moving makes me sick

On the move and sick of it

YOUR HEALTH
DR GITA MATHAI

Indians love to travel. We travel to attend family events, on pilgrimages and to holiday in exotic spots. Yet, for 25 per cent of the population, travelling is not a pleasure but an exhausting saga of attacks of kinetosis (a fancy medical word for motion sickness). The giddiness, fatigue, nausea and vomiting (all or any of the symptoms) that characterise kinetosis also affect 45 per cent of daily commuters and a staggering 60 per cent of student aircrews. Travelling by plane, ship, or car (especially along winding roads) is torture for those affected by motion sickness.

Kinetosis can also affect people who watch movies or TV programmes on large screens, play computer or video games for prolonged periods, deal with virtual reality or ride roller-coasters and giant wheels.

What causes this exhausting illness? The inner ear has a vestibular apparatus that detects movement. Its input is validated by sensory input from the eyes and from the brain’s perception of the position of the body and limbs. The input becomes discordant when the body is still but the eyes perceive movement, as in a train, with 3D games, virtual reality and large screens. Motion sickness is caused by movement that is felt but not seen or seen but not felt. The brain gets confused, as it cannot reconcile the sensory inputs. It decides that a hallucinogenic toxin has entered the body and causes violent contractions of the stomach to expel the “poison”.

Motion sickness is more likely in 2-12 year old children, particularly if they are fed a heavy breakfast before a long commute to school. Infants (under two years) are immune. Women are more likely to have motion sickness if they are pregnant, menstruating, or on hormone therapy. The anxiety brought on by the thought of motion sickness is likely to precipitate an attack.

If the nausea is tolerated long enough, motion sickness may go away. This, however, cannot be guaranteed and is not a viable option.

Most victims of motion sickness prefer to take medication before going on a journey. Such pills should be swallowed at least an hour before travel to give them sufficient time to act. A wide range of centrally acting medicines like Dramamine, Avomine or Stugeron can be used. Sedation is a side effect and must be anticipated. The usual anti emetics like metachlopromide (Perinorm) Domperone or Ondesterone do not work in motion sickness. It is advisable to contact your physician and obtain a prescription for the drug that suits you best. The dosage in children has to be calculated on a mg/kg basis and is not based on age.

Certain simple precautions can help you cope:

Be aware of situations that tend to trigger symptoms and avoid them.

Optimise seating position while travelling. Sit in the front seat of a car or bus, or over the wing of an aircraft. Keep your head still. Try to focus on a distant stationary object.

Do not eat a heavy meal, drink caffeinated beverages, alcohol or eat chocolate or sweets before travel. Chewing gum does help.

Eating ginger helps some people.

Some odours like mint or lime may reduce nausea. Other smells like cigarette smoke may aggravate it.

Acupressure has proven to be useful in motion sickness. Steady pressure over the K-9 point located on both hands in the middle phalanx of the fourth (ring) finger stops the nausea. You can also try the P6 acupressure point located on the inside of the wrist, three finger widths up the arm. Repeat the pressure on both wrists.

Wristbands that apply continuous pressure to these areas are available commercially. Magnetic bracelets have anecdotally been known to help some people. It is better to try non medical interventions before opting for sedative medication.

The good news is that these pressure points also work in the morning sickness of pregnancy. The bad news is that once you have motion sickness, it can return to torment you at any age, even after a long, symptom-free interval. It has to be factored in when choosing a career — becoming an airline pilot, astronaut or sailor may not be a logical choice.

Dr Gita Mathai is a paediatrician with a family practice at Vellore. Questions on health issues may be emailed to her at yourhealthgm@yahoo.co.in