flying the airplane! If opened doors have killed people because of distraction, I can’t imagine having someone next to you being violently sick would be that far behind.)

The more comfortable people are with their surroundings, the more likely they are to stave off urges to redecorate.

PILOTS -- SPECIAL EQUIPMENT
You need to be prepared for an unfortunate comeuppance. Have a separate sealable container to place previously contained contents in, once liberated. Remember, aside from fumigating upholstery, better count on steam cleaning down to the floorboards if there’s anything left that soaks through. Gastric juices are corrosive! (The stomach secretes hydrochloric acid, and the pH of those gastric juices can be as low as 1.0. That would not help your airframe any, nor would it do much for any control cables or any other structural member it had a chance to fester on.)

BOTTOM LINE: Feeling green around the gills isn’t fun, and we need to be sympathetic if it happens to someone else. Like anything else though, especially in aviation: being well prepared really helps.

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