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Aviation Forum / General / Soaring / December 2007The Relief Band for Nausea Relief
I've reviewed the relief band in the context of my experience as a glider pilot. I'd love to hear comments from other pilots about their experiences. http://joelodom.blogspot.com/2007/12/relief-band-for-nausea-relief.html > I've reviewed the relief band in the context of my experience as a > glider pilot. I'd love to hear comments from other pilots about their > experiences. > > http://joelodom.blogspot.com/2007/12/relief-band-for-nausea-relief.html Doesn't work for me. Since this whole business is really just psychological, maybe I'm too skeptical for it to work. Luckily a friend very graciously lent me his (his wife swears by it, just goes to show...) and so I was only out a pair of batteries. If you can take one for a test run then it's probably worth a shot.  SignatureMichael Ash Rogue Amoeba Software I know someone with a couple thousand hours in gliders, who admits to getting airsick at the beginning of the season every year. He swears by the accupressure bracelets (wristbands) and raspberry tablets. Since I don't have a problem with motion sickness I do not know what either does or why, but he says they work. > I've reviewed the relief band in the context of my experience as a > glider pilot. I'd love to hear comments from other pilots about their > experiences. > > http://joelodom.blogspot.com/2007/12/relief-band-for-nausea-relief.html I have used and recommended ginger as a nausea treatment. It's the only one that has worked for me and several colleagues. Trust me, it's one of the old wives remedies that really does work and has no side effects. Magnets, pressure devices and psychic bracelets all belong to the "faith healer" category. Mike I'm one of the colleagues Mike referred to and I endorse using ginger. I cut off a 1/4 slice of the root and put it in my cheek like chewing tobacco. Stays with me the whole flight. Took a couple flights to get use to the taste, but now I enjoy it. >I have used and recommended ginger as a nausea treatment. It's the > only one that has worked for me and several colleagues. Trust me, [quoted text clipped - 5 lines] > > Mike Works for me, though I rarely find that I need it while soaring. I do find that it is only effective if the directions are followed precisely. It has to be positioned so the "tingle" goes up the palm to the two middle fingers. bumper > I've reviewed the relief band in the context of my experience as a > glider pilot. I'd love to hear comments from other pilots about their > experiences. > > http://joelodom.blogspot.com/2007/12/relief-band-for-nausea-relief.html > I've reviewed the relief band in the context of my experience as a > glider pilot. I'd love to hear comments from other pilots about their > experiences. I sail as well as flying, and am cursed with rotten sea-sickness. I tried the pressure bands and they did have some effect, but the only thing that works effectively for me is transdermal hyoscine - Scopaderm patches. When they went off the market for a few years I had to give up sailing. I've never needed or tried them for flying though. Ian >> I've reviewed the relief band in the context of my experience as a >> glider pilot. I'd love to hear comments from other pilots about their [quoted text clipped - 9 lines] > > Ian Would suggest that being PIC and the potential effects of Scopolamine/ Hyocyamine are not compatible. Effects are subtle and variable from time to time as well as from individual to individual. Not at all benign for flying--or driving, or running dangerous machinery. Hartley Falbaum > >> I've reviewed the relief band in the context of my experience as a > >> glider pilot. I'd love to hear comments from other pilots about their [quoted text clipped - 7 lines] > > > I've never needed or tried them for flying though. > Would suggest that being PIC and the potential effects of Scopolamine/ > Hyocyamine are not compatible. Effects are subtle and variable from time to > time as well as from individual to individual. > > Not at all benign for flying--or driving, or running dangerous machinery. I think the "potential" bit is important. It would be daft to go flying without knowing the effects of this - or any - medication. However, having had dozens of those little patches behind my ears for, cumulatively, months of my life, I am happy with them and quite confident that I could fly or drive with them. The same may not go for others, of course. They take 24 hours to get up to full power anyway, so anyone trying them should have reasonable warning of side effects. In flight air-sickness would, I suspect, be far more dangerous. Ian >>>> I've reviewed the relief band in the context of my experience as a >>>> glider pilot. I'd love to hear comments from other pilots about their [quoted text clipped - 25 lines] > > Ian Scopolamine not only causes tiredness it can also cause blurred vision and dilates the the pupils which are also reasons not to use it while flying. Wayne Hoover > Scopolamine not only causes tiredness it can also cause blurred vision > and dilates the the pupils which are also reasons not to use it while > flying. Indeed - if one is so affected. If one is not so affected, no problem. Ian > > Scopolamine not only causes tiredness it can also cause blurred vision > > and dilates the the pupils which are also reasons not to use it while > > flying. > > Indeed - if one is so affected. If one is not so affected, no problem. As a physician and aviation medical examiner I wish to demur as clearly as possible from any recommendation to use scopalamine for motion sickness while flying. 1: Users of perfomance-decreasing drugs are almost never aware of mild impairments that are nevertheless easily measured in formal testing. Therefore to say, 'try it and if you don't feel it affects you' is to perpetuate personal cluelessness. 2: scopalamine is a prohibited medication per FAA aeromedical rules, so if you have an incident and are found to have been using it, be aware that your insurance may not cover you, and you may face enforcement action on your licence if you survive. The non-requirement of medical certification for glider pilots is not permission to fly impaired. Every pilot is required by FARs to refrain from flying with any unsafe condition. 3: scopalamine has an incredibly long persistence in the body. For example, years ago, I put a patch on my teenage daughter before an airplane trip because she feared motion sickness. She became drowsy after a couple of hours, and I peeled it off promptly. She spent most of the next two days sleeping off and on. She said she 'felt fine' (see point 1). 4: I would no more fly with a pilot using scopalamine than I would fly with a pilot who just had a glass of wine. 5: Air force and astronaut use of scopalamine is done because of the nature of the mission, and the fact that motion sickness can be literally incapacitating - when the choice is between incapacitation and decreased function, and one can't abort the mission, the choice is no choice at all. But the fact that it's used in severe situations does not mean it's a good idea in recreation! 6: If I knew that a physician colleague had actually recommended scopalamine for a pilot, and an incident had occurred, I would be unhappily willing to serve as an expert witness against that colleague. (It is a standard of medical practice to do no harm.) Dan Johnson md > As a physician and aviation medical examiner I wish to demur as > clearly as possible from any recommendation to use scopalamine for > motion sickness while flying. <snip> So would you say the mild, unnoticeable impairment is worse than vomiting repeatedly over the controls? What would you say to the pilot faced with such a choice? Dan > > As a physician and aviation medical examiner I wish to demur as > > clearly as possible from any recommendation to use scopalamine for [quoted text clipped - 5 lines] > vomiting repeatedly over the controls? What would you say to the pilot > faced with such a choice? If I read Dan G correctly, he has said that just because a person that has taken the scopalamine thinks they are unaffected doesn't mean that's actually the case. They might actually be suffering considerable impairment. Quite how someone who suffers airsickness gets over it is another matter. I suspect a lot of them move on to some other sport. > 2: scopalamine is a prohibited medication per FAA aeromedical rules, > so if you have an incident and are found to have been using it, be [quoted text clipped - 3 lines] > impaired. Every pilot is required by FARs to refrain from flying with > any unsafe condition. You piqued my interest in the US rules so I went looking for them. As far as I can see there is no such thing as a "prohibited" medications list in FAA regs. I did find, in Title 14 Part 91, the following: 91.17 Alcohol or drugs. (a) No person may act or attempt to act as a crewmember of a civil aircraft-- (1) Within 8 hours after the consumption of any alcoholic beverage; (2) While under the influence of alcohol; (3) While using any drug that affects the person's faculties in any way contrary to safety Also on the FAA website a guidance note on OTC medicines: http://www.faa.gov/pilots/safety/pilotsafetybrochures/media/Meds_flying_web.pdf Which makes it clear that a pilot should not fly if using a drug that lists drowsiness as a side-effect. All the new-generation "non-sedating" antihistamines list "drowsiness" as a side-effect and I personally know several pilots who use them for hay-fever relief :-/. Dan On 12/27/07 5:01 PM, in article 1054a916-68c7-4785-aca1-73d232ad846a@r60g2000hsc.googlegroups.com, "Dan G" <dangrey@gmail.com> wrote: >> 2: scopalamine is a prohibited medication per FAA aeromedical rules, >> so if you have an incident and are found to have been using it, be [quoted text clipped - 21 lines] > > Also on the FAA website a guidance note on OTC medicines: http://www.faa.gov/pilots/safety/pilotsafetybrochures/media/Meds_flying_web.pd> f > Which makes it clear that a pilot should not fly if using a drug that > lists drowsiness as a side-effect. [quoted text clipped - 4 lines] > > Dan The FAA allows a lot of medications to be used by pilots that have potential side effects. Then again, there are certain medications that are prohibited outright, whether or not the pilot has side effects. Examples of ones that can be used if there are no side effects after a 48 hour ground test (this assumes that the underlying condition itself would not prevent safe performance of crew duties): Motrin and other NSAIDs Antibiotics Non-sedating antihistamines (Allegra, Claritin, and Clarinex if no side effects after 48 hours, but not Zyrtec) Blood pressure meds (there are some additional rules with this one.) Etc. etc. There are many like this. Examples of meds that can't be used at all, regardless of side effects, or effects of the underlying disorder: Antidepressants Antipsychotics Muscle relaxers Antiseizure meds (whether or not there is a seizure disorder) Sleeping pills (duh!) Narcotic pain killers etc. etc. There are many like this, also. Sometimes history of use of these meds requires a waiver ("special issuance", in FAA lingo), sometimes just a waiting period after the last dose. For what it's worth, you should get competent advice from someone who knows before flying after use of any meds. But the truth of the matter is, FAR 61.53 makes you your own flight surgeon, by placing the responsibility for medically grounding and ungrounding, squarely on you. Even power pilots who require a medical can determine (between their medicals) for themselves if they can safely perform their crew duties. AME's only perform the medical exam, they don't ground and unground the way a military flight surgeon does, between medicals. Again, I recommend you make this kind of decision only after seeking competent advice (which, in some cases is not your local AME: many of them do so few medicals and have such little aviation medicine expertise that they just don't know, no matter how well meaning they are). Respectfully, Bullwinkle Also a physician, board certified in Aerospace Medicine > Examples of meds that can't be used at all, regardless of side effects, or > effects of the underlying disorder: [quoted text clipped - 7 lines] > these meds requires a waiver ("special issuance", in FAA lingo), sometimes > just a waiting period after the last dose. Can you or anyone else link to this list please? Dan On 12/27/07 5:49 PM, in article 1da22e69-3628-4ff1-9ad5-9e4314d8e047@n20g2000hsh.googlegroups.com, "Dan G" <dangrey@gmail.com> wrote: >> Examples of meds that can't be used at all, regardless of side effects, or >> effects of the underlying disorder: [quoted text clipped - 11 lines] > > Dan The FAA doesn't publish a list of approved and disapproved meds: they say it would change too frequently to keep current (probably true). Good approximations of the current meds list can be found at either: Www.aviationmedicine.com Www.leftseat.com Respectfully, Bullwinkle > For what it's worth, you should get competent advice from someone who knows > before flying after use of any meds. [quoted text clipped - 7 lines] > do so few medicals and have such little aviation medicine expertise that > they just don't know, no matter how well meaning they are). Amen. I wasn't going to take the time to add anything to this thread, but can't resist a summary. Pilots may be: 1: Unimpaired 1B: Unaware of impairment (feels the same as unimpaired) 1C: "Potentially" impaired (by meds, fatigue, etc.) 2: Impaired and aware of it. 2B: Able to compensate or escape to safety 2C: Unable to compensate or escape Advice-givers should generally refrain from recommending anything that could be associated with potential impairment (see elsewhere in this thread for instances of such). Pilots are responsible for self-assessment, but as this is difficult (impossible to do objectively), should seek and welcome observations and counsel of others in the decision not to fly. Example of "medical" impairment: Simply stay sober while watching other people consume ("medical") alcohol at a social gathering. If you're watching carefully, just ONE drink changes the verbal and motor performance of everyone except a daily-drinker. They s-l-o-w d-o-w-n mentally, physically, verbally. Example of physical impairment relevant to this thread: motion sickness and the sopite syndrome (motion-induced drowsinesss): I get very sleepy before I get sick; vomiting on my shirt on final (which I've done) is not as distracting, in my experience, as experiencing micro-sleep while thermaling (which I've done). I realized this spring that this is getting worse for me; one April day at 3000 agl, I forced myself to make 2 decisions: one, to return, land, and stow the glider; two, to decide whether I should quit soaring. My decision is relevant to the suggestion by some that motion-sickness drugs are all right because they help, because the impairment of drug (undetected by the user) is less than the impairment of the motion sickness (unavoidable and distracting). My decision was to *acclimate*, not to take medications - the 'treatment' was to take soaring flights more often, briefly, to acclimate to motion sickness, and to drink a cup or two of coffee before lunch (caffeine has been shown to enhance performance slightly) on soaring days. As an AME, physician, and opinionater, I feel quite safe in recommending that one acclimitize. There are ways to do this other than flying; I know of an aerobatic pilot who stood on his head several times a day to maintain acclimation during non-flying periods; or play that involves spinning and jumping should also help. On the other hand, I do not feel quite safe in recommending that anyone fly when potentially or actually impaired. In saying this, I realize that some tasks are simple and hard to mess up, e.g., local soaring on a sunny calm day. And other tasks are exceedingly complex, e.g., single-pilot hand-flown IFR in IMC, at night, in rain or snow, to minimums, in a complex turbocharged airplane, or contest flying on the ridge with complex navigation and planning tasks. (We just lost a colleague in NZ like this, obviously one factor went undetected; what it was, we'll never know.) Thus "Impairment" is relative to the task at hand. Best wishes, Dan Johnson > > > Scopolamine not only causes tiredness it can also cause blurred vision > > > and dilates the the pupils which are also reasons not to use it while [quoted text clipped - 5 lines] > clearly as possible from any recommendation to use scopalamine for > motion sickness while flying. You go right ahead, and welcome. I never have felt the need to use a patch while flying because, although I am plagued by sea-sickness, I have never had any significant problems in the air. If I did start to suffer air- sickness, however, I would cheerfully consider using Scopaderm TTS patches. They are available in the UK as an over-the-counter medicine, and the relevant warning simply says (and I quote) "This medication causes drowsiness which may continue the next day. If affected do not drive or operate machinery. Avoid alcoholic drink." Note that "if affected". As I wrote before, I have spent months of my life wearing these patches and have noticed no side effects at all, save a slightly dry mouth which is useful reassurance that the patch is active. I'm not a doctor (well, not your sort). I'm not making any recommendations. I am, however an experienced user of Scopaderm, and I have a healthy desire to preserve my own life. Best wishes, Ian <snip> > I never have felt the need to use a patch while flying because, > although I am plagued by sea-sickness, I have never had any [quoted text clipped - 9 lines] > save a slightly dry mouth which is useful reassurance that the patch > is active. <snip> Who is going to judge if you are affected? Judging ourselves is the hardest thing to do. > > Note that "if affected". As I wrote before, I have spent months of my > > life wearing these patches and have noticed no side effects at all, > > save a slightly dry mouth which is useful reassurance that the patch > > is active. > Who is going to judge if you are affected? Judging ourselves is the > hardest thing to do. That's a very good question. Can I stress that I would only consider wearing the patches while flying as a last resort. As for effects, there are two categories. First, drowsiness. I have worn them enough to be confident that FOR ME there is no problem with drowsiness. It's only a potential side effect - some people are strongly affected and some not at all. Second, other impairments. I have not seen anything in the literature - I read this up quite carefully, as a lay person, before using the patches whilst sailing single-handed - to back up the suggestion that Scopolamine generally or even commonly has similar effects to alcohol. If I did decide to try it then I would certainly fly with an instructor and ask for a really tricky check flight. Any problems and of course I wouldn't fly solo. Ian >> If affected do not drive or operate machinery. > Who is going to judge if you are affected? Judging ourselves is the > hardest thing to do. The same person that judges if you are fit to fly based on all factors: Had enough sleep? Backache? Headache? Leg(s)/Arm(s) ache? Emotionally fit? The list is endless. If you are in doubt about being able to judge if you are fit to fly, then don't fly. Regards, -Doug > >> If affected do not drive or operate machinery. > > Who is going to judge if you are affected? Judging ourselves is the [quoted text clipped - 4 lines] > Emotionally fit? The list is endless. If you are in doubt about being > able to judge if you are fit to fly, then don't fly. The problem as I understand it with this drug is that what it impairs in those affected are the faculties we use to decide if we are impaired... >>>> If affected do not drive or operate machinery. >>> Who is going to judge if you are affected? Judging ourselves is the >>> hardest thing to do. >> The same person that judges if you are fit to fly based on all factors: >> Had enough sleep? Backache? Headache? Leg(s)/Arm(s) ache? >> Emotionally fit? The list is endless. If you are in doubt about being >> able to judge if you are fit to fly, then don't fly. > The problem as I understand it with this drug is that what it impairs > in those affected are the faculties we use to decide if we are > impaired... It is up to you and your judgment to decide to do something like what Ian has suggested: "If I did decide to try it then I would certainly fly with an instructor and ask for a really tricky check flight. Any problems and of course I wouldn't fly solo." Now, if this drug is so perverse that when taken it causes one to then cancel the flight evaluation, then we really do have a problem. ;-) Regards, -Doug > > The same person that judges if you are fit to fly based on all factors: > > Had enough sleep? Backache? Headache? Leg(s)/Arm(s) ache? [quoted text clipped - 4 lines] > in those affected are the faculties we use to decide if we are > impaired... That claim has been made, but I have seen no evidence here or elsewhere to support it. The four main side effects of Scopolamine - are dry mouth, drowsiness, dizziness and blurred vision. Of these only the dry mouth is common. The claim that a Scopaderm TTS patch has the same effect as a glass of wine does not seem to be borne out by the literature, though I am happy, as always, to take correction on that point. Ian > Would suggest that being PIC and the potential effects of Scopolamine/ > Hyocyamine are not compatible. Effects are subtle and variable from time to > time as well as from individual to individual. Test before use - i.e., take a few times when you're *not* flying or driving to see if it has any effect. Scopolamine only produces tiredness in less than 20% of subjects (do a pubmed search). If it *does* make you tired, there are alternatives that are less effective for reducing sickness but also have a lower rate of inducing tiredness. I can't recall the exact drugs off the top of my head but again a pubmed or Cochrane search should find the answer. Also agree with Ian - being perhaps a little tired (and who hasn't flown a bit tired, especially towards the end of a long flight?) is safer than vomiting all over the controls! The obvious rejoinder is not to fly at all, but that may not be acceptable to the person concerned. BTW Scopolamine is also widely used by astronauts, many of whom (think it's something like half) suffer from space sickness. You don't know if you're susceptible until you're in zero G for some time, so it's impossible to know if an individual is going to suffer before flight. Both NASA and the Russians seem happy for their people to be fully dosed up on scopolamine during missions! Dan > If it > *does* make you tired, there are alternatives that are less effective > for reducing sickness but also have a lower rate of inducing > tiredness. When I was looking for an alternative to the patches I visited a very helpful doctor on the Isle on Man. He was a sailor too, and was happy to prescribe me something more powerful than the usual over-the- counter stuff. As usual, the drugs came with a patient information leaflet, including details of side effects. "Caution. May induce nausea, dizziness and vomiting." Not, I felt, the greatest confidence builder for an anti seasickness pill. Ian > Also agree with Ian - being perhaps a little tired (and who hasn't > flown a bit tired, especially towards the end of a long flight?) is > safer than vomiting all over the controls! The obvious rejoinder is > not to fly at all, but that may not be acceptable to the person > concerned. This will obviously depend on just how tired we're talking, and also personal experience, but speaking for myself as someone who's done both, I would *vastly* prefer being a little tired. Recovery from airsickness is faster but the episode itself is much more impairing and dangerous. SignatureMichael Ash Rogue Amoeba Software |
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