It's really hard to tell what might work, because I'll often lead a trip with 4 hours of sleep. I have some more scolpamine patches, but I'm kinda nervous about trying it again after becoming so violently ill the last time I used one. I might get with my doctor to see what other ideas he can come up with. Dramamine isn't working, so I'll try Bonine next. I have made some real progress in that I can paddle around on the open water and sometimes not get sick at all, but if I stop "driving" it gets ugly fast.