It’s enough to make you sick

A fairly common occurrence with pilots is air sickness — the nausea or vomiting associated with flying, especially when flying aerobatics.

I have been doing flight physicals and have been around aviation for the last 40 years and I have found that nausea in most airmen can be dealt with in one way or another. 

However, once in a while, I run into that rare individual whose nausea is severe enough to cause extreme difficulties. An Asian student at a local flight school recently came to my office complaining of nausea and vomiting every time he flew. My examination was unremarkable, and he had not had problems with motion sickness in cars prior to coming to the U.S. for flight training. He also did not describe any problems with, say, roller coasters at amusement parks.

It reminded me of my trip to Florida in 1999 to get checked out in my new Extra 300 aerobatic airplane. My checkout was to be done by none other than the famous Clint McHenry, well-known aerobatic contestant and air show pilot.  Before the trip, I was concerned about nausea.  At times during my previous flight training I had felt nauseated, especially doing ground reference maneuvers on a warm day with some bumps. So, I packed some anti-nausea medications, as well as a ReliefBand, an electronic anti-nausea device given to me by a friend.

The day came and I hopped on an airliner for the trip to Florida. I was very anxious — I found myself actually nauseated on the drive to the airport, probably due to nerves.

On my arrival, McHenry discussed the checkout we would be doing. The first order of business would be simply to get comfortable flying the airplane normally, which meant lots of takeoffs and landings.  However, each flight also would include aerobatics and that is what worried me.

The FAA does not allow a pilot-in-command to take typical over-the-counter or prescription anti-nausea drugs or use any of the anti-nausea patches worn behind the ears, such as Transderm with scopolamine, due to sedation. Because of that, I decided to let McHenry take over the PIC duties so I could take the medications. I also wore the ReliefBand. It straps to the inside of the wrist and works like acupuncture, delivering a mild electric shock to the median nerve, which blocks nerve impulses that produce nausea and vomiting. The stimulation produced by the ReliefBand is adjustable to five different levels.

When we got in the airplane and flew off, I was still feeling some nausea. As we progressed through the first aerobatic maneuvers, my nausea increased. Luckily, the flights were all short (30 minutes), because the aerobatic fuel tank in the Extra holds only 13 gallons. As the flight progressed, I found myself dialing the ReliefBand stimulation up to number five, which made my entire left hand shake markedly. It certainly kept my mind off the nausea.

Upon landing, I had to rest for two hours, drink 7-Up, recline in a chair, and take a nap — all to get ready for the next flight. By repeating this regimen, I was able to fly approximately three times a day until I finally soloed.

The good news is that, with experience, nausea symptoms do get better — 99% of the time. I’ve had this airplane for five years now and fly it quite hard. I do not take anti-nausea medications, and I do not use the ReliefBand, but I can induce nausea by flying hard aerobatics several times. I never get to the point of throwing up, and between flights I rest and drink some 7-Up to settle my stomach.

I advise students who are experiencing nausea early in their training to let their instructor know.  Try to schedule training flights early in the morning or late in the evening when the air is smooth and the temperature is cooler.  Eat only light, non-spicy meals before a scheduled flight.  To reduce stomach acid, you can take over-the-counter antacids such as Tums or you can take medicines such Tagamet, Zantac and Nexium. These all can be taken safely because they produce no sedation. Use of the ReliefBand is also allowed by FAA. It costs about $79 and you can find it at Aeromedix.com. Of course, if you become nauseated with every flight, it’s time to see your doctor.

Dr. Guy Baldwin is a family physician and Senior Aviation Medical Examiner in Tulsa, Okla. A member of the EAA Aeromedical Council, he has more than 4,000 hours. He owns a Harvard T-6, a Cessna 210 and an Extra 300, in which he flies in airshows and aerobatic contests.

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