The taming of motion sickness

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Motion sickness, as many travelers know all too well, can strike on ships, trains, planes or in a car -- whenever the balance center in the inner ear senses motion that the eyes do not. Those mixed signals, which are sent to the brain, can literally be sickening.

So, if you're prone to motion sickness, don't even think about reading on a winding road or on a bumpy flight; the words on the page are still, but your inner ear senses movement. The result can be nausea, dizziness, clammy hands and, alas, vomiting.

The most common advice for avoiding carsickness and seasickness is to look at the horizon, as that reference point makes it clear you're moving. On a ship, it may be a good idea to stay out on deck where you can keep your eyes on the horizon. In a car, it helps to drive or sit in the front seat (as opposed to the back seat) because you can see farther ahead. On a plane, try to book a seat near the wings where it is more stable.

The youngest among us are thought to be the most susceptible to motion sickness, although it's not known why. Children, who can barely see out of a car window, pose a special challenge for parents, because they are doomed to the back seat. (Even puppies are more susceptible than adult dogs; panting, drooling and dilated pupils are all signs of motion sickness in animals.)

A few tricks will help smooth the car ride for young and old, human and canine: Stick to highways rather than stop-and-go routes or snaky back roads, and consider getting new shock absorbers, if needed, to minimize bounce.

Cooler temperatures might also help, said Dr. Joseph M. Furman, a professor of otolaryngology and neurology at University of Pittsburgh Medical Center, who used to drive with the windows cracked in winter to soothe his son who was in elementary school. If his daughter asked why, he would say, "Do you want your brother to puke or do you want to put on a coat?"

The best way to avoid motion sickness is, obviously, to avoid travel, which is next to impossible during the holidays, with invitations beckoning from far and wide. But planning can help make it more bearable. Below are suggestions from experts on how to combat motion sickness, especially in cars, and with special attention to children.

Technology fix

These days, children are often pacified with their 67th viewing of "Toy Story 3." But the jury is out as to whether movie watching en route will only make them more squeamish. Dr. Anne Mounsey, an associate professor of family medicine at the University of North Carolina in Chapel Hill, tells parents any screen activity requires "trial and error."

Children, or passengers of any age, who are only mildly sickened en route might do fine watching a fixed screen like a DVD player in a minivan. But a tablet that must be held steady? Not a great idea. Similarly, a hand-held game console provides too much visual stimulation at close range.

Children or adults can listen to an iPod instead, with their heads on the headrests for stability, eyes closed to limit stimuli.

And in this age of nonstop engagement with personal technology, a recommendation from Dr. Abinash Virk, the director of the travel and tropical medicine clinic at Mayo Clinic, in Rochester, Minn., is refreshing. "Spacing out is great," Dr. Virk said. "Your brain is having to deal with input from ears and eyes. The more you try to do the more likely you'll get nauseated."

Medication fix

There are several drugs that can be useful. A prescription-only scopolamine patch -- worn behind an ear -- reduces nausea associated with motion sickness, studies have shown. But its side effects include dry mouth and blurred vision. That said, the patch lasts three days, making it convenient for the seasick-prone on a Caribbean cruise. However, children under age 18 should not use a scopolamine patch as it can cause "terrible toxicity," said Dr. Sydney Spiesel, a clinical professor of pediatrics at Yale University School of Medicine. It should also not be used by anyone who has or has had glaucoma.

Over-the-counter options include Dramamine, which has recently introduced chewable tablets in grape flavor, and can be used by children 2 and older. It treats nausea and vomiting, and also may cause drowsiness.

"If you're asleep, you don't get motion sick," Dr. Furman said. "Eyes are closed, the brain circuitry shuts down."

Bonine, which can be used by those 12 and older, is an antihistamine that can also tackle nausea and other symptoms of motion-related illness. Dr. Mounsey, who was an author of a recent review of research, said that antihistamines like Zyrtec and Allegra won't alleviate motion sickness.

Most drugs work best if ingested an hour before travel, although a scopolamine patch must be worn at least four hours in advance. But that time frame might change in the future. With U.S. Navy medical researchers, NASA's Johnson Space Center developed a scopolamine nasal spray that can deliver a fast-acting remedy for motion sickness. NASA also worked with a pharmaceutical company to create nasal gel to treat, er, space sickness.

"It gets into the bloodstream quickly," said Capt. Rita Simmons of the Naval Medical Research Unit in San Antonio, who worked with Lakshmi Putcha, the chief pharmacologist at NASA. "Side effects are almost zero."

In October, NASA and Epiomed Therapeutics of Irvine, Calif., signed an agreement to commercialize a nasal spray to fight motion sickness, so in the future a squirt of scopolamine midflight might make those paper bags tucked in the seat pocket unnecessary.

Alternative meds fix

Ginger has been shown to prevent nausea associated with motion sickness, so pack powdered-ginger capsules, crystallized ginger or even ginger Altoids. Some motion-sickness sufferers wear acupressure bands, which have a plastic stud that has to be positioned correctly on the inner wrist, to help keep nausea at bay. But evidence proving their efficacy is mixed. Still, at $10 or less each (Sea-band, for instance) there's little downside to trying them, and if they work for you, they are reusable.

If all else fails

Occasionally, no amount of strategizing can prevent the inevitable.

"Different kids have different degrees of sensitivity to motion sickness," Dr. Spiesel said. "If you have a kid who is really sensitive, you want to be careful what you feed them, and match the upholstery of the car. Sometimes nothing you do helps."

Or there's the Hurl-e, also known as the CarSik bib, which is a hands-free bag for those who may succumb to vomiting. Costing $10.74 for a six-pack, bags have a strap so they can be worn like a bib, and make cleaning up a cinch.

A YouTube video about the CarSik bib touts its virtues this way: "Drive with peace of mind knowing that if your child gets carsick it will stay clean and dry and you won't have to deal with the mess."

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