My earliest memory of car rides over the hill and through the woods (actually, north Texas cedar breaks) to Grandma’s house was of leaning out the car window to barf due to motion sickness. After a few such episodes, I always got the “shotgun” (front) seat, as that helped keep my lunch safely in place. My earliest memories of riding in Dad’s friend’s Cessna 170 on hot West Texas summer days are similar. Mr. Husky seemed to enjoy showing off what passed for a lake southeast of town by repeated steep-turn circles over it, with me in the deep pit back seat. Then there was the late-summer-day, dehydrated/hungry glider ride, including tight circling in the meager thermal over a pig farm… Need I say more?
Did things get better when I grew up? Only a bit. I have never been able to read during car trips, becoming queasy after only a few minutes. As it happened, my career required frequent airline travel, and I suffered motion sickness while taxiing, in cruise, on descent, and after landing. Only stewardesses – sorry, cabin attendants – of a certain age could tell of how much they disliked my presence on an airliner. Dramamine and I became good buddies, and I regarded the designer of reclining airliner seatbacks as a hero.
On one trip, sitting first row in first class, my seatmate insisted on a long conversation while turbulence made me increasingly ill. When I told him I was getting a bit sick, he launched into a long and colorful story about spectacular airsickness episodes as we bumped and ground down the final approach. Some people are so helpful! When the stomach pressure was about to explode, I bolted for the nearby lav; when the shocked stewardess tried to stop me, I said, “You’ll be happy I got up,” and she would have been. (Of course, if I tried that these days, I’d be tackled by her and nearby passengers and beaten to a pulp as a terrorist!)
Then there were boats: I could get nauseated just sitting in a docked boat rocked by a passing cruiser.
A passing anecdote: one day my dad called my brother to go flying on a warm West Texas day. On the way to the airport, they decided to stop off for a big Tex-Mex lunch of enchiladas, beans, chili, the whole bit. Big mistake. Once aloft and on their way somewhere, turbulence began to make them both airsick. They turned for home, and all the way back, argued over who needed to take the stick to keep from soiling the rented Cessna’s interior. So I wasn’t the only one in our family affected!
When we read about the pre-WWII Golden Age of Aviation, there is little mention of airsickness. Photos show men in suits with tightly buttoned collars and suits, and women in corsets, heels, hats, and stylish dresses. Just the thought of flying in such garb makes my stomach roil and my hand reach to unbutton an imaginary collar.
How, then, did this weak-stomached retcher become a pilot? I have told a big part of the story before, but there is more. On a particularly miserable airline flight, I realized that part of my intolerance for flying resulted from ignorance of what was going on. I had developed a kind of generic unease or fearfulness about flying that exaggerated my lifelong motion sickness. It seemed to me that learning more about airplanes would help. It was reassuring that even the great Bob Hoover had to conquer airsickness during his primary training.
All this coincided with my father’s death and a period of reflection and reaction, which included dealing with the motion sickness problem.
Having watched many an airshow and movie about WWII and later air combat, I have often wondered how the airmen tolerated the +/- g-forces, twisting maneuvers, inverted flight, and constant head-turning required. Turns out even our aerobatic and combat heroes are not immune to motion sickness. A report prepared by the American Society of Aerospace Specialists for the Aerospace Medical Association (ASAMA) to provide clinical guidelines for diagnosis and management of motion sickness states that more than 75% of troops become airsick “under extreme conditions.”
Of military primary flight students, 63% reported airsickness on the first flight, and only 15-30% claimed never to have gotten sick during training. For unknown reasons, the incidence of airsickness is reportedly twice as likely for women as for men; for both sexes, the incidence decreases with age. The report says, believably, that airsickness “can be induced in anyone with an intact vestibular system given the right type and duration of provocative stimuli.” It’s no surprise that the good doctors say the effects of airsickness “can range from distraction to near-incapacitation.” I’ll second that.
There is good news in the military experience; repeated exposure to the aerial environment and sometimes specific “desensitization” treatments in a lab can relieve airsickness in up to 85% of cases. From 1955 through 2001, 365 USAF crew members (not necessarily all pilots) were referred for evaluation of airsickness, and 199 (~55%) returned to flying status. It’s not clear to me what treatments the successful ones might have gotten.
The ASAMA report describes the USAF recommendations for prevention of airsickness, and they make sense to me, having used most of them myself:
- Avoid high-fat meals before flight
- Maintain adequate hydration
- Limit head motion during flight [in combat???]
- Watch the horizon [in combat???]
- Blow cool air on the face
- Slow diaphragmatic breathing
For me, being well-hydrated, not recently fed, and having cool air blown on my face are very effective measures.
There are some medications effective in reducing the occurrence or severity of motion sickness. The two most effective and best known are promethazine and scopalamine, but unfortunately, their sedating properties make them illegal for pilots. Other medicine and physical measures lack firm scientific data to support their use, but hey, I won’t argue with apparent success for those who favor them.
It’s possible to predict who is at highest risk of airsickness, which is especially common in those who are anxious at the time of flight. A study reported in the Journal of Aviation/Aerospace Medicine found that among civilian primary flight students flight-day anxiety was predicted by insomnia the previous night, fatigue, urinary frequency (!), and “apprehension.”
Looking back at my own motion sickness issues in aircraft, I believe a big factor was my ignorance about and generic fear of flying. On airliners, I used to react with concern to various sounds – sudden power reductions, pitch changes, sounds of flap motors and landing gear deployment, panels slamming shut, etc. My flight ground school began demystifying some of these things, and remarkably, I never got airsick during my student flights. As my dad and brother found, having one’s hand on the stick is good treatment for airsickness! The more I learned about aircraft and how they work, the more fascinating they became; it became an airline trip game to feel and hear the changes that used to concern me— even to predict them and explain them to concerned fellow passengers. From the time I began my private pilot training, I never again had more than occasional queasiness on an airliner, even in heavy turbulence.
Motion sickness is partly in the inner ear, but also in the brain and the mind.
I have tried online to find information about airsickness in early aviation, with limited success. One online history article merely says, about the DC-3 era, “The airlines wanted to fly higher, to get above the air turbulence and storms common at lower altitudes. Motion sickness was a problem for many airline passengers, and an inhibiting factor to the industry’s growth.” Having bumped along at low altitudes in light GA aircraft and a DC-3, I can easily imagine the “inhibition.” If any readers come across contemporary publications about airsickness, I’d very much like to have the information.
My experience in giving rides to non-aviators suggests that the pilot can do a lot to reduce the risk of airsickness among naive passengers. My rules have been to give rides only in calm air, preferably late day (with the benefit of distractingly beautiful sunsets and city lights coming up); explain everything in advance; keep up a calm chatter when ATC permits; not banking more than 20 degrees, and even then with explanations and advance notice; keeping an eye on the passenger’s facial expression and body language; and keeping a first flight short, usually 15-20 minutes. I’d be interested to hear others’ experiences, preventative measures, and methods for cleaning up an aircraft interior after a real Barf-O-Rama!