When cookies are tossed; tools for successfully managing motion sickness

Airman, March, 2005 by Scott Wagers

How excited would you be about your job knowing that every day you show up for work, there is a very good chance you'll lose your lunch? That you'll become so physically ill, that your stomach will upchuck everything you've eaten since you were in the 1st grade.

For nearly four years, Staff Sgt. Scan White has lived with that reality. Despite this, he quickly describes his job as "the opportunity of a lifetime."

The location of Sergeant White's work center is part of the problem. When it's not physically moving in well-choreographed loops through the lower atmosphere, you'll find his red, white and blue painted office parked on the flightline at Nellis Air Force Base, Nev.

Sergeant White is not an enlisted pilot. He is one of two aerial-qualified still photographers in the U.S. Air Force's Aerial Demonstration Squadron--better known as the Thunderbirds.

But it's not the physical act of flying that causes the occasional malaise to the 12-year veteran with nearly 150 flying hours in the F-16 Fighting Falcon. It's what he does while he's flying that can turn his stomach inside out.

"It doesn't happen all the time and it's specifically related to looking through the camera during the aggressive parts of the flight," explained Sergeant White.

He further describes a four-ship configuration called the "Diamond Roll" where spacing between wing tips is a mere 19 inches apart and skillfully maintained throughout the entire spiraling maneuver.

"When I'm framing up the plane next to me, it looks as though we're sitting completely still. But my inner ear--feeling an average of four to

five G's or higher, depending upon which position we fly--definitely knows I'm moving." And that's where it can get ugly.

With a camera in one hand, and a freezer bag in the other, Sergeant White is sometimes overwhelmed with an onset of extreme nausea, cold sweats and ultimately the uncontrollable need to throw up.

"It's called sensory conflict," said 1st Lt. Eydin Hansen, an aerospace physiologist assigned to the 75th Aeromedical Squadron at Hill Air Force Base, Utah, "and it's the number one culprit of airsickness."

Human bodies have three balance systems. The vestibular sensory system, located in the inner ear, senses head movement through space by detecting either rotational or linear movement. Ocular (visual) sensors, meanwhile, provide the brain with a three-dimensional validation of location and movement. And last, the proprioceptive system (often called intuition or the sixth sense) uses special pressure sensors in muscles, tendons and joints to sense gravity and joint position.

"The problem occurs," said Lieutenant Hansen, "when one or more of these systems produce conflicting information. In Sergeant White's case, his vestibular sense conflicts with the visual sense, which creates an abnormal physiological state. This results in motion sickness."

Potentially afflicting all who travel by land, sea or air, many have succumbed to its wrath. In its passive state, symptoms are drowsiness, sweating, nausea, pallor and headaches. In its active state, you get the bonus symptom of actual vomiting, which can range anywhere from "slight spillage" to a "fire hose projectile spew."

As powerless as this notoriously unpleasant phenomenon makes us feel, there are definite ways to combat it.

In the early 1980s, the Air Force began the Air Sickness Management program to assist more than half of the student pilots who statistically encounter airsickness to some degree in their training. The program, shaped by flight surgeons, psychologists and aerospace physiologists, has evolved into a five-phase program aimed at early detection and treatment.

In the early phases, student pilots are educated on diet, hydration and relaxation techniques under the watchful supervision of a flight surgeon. If this proves unsuccessful, later phases can involve everything from temporary prescriptions of medication, biofeedback testing and even riding a mechanical device known as the Barany Chair. Used as a spinning platform to simulate movement encountered in flight, the chair tests a student's ability to perform standard in-flight tasks of varying complexity while learning to overcome sensory conflict.

By eliminating physical and psychological barriers that impede pilot training, the goal of the management program is to maximize the rate of learning and ultimately increase pilot retainability.

For those who don't have access to an aerospace physiologist and a structured five-phase course--like the Airman of the quarter rewarded with her first F-15 incentive ride or the family going whale watching off the coast of California--the options are many. And they're all better than hugging a cold porcelain commode.

Lieutenant Hansen attributes 60 percent of one's success in preventing motion sickness to diet alone (see sidebar). He also prescribes exercises in learning to control visual cues, getting proper rest and using diaphragmatic breathing to relax one of the most powerful tools you have in fighting motion sickness: your mind. When not in control of this mental resource, you leave yourself vulnerable to stress and anxiety--something that Sergeant White is admittedly familiar with.