By James Wysong Travel columnist
updated 10/10/2007 2:49:18 PM ET 2007-10-10T18:49:18

Lots of people say they never get airsick, but let me tell you something. I deal with at least two cases of airsickness each flight, and 90 percent of the time, the shaky, pale-faced victim says, "But this has never happened to me before!"

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True, some people are more susceptible to airsickness than others, but no one is immune, and if you fly often enough, sooner or later you will be caught with your guard down.

In my 20 years of flying as a flight attendant, I've seen a lot of airsickness and food poisoning on airplanes — and I've experienced them myself. I have been vomited on, I've assisted passengers who've been barfed on, I've cleaned the cockpit panels after a pilot tossed his cookies, and I once worked a flight from Paris on which 127 people got sick from bad sandwiches. Believe me, I know a thing or two about airsickness.

The usual culprit is motion sickness, a disturbance in the inner ear that is caused by certain kinds of repetitive motion, such as from the swell of the sea, the movement of a car or the motion of a plane in turbulent air. Airsickness can come on quickly during turbulence and sudden altitude changes, but it can also occur on relatively smooth flights.

Motion sickness is actually a normal response in healthy individuals. It arises when the inner ear senses motion, but other organ systems — like our vision and our muscles — don't. The central nervous system gets mixed messages, and you get motion sickness. It is nature's way of telling the brain that something is wrong. Symptoms of motion sickness include nausea, vomiting, dizziness, sweating and a general feeling of unease. Females are more likely than males to suffer from motion sickness, which for some reason increases during menstruation and pregnancy.

There are lots of remedies suggested for motion sickness, and some of them work for some people sometimes. Here are some of the more effective ones:

1. Certain medications, such as Dramamine, the scopolamine skin patch and Benadryl, are very effective. They work best if they are taken a couple of hours before the flight, so if you know that you are susceptible to motion sickness, plan ahead. As always, it is best to consult with your doctor before taking any medications.

2. You can also try ginger. It seems to work, and it is available in many different forms, including capsules, tea and old-fashioned ginger snaps.

3. Be sure to choose your seat location carefully. Sit by a window and look out, and if possible, get a seat over the wings or far forward in the airplane, as these are the best places for a smooth ride.

4. Avoid alcohol; it can make the symptoms more severe.

5. Don't try to read or write or do any kind of craftwork in your lap. Instead, look as far forward as you can, or look out the window and focus on distant objects.

6. Eat dry crackers or olives, or suck on a lemon — anything to dry out the mouth and lessen the feelings of nausea.

7. The old wives' tale may be true: Drinking a carbonated beverage like 7UP, sparkling water or ginger ale always seems to help.

Other causes of in-flight illness include food poisoning, dehydration, adverse reactions to prescription medications, alcohol and fear of flying. In other words, there are plenty of reasons to reach for the barf bag. But what else should you do if you or someone around you begins to get sick?

1. Locate the barf bag. It is always a good idea to check the seat-back pocket for a sick bag before takeoff. You sure don't want to be hunting for it when you really need it. With airplane turn times now very tight, it is easy for the cleaners to miss replacing those that have been taken or used. If you can't find your sick bag, ask a flight attendant for another one or get one from the lavatory.

2. Head for the restroom. Nobody will blame you if you make a dash for the restroom, even if the "Fasten Seat Belt" sign is on. Flight attendants can't give you permission to leave your seat when the sign is on, and they might even shout at you, but that's nothing compared to throwing up on another passenger or soiling your seat.

3. Let someone know. If you have food poisoning or otherwise become very sick, let a travel mate, seat neighbor or flight attendant know before you camp out in the lavatory. Even though the last thing you want is to be checked on in such a condition, a few people have actually died unattended in the lavatory because they did not alert anyone to the gravity of their condition.

4. See no evil, smell no evil. The simple sight or smell of vomit can cause a chain reaction. In fact, I once witnessed 15 passengers get sick from watching one truly ill traveler vomit over and over. So, when you see someone sick, don't let your morbid curiosity take over. Look away and plug your nose.

5. Cut the line. If you are waiting in line for the lavatory and are about to be sick, go to the front of the line and explain. Nobody will stand in your way, and that passenger you would otherwise have upchucked upon will be very appreciative.

6. Take care of the disposal. Don't be offended if a flight attendant refuses to throw away your barf bag. Understand that flight attendants are in charge of serving food and drinks, so for health reasons they cannot handle the bag. Just take the sick bag to the lavatory and dispose of it in the waste receptacle.

I was surprised to discover that there are many avid sick-bag collectors out there. The Guinness world record-holder has a collection of 5,180 sick bags from 1,003 different airlines. There is even a virtual Air Sickness Bag Museum with an extensive online collection available for viewing. I guess if you're going to have a sick hobby, that's the one to have.

Fly happy and safe, and may you have no use for the barf bag.

James Wysong has worked as a flight attendant with two major international carriers during the past fifteen years. He is the author of the "The Plane Truth: Shift Happens at 35,000 Feet" and "The Air Traveler's Survival Guide." For more information about James or his books, please visit his Web site or e-mail him.

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