Monday, April 21, 2014

Hiccup Hell

Keeping with the theme of hellish medical posts (which explains the lack of posts here - I haven't had other medical issues that start with 'H'), here's another.

Almost two weeks ago I started having hiccups.  Not a problem, right?

They lased overnight, ruining any hope of a full night's sleep.  Well, that's unusual, but I can get by missing one night's sleep, right?

Not really.  Hiccups at night can't be stifled, so they tear into your throat when you do manage to get a moment's sleep.  After a night of this, you wake with a shredded throat and no voice.

I started missing work after that first ruined night. By the second night I had delirious moments from the lack of continuous sleep.

Non-stop hiccups are tiring, fatiguing, and exhausting.  For the first day or two, that can be partially fought with sugar and caffeine.

I searched online for every hiccup home remedy.  The highest rated ones fall into two categories:
  1. Distract the autonomic nervous system.
  2. Stimulate the Vagus nerve.
The first group generally involves increasing the blood CO2 levels by any of a variety of means: Holding your breath, breathing into a paper bag, drinking water slowly, and so on.  The plan here is to make the body worry about getting rid of CO2, and thus weaken the hiccup feedback loop.

The Vagus nerve, among other things, carries sensation from the stomach to the brain.  So the second group involves eating food with strong "stomach reactions", the two most common of which are sweet (sugar, honey) and hot spices.

For me, the first group did absolutely nothing. The second group could give a few minutes of relief, but the hiccups always returned.

There was a third group I found on my own: Activity.  Climbing a flight of stairs could yield 20 minutes hiccup-free.  But I was too unsteady to risk running or riding a bike, and walking didn't quite do the job. 

And I was getting more tired with each passing day.  By the third day, it became sheer torture.  My diaphragm was so tired that it was increasingly difficult to stifle each hiccup.

On the morning of the fourth day (after the third sleepless night), I decided to go to Urgent Care.  The moment they opened.

I learned there is only ONE drug that is FDA-approved for treating chronic hiccups: Thorazine.  Yup, the drug that 20 years ago was THE front-line anti-psychotic.  Turns out that. while it is seldom if ever used today as an anti-psychotic, it enjoys continued use for a surprising variety of other uses.  Go figure.

What hasn't changed is Thorazine's side-effects, though I was mercifully on the lighter end of the scale, primarily having to deal with sleepiness and dizziness, but not much else.   And it does NOT mix with alcohol or other depressants such as sleep-aids, though I wasn't in the mood for alcohol and had no need for sleep aids (they can't stop hiccups).

Like many drugs that affect the nervous system, it takes time for Thorazine to attain its beneficial effects, which for me started happening last Thursday, 4 days after starting.  Friday saw a 50% decrease in hiccups, though I still had terrible sleep Friday night, and still woke with a shredded throat.  Saturday night was far better, and I felt I was back to normal Sunday night. 

I took my last dose this morning, and this evening I can tell it is rapidly leaving my system.

The cause of the chronic hiccups was till a mystery to me, until I talked with my Mom.  She told me that my cousin had a prolonged bout of hiccups a few days after his prostate surgery. 

I had had a scheduled colonoscopy on April 2nd which included light anesthesia, and the hiccups started on the 8th.   A bit longer delay of my onset, but could it be the key factor? 

My earlier searches failed to turn this up as a possible cause, but with a better search, there are tons of links.  That's my best guess so far.

Tomorrow I start (gradually) resuming my training load!  Yay!

No comments:

Post a Comment