Keeping lunch down when going up Published Nov. 1, 2010 By Brian McGloin 502nd Air base Wing OL-B Public Affairs RANDOLPH AIR FORCE BASE, Texas -- Even the bravest fighter pilots and toughest medevac helicopter pilots may occasionally need an air-sickness bag. Air sickness has nothing to do with how tough or strong someone is. It's a complex problem with a variety of causes which affect many people to varying degrees. For aircrew, three episodes of air sickness means a referral to the flight surgeon for evaluation. A popular hypothesis for the cause of motion sickness is sensory conflict -- the eyes see one thing, the inner ear feels something else and the skin says the body isn't moving, all at the same time. Two other causes are anxiety and lack of adaptation to the flying environment. The 359th Aerospace Medicine Squadron is equipped to help both new and seasoned pilots and aircrew members overcome air sickness through simple but effective means using progressive relaxation techniques and a device called a Barany chair, named after Hungarian Nobel-laureate physiologist Robert Bárány. The 359th AMDS uses a process which takes three consecutive days and has a very high success rate. "Pilots are our primary customers," 2nd Lt. Shannon Scannon, 359th AMDS, aerospace and operational physiologist, said. "Any aircrew member can be put in the chair." On the first day of training, aircrew members are interviewed to find potential causes of their air sickness. They're asked about how they felt sick and which phase of flight their symptoms may have appeared, as well as their specific diet, sleep patterns, and what fluids they have consumed. After the interview they're strapped into the Barany chair and spun at a steady pace in the same direction to stimulate their vestibular system. "Our goal is to spin them at about 25 revolutions per minute," Lieutenant Scannon said. "It's just enough to get the fluid in the ears moving." The aircrew members are spun three times for ten minutes each with ten minute breaks between spins. While they are rotating they have to perform tasks or exercises, such as tilting their head to the left or right, which can be surprisingly disorienting. Lieutenant Scannon said the first day is not very aggressive, but as the days continue, the training becomes much more intense. She said the goal of the training isn't to induce vomiting, rather to help pilots and aircrew members "become acclimated to the motion and to learn techniques that they can use to overcome air sickness." "I never had anyone actively get sick on the third day," Lieutenant Scannon said. "We want to help them learn techniques to minimize air sickness to complete their mission." In concert with rotating in the Barany chair, the 359th AMDS teaches progressive relaxation techniques to combat stresses during flight. She said progressive relaxation is a process that has two key elements: diaphragmatic breathing and muscle tensing. Diaphragmatic breathing is the first stage in the training. It teaches a relaxed but deliberate breathing rhythm using abdominal muscles, inhaling through the nose and exhaling through the mouth. The second step is muscle tensing. This step teaches one to focus on clenching and releasing various muscle groups in the body, which eases anxiety and also forces one to be physically relaxed. While these methods may seem unrelated, both work in concert to stimulate specific nerves which elicit physiologic responses leading to acclimation. She said the Barany chair is a more extreme version of the sensations pilots and aircrew members may feel in an aircraft. "The Air Sickness Management Program in its entirety is significantly more involved than is depicted here," Lieutenant Scannon states. "Simply spinning in a chair downplays the complex mechanisms involved in acclimation training." "If they make it through the chair, they should be able to fly." The 359 AMDS Aerospace and Operational Training Flight stresses they are standing by to assist any aircrew member with this or any other type of human factors related issue.