Student Keeps Getting Motion Sickness

J. Taylor Stanley

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Taylor Stanley
I am a CFI with about 1200 hours of dual given, and I have never seen this problem before. He is about 20 years old and in good health, holding a 1st class medical. He has about 12 hours TT now and on about 50% of flights, he gets sick and we have to land. On three occasions, he has actually thrown up. It happened again this morning. He has tried eating before a flight, not eating before a flight. He has tried Dramamine with limited success. I asked him point blank after todays incident if he drinks heavily or does drugs the night before that might give him a hang over. He said he does not. He said he isn't nervous before the flights, so he doesn't think it is that. I told him I think he should pause training until he can consult with a doctor to try to get something figured out. Has anyone seen this before? Any suggestions?
 
Does the student notice any improvement when taking Dramamine? Obviously one can't take that when PiC but I think it can be used to be able to accomplish tasks for a while before having to head back. And ideally these durations will increase before having to call it quits.

And there are two kinds - one is non-drowsy, which is less potent but keeps me functioning at a higher level than the normal brand. I used to do this when flying with a CFI and weaned myself off of it over time before I solo'd.

Also have the student try ginger tablets. They can be taken right before flying, along with Dramamine.

I also avoid dairy before flying.
 
Also want to add that this is very similar to my situation - for someone who has a history of motion sickness, 12 hours is still pretty early. And I appreciate that as a CFI you are clearly concerned and are working extra to help the student succeed.
 
only 12 hours? that's not enough time to get acclimated to all the stress and sensations of flying.

I say this as someone who doesn't do well in turbulence, etc etc.

I managed to work through it (sort of). Flying when well rested, flying on calm days, short flights, cooler time of day. I was chewing gum during lessons, but that probably didn't help. Air from the vents (most of my primary time was in a 172)... so getting air wasn't a problem, if you know what I mean.

Some people never get used to it, some people (like me) develop a reasonable tolerance, some people get over it completely, and some people were like my Dad who never got seasick (wish I got that trait from him)

Patience.
 
I did not vomit but I did feel sick or uncomfortable numerous times, people say it gets better but does it? Or do you stop doing so many stalls and unusual attitudes once you get your ticket. Unusual attitudes under the hood is terrible for me and I really need to end the flight after recovering from one. Emergency descents are the worst, my ears feel like crap for weeks!! I can keep flying but at that moment flying is no longer enjoyable for me.

As a CFI, notice what the student feels comfortable and uncomfortable with, you can only know this through trust and communication. As a CFI you have a natural power over the student but the student needs to trust you to be able to communicate how he feels. Usually a student might think this means they are not fit to fly or that they would be looked upon negatively so they won’t communicate the truth to you. How can you fix it?

When a student gets tunnel vision or feels uncomfortable then the lesson should end. I find this happens to me about 30/40 minutes into the lesson. I usually just put up with the rest of the lesson but it isn’t the most effective way to learn. After all the CFI and student drove to the airport and who wants to only fly for 30min? But that might be a better approach to make the lessons shorter too. (Doesn’t help from a business standpoint, yes I know)

Also, ask the student to take a magnesium pill before flying, that helps in stressful situations.
 
Also - I've read that actually getting to the point of vomiting is not productive towards increasing tolerance, so maybe stick to pattern work for a while (where you're in a situation where you can be on the ground in a couple of minutes, as soon as the student is uncomfortable) to see if you can go longer and longer over a few sessions.

How often is the student flying? If it's only once per week or less, then it will be hard to build tolerance.
 
I am a CFI with about 1200 hours of dual given, and I have never seen this problem before. He is about 20 years old and in good health, holding a 1st class medical. He has about 12 hours TT now and on about 50% of flights, he gets sick and we have to land. On three occasions, he has actually thrown up. It happened again this morning. He has tried eating before a flight, not eating before a flight. He has tried Dramamine with limited success. I asked him point blank after todays incident if he drinks heavily or does drugs the night before that might give him a hang over. He said he does not. He said he isn't nervous before the flights, so he doesn't think it is that. I told him I think he should pause training until he can consult with a doctor to try to get something figured out. Has anyone seen this before? Any suggestions?

How long into the flight does he get sick?

Dramamine is a no-no and should not be used.
 
Seen it before. I'd recommend the student rule out inner ear problems with an ENT before going much further in training. You can try a DIY barany chair to see if that induces motion sickness symptoms.
 
Thanks for all the replies. I had never seen this, so I didn't really have a timeline on how long it can take to get over. He seems to only get sick we we are doing high altitude stuff (stalls/steep turns). He has never had an issue we when stay in the pattern and do touch and goes. He was flying multiple times a week, but we had a pause, and this was his first flight after a 6-8 week hiatus.

How long into the flight does he get sick?

Dramamine is a no-no and should not be used.

Today, we took off climbed direct to 3000. We did slow flight twice, then went immediately into doing a power off stall. I then demonstrated one and he said he wanted to take a break and cruise for a minute. So we did for about 5 minutes. He did one more on his own and immediately felt sick. So I took the controls, while the vomited, and I flew the 8 miles back and landed. The total flight was 0.6 on the hobbs.

On days when we take it easy and just practice landings, he does ok. But as an instructor, I feel like I need to give him a realistic view on expectations he must meet to not only solo, but become a commercial pilot. We have only done steep turns once, because it immediately made him sick. I need to be pretty sure that he will be fine before I can solo. A student pilot trying to fly solo while throwing up would probably be bad.
 
Are you talking 30degree turns or 45/50degrees turns? I can do 30deg fine but still I can feel uncomfortable with 45/50 especially if something isn’t set up correctly. Maybe do those maneuvers at the end of training since you’re planning to go back in. In reality you never have to do stalls or 45/50degrees turns when flying on your own but yes he needs to demonstrate control of the aircraft and getting back safely before going out solo.
 
Yeah, sounds familiar. Steep turns got me a couple times early on. And maybe still? if I do more than three or four in a row, but I haven't tried in a while so I'm not sure.
I do hope that it's not a real medical issue, and is just normal motion sickness. If the student has a tolerance for putting in more hours than others, then I would say keep at it, just based on my personal experience. Maybe save the steep turns for last, just try one, then head back.

And yes they need to really be confident that this won't happen when solo. But baby steps are necessary here anyway. Hopefully they have the patience and pocketbook to allow for this to take a bit longer than it would otherwise.
 
Thanks for all the replies. I had never seen this, so I didn't really have a timeline on how long it can take to get over. He seems to only get sick we we are doing high altitude stuff (stalls/steep turns). He has never had an issue we when stay in the pattern and do touch and goes. He was flying multiple times a week, but we had a pause, and this was his first flight after a 6-8 week hiatus.



Today, we took off climbed direct to 3000. We did slow flight twice, then went immediately into doing a power off stall. I then demonstrated one and he said he wanted to take a break and cruise for a minute. So we did for about 5 minutes. He did one more on his own and immediately felt sick. So I took the controls, while the vomited, and I flew the 8 miles back and landed. The total flight was 0.6 on the hobbs.

On days when we take it easy and just practice landings, he does ok. But as an instructor, I feel like I need to give him a realistic view on expectations he must meet to not only solo, but become a commercial pilot. We have only done steep turns once, because it immediately made him sick. I need to be pretty sure that he will be fine before I can solo. A student pilot trying to fly solo while throwing up would probably be bad.
I felt unwell doing aggressive steep turns during my commercial training, when I had hundreds of hours. I still don't tolerate aerobatics well, even mild aerobatics, like spins. Some people are just like that.

The moment he is feeling unwell, he should get on the controls, and you should land promptly. He'll eventually get more acclimated. But he's not going to feel better in the air. And he's not learning anything by puking except that flying makes him puke.
 
Thanks for all the replies. I had never seen this, so I didn't really have a timeline on how long it can take to get over. He seems to only get sick we we are doing high altitude stuff (stalls/steep turns). He has never had an issue we when stay in the pattern and do touch and goes. He was flying multiple times a week, but we had a pause, and this was his first flight after a 6-8 week hiatus.

Today, we took off climbed direct to 3000. We did slow flight twice, then went immediately into doing a power off stall. I then demonstrated one and he said he wanted to take a break and cruise for a minute. So we did for about 5 minutes. He did one more on his own and immediately felt sick. So I took the controls, while the vomited, and I flew the 8 miles back and landed. The total flight was 0.6 on the hobbs.

On days when we take it easy and just practice landings, he does ok. But as an instructor, I feel like I need to give him a realistic view on expectations he must meet to not only solo, but become a commercial pilot. We have only done steep turns once, because it immediately made him sick. I need to be pretty sure that he will be fine before I can solo. A student pilot trying to fly solo while throwing up would probably be bad.

First, any acclimation he did have (which with 12 hours would not be a lot) would be gone after a 6-8 week break. Second if I had a student that tended to get sick the last thing I would be doing is slow flight, stalls, and steep turns, all of which tend to make people sick. Instead, you could go to another airport close by and work on radio skills, pilotage, and traffic pattern entries. Land, take a break, return. This way you're not in the air more than 20 minutes or so at a time. After he gets used to that, do a maneuver like slow flight once per flight, then work up. He needs to get acclimated gradually.
 
I hope he's able to sort it out, because I don't want to know how he's going to do once he's under in the hood in unusual attitudes. He's going to have to be wearing an airsickness receptacle like it's a feed bag.

Only other thing I could recommend is constantly checking to make sure he's looking out the window. If he fixates too much in the cabin/on the panel and loses outside reference, I can see how he might get a little nauseous (like being below deck on a boat when its wavy).
 
Sounds like when he loses sight of the horizon or the horizon tilts badly on him then it induces vertigo/nausea.

Rather than jumping into steep turns, perhaps find out where his tolerance lies. While he is looking OUTSIDE at the horizon, what degree of bank seems to be the threshold where he gets sick?

As @dmspilot suggests, stick with maneuvers which do NOT induce sickness.

But as an instructor, I feel like I need to give him a realistic view on expectations he must meet to not only solo, but become a commercial pilot.
I am pretty sure he is (at this point) well aware.
 
In the words of Viper "Keep sending him up"

The guy obviously wants it if he keeps going up even after getting sick. I agree that 12hrs isn't much, but it has to be annoying to you as an instructor as it must make it hard to stick to a normal schedule. I second the motion to skip the maneuvers for a bit and work on something smoother. Yes, this will delay his soloing time, but it will be much quicker than never soloing in the first place.

Good luck.
 
I highly recommend ginger, whether that is candied ginger or just ginger tablets, or peppermints (either hard candy or Altoids). They will help whether eaten before or during flight. Flying straight and level and focusing on the horizon or into the distance will help if already queasy; if it's hot, a little cool water may help a lot.

I used to get pretty queasy if practicing too many steep turns or repetitive ground reference maneuvers when it was hot and bumpy. I was really good at keeping the queasy from progressing to the next stages (from lots of long, long car rides) so never actually got beyond queasy, though. Ironically enough, unusual attitudes didn't bother me in the least bit, so I suspect that my airsickness from steep turns was mostly mental and not physiological.
 
I do wonder if it's that he's looking at the instruments. Like, if you ban him from looking inside, would that help? Also it's worth trying to ensure he's not hot, as you're much more likely to feel ill if you're hot and sweaty.

I don't really know if this transfers to flying, but with VR there's this idea of 'getting your VR legs'. First time I got an early developer Oculus, I booted up the first demo, pressed forward on the controller and immediately felt sick, even from a very small movement. I know some people can take almost anything in VR, and that's definitely not me, but I did find that with time my ability to put up with movement in VR improved.

If that young man has access to an Oculus Meta Quest or other VR headset, perhaps he could try playing with it a bit until he finds the nausea reduce. Probably best not to leap in to any extreme experiences, but first find one that feels a bit uncomfortable but bearable and just play it a bit every day until it's easier to do and then move up to something with some more movement in it.

Anyway, I'm not sure if it will transfer, but if this poor chap is very motivated it might help, and it's a lot cheaper than throwing up while the Hobbs is ticking.
 
another thought - what airplane is being used? heavier airplanes with higher wing loading will ride a little better... even if the effect is more placebo than real.

my very first flight lesson was in a C-152 and we switched to the 172 after that - sure it cost more, but I felt better.
 
I am a CFI with about 1200 hours of dual given, and I have never seen this problem before. He is about 20 years old and in good health, holding a 1st class medical. He has about 12 hours TT now and on about 50% of flights, he gets sick and we have to land. On three occasions, he has actually thrown up. It happened again this morning. He has tried eating before a flight, not eating before a flight. He has tried Dramamine with limited success. I asked him point blank after todays incident if he drinks heavily or does drugs the night before that might give him a hang over. He said he does not. He said he isn't nervous before the flights, so he doesn't think it is that. I told him I think he should pause training until he can consult with a doctor to try to get something figured out. Has anyone seen this before? Any suggestions?
No real suggestions beyond what others have said except to encourage him to continue if he is highly motivated - he may "grow out of it". I myself was somewhat queasy on my first few flights as a student -
but it soon went away. Since then I have flown thousands of hours (more often passenger than pilot) in all sorts of aircraft, and have never been airsick. I also worked on ships for a dozen years or so, and
never got seasick, either, despite riding out a few typhoons. I remember one guy who came out to work on the ship and was instantly seasick in what I would consider fine weather. He tried three times, and
simply could not tolerate being at sea. He had to give up the job.

Dave
 
Just a question, do you teach integrated method with the student looking outside at horizon or do your students live on the instruments?
 
A good friend of mine in the Navy (NFO) got sick EVERY flight. It can happen.

It’s too early to get too excited one way or the other. If he’s game, keep doing like you’re doing, but maybe concentrate a little bit on dealing with it and keeping flying.
 
How much flying are you doing as the CFI. I puked like Linda Blair my first dozen hours or so but my CFI did a lot of the flying. When I was behind the controls; I never got sick. At about 15 hours........it just magicaly stopped. Was it due to magic or because I was now in control of the aircraft more? I believe it to be the latter.
 
I have a pilot friend (instrument rated too, IIRC) who gets motion sick relatively easily, especially in turbulence. He takes getting sick in the cockpit as a matter of course, even going as far as buying a one-handed cup of some sort that holds a sick bag so he can still keep flying with his free hand if he needs to vomit. He said once he vomits he feels fine the rest of the flight.
One thing I would suggest the student in question could try is chewable papaya enzyme tablets. I find that helps me quite a bit on the occasional times I feel off.
 
I also had motion sickness early in my training. As someone else posted I took ginger tablets. I‘d take one the night before,one in the morning and one on the way to the airport. Just ate a bowl of cereal for breakfast. It helped me get through the early hours. After 10 to 15 hours the problem went away. Take everthing slow and keep the fresh air flowing if possible. Steep turns would really set me off.
 
Thanks for the insights guys. My student and I have both reviewed the responses and are formulating a plan moving forward to do our best to get him over the hump.

Just a question, do you teach integrated method with the student looking outside at horizon or do your students live on the instruments?

I am pretty big on looking out the window. I have found that if you can get them to look out the window and watch their pitch, they will be much more consistent than when chasing numbers.
another thought - what airplane is being used? heavier airplanes with higher wing loading will ride a little better... even if the effect is more placebo than real.

my very first flight lesson was in a C-152 and we switched to the 172 after that - sure it cost more, but I felt better.

We are in a 172N.

I hope he's able to sort it out, because I don't want to know how he's going to do once he's under in the hood in unusual attitudes. He's going to have to be wearing an airsickness receptacle like it's a feed bag.

Only other thing I could recommend is constantly checking to make sure he's looking out the window. If he fixates too much in the cabin/on the panel and loses outside reference, I can see how he might get a little nauseous (like being below deck on a boat when its wavy).

This was a concern of mine. He will have to get through the instrument, and if he wants to be an instructor, he is literally going to do 1500-2000 stalls and steep turns over the next few years. But he really wants to do it, so we both think it is worth continuing on.
 
I fought this hard as a student and still have to be careful when doin lots of maneuvers. My first flight was 9 minutes and I was puking. Each lesson got a bit longer each time until eventually i had built up a tolerance. Most days in the beginning i was sleeping it off in my car for hours after a lesson. My built up tolerance goes away if I do not fly though. But after 1000 hours in four years I wouldn’t trade those crappy sickness days for anything. Tell your guy to stay after it and battle though it.


Sent from my iPad using Tapatalk Pro
 
If he wants to be a pro, just wait for the simulator. Could get ugly.
20,000 hours and I still have a tough time taxiing. Repositioning the sim?? Close your eyes.
 
There is an acupressure band they sell at west marine for this. Never had the problem. However when I was training my CFI asked me about the same problem with one of her students and I mentioned it and the student bought one and it worked great. Is it placebo, who knows, but she started selling them and had many positive outcomes. My guess from her experience that there are more than we think that get some degree of motion sickness when flying and just deal with it.
 
Growing up, my dad always had boats. I remember as a teen my dad & I would go fishing quite a bit. For a long time mom would insist on going with us.... she tried to power through, I suppose so she could spend time with us.... but she would start getting sick before a foot ever hit the floating dock... let alone getting on the boat. She tried and tried and tried.....

I think with some folks it's a phycological thing and has nothing to do with actual vertigo or motion. Who knows, maybe hypnosis might help some folks like that!

I'd sometimes get a little queasy on boats. Rarely to the point where I almost wish I'd get sick but I never did. It was generally only when I had an empty stomach, it was hot, no wind, down below, anchored ion a confused sea, etc... I fond that keeping a little something on the stomach helped me....crackers or whatever... I never recall feeling that way in an airplane....

and all the tips and advice here remind me of those times on SCUBA dive charter boats.... someone would be sick and it seems everyone on the boat would be approaching that person with tips trying to be the hero (especially if it was an attractive girl).... do this, do that...ginger, look at the horizon, stand on the stern, stand in the middle, eat something, don't eat something, ..... when all that person would want is to be left alone. I remember hearing a few times when these folks would be offered ginger, that they would later say they wish they'd never eaten it...it burned coming back up. It clearly helps a lot of people, but I think it must depend greatly on timing and on the person. Everyone is different
 
Thanks for the insights guys. My student and I have both reviewed the responses and are formulating a plan moving forward to do our best to get him over the hump.



I am pretty big on looking out the window. I have found that if you can get them to look out the window and watch their pitch, they will be much more consistent than when chasing numbers.


We are in a 172N.



This was a concern of mine. He will have to get through the instrument, and if he wants to be an instructor, he is literally going to do 1500-2000 stalls and steep turns over the next few years. But he really wants to do it, so we both think it is worth continuing on.
Cover all the instruments except the airspeed and altimeter, have fly the plane looking 98% outside. Instruct him to minimize head movements and when he does scan right and left for his head to move slowly and smoothly with his eyes tracking the horizon.

Also you need to limit the lesson duration to 1 hour and only smooth days. Mornings and evenings.
 
A close friend suffered the same. He became "cured" when he became confident. The minor motion sickness that may have been "real" was exacerbated by anxiety, apparently.
 
USN's attitude is "train it out of you". They are only 90% correct. Agree with trying the accupressure band.

Also: Let him do the power off stall, so that he has direct control feedback, and set it up for only 100 vertical feet altitude loss. If he can conquer that, then wait a lesson and reconfirm it again.

And only then move on to the 45 deg. banked turn as it will be quite a few attempts beforfe he can pull that off with the g vector going straight down through the floor (and not necessary for solo).

This is about operant conditioning.

Many moons ago I was latching down the helmet on a pressure suit in the back seat of a F105.... and thinking "hmm. this might not work out so well". But it did.
 
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Keep the airplane cool to outright cold if possible. Definitely keep the air flowing. Tell him as soon as he feels a little stir to look outside for the horizon and stay outside until it subsides.

I do these things and they work well. My instructor is really good at unusual attitudes, he gets it going. I'm usually good for about three, but I do feel queasy sometimes. I just speak up, we stop for a few minutes until I'm good, then move on.

The hardest issue is IMC when the leans start happening. For that I just spend more time on the artificial horizon, which works pretty well.
 
Fun Fact:
Bob Hoover taught himself aerobatics to get over his problem with airsickness.

Note: I an not suggesting someone should attempt self taught aerobatics - yes Bob Hoover got away with it (he did peal the fabric off the top of a wing once), but neither you or I are Bob Hoover.
 
As PaulS said, keep the cockpit cool and the air flowing. One other thing to try, is get in the air right at sunrise, and try the stalls without him having his eye inside the cockpit. Having an indistinct horizon for a few maneuvers can big a big help in getting acclimated to the rapid changes the body feels. Would be willing to bet he has no problems with roller coasters.
 
I had that problem when I started my fixed wing lessons, coming from many years flying helicopters. I used a combination of ginger pills, ginger gum, and acupressure bands on my wrists. Eventually it just went away, and I’ve been fine for years. It may have taken more than 12 hours, but the problem just resolved itself.
 
Ha! You are so right! If I don't get a "hey I''m gonna move the sim" I feel like I'm going to barf. Taxiing feels like floating. Sims are wierd.
 
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