Speaker 1: My name is Christina Kopka Decker, and for as long
Speaker 1: as I can remember, I have experienced motion sickness in cars, planes, boats, trains,
Speaker 1: and theme park rides. The first time I experienced severe
Speaker 1: motion sickness, however, was when I was sixteen years old
Speaker 1: on a flight from Los Angeles to New York. As
Speaker 1: soon as the plane took off, I was hit with
Speaker 1: intense vertigo and nausea. Within about fifteen minutes, I began vomiting,
Speaker 1: which quickly turned into dry heaving. For the remainder of
Speaker 1: the six hour flight, the plane suddenly felt smaller, breathing
Speaker 1: felt heavier, and my head was spinning so intensely that
Speaker 1: it felt like it might explode. I felt overheated, overwhelmed,
Speaker 1: and my mouth was either extremely dry or excessively watery.
Speaker 1: I am now thirty seven, and unfortunately this has never changed.
Speaker 1: The difficult part is that I love to travel, so
Speaker 1: in many ways travel means excepting that I will likely
Speaker 1: suffer through the journey. Over the years, I have seen
Speaker 1: many specialists, including neurologists and ear nos and throat doctors.
Speaker 1: I have tried vestibular therapy, had CT scans, MRIs, and
Speaker 1: undergone hearing tests, doctors ruled out Meneer's disease, which causes
Speaker 1: symptoms similar to what I experience. Despite all of these evaluations,
Speaker 1: no one has been able to explain why my motion
Speaker 1: sickness is so debilitating. Even when I am the one driving,
Speaker 1: I sometimes experienced nausea and vertigo, especially on winding roads
Speaker 1: or in heavy traffic, which is nearly impossible to avoid.
Speaker 1: While living in Los Angeles. One of the worst happened
Speaker 1: during a flight with very heavy turbulence. I was vomiting
Speaker 1: into a sickness bag, only to realize too late that
Speaker 1: the bag was broken at the bottom. I had to
Speaker 1: sit there with vomit in my lap and around me
Speaker 1: for a large portion of the flight because the turbulence
Speaker 1: was so bad the flight attendants could get up to
Speaker 1: help me. When I finally reached my destination, I usually
Speaker 1: can't eat anything. I typically need to sleep off the
Speaker 1: motion sickness before I feel well enough to explore the
Speaker 1: city I traveled so far to see. The only treatment
Speaker 1: that has consistently helped me is a combination of zofran
Speaker 1: meclasine and a risk device that uses electrical shock therapy
Speaker 1: kind of similar to a tens machine. Even with this combination,
Speaker 1: I still experienced severe motion sickness, but it significantly reduces
Speaker 1: my vomiting and makes travel somewhat more bearable.
Speaker 2: Christina that thank you for sharing your story. First of all,
Speaker 2: that sounds I mean, that sounds unimaginably.
Speaker 3: I can't awful.
Speaker 2: Sounds awful, But I'm glad that there's finally some something
Speaker 2: that you're finding.
Speaker 3: Some relief, some of relief. Yeah.
Speaker 2: Yeah, but thank you again for sharing your story. We
Speaker 2: really appreciate it.
Speaker 3: We do.
Speaker 4: Thank you.
Speaker 1: Hi.
Speaker 3: I'm Erin Welsh and I'm Erin on an update and
Speaker 3: this is this podcast will kill You. Welcome to Motion Sickness. Welcome, Welcome.
Speaker 2: This is one of the most universal experiences humans.
Speaker 3: Right, I mean yeah, I guess maybe, or.
Speaker 2: Like the potential for universality is quite high exist just
Speaker 2: to you know, be precise about it.
Speaker 3: I am really excited about this episode. And when you
Speaker 3: proposed it, and I think that you have many times.
Speaker 2: Maybe like three years ago was the first time I
Speaker 2: was like.
Speaker 3: We probably and I was like, absolutely not. And I
Speaker 3: am thrilled that I finally said yes to it, because
Speaker 3: it's really really interesting.
Speaker 2: That I finally bullied you into it. I was like,
Speaker 2: we're doing It's on the calendar.
Speaker 3: You can't it's super super interesting. Yeah, and I'm really
Speaker 3: excited about it.
Speaker 2: It is I like what drove me always to be
Speaker 2: like we should do this. It's not because I knew
Speaker 2: anything about it. It's not because I personally have experienced
Speaker 2: a lot of motion sickness. I really know, not at all.
Speaker 2: Like there was John.
Speaker 3: And I were.
Speaker 2: Fishing off like it in the ocean, and it was
Speaker 2: a small boat and the waves were quite choppy, and
Speaker 2: John quickly because his eyes were focused on the rod
Speaker 2: and not the horizon, fish and the fish and John
Speaker 2: was within I don't know how much time scream barfing,
Speaker 2: poor guy, just like just NonStop. And I was and
Speaker 2: he was like, you are completely fine. Like I felt nothing.
Speaker 2: I mean I felt bad for him, but like physically.
Speaker 3: I felt I felt nothing. Uh so, yeah, I am.
Speaker 3: I am.
Speaker 2: I am one of the ones who can read in
Speaker 2: a car and a bus, on a train, whatever, same,
Speaker 2: no problem.
Speaker 3: Same. I can remember one time I'm feeling a little
Speaker 3: bit motion sick and it was on day two of
Speaker 3: a twenty two day research cruise in the middle of
Speaker 3: the ocean. And yeah, day two, I was like a
Speaker 3: little like, ooh, I don't think I'm gonna eat today
Speaker 3: as much as usual. Yeah, And that was it. So
Speaker 3: I feel very lucky that I haven't experienced a lot
Speaker 3: of it, because otherwise I'm like, I'll eat an entire
Speaker 3: funnel cake and then go on the tilta whorl and
Speaker 3: be like this was the best day ever. Yeah, so
Speaker 3: roller coasters.
Speaker 2: I remember as a kid, the one time I remember
Speaker 2: really feeling quite nauseous was like on a bus, on
Speaker 2: the school bus, reading a book because I had no friends,
Speaker 2: So I'll just read books on the school bus.
Speaker 3: My little animals.
Speaker 2: Yeah, and so I remember that. But but then ever
Speaker 2: since then, which is interesting because I feel anyway we'll
Speaker 2: get there in terms of the age distribution.
Speaker 3: There's so much to cover. There's so much. I'm really
Speaker 3: excited about it. Maybe we should start and I'm just blathering,
Speaker 3: Maybe we should.
Speaker 2: Maybe we we have.
Speaker 3: Quarantine any time, it's quarantine, ay times.
Speaker 2: Anytime.
Speaker 3: What are we drinking this week? Ere we're drinking motion potion.
Speaker 3: Motion potion.
Speaker 2: It's ridiculous and it is ginger based essentially. However, listen
Speaker 2: to our ginger episode. Yeah, this is not curative or
Speaker 2: prevented by any means.
Speaker 3: There's also like very little data that ginger is helpful
Speaker 3: for nausea associated with motion sickness, like particular.
Speaker 2: Yeah, this is also when I say ginger episode, I
Speaker 2: mean health myths are health myth. Yeah, we did not
Speaker 2: do an episode on ginger. But it's yeah, so it's
Speaker 2: it's ginger ale, it's lime juice, it's mint, it's candy ginger,
Speaker 2: it's you know, a tasty little bits, really really tasty.
Speaker 3: You can find the recipe on all of our socials
Speaker 3: where we are This podcast will kill You, I think
Speaker 3: mostly is our socials, maybe tea titles, maybe TPWKY who knows. Also,
Speaker 3: we'll probably post it on our website, this podcast will
Speaker 3: kill You dot com. Have you checked it out? We
Speaker 3: have a whole bunch of stuff there.
Speaker 2: Out the end the end website. We don't need to
Speaker 2: go into that. We said, you know the spiel there,
Speaker 2: Let's get to the good stuff.
Speaker 5: Okay, yeah, right after this break, Jinks.
Speaker 3: I actually want to start this section with a quote,
Speaker 3: Oh my god, I do the same thing I was
Speaker 3: gonna say, like, this is really your vibe, but I'm
Speaker 3: stealing it a little bit. Okay, this is a quote
Speaker 3: from a two thousand and six paper by Shoe, Pock
Speaker 3: and Gordon, and it describes the constellation of symptoms that
Speaker 3: we can see in motion sickness. And I really like
Speaker 3: it because I think it just like sets us up
Speaker 3: to really like picture what it is that we're talking
Speaker 3: about today.
Speaker 2: You ready, I feel like I'm gonna get sympathy nausea,
Speaker 2: which that is something that I do occasionally get with,
Speaker 2: like am I is the dog gonna barf?
Speaker 3: Is John barf in the boat? Yeah? Then you feel nauseous.
Speaker 3: If I smell vomit, then it will make me nauseous.
Speaker 3: But away, yeah, okay, Okay, anyways, here we go. Ready, yeah,
Speaker 3: quote the development of motion sickness. Sorry, it's kind of
Speaker 3: a long quote, just so you know.
Speaker 2: Okay, Okay, I'm strapped and I'm ready.
Speaker 3: Quote. The development of motion sickness symptoms follows an orderly
Speaker 3: sequence that varies with the intensity of the stimulus and
Speaker 3: the susceptibility of the individual. The initial symptom is usually
Speaker 3: discomfort around the upper abdomen stomach awareness this quote, okay,
Speaker 3: which is followed by nausea and increasing malaise. Concurrently, pery
Speaker 3: oral that means around your mouth and facial pallor appear
Speaker 3: accompanied by cold sweat. With rapid worsening of symptoms, there
Speaker 3: can be salivation changes, feeling of body warmth, dizziness, wretching
Speaker 3: and recurrent vomiting. Lethargy, fatigue, and drowsiness can persist for
Speaker 3: hours after the motion stimulus ends. End quote. I feel
Speaker 3: like it really walks us through what it looks and
Speaker 3: feels like to start having motion sickness.
Speaker 2: It does, And I have so many questions.
Speaker 3: No, I will wait them, I will wait.
Speaker 1: Yes.
Speaker 3: I also want to mention that there's another kind of
Speaker 3: phenomenon that we see described alongside motion sickness that's called
Speaker 3: soapite syndrome. I think that's how you say it. And
Speaker 3: it's this kind of like drowsiness, lethargy, like decreased cognitive
Speaker 3: motor functions. A lot of times we see it marked
Speaker 3: by yawning, like an increase in yawning, and this can persist.
Speaker 3: It can start with the motion stimulus itself, and then
Speaker 3: it can persist for like a long time after. In
Speaker 3: some cases, people can also get things like eyestrain, difficulty focusing, headaches,
Speaker 3: and things like that. So motion sickness overall is this
Speaker 3: feeling of unwellness and a lot of times nausea and
Speaker 3: vomiting specifically that we get that is associated with motion
Speaker 3: or movement. And like we read in all of that description,
Speaker 3: while it very classically like nausea and vomiting and things
Speaker 3: are like that kind of first part of the symptoms,
Speaker 3: there's a really wide array of how people can present
Speaker 3: with motion sickness overall. But it's not just any motion
Speaker 3: that triggers motion sickness. It's specific types of motion. Because
Speaker 3: we don't tend to get motion sick when we're walking
Speaker 3: or running or riding a bike, but we do if
Speaker 3: we're on a boat or a train or sitting in
Speaker 3: the back seed of a car. And motion sickness can
Speaker 3: also be caused by perceived motion, as in people can
Speaker 3: get motion sickness from things like virtual reality or like
Speaker 3: really immersive three D movie screens without moving at all.
Speaker 3: I m AX, So, what in the absolute heck is
Speaker 3: going on causes us to get sick from movement or
Speaker 3: the perception of movement? Perception of movement? I'm really excited
Speaker 3: to try and tell you. That's what I'm going to
Speaker 3: try and do right now, just so you know. So
Speaker 3: first of all, we don't really know. That's just like
Speaker 3: I'm going to say that at the front, Okay, like
Speaker 3: we we think that we know. And the overall consensus
Speaker 3: hypothesis idea is that there is some kind of sensory conflict, right,
Speaker 3: That's what it's called between the actual sensations that you
Speaker 3: are receiving into your brain m hm and what your
Speaker 3: brain expects to be receiving. Yeah, And these conflicts can
Speaker 3: happen between a number of different sensory systems or a
Speaker 3: number of different of like ways that we perceive things
Speaker 3: around us. So the main sensory systems that are involved
Speaker 3: in motion sickness, let's dig into them a little bit,
Speaker 3: are the visual system, the vestibular system. Love the stipular system,
Speaker 3: I know, it's quite exciting, and the propriaceptive system. Love
Speaker 3: around a.
Speaker 2: Tocoo system, I love them all.
Speaker 3: Listen, we're here for our sensory systems, okay. So our
Speaker 3: visual system is obviously our eyes, right, These are perceiving
Speaker 3: the world around us visually. They're sending the inputs that
Speaker 3: they receive into the visual centers of our brain in
Speaker 3: order to map out the world. I'm not going to
Speaker 3: dig much deeper than that. Our eyes also have quite
Speaker 3: a lot of reflex movements and things built in that
Speaker 3: we are totally unaware of, such that if we turn
Speaker 3: on head or experience any kind of motion, our eyes
Speaker 3: are actually making teeny tiny micro adjustments in the opposite
Speaker 3: direction of whatever our movement is so that our visual
Speaker 3: field stays steady.
Speaker 2: I learned about this recently when interviewing someone for an
Speaker 2: episode of Advances and Care on concussion detection, because we
Speaker 2: do not have a good system right now for diagnosing concussions,
Speaker 2: and so one of the thoughts is that, like we
Speaker 2: can detect it potentially with these small eye movements, because
Speaker 2: when we get a concussion sort of all of these
Speaker 2: little all of these sensory systems are disrupted a bit,
Speaker 2: and so can we detect severity, intensity, duration, whatever of
Speaker 2: a concussion with these eye movements.
Speaker 3: It is, there's so much there. It's just really cool.
Speaker 3: It is really cool. So this like our eyes making
Speaker 3: these little microadjustments, and it's part of what is called
Speaker 3: the vestibulo ocular reflex. So that means that our eyes
Speaker 3: are connected to our tibular system. Okay, and this is
Speaker 3: the system that detects the position and movement of mostly
Speaker 3: our head in space. It is a complex system and
Speaker 3: we don't need to get like deep into the weeds
Speaker 3: of it. But the peripheral parts are located in our
Speaker 3: inner ears, where we have these two teeny tiny organs
Speaker 3: called odoliths that are not just little rocks, but they're
Speaker 3: actually teeny tiny little organs that detect movement, specifically in
Speaker 3: the forward, backward, and the side to side direction not rotating.
Speaker 3: And then we also have three sets of on each
Speaker 3: ear these things called semi circular canals that are these
Speaker 3: little fluid filled tubes arranged in different planes. They look
Speaker 3: like I don't know, like you know those fancy French
Speaker 3: cookies like Palmier's or whatever, like a grape cluster. No, no, no,
Speaker 3: google it pick, thank you have it. Okay, they're like
Speaker 3: little canals. Anyways, they're in our inner ears as well.
Speaker 3: They're filled with fluid and they sit at different angles
Speaker 3: so they detect rotational movement. Okay, so like looking around
Speaker 3: you rotational movement cool side to side, side, like looking
Speaker 3: to your left, looking to your right, yeah, right, okay, okay, okay,
Speaker 3: And all of these together are semi circular canals, are otoliths.
Speaker 3: They are involved in sensing the position and the movement
Speaker 3: of our head, and they are obviously connected directly to
Speaker 3: multiple different parts of our brain, and they are involved
Speaker 3: in this vestibulo ocular reflex, so they're connected to our
Speaker 3: eyes to help with these little movements, and something called
Speaker 3: our vestibulo spinal reflex which helps us to maintain head
Speaker 3: and postural stability, making these little compensatory body movements that
Speaker 3: again we don't really notice or recognize when we are
Speaker 3: moving our head in space. Okay. Some of the parts
Speaker 3: of the brain that are very involved in this vestibular
Speaker 3: system are our cerebellum, which is the bottom like back
Speaker 3: part of our brain. I have a brain, but I'm
Speaker 3: not going to reach for it because I'll knock it over.
Speaker 3: I have a brain. Oh yeah, there you go. It's
Speaker 3: the bottom of the back. We see that little back, bitch,
Speaker 3: you can't. We also then also have proper reception. Okay.
Speaker 3: Propriate reception is our ability to know where our limbs
Speaker 3: and other body parts are in three dimensional space.
Speaker 2: It's such a mysterious sense. I love it.
Speaker 3: It's mostly gathered from like mechanal receptors that again we
Speaker 3: don't recognize or notice. But there are things all around
Speaker 3: our body that integrate into our brain to tell our
Speaker 3: brain whether you can see it or not. You know
Speaker 3: where your hands and feet are, nice k. So to
Speaker 3: know and understand where we are in space and how
Speaker 3: we are moving through space, our eyes, our vestibular system,
Speaker 3: and our appropriate reception have to all work in concert,
Speaker 3: and they work based on kind of like maps that
Speaker 3: we have developed in our brain by existing on the
Speaker 3: Earth thus far, like, our brain knows that gravity is
Speaker 3: a force that is always present and whose vector points
Speaker 3: down towards the Earth right. We don't have to think
Speaker 3: about it. We literally don't feel it, but it is
Speaker 3: always something that our brain and our body is responding
Speaker 3: to because it's a force that we're always exposed to.
Speaker 3: So when the system is working well, for example, we
Speaker 3: might be walking with our eyes open. As sighted individuals,
Speaker 3: our eyes are going to perceive that we are moving
Speaker 3: through the world where the horizon and the stuff around
Speaker 3: us is remaining relatively fixed right like it is, it
Speaker 3: is moving past us. Our vestibular system is perceiving our
Speaker 3: head moving through space, little tiny microadjustments are being made,
Speaker 3: and our appropriate sective system perceives that our limbs are
Speaker 3: propelling us forward. It's we're standing upright, gravity is directing downwards,
Speaker 3: the horizon is there. Everything is great, and we experience
Speaker 3: no sensory conflict whatsoever. Uh huh.
Speaker 1: Cool.
Speaker 3: But however, if instead we are on a boat on
Speaker 3: the ocean, and we are sitting inside of our cabin,
Speaker 3: for example, then our vestibular system senses quite a lot
Speaker 3: of movement, right, There's changes in velocity, there's changes in
Speaker 3: direction as this boat is moving upon the waves. But
Speaker 3: if we're sitting inside of our enclosed cabin, our eyes
Speaker 3: are perceiving that the world the cabin inside the boat,
Speaker 3: or even worse, the book that we're sitting there reading
Speaker 3: inside of the cabin inside of the boat. The boat
Speaker 3: around us is too fixed because it's moving the same
Speaker 3: way that our body is moving, instead of our body
Speaker 3: moving through space like if we were walking. Yeah, does
Speaker 3: that make sense? Yes, So those two senses, our vestibular
Speaker 3: system and our visual in puts are in conflict, and
Speaker 3: they're not what our brain expects to be perceiving. This
Speaker 3: causes a cascade of hormones and neurotransmitters and things to
Speaker 3: be released, telling our brain whoa whoa, whoa, whoa, something
Speaker 3: is not right. We should panic, wow, motion sickness ensues.
Speaker 3: But like, okay, why is this a bad thing? Like
Speaker 3: why is this thing? This is where?
Speaker 2: Like and I know that it is not. Nothing has
Speaker 2: to be good or bad. It just has to be
Speaker 2: like our bodies don't have not evolved in this space
Speaker 2: before to anticipate these changes and then get rid of
Speaker 2: the conflict, de escalate the conflict. Yeah, but why does
Speaker 2: it result in these nausea?
Speaker 3: But why? But why? But why is a question that
Speaker 3: we absolutely do not have an answer to, Like we
Speaker 3: do not know why.
Speaker 2: Okay, I've read some and we can talk about it
Speaker 2: if you want later on.
Speaker 3: Like the hypothesis hypotheses, I have them, Like yeah, so
Speaker 3: we yeah, we don't know why. There are a lot
Speaker 3: of hypotheses. There's one that's like maybe we get nauseous
Speaker 3: especially and have vomiting as a byproduct of like our
Speaker 3: toxin defense system. I don't I don't like this one.
Speaker 3: But yeah, no, it doesn't really have any evidence for it.
Speaker 3: It's this idea that like our vestibular system gets activated
Speaker 3: by these movements and it triggers the same response that
Speaker 3: we would have from exposure to toxic substances. It doesn't
Speaker 3: It doesn't really make any sense.
Speaker 2: You all your sensory inputs, if you have some sort
Speaker 2: of like neurotoxin that you have ingested or consumed in
Speaker 2: some way, then it's possible that all these different things
Speaker 2: would be off, Your perception would be off, you would
Speaker 2: be like I'd lose exact blence.
Speaker 3: It's just like the same accidental right, right, But no,
Speaker 3: it doesn't make sense. We're discounting that one. Most of
Speaker 3: the papers do too. It's not just us. There's also
Speaker 3: this idea that we have just this inappropriate activation of
Speaker 3: like our autonomic system, with like our vestibular system interacting
Speaker 3: with our autonomic system and causing this dysfunction. There's again
Speaker 3: not like a really clear evidence of this. There's some
Speaker 3: thought that maybe it's just a byproduct of the proximity
Speaker 3: of our vestibular system and these like motion detectors to
Speaker 3: where our vomiting circuitry also sits like we have multiple
Speaker 3: Sometimes people say we have a vomiting center, and that's
Speaker 3: not quite true, but there are multiple brain areas that
Speaker 3: are involved in nausea and vomiting.
Speaker 2: I have never heard anyone say we have a vomiting Oh,
Speaker 2: it's in a lot of the papers.
Speaker 3: I believe you. I believe you. But but it's not
Speaker 3: just one. It's like multiple parts of our brain that
Speaker 3: are involved. So is it just like this kind of
Speaker 3: spillover of the inputs happening to be there. I don't know,
Speaker 3: we don't know.
Speaker 2: I think that, like what what seems likely is that
Speaker 2: it's not an adaptive response, right, It is just something
Speaker 2: that like sing, I mean, and maybe that's really unsatisfying,
Speaker 2: and so we keep looking for hypotheses that make more
Speaker 2: sense or have more give us more of an answer
Speaker 2: or a story. But I think it could just be
Speaker 2: that it's a maladaptive response to right, this thing that
Speaker 2: we did not evolve experiencing.
Speaker 3: Right, And it's just and it's it's this response that
Speaker 3: different people get at different levels, depending on the circumstances
Speaker 3: in which they're exposed to these potentially nauseogenic movements, which
Speaker 3: I think is a great word. Let's talk about these circumstances.
Speaker 3: Let's talk about them a little bit, because there's some
Speaker 3: other ones too. Okay, So we talked already about if
Speaker 3: you're sitting still, you're sitting and the world is moving
Speaker 3: around you, but it looks like the things around you
Speaker 3: aren't moving the way that you expect. So that's one
Speaker 3: type of mismatch that we might see. Another that we
Speaker 3: might see would be if you're again on a boat,
Speaker 3: but you're standing out at the side and you're looking
Speaker 3: over the side of the ship. Your body is moving
Speaker 3: one way, your eye, your head is moving one way.
Speaker 3: Your vestibular system is saying there's this kind of movement happening,
Speaker 3: but your eyes are only seeing the waves going up
Speaker 3: and down across the ship. So that's another way that
Speaker 3: you might have this mismatch.
Speaker 2: Was poor John, I think was yeah, exactly, poor guy.
Speaker 3: It was. It was. It was brutal, it was awful,
Speaker 3: like it sounds. It sounds really bad. And then as
Speaker 3: soon as he was.
Speaker 2: On land he was like, I'm fine, of course, I
Speaker 2: mean after a while, but after a while.
Speaker 3: Yeah, But then we also, like we said it at
Speaker 3: the very beginning. Can have this conflict if you are
Speaker 3: sitting completely still but watching an immersive like VR or
Speaker 3: three D movie on a large screen, because then your
Speaker 3: visual systems are telling your brain we are moving rapidly
Speaker 3: through space, and your body and your head are sitting still.
Speaker 4: Right.
Speaker 3: This is sometimes called pseudo motion sickness or cyber sickness,
Speaker 3: which I think.
Speaker 2: Is it's from the net or something right.
Speaker 3: That's completely hilarious. So this is the kind of working theory,
Speaker 3: working hypothesis really of how motion sickness happens. That we
Speaker 3: have these conflicts or what's sometimes called neural mismatch, and
Speaker 3: these three systems, visual, vestibular, and appropriate reception can all
Speaker 3: be involved, but the vestibular system in particular is probably
Speaker 3: the most important and kind of must be involved. People
Speaker 3: who have complete lesions of their vestibular systems, like not
Speaker 3: functioning vestibular systems bilaterally, it's near impossible to get motion sickness.
Speaker 3: But people who are blind or lack visual inputs entirely,
Speaker 3: or cited people who are blindfolded can still be susceptible
Speaker 3: to motion sickness even without seeing right. It's very interesting exactly,
Speaker 3: And so it's in part because again we have two
Speaker 3: different parts of our vestibular system in what is sensing
Speaker 3: rotational movements and what is sensing lateral and forward and
Speaker 3: backward movements. And so even if you have a conflict
Speaker 3: between these two parts of your vestibular system, that alone
Speaker 3: could be enough to cause motion sickness in some cases.
Speaker 3: And what kinds of motion is it? Why do we
Speaker 3: get motion sick on a boat but not on a bike? Right?
Speaker 3: Part of it is active movement. Right, when we are
Speaker 3: propelling our own bodies, we are less likely to get
Speaker 3: motion and sickness. Why is it because our brains are
Speaker 3: more like ready to accept that this motion is coming
Speaker 3: from us. So even if there's a discrepancy, our brain
Speaker 3: is accepting it.
Speaker 2: There's like the volition yes, volitional idea where it's like, oh,
Speaker 2: if you're driving the car, does that make you less
Speaker 2: likely if you're riding the bike?
Speaker 3: Yeahpelling the bike exactly. Yeah, it's probably not that when
Speaker 3: it comes to bikes and things, because not all types
Speaker 3: of motion tend to cause motion sickness. When we think
Speaker 3: of motion sickness, most of us think of a boat.
Speaker 3: I've used that as an example a lot, and see
Speaker 3: sickness is like the most infamous. But on a boat,
Speaker 3: despite the fact that we are subject to a whole
Speaker 3: bunch of different kinds of motion, it is only the
Speaker 3: low frequency heave motions that you have on a boat.
Speaker 3: The like. That was not a good example, but you know,
Speaker 3: what I'm saying, it's the heave motions that are the
Speaker 3: trigger for motion sickness. We don't see motion sickness walking,
Speaker 3: bike riding, horseback riding much less common to have motion sickness.
Speaker 3: Camel riding, elephant riding much more likely to have motion sickness.
Speaker 2: Glad you mentioned camels. I mentioned it too, camels.
Speaker 3: And the difference in these types of motions is the
Speaker 3: frequency of these movements. So lower frequency movements, so anywhere
Speaker 3: from like point one to point five, and especially point
Speaker 3: two hurts or point two cycles per second movements tend
Speaker 3: to be substantially more nauseogenic than higher frequency movements. Actually
Speaker 3: movements that are faster than one hurts or one cycle
Speaker 3: per second.
Speaker 2: And so is this are we talking forward motion or
Speaker 2: up and down?
Speaker 3: I don't really understand how those measurements work, honestly, there
Speaker 3: was so much physics in this that I have a
Speaker 3: hard time. Also because it can be movements in any direction.
Speaker 3: So this could be up and down movements, it could
Speaker 3: be forward backward translational movements, it could be rotational movements
Speaker 3: like choreolist type of movements. But it's all about the
Speaker 3: and like different ways, especially when it comes to like
Speaker 3: horizontal and spinning type of movements. If you do them
Speaker 3: in a certain way, even at different frequencies, then you
Speaker 3: could trigger motion sickness. But in general, especially for up
Speaker 3: and down movements and forward backward movements, it's these lower
Speaker 3: frequency like you think of how an elephant moves versus
Speaker 3: how a horse moves, bouncing up and down a little bit.
Speaker 2: I think I think that makes sense, where it's like
Speaker 2: it's deeper and more sort.
Speaker 3: Of more like lower, yeah, longer, longer, frequencies longer. But
Speaker 3: I assume camels can jog trot. Yeah, maybe you're less
Speaker 3: like we did get mad.
Speaker 4: I don't know.
Speaker 3: But is it also that like the way that you're sitting,
Speaker 3: like it's side to side movement is also different than
Speaker 3: what you would have on a horse. I don't. It's
Speaker 3: a really interesting and I don't fully understand thresholds might
Speaker 3: be different for different people, and they absolutely are, And
Speaker 3: like people have proposed hypotheses again as to like why
Speaker 3: is it that these low frequency movements are the ones
Speaker 3: that are more nauseogenic, And so it's thought that maybe
Speaker 3: for some reason that again, is it just this like
Speaker 3: mismatch type of thing that these frequencies just happen to
Speaker 3: be where we have more of these errors in signaling
Speaker 3: between our vestibular systems and our other somato sensory systems.
Speaker 3: We just have more errors between what we sense and
Speaker 3: expect in terms of our verticals or in terms of
Speaker 3: our horizontal movements. Some people propose that this type of frequency,
Speaker 3: these low frequencies, are like the limit of human body motion,
Speaker 3: so we can't figure out how to maintain stability of
Speaker 3: our bodies at these frequencies because our bodies don't move
Speaker 3: at those frequencies very often. But I don't know, I
Speaker 3: don't know. Yeah, And other people say that maybe at
Speaker 3: these low frequencies, our brain can't interpret these type of
Speaker 3: accelerations as movement through space, so it's interpreted as a
Speaker 3: tilt in the force of gravity, which is like our
Speaker 3: brain going, oh, why are we upside down when we're
Speaker 3: not really upside down at all, So then that confuses
Speaker 3: our brain. I don't know, Okay, yeah, it's all quite confusing.
Speaker 3: And then like what happens next is also still confusing.
Speaker 3: So I said that there's like a series of signals
Speaker 3: that get sent right to our brain via a bunch
Speaker 3: of different neurotransmitters, A stetylcholine is involved, Histamine is very involved,
Speaker 3: and we we still don't really know like why, like
Speaker 3: why exactly is this happening. But in the end result
Speaker 3: is that our autonomic system gets activated. Different regions of
Speaker 3: our brain involved in vomiting, our vomiting centers get activated,
Speaker 3: and especially areas of our brain like our lower brain
Speaker 3: in our cerebellum, as well as parts of our brain
Speaker 3: stem end up getting activated. And we see this drop
Speaker 3: in our stomach fundus. We see relaxation of our sphincters,
Speaker 3: we see gastric stasis, so things are moving slower, and
Speaker 3: then you know vasodilation versus vasoconstriction, which is why we
Speaker 3: have the power and sometimes cold sweating.
Speaker 6: Oh okay, okay, okay, So this is this is truly
Speaker 6: a cascade of a multiple different, multiple different signaling pathways.
Speaker 3: Signaling pathways just not kind of working in concert.
Speaker 2: Yeah, and then that is causing all of these these
Speaker 2: these different effects like nausea, like power, like cold sweat,
Speaker 2: what is what are cold sweats?
Speaker 3: How? What is? Yeah? Well, like you're not like you
Speaker 3: don't have a fever, you like feel cold, but you're sweating. Yeah,
Speaker 3: that's a cold sweat. Yeah, but like what is the
Speaker 3: cause of that? What is the mechanism?
Speaker 2: Okay, Like I've experienced cold swets.
Speaker 3: You know, You've never had a cold set, so like
Speaker 3: tell me.
Speaker 2: But and and so pallor makes sense because you're kind
Speaker 2: of you're just draining blood and then that where's that
Speaker 2: blood going?
Speaker 3: What? Yeah? Well, and some of that is stuff that
Speaker 3: we just see with nausea in general, right, and so
Speaker 3: some of that is just like directly involved in the
Speaker 3: in the nausea response. Even when you get nausea and
Speaker 3: vomiting from a toxin or from an infection or from
Speaker 3: chemotherapy or whatever, it is, so okay, So okay, okay.
Speaker 3: So there are multiple different things.
Speaker 2: I mean, so there's like nausea and then like the
Speaker 2: constellation of things that often happen with nausea yep. And
Speaker 2: then there are other effects that might or may not
Speaker 2: be direct closely tied to nausea in like that that
Speaker 2: cascading pathway medications, medication, Do they work on the same
Speaker 2: root source?
Speaker 3: Can they control everything? Yeah? Excellent questions, Aaron. So the
Speaker 3: best treatment is prevention, and that's often not possible. Most
Speaker 3: of the non pharmacologic methods that we have are like behavioral, right,
Speaker 3: so that's things like looking at the horizon, like fresh
Speaker 3: air fresh air. There's a lot of things that they
Speaker 3: market that are focused on the idea of reducing conflicting
Speaker 3: sensory input or like providing other sensory input for you
Speaker 3: to like be distracted or things like that, you know whatever.
Speaker 3: But like the idea of looking out at the horizon
Speaker 3: is that you're like reducing visual sensory conflict. Right, the
Speaker 3: horizon is not moving, it's fixed the way that you
Speaker 3: expect it to be, and so then that's going to
Speaker 3: help reduce some of that sensory conflict. There's a lot
Speaker 3: of like ACUU pressure bands that you can wear, and
Speaker 3: there's very mixed data on whether or not these have
Speaker 3: any actual effect, but some people find them helpful and
Speaker 3: there's like no side effects with them. And the biggest
Speaker 3: downside of all of our pharmacologic methods, so like drugs
Speaker 3: to treat motion sickness or prevent motion sickness, do tend
Speaker 3: to have quite a lot of side effects, especially drowsiness,
Speaker 3: which is a huge problem if you're the one like
Speaker 3: flying the plane or driving the boat. Yeah, yeah, but
Speaker 3: they do tend to fall in kind of two main
Speaker 3: classes that work on two of those receptors and neurotransmitters
Speaker 3: that I mentioned already, which is like acetylcholine and histamine,
Speaker 3: So anahistamines and specifically antihistamines that can cross the blood
Speaker 3: brain barrier because they have to be able to get
Speaker 3: into our brain and central nervous system to have an effect.
Speaker 3: Can block histamine and then reduce a lot of the
Speaker 3: symptoms that are associated with the because histamine is involved
Speaker 3: in all of the action going on. Okay, so interesting, Okay,
Speaker 3: So that's what dramamine if you've heard of the brandname dramamine,
Speaker 3: which is di menhydroenate, that's an anahistamine, not dissimilar to
Speaker 3: benadryl or difen hydromene, and both of these can be
Speaker 3: effective for motion sickness, but they tend to cause like
Speaker 3: dry mouth, dry eyes, drowsiness, et cetera. So there that's
Speaker 3: a downside. So the other big one that we use
Speaker 3: is scopalamine, and this acts on acetylcholine receptor, so a
Speaker 3: different type of receptor, and we think that it acts
Speaker 3: kind of on both sides. We don't exactly know, but
Speaker 3: We think that it acts both on the vestibular side
Speaker 3: and the vomiting center side of the transmission pathway, where
Speaker 3: our vestibular system is talking to vomiting parts of our
Speaker 3: brain and saying be nauseous. So scopalamine is working on
Speaker 3: both ends of the spectrum in that way. It tends
Speaker 3: to have quite a lot of side effects, especially if
Speaker 3: you give it as an oral medicine, and so we
Speaker 3: often use it as a patch that you cook behind
Speaker 3: your ear, okay, And there's also like a nasal spray
Speaker 3: formulation I think too. The nice thing about the patch,
Speaker 3: even though it takes a lot longer to kick in,
Speaker 3: is that if you know I'm gonna be on a
Speaker 3: cruise for the next five days, you put it on
Speaker 3: a few hours before the start of the cruise and
Speaker 3: then it lasts for seventy two hours, which is kind
Speaker 3: of nice because usually by that time you've acclimated, and
Speaker 3: habituation or acclamation uh huh, is like the best thing
Speaker 3: that you could possibly do to treat or deal with
Speaker 3: motion sickness. And what I think is really interesting about
Speaker 3: the idea of acclamation is that it the fact that
Speaker 3: we can acclimate, that we can get used to these
Speaker 3: motions over time kind of also lends support to this
Speaker 3: idea that it's a sensory conflict to begin with.
Speaker 2: Right because you're kind of disentangling these conflicts.
Speaker 3: Your brain is getting used to a new normal where
Speaker 3: it's like, oh, it is okay that all of my
Speaker 3: environment is moving along with me. I don't have to
Speaker 3: worry about this. And if you've ever been on a
Speaker 3: long cruise or like people who go to outer space
Speaker 3: and come back apparently get this a lot. There's something
Speaker 3: called mald Debauchmont or like this. Yeah, and that's when
Speaker 3: it feels really disorienting to walk on flat, unmoving ground
Speaker 3: after you've been in outer space or on a boat
Speaker 3: for a really long time, and that's like you've acclimated,
Speaker 3: you've habituated to this sense of movement, and now you're
Speaker 3: back on flat ground. Your brain's like, whoa, whoa, whoa, whoa.
Speaker 3: This isn't what I expect to happen right now. Isn't
Speaker 3: that so interesting?
Speaker 2: Yes?
Speaker 3: That usually gets better a bit quicker. Okay, that makes sense.
Speaker 2: Yeah, I have a few questions, So habituation acclamation, how
Speaker 2: long does it take?
Speaker 3: Is that's one of the questions. I'm saving the rest
Speaker 3: for it depends on the person, right, everyone is so
Speaker 3: differentially susceptible to motion sickness. Depends on the person. But usually,
Speaker 3: like even if you are, let's say, on a cruise,
Speaker 3: it's the first like twelve to twenty four hours that
Speaker 3: things are probably the worst, and usually within two to
Speaker 3: three days you're pretty well acclimated. So if someone, for example,
Speaker 3: is like in the military and training for like intense flights,
Speaker 3: you know, with a lot of spinning or whatever, they
Speaker 3: might need more intensive like habituation therapy. But if you're
Speaker 3: just like on a boat or something like that, it's
Speaker 3: usually within a couple of days that you're going to habituate.
Speaker 3: But there's like regimens that people sometimes use to like
Speaker 3: get used to something so that even if they're exposed
Speaker 3: in the future, they don't get as motion sick as
Speaker 3: they used to.
Speaker 2: So is that is that something? That was my other
Speaker 2: kind of like question trying to get at this. Can
Speaker 2: you become less motion sick over time?
Speaker 3: Yes? It seems like yes by doing these habituation routines,
Speaker 3: which can sometimes be quite time intensive because you have
Speaker 3: to be able to like go in a mover jiggler thingy, and.
Speaker 2: You have to want to expose yourself to be over
Speaker 2: and horribly sick.
Speaker 3: Yeah exactly, Yeah, Okay.
Speaker 2: Differential susceptibility, why is are there genetic links? Is it
Speaker 2: run in families? And then age ranges all of that stuff.
Speaker 3: Give it. I can't wait. So anyone can get motion
Speaker 3: sick given the right set of circumstances. We think like
Speaker 3: even astronauts, like you think an astronaut has to go
Speaker 3: through so much training, but some of the papers that
Speaker 3: I read said that like seventy percent of astronauts going
Speaker 3: up for the first time we'll have some degree of
Speaker 3: space sickness the first twenty four hours that they're up there.
Speaker 3: So everyone, under the right set of circumstances, you could
Speaker 3: probably provoke motion sickness. But some people like Christina in
Speaker 3: our first hand account, get really severe motion sickness with
Speaker 3: things that other people don't feel motion sick at all.
Speaker 3: We don't really know what it is about one person
Speaker 3: that makes them more susceptible than another person, and we
Speaker 3: don't have tests or things that we can do to
Speaker 3: try and guess are you going to get motion sick
Speaker 3: or are you not? There does seem to be a
Speaker 3: big heritability component, so twin studies have like seventy percent,
Speaker 3: so it's estimated like fifty to seventy percent concordance, especially
Speaker 3: in childhood and age ranges. Usually susceptibility to motion sickness
Speaker 3: doesn't really develop until age like six to seven. Babies
Speaker 3: are like considered union entirely. We don't know if it's
Speaker 3: just because they lay their flat like a potato.
Speaker 2: And I was also wondering if it's well, first of all,
Speaker 2: their sense, their senses are still being developed, like.
Speaker 3: Diaster, they can't see, like.
Speaker 2: Yeah, it's but also they're being carried around a lot,
Speaker 2: and so I wondered if that was that, like, but
Speaker 2: then it's human.
Speaker 3: It's the thing. And they were meaning for so long
Speaker 3: like in your uterus in it floating around in fluids,
Speaker 3: so they're just all leaping to bop, right, they're like
Speaker 3: they expect motion. So I don't know, but it tends
Speaker 3: to not develop until age six to seven, and then
Speaker 3: it actually peaks in like age nine to eleven, so
Speaker 3: like kids tend to be anamorphs on the bus. But
Speaker 3: obviously many adults still experience motion sickness, though the like
Speaker 3: rates of it does decline and the severity tends to
Speaker 3: decline into adulthood. People who are assigned female at birth
Speaker 3: are much more susceptible, we think than people assign male
Speaker 3: at birth, but we don't know why, Like there's not
Speaker 3: any clear reasons why. And like I said, like site
Speaker 3: is not required for motion sickness, so people who are
Speaker 3: blind can still get motion sick We do know that
Speaker 3: there's some associations with like migraines and some other especially
Speaker 3: vestibular migraines, but also some other like vestibular disorders and
Speaker 3: an increased susceptibility to motion sickness, but we don't really
Speaker 3: know why, like is it overlapping pain pathways? Is it
Speaker 3: overlapping autonomic reactivity. We don't really understand these associations, but
Speaker 3: we just see that they exist in the population. Yeah,
Speaker 3: there's some like I think one paper found like thirty
Speaker 3: five possible single nucleotide polymorphisms that might be associated. So like,
Speaker 3: we have no idea what the genetics of motion sickness are.
Speaker 3: We just know that there's probably some kind of heritability component.
Speaker 3: So that's motion sickness. That's I know, right, It's so weird.
Speaker 3: It's so weird to think about how like, why do
Speaker 3: some of our brains, if it's this sensory conflict, why
Speaker 3: are some of our brains so like on edge about
Speaker 3: this conflict and making us so sick? Whereas other people
Speaker 3: can tilt a world after a funnel cake and be like,
Speaker 3: no problem, I'm not even a little bit nauseous. That's
Speaker 3: so weird. It is very weird. Weird is the word
Speaker 3: for this motion sickness. It's weird. It's weird. Yeah, so
Speaker 3: can you tell me about, like how you got to
Speaker 3: this point. I'm assuming it's just human. I can't wait
Speaker 3: to hear about other animals.
Speaker 2: Do you go about it all very very minor lyate? Okay,
Speaker 2: tell me there is some fun stuff to cover, so okay,
Speaker 2: I'm excited about it. I can think of no better
Speaker 2: way to start the history of motion sickness than with
Speaker 2: this quote. I had to do a quote quote. Whenever
Speaker 2: we relinquish our intended status as self propelled animals and
Speaker 2: step aboard some vehicle or device that transports us passively,
Speaker 2: we incur the risk of motion sickness. This wretched and
Speaker 2: debilitating condition has always been intimately linked with man's technological
Speaker 2: efforts to improve and extend his natural powers of locomotion.
Speaker 3: That's at quote, You've got a great, great ut good. Yeah.
Speaker 2: So those two lines are what kick off the prologue
Speaker 2: of this book called motion Sickness by J. T. Reason
Speaker 2: and JJ Brand, and it really gets straight to the
Speaker 2: heart of the matter. Motion sickness is a problem of transportation,
Speaker 2: specifically being transported by something other than yourself.
Speaker 3: Yeah.
Speaker 2: And we might use different names to refer to the
Speaker 2: sickness caused by the specific mode of transport, So like
Speaker 2: sea sickness, car sickness, air sickness, space sickness, space, cyber sickness,
Speaker 2: but they all signify an external source and almost almost
Speaker 2: uniquely human experience, unless you're a dog on a road trip,
Speaker 2: for example, or in a fish tank, or a fish
Speaker 2: in a fish tank.
Speaker 3: Does happen? Does happen? I learned that and I was like,
Speaker 3: fish can get No. I know, it is amazing, it
Speaker 3: is ridiculous. I love it.
Speaker 2: But given how, given how the vast majority of us
Speaker 2: are susceptible to motion sickness, and our wide array of
Speaker 2: transportation options, it's safe to say that.
Speaker 3: But we've been dealing with this for quite some time.
Speaker 3: How long? How long? Forever? Forever? I mean yes and no.
Speaker 2: Right, Okay, because so our written record on motion sickness
Speaker 2: extends back to ancient Greece and ancient China at the
Speaker 2: very least. But is that when the first transportation devices
Speaker 2: were used? If for humans we have to have some
Speaker 2: sort of external transportation, when was that, Yeah, it was
Speaker 2: before ancient Greece and ancient China. So I started to
Speaker 2: look for when the earliest boats were built, thinking, okay,
Speaker 2: that's a likely candidate for the oldest method of artificial transport.
Speaker 2: Ok But then I realized that it wasn't about the
Speaker 2: boat necessarily, boat raft whatever. The real question was not
Speaker 2: about how ancient humans spent time on the water, but
Speaker 2: when they did. That likely dates back to at least
Speaker 2: fifty to sixty thousand years ago, seriously, seriously, seriously. So
Speaker 2: it was then that early modern humans migrated over water
Speaker 2: from Southeast Asia to a land mass called Sahul, which
Speaker 2: is Australia and New Guinea joined with a land bridge.
Speaker 2: Because water levels were a lot lower than okay, kilometers
Speaker 2: of ocean had to be crossed with seaworthy vessels.
Speaker 3: I had to have gotten seasick. Yeah.
Speaker 2: Yeah, and prior to this, it's thought that all other
Speaker 2: haminin migration had been over land, and it's it's unclear
Speaker 2: what as far as I could tell, it's not clear
Speaker 2: exactly what types of boats were constructed. And it's probably
Speaker 2: the case that it wasn't like let's build a boat
Speaker 2: and immediately go like the people were using it for
Speaker 2: coastal exploration and.
Speaker 3: Fishing or scattered at local Yeah.
Speaker 2: Yeah, yeah, and so but that is at least, like
Speaker 2: I think a pretty hard line is when humans had
Speaker 2: to spend extended time on the water.
Speaker 3: You know, they didn't talk about this in w Wana
Speaker 3: at all. Motion sickness.
Speaker 2: Yeah, it's been a while. No points for accuracy, points
Speaker 2: for great songs, zero for accuracy. But yeah, so my
Speaker 2: guess is that there were there was at least.
Speaker 3: A barfing human or two for su watercraft. Yeah, there
Speaker 3: must have been. There must have been.
Speaker 2: But humans, like like we've touched on briefly, they're not
Speaker 2: the only animals to experience motion sickness. Dogs, fish, amphibians, primates,
Speaker 2: and many other animals are also susceptible, and so this
Speaker 2: points to a deep evolutionary origin of the physiology that
Speaker 2: makes us all susceptible to motion sickness, and that is
Speaker 2: primarily are not primarily but like a big chunk of
Speaker 2: it is our vestibular system yep.
Speaker 3: And so while those early.
Speaker 2: Humans crossing to Sahole might have been among the first
Speaker 2: of our species to get seasick, they likely weren't the
Speaker 2: first organism's overall.
Speaker 3: As an example, did you know.
Speaker 2: What the leading hypothesis for how New World primates got
Speaker 2: from the Old World is?
Speaker 3: I don't know. Were they like holding onto a coconut
Speaker 3: or something, basically, yeah, floating?
Speaker 2: I have I keep checking this because I'm like, this
Speaker 2: can't be real. It's thought that they crossed the Atlantic
Speaker 2: Ocean on some sort of big vegetation containing rafts.
Speaker 3: M m hm.
Speaker 2: They crossed an ocean, Aaron, How did they?
Speaker 3: How did they do that? I don't know? And I
Speaker 3: mean enough of them to like establish new lineages, so
Speaker 3: not just like one Yeah? Was it multiple times? Yeah? Yeah?
Speaker 2: And so that but that is our current best guess
Speaker 2: based on fossil evidence and what the oldest fossils seem
Speaker 2: to be related to what primates in Africa. Yeah, so
Speaker 2: they probably got motion. Yeah, they had to cross a
Speaker 2: distance of around fifteen hundred to two thousand kilometers. Wow,
Speaker 2: I don't know how they all didn't. Like where was
Speaker 2: the water coming from? Again, I guess giant vegetation raft
Speaker 2: if there was enough fresh water in the vegetation and
Speaker 2: they were consuming that.
Speaker 3: I don't or like rain fall.
Speaker 2: Yeah, maybe there was an island stopover in between.
Speaker 3: Wow, this is fascinating erin So.
Speaker 2: If that's how it went down, definitely motion sickness on
Speaker 2: the table for these primates, little adventurous primates. But yeah,
Speaker 2: so motion sickness was not an unfamiliar experience to well,
Speaker 2: at least those primates, at least some early humans. But
Speaker 2: the same goes for ancient humans. So by eight hundred BCE,
Speaker 2: humans had come a long way in boat in both
Speaker 2: boat making and livestock domestication, which enabled the use of carts,
Speaker 2: and as a result, motion sickness had become a common occurrence,
Speaker 2: occasionally known as the plague at sea.
Speaker 3: And there's so many to choose.
Speaker 2: Fro us, right, there's typhus, there's scurvy, theresis I think
Speaker 2: was you know, at least happened. There's actual many people,
Speaker 2: there's plague, yellow fever, I mean anyway, But various explanations
Speaker 2: were proposed as to what the cause of motion sickness
Speaker 2: was in ancient Greece and Rome, and of course we've
Speaker 2: got the humors blamed.
Speaker 3: Humors were out of.
Speaker 2: Balance, the stomach in your yellow bile of course, playing
Speaker 2: an outsized role. I wasn't always thought to be bad
Speaker 2: because like sometimes emetics were prescribed to be like, right, got.
Speaker 3: Too much, You've got to get rid of this. Yeah, yeah, yeah.
Speaker 2: And in ancient China it was thought that motion sickness
Speaker 2: was due to an improper or impeded flow of chi
Speaker 2: or life force, with some liver involvement, Whereas in China
Speaker 2: the illness was broken down into the mode of transport,
Speaker 2: so it was called cart influence or ship influence.
Speaker 3: Okay.
Speaker 2: In ancient Greece and Rome, the focused romane primarily on
Speaker 2: sea vessels, hence the etymology of the word nausea, which
Speaker 2: comes from the word for seasick, not like nau for ship,
Speaker 2: like nautical.
Speaker 3: Like nautical nautical nausea. Cool. I had no idea nausea
Speaker 3: comes from ships. That's just how intertwined they are.
Speaker 2: Yeah, wow, yeah. The description of symptoms from these ancient
Speaker 2: texts spot.
Speaker 3: On, right.
Speaker 2: We've got dizziness nausea, vomiting, loss of hunger, exhaustion, and anxiety.
Speaker 2: And while there was no consistent pattern seen in terms
Speaker 2: of predisposition, some writers would try to make a link
Speaker 2: between disposition and susceptibility. It was generally observed that people
Speaker 2: could become acclimated to transport and over time they would
Speaker 2: be less likely.
Speaker 3: To get sick.
Speaker 2: Another way to avoid getting motion sick was, of course,
Speaker 2: by concocting various remedies or choosing certain diets.
Speaker 3: Oh dear, so for.
Speaker 2: Instance, grinding up wormwood and mint and then mixing it
Speaker 2: with oil and vinegar and rubbing it into your nostrils.
Speaker 3: Oh okay, an odor thing. People a lot of those
Speaker 3: in modern days. There's there's no evidence for odor things,
Speaker 3: just there's clear.
Speaker 2: It's there's a long history of this sort of thing.
Speaker 3: Yeah.
Speaker 2: Others claimed that quote seasickness will not be able to
Speaker 2: torment him who drinks vermouth mixed with wine before setting off.
Speaker 3: Oh, not true. Don't give it a whirl. Doesn't sound great.
Speaker 3: You could also take.
Speaker 2: A bit of earth from your kitchen hearth and hide
Speaker 2: a bit under your hair, or write the character for
Speaker 2: dirt on your palms, kind of as like a grounding stability.
Speaker 3: That was an another common practice.
Speaker 2: Oh, I kind of like that, I know, if all
Speaker 2: else fails fast, just don't nothing nothing.
Speaker 3: I mean that is like still a recommendation today is
Speaker 3: like don't eat heavy meals, et cetera, so that you
Speaker 3: just have less food to barfucks so you feel less nauseous. Yeah.
Speaker 2: Yeah, But the sheer variety of remedies or preventatives points
Speaker 2: to just how big a challenge motion sickness posed. More
Speaker 2: than a temporary setback or period of discomfort, it could
Speaker 2: mean life or death, particularly during war. Julius Caesar wrote
Speaker 2: that in forty eight BCE, when his troops landed on
Speaker 2: enemy shores after a stormy voyage, they were too exhausted
Speaker 2: to do anything other than surrender, and they were promptly massacred.
Speaker 2: Oh whoa yeah. Writings describing the Battle of Redcliffe, which
Speaker 2: took place in China in two oh seven CE, mentioned
Speaker 2: that seasickness was a big problem, and so the ships
Speaker 2: were tied together to increased stability. That meant that when
Speaker 2: one ship was set on.
Speaker 3: Fire, they all went up in flames.
Speaker 4: Oh that's at least with some texts suggest who the
Speaker 4: plague at sea moved to be a predictable and unwelcome
Speaker 4: companion to any war since ancient times that involved ships
Speaker 4: or camels.
Speaker 2: Apparently, camel sickness became an issue for some of Napoleon's
Speaker 2: soldiers in the late seventeen hundreds, really camel sims who knew,
Speaker 2: but its predictability did nothing to help with prevention or
Speaker 2: treatment or understanding why it happened. And as transport grew
Speaker 2: more common beyond wartime, many people had an opportunity to
Speaker 2: experience at firsthand, such as famous Charles Charles Darwin.
Speaker 3: Yeah, he was super, super susceptible to motion sickness apparently.
Speaker 2: Yeah, so he spent nearly five years on board the Beagle,
Speaker 2: actually more like three years on shore. Two years, like
Speaker 2: three fifths of his time was spent on land.
Speaker 3: Okay, I need recovery time. Yeah, I'm just looking birds here.
Speaker 2: Oh that's a really interesting specimen. Let me just spend
Speaker 2: two months. But yeah, so this is the time. Then
Speaker 2: he collected all those observations to develop the theory of
Speaker 2: evolution by natural selection, and during much of his time
Speaker 2: he horribly, horribly suffered from motion sickness. So I have
Speaker 2: a couple quotes from his letters. In one he wrote, quote,
Speaker 2: I hate every wave of the ocean with a fervor
Speaker 2: which you, who have only seen the green waters of
Speaker 2: the shore can never understand.
Speaker 3: You have no no idea what I've been through.
Speaker 2: Yeah, I hate every wave. And then quote this is
Speaker 2: a little more measured, not really quote if a person
Speaker 2: suffer much from sea sickness, let him weigh at heavily
Speaker 2: in the balance. I speak from experience. It is no
Speaker 2: trifling evil which may be cured in a week. And
Speaker 2: he probably had something else going. Oh, there have been
Speaker 2: so many different hypotheses about what afflicted Darwin.
Speaker 3: But you had terrible motion sickness. Sickness.
Speaker 2: Yeah, yeah, But this didn't mean that people didn't try
Speaker 2: to cure motion sickness.
Speaker 3: There was always there was always the will to.
Speaker 2: Explore new options and to understand what was actually happening,
Speaker 2: And so by the late nineteenth century, scientists and sailors
Speaker 2: had accumulated heaps of explanations and remedies for motion sickness,
Speaker 2: things like, in terms of hypotheses, cerebral anemia or cerebral
Speaker 2: hyperemia basically irregular blood flow to the brain of some sort.
Speaker 2: Others believed that disturbed vision or respiration played an outsized role.
Speaker 2: Maybe it was maybe it was the digestive system that
Speaker 2: experienced too much mobility to little mobility, all things everything. Yeah,
Speaker 2: one guy was certain that it was an infection, just
Speaker 2: like yellow fever or bubonic plague, and so he wrote
Speaker 2: this paper, and in response, a reviewer from The Lancet wrote,
Speaker 2: this is like an eighteen fifty. By the way, it
Speaker 2: is a pity that people should so cruelly waste their
Speaker 2: time and trouble.
Speaker 3: Oh that brings you right back to grad school.
Speaker 2: Reviewer three, right there, exactly, completely devastating.
Speaker 3: Wow.
Speaker 2: A tentative breakthrough arrived in eighteen eighty one when a
Speaker 2: couple of researchers noticed that motion sickness produced very similar
Speaker 2: symptoms as a condition called many years disease. So it
Speaker 2: turns out our stomach wasn't to blame, Our blood wasn't
Speaker 2: necessarily to blame. It was our vestibular system that helps
Speaker 2: us balance and sense our body's position in space.
Speaker 3: And so as the.
Speaker 2: Vestibular hypothesis grew in support overtaking the blood and guts ideas,
Speaker 2: others still emerged, such as the psychological explanations believing that
Speaker 2: motion sickness was all in your head and like a, well,
Speaker 2: you just have a nervous disposition sense, not inl like
Speaker 2: this is disrupting your vestibular system sense.
Speaker 3: Yeah, that by the way. There Actually I found that
Speaker 3: there have been papers that have very clearly shown there
Speaker 3: is no like personality, no opponent to motions I mean.
Speaker 2: And to show you how how clearly there is no link,
Speaker 2: there was a paper I read from I think nineteen
Speaker 2: forty nine that was like so disparaging of this idea.
Speaker 2: They were like, this is utter garbage.
Speaker 3: It was given even in the bodies, yeah, when that
Speaker 3: was still in vogue.
Speaker 2: But yeah, so supporters of this idea would point to
Speaker 2: stories of sailors who were completely wrecked by seasickness and
Speaker 2: then suddenly recovering after hearing that the ship was under fire,
Speaker 2: or the fear of motion sickness becoming a self fulfilling prophecy,
Speaker 2: or the claim that some people's sickness was effectively treated
Speaker 2: with placebo, and so under this hypothesis it was like
Speaker 2: mind over matter.
Speaker 3: It was the only way to go. But these stories were.
Speaker 2: Primarily anecdotes, possibly invented, and in general, this neur quote unquote,
Speaker 2: neurotic theory of motion sickness did not gain a lot
Speaker 2: of traction, in large part because, yeah, it did not
Speaker 2: hold up to any scrutiny even then. Even then, so
Speaker 2: research had shown that almost everyone was susceptible to motion sickness,
Speaker 2: but not everyone had a nervous constitution.
Speaker 3: So checkmate, whatever that means. Whatever that means.
Speaker 2: Yeah, motion sickness again became a pressing issue when war
Speaker 2: was on the horizon, specifically World War Two. You've got
Speaker 2: tens of thousands of soldiers about to be transported over
Speaker 2: water and spend extensive periods on ships or in the
Speaker 2: air and airplanes, and so motion sickness posed a substantial
Speaker 2: threat to wartime efforts. We got to have our soldiers
Speaker 2: and you know, fighting fighting shape. That's can't my brain.
Speaker 2: But so despite the attention paid to the condition in
Speaker 2: the century before, little progress had been made in understanding
Speaker 2: or treating it. To quote this nineteen forty eight paper,
Speaker 2: the same one that was like disparaging of the psychological
Speaker 2: links by Taylor and Bard. Quote, the literature on motion
Speaker 2: sickness which appeared before World War Two contains amazingly little
Speaker 2: factual information concerning this common disorder. Like the extensive folklore
Speaker 2: devoted to the subject, most of the publications were replete
Speaker 2: with uncritical considerations of a number of possible ideological factors
Speaker 2: and with accounts of uncontrolled and statistically deficient excursions into
Speaker 2: the field of prevention and cure and quote cutting just brutal.
Speaker 3: Like no one has done anything. Use this is a waste.
Speaker 2: You alted your entire career studying this. But they weren't wrong, really,
Speaker 2: like there still was not any way to effectively manage
Speaker 2: motion sickness, although people still had their pet remedies, ranging
Speaker 2: from the sensible fasting dry toast, you know, choices that
Speaker 2: are often still recommend or to the to the confusing
Speaker 2: even barf inducing, nausea inducing certainly quote soup made of
Speaker 2: horse radish and rice seasoned with red herrings and sardines
Speaker 2: and quote I actually kind of want to try that.
Speaker 2: It sounds I love horse radish and sartines, but like
Speaker 2: I do not, I know that that is not something
Speaker 2: that I would want to gorge myself on.
Speaker 3: Prime to getting hired to a ship voyage. Yeah, thanks, uh.
Speaker 2: That though I don't even think that was Maybe it's
Speaker 2: in contention for as bad as the suggestion to feast
Speaker 2: on pickled onions, which I also loved, don't get me wrong.
Speaker 2: But the idea was to eat so much of them
Speaker 2: that you had a tremendous amount of gas so that
Speaker 2: your stomach maintained a steady pressure, thinking it was like
Speaker 2: a atmospheric pressure thing.
Speaker 3: I don't know. That sounds so uncomfortable, I don't know.
Speaker 2: And then all of these were to be washed down
Speaker 2: with your beverage of choice, you know. Top recommendations included coffee, brandy,
Speaker 2: but the top fave was champagne.
Speaker 3: Champagne. Yeah, the idea of champagne to prevent motion sickness
Speaker 3: is hilarious. I know, I know, it's it's great.
Speaker 2: There's there's a so fancy not sparkling wine, champagne, Champagne, champagne.
Speaker 2: That motion Sickness book that where I started the quote
Speaker 2: from in the beginning of this has a table. They
Speaker 2: put together a table of motion sickness preventatives and the
Speaker 2: number of citations for each one in like historical times,
Speaker 2: so ranging from warm salt water to opium chloroform to
Speaker 2: nitrous oxide, kaya bepper to atropine, which is actually kind
Speaker 2: of funny because that was used a little bit later on,
Speaker 2: but none of these had enough support to actually do
Speaker 2: anything in a major world war. So, in the words
Speaker 2: of one writer from the peer quote, I am convinced
Speaker 2: that the only real and complete cure is to sit
Speaker 2: under a big tree and quote, get off that boat.
Speaker 3: Get off.
Speaker 2: The more statistically organized trials on compounds like belladonna, derivatives
Speaker 2: and barbituates were conducted during the war, and it's hard
Speaker 2: to know.
Speaker 3: If the cure was worse than the disease.
Speaker 2: So on the one hand, you've got soldiers reporting that
Speaker 2: D Day quote had resulted in the greatest mass vomiting
Speaker 2: ever known in the history of mankind and quote which
Speaker 2: makes sense?
Speaker 3: Think of that? Think about that. Yeah.
Speaker 2: And on the other hand, you've got a war correspondent
Speaker 2: describing that the sea sickness pills prescribed by the army
Speaker 2: quote not only put us to sleep, but they constricted
Speaker 2: our throats, made our mouths bone dry, and dilated our
Speaker 2: pupils until we could hardly see quote.
Speaker 7: YEA.
Speaker 2: Turns out those guys had taken the twice a recommended dose,
Speaker 2: so that could have been partially too.
Speaker 3: Maybe a little bit of user error there.
Speaker 2: Might be, but also complicating drug development for sea sickness
Speaker 2: was that during this time it was common for the
Speaker 2: placebo pill to be a lactose pill, which I would
Speaker 2: imagine could cause symptoms mimicking motion sickness and those of lactosey. Yeah,
Speaker 2: it was like, well, we tested this against the lactose
Speaker 2: placebo and I was like.
Speaker 3: Excuse me, what why? Why?
Speaker 2: So Yeah, Unfortunately, true relief for many would not arrive
Speaker 2: until the war was over.
Speaker 3: We love a serendipitous discovery in science.
Speaker 2: Maybe you're a great storytelling So in the case of
Speaker 2: motion sickness, that story involves a pregnant woman who had
Speaker 2: severe allergies and hives to probably tell where this is going.
Speaker 2: So in nineteen forty seven, she had been prescribed in anahistamine,
Speaker 2: which was effective in relieving her symptoms, but she was
Speaker 2: also surprised to find it had an other consequence her
Speaker 2: entire life. She had gotten carsick really easily, but while
Speaker 2: she was taking this drug, she found that she could
Speaker 2: ride in cars with no problem at all.
Speaker 3: Wow, even while pregnant. Even while pregnant. Yeah.
Speaker 2: So she told her medical advisors about this, who had
Speaker 2: her try it out against a placebo.
Speaker 3: No dice still got.
Speaker 2: Carsick, and they began to plan a larger study testing
Speaker 2: whether this drug could prevent seasickness in a group of sailors.
Speaker 2: And it worked, I mean remarkably, remarkably well. It was
Speaker 2: like such a clear relationship. It wasn't like, oh yeah,
Speaker 2: some people found really if it was like no, the
Speaker 2: vast vast majority were completely either prevented or alleviation of symptoms.
Speaker 3: Wow. Trade name drama mean drama, mean drama. Mean.
Speaker 2: As the nineteen fifties closed into the nineteen sixties, space
Speaker 2: travel provided new motivation to understand the sight the physiological
Speaker 2: impact of unnatural motion on the human body, and finally,
Speaker 2: some plausible mechanisms began to crystallize, explaining both what is
Speaker 2: happening and why. And you already went through both the
Speaker 2: what and the why. But I think that, yeah, it
Speaker 2: seems to come down to our brains get overwhelmed by
Speaker 2: all these confusing and contradictory sensory inputs, and.
Speaker 3: Then we get nausea, pallor cold, sweats, vomiting, et cetera.
Speaker 3: Basically so so interesting. Yeah, I mean, like.
Speaker 2: I said a couple times, now, we humans did not
Speaker 2: evolve under non self propelled transport I feel.
Speaker 3: Like that is such an interesting part of the story.
Speaker 3: Erin it's like that, but especially in the context of
Speaker 3: all animals, not all, but so many animals being susceptible
Speaker 3: under the right conditions, that it really is just like
Speaker 3: we're just doing this to ourselves. But like now we
Speaker 3: can't not write, like you can't not go in a
Speaker 3: car or a train or a plane or a boat,
Speaker 3: like you have to get around somehow.
Speaker 2: Yeah, it's so interesting, right, and so it is, Yeah,
Speaker 2: like I think it it is shows that we don't know,
Speaker 2: like we if all the underconditions of how to interpret
Speaker 2: the world around us, and we don't know what to
Speaker 2: do when that world moves out of our control.
Speaker 3: Right in a way that just doesn't make sense for
Speaker 3: our brains yep, and what our body can do.
Speaker 2: And so we we have, you know, recent advancements in
Speaker 2: our understanding of the physiology and underpinnings of motion sickness,
Speaker 2: and we have some different drug formulations like like you said,
Speaker 2: this is an unavoidable consequence of our technological prowess as
Speaker 2: a species, at least for now, like we we have
Speaker 2: to this is what we are dealing with. And so
Speaker 2: for anyone who has experienced motion sickness or who has
Speaker 2: witnessed it firsthand. It is clearly both wretched and debilitating,
Speaker 2: which is what the first quote those those words I was.
Speaker 2: I read that quote to John and he was like,
Speaker 2: that is exactly it is exactly debilitating the word.
Speaker 3: That I would choose.
Speaker 2: And in some respects we have come a long way
Speaker 2: in the past few decades, but in others we're still
Speaker 2: completely at the mercy of the waves or the camel
Speaker 2: that we're writing. So tell me, Aaron, I guess how
Speaker 2: many of us can expect to be motion sick? Do
Speaker 2: we have promising research on the horizon, What's what's going
Speaker 2: on today?
Speaker 3: I'd love to tell you, Aaron, No, we I mean,
Speaker 3: like I said, already, all of us could get motion sick.
Speaker 3: It really just depends on if we're exposed to the
Speaker 3: right sort of stimulus. And we know this from looking
Speaker 3: at different scenarios. On large planes, like the commercial airlines
Speaker 3: that most of us fly on, it's usually less than
Speaker 3: one percent of people that tend to get motion sick,
Speaker 3: whereas in little planes like a Cessna or a little plane,
Speaker 3: up to twenty five percent of passengers might get sick.
Speaker 3: And even on commercial planes. While it's usually less than
Speaker 3: one percent that are getting sick overall, on a particular
Speaker 3: flight where people are getting sick, it can sometimes be
Speaker 3: up to eight percent of people. So it really depends
Speaker 3: on the amount of turbulence and like what you're experiencing
Speaker 3: on that particular flight. Up to one third of people
Speaker 3: can get sick on long distance car rides. On cruises,
Speaker 3: motion sickness is the most common reason for physician consultations,
Speaker 3: more than infections, more than injuries.
Speaker 7: What about neurovirus exactly, including neurovirus, some more people go
Speaker 7: to the doctor, and that's just the people who didn't
Speaker 7: already come with dramamine and scopalamine and have the medicines
Speaker 7: that they need so that they don't need to see
Speaker 7: the doctor, right, And that's on huge cruise liners.
Speaker 3: On life rafts, it's like fifty to sixty percent of
Speaker 3: people who are going to get motion sickness on something
Speaker 3: like a life raft, especially in more uh, what's the
Speaker 3: word bad seas toppy water sea toppy water adverse conditions work,
Speaker 3: So any of us could where do we go from here?
Speaker 3: I have no idea. I did not see anything about
Speaker 3: like new medications, new treatments. There is a lot of
Speaker 3: and maybe maybe a lot is even a stretch, but
Speaker 3: there will be changes in who is experiencing and how
Speaker 3: people are experiencing motion sickness with an increase in the
Speaker 3: use of things like virtual reality. There's some papers out
Speaker 3: there that are like what about self driving cars? Oh? Interesting, right,
Speaker 3: because in a self driving car, you're obviously not the driver,
Speaker 3: and we do see that people tend to get less
Speaker 3: motion sick if they are not just the one like
Speaker 3: driving the thing, but even if they're engaged in certain
Speaker 3: types of tasks. So like having to use your brain
Speaker 3: for certain types of tasks but not others can help
Speaker 3: to reduce your susceptibility to motion sickness, which is super interesting.
Speaker 2: Like like being the car DJ or the math reader or.
Speaker 3: Yeah, or like maybe not reader because then you're looking
Speaker 3: at papers. But like people who had to do I
Speaker 3: think mental arithmetic were less likely to get motion sick
Speaker 3: than people who were just supposed to think about not
Speaker 3: getting motion sick or something like whoa, that's weird, okay, okay,
Speaker 3: so anyways there, but again we don't really know like
Speaker 3: why why is that? Is it just because your brain
Speaker 3: is having to focus on other things, so it's not
Speaker 3: bothering to interpret these sensory discrepancies or something like. We
Speaker 3: really have no we don't know, We do not know,
Speaker 3: but there probably are going to be more of us
Speaker 3: that are getting sick in different situations, right because of
Speaker 3: the changing ways that we do technology today versus how
Speaker 3: we used to in the past. And that's all I
Speaker 3: got for you. Aarin about motion sickness.
Speaker 2: It's so interesting that there's not more about like research
Speaker 2: for either pharmaceuticals or because like.
Speaker 3: And maybe I just missed it, So if someone's working
Speaker 3: on it, please tell me and I'll apologize. But I
Speaker 3: didn't see anything. It was hard to find recent papers
Speaker 3: in general. Most of my papers were old. I think
Speaker 3: it's it is.
Speaker 2: It is really striking to me that, like, it seems
Speaker 2: that placebo effect which we were talking about before we
Speaker 2: started recording and how interesting it is and we should
Speaker 2: do an episode on it, shit.
Speaker 3: Doesn't seem to be there for motion sickness. It can be.
Speaker 3: There's some there's some there's some papers. I mean, especially
Speaker 3: when you think about like some of the there are
Speaker 3: some papers that show that things like these sad sea
Speaker 3: bands or that might be a brand name, so sorry
Speaker 3: about that. But like the motion sickness bands or other,
Speaker 3: and like is that a placebo or is that actually
Speaker 3: doing something? Who knows? But some papers seem to show
Speaker 3: that there's an effect and others don't. And similarly with placebos,
Speaker 3: like there's some that show that there might be in
Speaker 3: a placebo effect and others that don't really show much
Speaker 3: of a placibo effect. So it's all just it is really,
Speaker 3: I mean, motion sickness is a really interesting, weird and
Speaker 3: debilitating condition that any of us could experience. Yeah, oh,
Speaker 3: it's interesting that I didn't know about that.
Speaker 2: About the current research, it seems like historically there was
Speaker 2: not a lot of placebo effect observed. Maybe it's because
Speaker 2: they're using lactose pills.
Speaker 3: I don't know how much lactose was in the lactose pill.
Speaker 3: That's the story for another time, another day. But if
Speaker 3: you want to read more.
Speaker 2: We've got some sources. We did got a bunch, so
Speaker 2: let's see. I'm gonna I have a bunch, but I'm
Speaker 2: shouting out two in particular. One is that book by
Speaker 2: Reason and Brand Motion Sickness, published in nineteen seventy five.
Speaker 2: And then there was a great overview of the history
Speaker 2: like historical writings on motion sickness called by Hupbert at
Speaker 2: All from twenty seventeen called a Historical View of Motion
Speaker 2: Sickness a plague at sea and on land, also with
Speaker 2: military impact.
Speaker 3: It's very descriptive. I really enjoyed actually a textbook chapter
Speaker 3: from the Handbook of Clinical Neurology, I think it was
Speaker 3: chapter twenty seven called motion Sickness by Golding from twenty sixteen. Also,
Speaker 3: all of the papers, even the more recent papers looking
Speaker 3: at the mechanisms and this idea of like a sensory
Speaker 3: conflict a neural mismatch, cite this paper from nineteen seventy
Speaker 3: eight by Reason that was called motion sickness adaptation a
Speaker 3: neural mismatch model. They all still cite that paper like
Speaker 3: there's not been more data to show it. That's the
Speaker 3: author of the book. Yeah, oh yeah. So anyway, so
Speaker 3: that's a great paper. It's actually a really great paper.
Speaker 3: And then there's a bunch of other ones as well too,
Speaker 3: all about you know, the treatment, the path of physiology,
Speaker 3: et cetera. You can check them out on our website
Speaker 3: this podcast will Kill You dot com. I also have
Speaker 3: some extra reading if you want about like our vestibular
Speaker 3: system and our appropriateceptive system and little little little fun
Speaker 3: bits like checking down there. Yeah, this podcast will kill
Speaker 3: you dot com under the episodes tab.
Speaker 2: Thank you again to Christina for sharing your story with us.
Speaker 3: Thank you so much. It really does make you. Yeah.
Speaker 3: Thank you also to Bloodmobile for providing the music for
Speaker 3: this episode and all of our episodes.
Speaker 2: Thank you to Leanna and Tom and Mark and Jessica
Speaker 2: and Sabrina and everyone else who works.
Speaker 3: There's Does that work amazing? Yeah? Yeah, our list is
Speaker 3: growing ever longer. We keep probably missing people. Thank you
Speaker 3: to you everyone listening and watching. Hello, Hello, thanks we
Speaker 3: like Did you like this eupisode? I like to let
Speaker 3: us know? Do you get motion sick? Let us know?
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Speaker 3: have you yet have? Do you need to go to space? Oh?
Speaker 3: All right, to take it on the list anyway.
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