Chapter 4 : Feeling bad in the air

There are many people who suffer motion sickness of one form or another, with one of the most common forms being airsickness. This is a condition that is most commonly suffered by women and younger children, although it is one that can be suffered by anyone.

All forms of motion sickness happen because there is a lack of balance between the information being fed to the brain by the three parts of the human body where motion is sensed being the eyes, the inner ear and the body. In the labyrinth or inner ear, motion sickness has an adverse effect on your normal sense of equilibrium and balance hence your spatial orientation is also adversely affected:

As an example, when your motion is voluntary (if you are walking or running for instance) the messages being sent to your brain by all three points of reference tie together as what your eye is seeing and your body and vestibular system (the inner ear) are feeling are all in agreement with one another.

However, when the motion is involuntary such as when you are in a plane going through an area of turbulence or on a ship that is rolling in heavy seas, what your eyes are telling your brain and what you are feeling are in direct conflict with one another.

It is believed or hypothesized that this conflict is a major cause of motion sickness although it should be noted that because of the complexity of motion sickness, this is only a hypothesis. It is however a hypothesis that is generally supported and believed by the majority of the medical profession because tests have indicated that this is most likely to be the cause of motion sickness.

One interesting fact is that in animals that do not have a vestibular system or people whose vestibular system is damaged, motion sickness never occurs. This suggests that it is the inner ear that is most critical in deciding whether airsickness will develop whilst the information sent to the brain from the eyes and the deeper tissues of the bodily surface do not seem to be as important. This theory is supported by the fact that blind people are not immune to suffering motion sickness.

All forms of motion sickness are more likely to occur when complex involuntary movements are involved, with both horizontal and vertical movement together being far more likely to cause airsickness than one or the other on their own. The kind of turbulence that is most often experienced in a plane generally involves up-and-down as well side to side movement, hence the susceptibility of many people to air sickness in turbulent conditions.

In this situation, you can certainly feel the motion it through the seat of your pants and your inner ear senses it too yet all you see is the inside of the plane which looks exactly the same as it did when you first boarded. Consequently, there is spatial confusion, a mismatch between what you see and feel, hence you feel sick.

Although the exact causes of the airsickness are not fully understood, it is generally believed that the imbalance between the messages being sent to the brain from various different parts of the body causes problems with various different neurotransmitters. These are naturally produced chemicals that enable the transmission of ‘signals’ throughout the brain and nervous system.

It is believed that an imbalance of neurotransmitters like histamine and norepinephrine is the most likely cause of motion sickness, hence the fact that many medicines that ‘treat’ motion sickness contain these particular neurotransmitters which you take in an effort to restore neurotransmitter balance.

The most common symptoms of suffering air sickness are nausea which often leads to vomiting, loss of appetite, cold sweats and pallid skin, lack of concentration, vertigo, headache and increased tiredness.

All in all, as anyone who has ever suffered the misery of motion sickness will tell you, it is no bundle of laughs and something that you definitely want to get over as quickly and effectively as possible.

The good news is that for most people, airsickness is not a serious condition whilst it is one that is likely to cease affecting you once the motion that causes it ceases as well. However, that is not always true, as some people do continue to suffer motion sickness symptoms for several hours or perhaps even a few days after the situation which originally induced their sickness has ceased.

Medicinal treatments for airsickness

The first thing to say is that most experts believe that it is probably impossible to completely remove the possibility of suffering airsickness 100% totally without surgically modifying the inner ear (which has proved to be an effective motion sickness cure in monkeys).

Assuming however that most people would not want to go to such radical lengths to get rid of a motion sickness problem, it is likely that you will look elsewhere for suitable airsickness treatments, knowing that they will not always work in every situation.

There are quite a few over-the-counter medical treatments for air sickness almost all of which should be taken or used at least a few hours before flying.

Some of these are antihistamines such as meclizine (Bonine, Antivert and Postafen being three very common brands), diphenhydramine (Benadryl or Dimedrol outside the USA and Canada) and belladonna in the form of scopolamine.

Side effects of drugs for airsickness

Looking at each of these drugs in turn, they all have some potential adverse side-effects of which you should be aware.

Meclizine is a known antiemetic (anti-nausea) and antispasmodic (it prevents muscle spasms) medicine that can be bought over-the-counter in most pharmacies and drugstores. It is believed that meclizine helps to reduce the likely susceptibility to nausea and vomiting by reducing activity in the part of the brain which controls nausea. It also helps prevent all forms of motion sickness by slowing down the activity of the neurons in the vestibular area of the brain as well.

The main side effect of taking this drug is that it generally causes drowsiness, which whilst it might not be a bad thing while you are flying can be a problem if you land and need to drive. Furthermore, it can sometimes cause the very nausea that it is supposed to prevent whilst also leading to an unnaturally dry mouth, blurred vision, constipation and excess water retention. In a very small minority of cases, meclizine has also be seen to be at least partially responsible for hypotension (low blood pressure) and heart palpitations.

Benadryl is used as an antihistamine, antiemetic, hypnotic and sedative drug. This drug is in fact one of the oldest known antihistamines, having been discovered in 1943, but it is still readily used and prescribed (although it can be bought over the counter) in many countries of the world.

Once again, the most common side-effect of taking diphenhydramine is profound rowdiness, sometimes accompanied by ataxia, dry throat and mouth, flushed skin, irregular or rapid heartbeat, blurred vision, short-term memory loss and constipation. Furthermore, due to its potential for an inter-reaction with other medications, using Benadryl when you are taking other drugs could have potentially harmful or hazardous side-effects.

A significant overdose of diphenhydramine could potentially lead to a heart attack, coma and death too, so despite its apparently benign nature, this is not a drug to toy with.

If this is the case with diphenhydramine, the same is even more true of scopolamine which given that it is related to belladonna should be no surprise. Scopolomine is a drug that has valid medical uses only in extremely tiny doses, as an overdose can cause delusions, deliriums, stupor and death!

It is an anticholinergic drug that prevents motion sickness by blocking the neurotransmitter acetylcholine in both the peripheral and central nervous system. As suggested previously, it is believed that motion sickness is caused by some form of upset balance between various different neurotransmitters and using scopolamine is believed to redress the balance, thereby reducing the susceptibility to airsickness.

Although this is a drug that can be taken orally, it is most commonly used in the form of an infused patch that will usually contain as little as 330 µg (micrograms) of the drug. This is affixed to the skin – usually behind the ear – around 3-4 hours before flying so that the drug can be released by the patch to be gradually absorbed through the skin.

As suggested, in an overdose situation, scopolamine can be very dangerous indeed, but as it is almost impossible to overdose if you are using transdermal patches (which is the most common form of usage in the West), this is not likely to be a problem for most people.

However, because of its anticholinergic qualities, scopolamine can cause a dry mouth, throat and nose or in more severe cases, impaired vision, sensitivity to light, constipation, problems urinating and rapid heartbeat or tachycardia.

It’s your choice

As suggested, most of the common over-the-counter medical products designed to deal with airsickness do have potentially unpleasant or even dangerous side-effects. Hence, you need to carefully weigh up the possibility of suffering these side effects before deciding whether taking drugs to calm your airsickness is for you or not.

Before doing so, it makes sense to consider the things that you can do to reduce the chances of suffering airsickness without resorting to chemical-based pharmaceutical drugs.

Tips for avoiding airsickness

There are plenty of things that you can do that will help to reduce the chances that you are going to suffer airsickness the next time you fly. However, it is important to note that whilst a few of these tips and ideas only become ‘operational’ after you board the plane, others need some forward planning.

For example, for two or three days before the flight, avoid eating and drinking the wrong things, and try to avoid overindulging as well. Do not eat very spicy, heavy or overly-fatty foods or foods that you know from past experience do not agree with you. Don’t drink too much alcohol either because you can guarantee that suffering a raging hangover whilst flying is not going to help with trying to avoid airsickness.

And of course, when you are actually flying (especially if you’re flying long-distance and will therefore be on the plane for several meals) the same rules should apply.

Avoid spicy foods, foods that are too fatty and don’t fall for the temptation of eating everything that is placed in front of you because of boredom. Do so and you are likely to feel overfull and bloated which again is not likely to make you feel a great deal better.

In fact, on shorter journeys, it is best to eat nothing at all if possible, although eating small amounts of dried foodstuffs like biscuits or crackers might help as they do tend to dry your mouth out. Whilst on the flight, try to avoid dairy produce (because of the protein and fat content) as well as vegetables and fruits because they may make your stomach unnecessarily acid.

Some studies have indicated that foods which contain too much salt may exacerbate airsickness as does food which is too rich in vitamin B1 such as pork, beef, eggs and fish. It also appears that if your levels of vitamins A and C plus iron are too low, this might make you more prone to airsickness as well (especially women).

Also, don’t fall prey to drinking too much just because it does not cost you anything to do so. Whilst there might not be a cost in monetary terms, there could certainly be a cost in terms of sickness if you overindulge.

Even foods that you know are likely to have a strong smell should probably be avoided whilst in-flight because a strong smell is often enough to turn your stomach queasy. Do not wear strong cologne or perfume for the same reason and if you are travelling with a companion, ask them not to refrain as well if possible.

When you are booking your ticket or checking in, try to choose a seat where there is likely to be the least motion. Generally speaking, this will be the middle of the plane in the area of the wings, so if you can get a seat here, it is likely to offer the least disturbed ride.

Also, if you are flying during daylight hours, it can sometimes help to have a window seat as well. By doing so, you have the ability to focus on the horizon out of the window which might help by minimizing your spatial disorientation.

Avoid reading on the flight if you are prone to airsickness because as anyone who has ever suffered motion sickness will tell you, having your eyes fixed on a book a few inches away will only exacerbate the mismatch between what your eyes are seeing and what your body and inner ear are feeling. Hence, if you read, you are almost certainly going to feel worse than you will if you keep your eyes fixed on the horizon outside the plane.

On most planes, there will be an air vent above your head so make sure you use it. Having a flow of air on your face and head will help to keep you cool and refreshed to at least a certain degree. Whilst the air flow is certainly not likely to be sea-breeze fresh, it can help mitigate the stuffiness and often unpleasantly warm atmosphere on-board.

Try to keep away from others who are suffering airsickness if possible as hearing others chatting about their sickness problems or even worse, seeing someone being sick is certainly not going to help you feel any better.

Homoeopathic treatments for airsickness

There are various homoeopathic treatments for motion sickness that you might consider using as an alternative to the medical drugs highlighted earlier.

The most common of these homoeopathic treatments are as follows:

Cocculus Indicus: This is probably the most common homoeopathic remedy for motion sickness, especially for sufferers who experience nausea which gets worse when they see or smell food. It is common for Cocculus to be given to travelers who commonly feel weak and experience a hollow or empty feeling in their stomach as a result of suffering airsickness. This is a remedy that is also very well suited to people whose condition is made worse by feeling cold, from moving about or from a lack of sleep.

Rhus Toxicodendron: Is probably better known by the more common name poison ivy but fortunately, in very small doses, it is not going to kill you! However, what it can do for anyone whose airsickness usually exhibits itself through nausea and vomiting (whilst there is also a lack of appetite at the same time) is help calm their condition down.

Often people who suffer these kinds of symptoms will feel weak and lightheaded because there is a distinct lack of nutrition inside them, so they might feel dizzy when standing. Sometime this feeling will be accompanied by an intense headache at the front of the head and your scalp might feel painfully sensitive to the touch as well.

Tabacum: This solution would be a suitable homoeopathic remedy for anyone whose airsickness is most commonly identified by them feeling nauseous and faint, with a green tinge or extremely pale color to their skin. Most commonly, these obvious symptoms would be accompanied by a sinking feeling in the pit of the stomach and possibly a severe headache that feels as if there is a very tight band wrapped around the head.

A combination: Sometimes, a homeopath is more likely to recommend a combination of several homoeopathic remedies rather than just one, mainly because people’s airsickness does not fit any of the specific category descriptions precisely. A relatively common combination would for example be a mixture of Cocculus Indicus, Tabacum and Petroleum, although if your homoeopath chooses to recommend only one substance to deal with airsickness, it is likely to be Cocculus.

Herbs for airsickness

Many studies have indicated that ginger appears to be more effective than a placebo in reducing the adverse effects of motion sickness. For example, in one study, a group who were given ginger extract reported significant reduction in nausea, vomiting and cold sweating when compared with the control group who were taking a placebo.

However, other studies have indicated that ginger may not be as effective as some experts suggest, so further study is obviously necessary.

Nevertheless, of the herbal remedies that have been put forward for dealing with airsickness, there is some evidence that ginger is the most effective, and therefore dosing yourself up with ginger capsules before and during your flight might help to reduce the severity of your problem if it does not get rid of it completely.

A combination of peppermint and black horehound has been used by some herbalists as an effective method of treating nausea, so whilst it is not specifically used as a treatment for motion sickness, it can certainly offset some of the worst effects of being sick on the plane.

Acupuncture and acupressure

Several studies have indicated that both acupressure and acupuncture can help to reduce the nausea and vomiting that is usually associated with air sickness.

Obviously, if acupuncture is the way you want to deal with your problem, you would do so before flying, whereas using an acupressure band is something that you can do throughout your flight. For this reason, it makes considerably more sense to consider using an acupressure band than it does to resort to more traditional acupuncture particularly as there seems to be little or no difference between the two in terms of effectiveness.

The acupressure band works by putting pressure on the acupuncture point known as the Pericardium 6 which is usually the one that is most commonly associated with nausea. This acupuncture point is located on the inside of the wrist, approximately half an inch to one inch above the central crease on your wrist. Thus, by applying pressure to this particular point on your wrist, the acupressure band can significantly reduce the level of nausea that you feel every time you fly.

Breathing and relaxing works again

In the same way that learning deep breathing techniques can help people overcome their fear of flying, studies indicate that people who suffer airsickness might significantly reduce the chances of doing so by forcing themselves to breathe deeply and slowly whilst sat in their seat.

Similarly, practicing progressive relaxation can be a big help too, not least because of the fact that for most people who suffer from airsickness, their problem is that least as much a psychological one as it is a physical condition.

As anyone who has ever suffered regular motion sickness will tell you, they almost always think themselves into a situation where they suffer because as soon as they get on the plane, they can think of nothing else but being sick. Consequently, it quickly becomes a self-fulfilling prophecy, meaning that if you recognize yourself in this situation, you have to do something to break the cycle of mentally making yourself sick.

Focusing your thoughts on breathing deeply or on carrying out a program of deep progressive relaxation will take your mind off your susceptibility to airsickness. Thus, even if it does little for you physically, just the fact that it allows you to think about something other than being ill could be enough to help you overcome your problem.

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