Transderm Scop Patch - anything better?

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crzyfish

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Location
SF Bay Area
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I get seasick, so I use the Transderm Scop (scopolamine). Normally, it works. I've been on 8-10ft choppy water and I'm fine (minus the cotton mouth). This time, I wasn't. I put it behind my ear a day before the dive in Cabo San Lucas. The air temp was 75 F, water temp 73 F. Three foot waves at Land's End, the boat was rocking hard but manageable. This was the second dive and I was chilled from the first dive. I was only wearing a 3mm but also had on a 1mm vest. I aborted the dive. I was done.

I was trained out of Monterey, CA. Cold and rough water. I couldn't handle this little chop. What's wrong with me? Why didn't the Transderm Scop work? I think I still had a little water in my left ear (same place where I put the patch) during my bad bout. I should also note, I get vertigo if I'm inverted, but the scopolamine should have prevented that.
 
Nothing's wrong with you. I've worn the patch and still gotten sick before. There's a lot that goes in to the seasickness equation, including:
  • Diet: what did you eat the morning or night before?
  • Alcohol: did you drink alcohol the night before?
  • Rest: did you get a full nights sleep?
  • Hydration; are you dehydrated?
  • Physical stress: how physically stressed you are? (Temperature can have a large impact of how much physical stress you experience. Usually warmer temps trigger seasickness for me)
  • Mental stress: are you anxious about the dive or something else?
Any combination of those things could trigger your seasickness, even with medication. I'm an avid fisherman and I tried every over the counter and prescription drug I could find and there were just certain situations in which I would get sick out on the water, regardless of sea conditions.

After a lot of research and consultation with my doctor I found that if I manage the things listed above that my susceptibility to seasickness is greatly reduced. For me: I have a light non-greasy dinner the night before and a light breakfast in the morning, limit my alcohol consumption the night before, get a good nights rest, drink plenty of water the night before and morning of, wear adequate exposure protection inside and outside of the water, and mentally plan and prepare for the days dive before getting on the boat to reduce mental stress (I also like to get to the boat early and get my gear setup early so that I'm not rushed).

Other tricks that I'm sure you've heard of but are worth noting are:
  • Sit over the boats center of gravity (on the lowest deck, somewhere near the center of the boat). The roll and pitch of the boat is much less in this area than any other area of the boat.
  • Avoid breathing exhaust fumes. Nothing gets me sick faster than breathing diesel exhaust.
  • Keep you eyes focused on the horizon.
  • If all else fails, jumping in the water and simply floating around on the surface sometimes helps for me. Don't descend until your feel comfortable. My GF does this all the time on boat dives - she's the first one in the water and the last one out....just bobbing around hanging on to the current line.
 
I agree with everything above except sitting on the lowest deck. For me, the important thing is to be outside where I can get a breeze on my face. YMMV. One other thing you can always try is ginger gum. It's only mildly effective, but it can be used on top of everything else, and I rather like the taste.
 
Ahh, scopalmine. User beware.

It works wonders for many in spite of some strong side effects that some experience.

What many are not aware of is scopalmine patch withdrawal syndrome. The occurs after the patch is removed and can be very debilitating and can last several days to weeks. The effects are much worse than seasickness. I witnessed the syndrome in my wife who after using it during a week long cruise could not go back to work and even get out of bed for another 2 weeks after removing the patch.

Lots of scary stories can be found in a Google search. Here is a scholarly article on it

Scopolamine Patch Withdrawal Syndrome
 
Side effects vary for patch users. Dry mouth is common with some experiencing blurry vision and other side effects.

The withdrawal syndrome affects a very small minority of users but for those that do get it it is severe and worth cautioning so potential users can make an informed decision.
 
I get dry mouth with the patch too. I haven't experienced the withdraw you speak of. I've never used it for more than a day at a time though.

I used to get seasick frequently, and would use the patch almost anytime I went offshore. I stopped using it about 5 or 6 years ago and I've only yakked once since then in 8 footers off key west. That's hundreds of hours fishing and diving from boats. Some of that success can be attributed to the ability of the body to adapt and get used to being on a rocking boat but I think a lot of it has to do with how I prep for a trip. The old adage "an ounce of prevention is worth a pound a cure" is very applicable to seasickness.
 
3 foot waves are still decent depending on how easily you get seasick. I will note that, for my girlfriend at least, the patch has seemed the most effective for her the larger and more intense the wave action. She gets seasick extremely easily and will still occasionally puke in nearly flat water (with the patch). Every time we have been in 5 ft + sea conditions she is laughing and the one having the most "fun" on the boat.

We have recently switched to using Kwells (300mg hyoscine hydrobromide) for day trips. I understand it to be the same as scopalamine, but I've never consulted a pharmacist or doctor on that. The patch adhesive tends to give her a rash at application site which inevitably is quite uncomfortable. We just did a trip with approximately 30 dives using Kwells and applying other good practices (like described by others above) and she made it the whole trip without feeding the fish. It would otherwise not be unusual for her to puke at least a few times...particularly days with more than 2 dives. This was also probably the first trip where she never dived on an empty stomach and usually had a breakfast of mostly bread or rice.
 
https://www.shearwater.com/products/peregrine/

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