I was very sad to read of the recent death of a crew member on the Salty Dog Rally. According to this article by Don Street, the cause may have been, at least partly, dehydration from seasickness.
And Don suggests how that could possibly have been avoided: a seasickness medication delivered by suppository.
Based on my own experience with a crew member who was so seasick I feared for his life, I think Don is probably right.
And, further, I recommend that all boats venturing offshore should carry anti-seasickness suppositories.
In the case on our boat, like Don’s experience, the crew member slept for about 6 hours (his first real rest in 3 days) after using the suppository and awoke able to keep down both food and water; and had no further trouble for the rest of the voyage.
What Don does not mention is the particular medication he used. In our case it was Gravol Suppositories¹. However, do be aware that the person who uses this will likely be out for the count and useless for at least four hours.
¹Clearly I’m not a doctor, so make sure you do your own due diligence, including consulting your doctor, to make sure this particular drug is going to be safe and efficacious for you and your crew.
Let me close by extending our condolences to the family of the crew member. How horrible that what should have been a fun life-experience turned into a tragedy.
Comments
If you have general thoughts on seasickness medications, please comment on one of these articles on seasickness, not here. We have already discussed medications and other remedies there.
I can attest to the effectiveness of the Gravol product in your article. After three days on passage from the BVIs to Bermuda, I was suffering terribly from seasickness not able to keep food, drink, or the oral version of Gravol down. After my watch, I was helped to the cabin floor by the other two people on board (the owner and crew). They were quite concerned for my wellbeing. I remembered I had brought the Gravol suppository and took it. After six hours of sleep during my off-watch I was back on my feet, did my three-hour watch, and was able to start drinking and eating again, even cooking dinner the next day. I was fine for the remainder of the trip.
I tried Sturgeron 15 on a passage from Newfoundland to Cape Breton with poor results. It prevented me from vomiting but I felt all the other symptoms of seasickness and was quite drowsy. I followed the package directions of one tablet every eight hours but failed to notice the part about “as needed”. Perhaps if I took only one tablet daily as mentioned in your article my results may have been better.
My best passage occurred from Nassau to Annapolis. My doctor prescribed an anti-vertigo medication, Teva-Betashitine 24 mg (Betahistine HCl). The only time I felt seasick was after I stopped taking the pills and we ran into stormy weather rounding Cape Hatteras.
Each passage had slightly different sea states but nothing terrible. However, they all had the ocean swells in common that get to me. I also believe different states of physical fitness and mental health could have affected the three different results above. Of note, the first two boats above were centre cockpit, 45 foot and 42 foot respectively, and the third was aft cockpit and full keeled, 41 foot.
On my next passage, I will try the Gravol 12-hour slow-release tablets to see if it helps ease the drowsiness (knockout) side effect. I will also include the Gravol suppository just in case; I know that it works. I may be a sucker for punishment but the joy of sailing won’t stop me! I’m sure that I am not alone here.
Hi Rob,
Thanks for the confirmation. I have had the same experience with Sturgeon.
Hi
Astronauts use Phenergan 25-50 mg every six hours as well needed. This will make you very sleepy if taken in that high a dose.
I use only one Phenergan 25 mg as a sleeping pill the night before a voyage like the Drake’s Passage and add scopolamine patch the next morning.
Scopolamine and Phenergan have serious side effects and should be tried out and discussed with your physician before a voyage.
The navy tested Phenergan against meclizine, bonine and the common OTC sea sickness pills by doing loops in a plane. Subjects got to 120 loops before “oops” with Phenergan vs 10-20 loops with the other common sea sickness anti-histamines.
Stugeron commonly causes a serious headache and is also not as effective as Phenergan.
I have been a ship’s physician on 44 cruises, multiple times across oceans and hold a US Coast Guard Captain’s license.
Best wishes
Charles
Charles L Starke MD FACP
s/v Dawnpiper
I believe Gravol is sold as Dramamine in the US. As far as I know, is not available as a suppository in the US.
Promethazine, generic for Phenergen, is available as a suppository and is very effective (and it knocks you out a bit), but it is prescription. My wife has used this for motion sickness and nausea related to chemo. Talk to a doctor, but it is the most common medication for serious nausea in the US.
Yes, this is a VERY important reality, and some effective treatment should be in the kit.
I am a doctor. Here is as statistically-valid review as you will find on the subject: https://pubmed.ncbi.nlm.nih.gov/21678338/
I know of sailing adventure trips which require all participants to pretreat with scopolamine patches. None of the treatment modalities mentioned in the article interact in a serious way with chronic medical problems or existing medications. The major risks are inattention when attention is required and inability to sweat when necessary for body cooling. Gravol is benadryl. Taking 100mg (instead of the usual therapeutic 25mg dose) will make you very sleepy, perhaps hallucinating. Phenergan is also sedating and can cause alarming side-effects on occasion (dystonia). Unless you are losing fluids excessively through the skin or bowel, the failure to take fluids and minimal-volume vomiting is unlikely to cause serious medical signs of dehydration for 3 days. This is particularly true because the symptoms of seasickness cause you to be mostly recumbent and useless during a passage. In the case quoted here, if the history is medically valid, seasickness was not likely to be the cause of death. As humans have experienced over the millennia, seasickness makes you want to die but doesn’t satisfy that wish.
Hi Bruce,
I agree seasickness in and of itself won’t kill you, although you might wish it would.
That said, having seen really bad seasickness on several occasions I think the dehydration can kill, and that’s why I think that some form of non-oral medication should be aboard all boats.
Also, I had, and have seen very bad issues with the patch to the point that I banned it on my boat:https://www.morganscloud.com/2017/01/07/seasickness-revisited/
Hi John,
Seasickness, as you mentioned is horrible.
I have had only once, when down in the engine room, temps close to 55C” and sky-lites closed in the Gulf of Biscay.
This well before the days of Gravol.
Afraid to die the first hour, afraid not to die the second !!