So, I’ll be visiting Los Angeles from May 19th to 25th. Despite the fact that I’m going to be meeting up with friends and doing other fun things (perhaps even some profitable ones), I’m not actually looking forward to the trip; that’s because I’m going to be flying, and I really hate flying. As long-time readers know I suffer from debilitating vertigo, accompanied by terror; in 2014 I even traveled to Seattle by train (more than three days each way) rather than fly. I’ve tried every motion-sickness remedy there is, both prescription and OTC, and none of them work at all; however, I recently hit upon the idea of trying a two-pronged attack, that being Valium for the anxiety and Zofran for the vomiting. The literature says the latter won’t prevent motion sickness, but I’m hoping the combination with Valium will. And if it doesn’t, I’m going to try betahistine on the way back (it’s not approved for sale in the US, so it may be a bit harder to obtain dependably). Sooner or later I hope to be able to come up with some combination of prescription & non-prescription drugs that will enable me to fly, even if it’s at the cost of sedating me into insensibility for most of the day; better to be groggy and loopy than terrified and vomiting. Anyhow, I will definitely be available for a limited number of bookings while I’m in town, so if you live in or near LA and you’ve been wanting to see me, now’s your chance!
Diary #305
May 3, 2016 by Maggie McNeill
22 Responses
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Good luck with the trip, in all respects! 🙂
If you are trying new meds (and in combination), might an alternative to Zofran be better?
“Ondansetron (Zofran) and …… do not reduce symptoms of motion sickness and should not be used.” 🙁
http://www.aafp.org/afp/2012/0715/p192.html
If you have had limited (any?) success with conventional meds : would you consider combining conventional and complementary techniques : meds and e.g. acupressure?
I hope you find a combination (combination meds or meds with other techniques) that works for you.
When I say “nothing works” I mean NOTHING. So please, don’t suggest DIY bullshit like acupressure that already failed me when I first discovered it in the ’90s and would be even less effective now that my vertigo is worse. I will try whatever meds I think have a chance of working, and frankly, the stronger the better.
Wow : sorry to have provoked such a strong negative reaction.
At risk of causing further upset, can I point out I wasn’t suggesting “alternative” techniques by eg acupressure, but “complementary” ; that is to say one doesn’t have to choose one or the other.
It was intended more as “if meds alone have had limited (nil?) success, and because of this you are trying a combination of meds, why not try a combination of meds and complementary techniques too?”
I’m a fan of mainstream pharmacology much more than “alternative woo-woo” (or, “DIY bullshit”?) but when pharmacology hasn’t helped so far, I still suggest considering BOTH together.
(I accept there is a risk of antagonism between the techniques, but there would also be the possibility of synergism, or just a cumulative effect).
The 5-HT(subscript 3) antagonists (such as Zofran) are potent for many causes of nausea and vomiting, so can be considered “stronger” but why consider them “stronger” in these circumstances when the evidence suggests they don’t work for travel sickness?.
Admittedly :
A) just because the evidence says they don’t work based on looking at a group of people doesn’t mean they won’t work for an individual : but if you were “gambling” would you base your gamble on what evidence is available
B) the studies didn’t look at combination therapies, so there isn’t the evidence for combinations.
However the point “if trying a combination, why not try a combination that includes an agent proven to work (that you haven’t yet tried!)”
I haven’t looked at if betahistine (your other candidate agent) interacts with Valium. Was your choice of Zofran influenced by interaction potentials?
If the stats say (for example) “0.1 % chance of success” : you don’t care about the 999 people it doesn’t work for if you are the 1 in 1000 it works for!.
Clearly, you can choose whatever meds you think will have a chance of working, even trying Zofran knowing the evidence. Again, I hope you find what works for you.
Please stop now. It’s incredibly insulting to suggest I didn’t try all this in my twenties (you know, after I’d already been suffering with vertigo for my entire life).
Not a huge fan of flying either Maggie, my problem is claustrophobia with a touch of vertigo. Best of luck, and I hope the trip goes with minimal difficulty. My very best, and you’ll be in my prayers for a safe and uneventful trip.
This seems a touchy subject. My SO has similar issues when flying what worked for her was ativan and reglan. A strong anti-anxiety and a chemo grade anti nausea drug. but it did make her groggy slept on the flight and rest of the day.
Ativan is a benzodiazapine, as is Valium. Zofran is a chemo-grade anti-nausea drug. Any questions?
Nope I think you’re on the right track. Just gave you an example of slightly different drugs that did work for one other person. Driving is a little better for her I can drive for short trips but if it’s more that about 30min drive she drives or else gets car sick.
I can ride shotgun as long as the driver is a good one and I don’t try to do anything stupid like look down or read.
Don’t like flying either, but in my case its cause I know too much about dem thar aeroplanes…and I want to be up in the cockpit in control of the durned thing.
Prayers for you Maggie…that you get through the trip as comfortably as possible.
I prefer road trips, though I don’t have vertigo. I still exercise caution, however.
When patients go for anesthesia and have a history of post op nausea they get Zofran, Scopalamine(patch), plus some kind of steroid. Usually Decadron.
I assume you have tried the first two. Have you tried Decadron?
I don’t do steroids.
It would be one pill one time taken a few hours before the flight. I promise you that if you needed anesthesia for surgery and gave your history in pre-op you would be given a one-time dose of iv decadron.
As usual, no one really knows why it works. The process of triggering nausea is obviously complex and not everybody is the same.
But think of this: The impact of post anesthesia nausea and vomiting is huge – both on costs and patient satisfaction.There is a LOT of interest in improving outcomes and anything that helps is seized upon.
I’ve used Zofran before for nausea and it works well. It takes about an hour or so to start being effective. Hope your flight goes well
Will you be speaking publicly or hosting any kind of reader’s get together while you are in town?
What about cannabis?
Don’t drug yourself, take the Coast Starlight!
A) I like drugs, thanks.
B) I get sick on trains, too.
C) I don’t have almost two days to waste on a train.
D) That would kind of defeat the purpose of testing the meds for future flights, wouldn’t it?
Honestly, y’all…
Heh, I meant the unpleasant, not the pleasant drugs. Sorry, though, that you get sick on trains. I find long train trips to an enforced reading (and sometimes writing) time. Anyway, happy trails to you!
Valium is not an unpleasant drug; it gives me such lovely sleep!