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How PainSci readers saved my dad from dangerous hiccups

 •  • by Paul Ingraham
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Weekly nuggets of pain science news and insight, usually 100-300 words, with the occasional longer post. The blog is the “director’s commentary” on the core content of PainScience.com: a library of major articles and books about common painful problems and popular treatments. See the blog archives or updates for the whole site.

Dear PainSci Subscribers and Members,

We all have (way) too much too read, so I bet you haven’t even noticed that I haven’t been producing as many posts lately (especially members-only posts). Right? Right. So here’s an informal one to tide you over until the next “real” post.

First, some reasons for the lull, one of which segues into a good story … which is kind of about you.

Last night, my father was saved from some truly savage hiccups — dangerous even. Seriously. It was actually scary. And those horrendous hiccups were cured creatively by Team PainSci. You did this. You! PainSci readers, fans, allies, subscribers, members genuinely made a difference for a bizarre and awful problem.

The general situation here right now

Posts aren’t the only thing I’m behind on. Normal updates to my articles and books dropped to an all-time low of one every two point seven days! The horror! I laugh at myself for feeling bad about this, but I do. Historically, I’ve aimed for an update every day or two, and I’ve never really let it get over 2. (This stat is always visible on the “what’s new” page.)

I’m not actually slacking off, though. Obviously. I literally don’t even know how to slack off.

The posts/updates lull is mostly due to increased investment in more epic content goals that can't be achieved one bite-sized shareable chunk at a time. Too many large works-in-progress. (Still, I probably should share more half-baked excerpts, because I’ve been too precious about posting only "finished" content. So brace yourself for that.)

Also … distractions! Especially:

  • I’ve been in a rough patch with my own health issues since midsummer, and that continue to worsen, so some some extra writing time has been devoted to my other newsletter, Project Try Everything … but I’ve been falling a little behind on that too! I’m actually just a noticeably less effective workaholic lately. Let’s spin that as a good thing!

  • Parents both have COVID right now, and it’s really not going great. The COVID hazard in Canada right now is ranked as “severe,” and is at the very top of the scale here in British Columbia — basically as bad as it has ever been. Canadian COVID hazard ratings from Covid-19 Resources Canada. Bloody hell.

So that’s what’s going on here in Canada, and at the Salamander’s world headquarters. Chaotic as it is, I’m going to take a few minutes to share this story (also shared on Facebook)…

Savage hiccups cured creatively by “Team PainSci”

A bad batch of hiccups is nasty at the best of times. But when your throat is so COVID-ravaged that you are literally struggling to drink anything, and you can barely take a breath without coughing, and the hiccups are frequent and lasting? You, my friend, have arrived in hiccup hell, and you need a hiccup miracle.

And that's where my father was living yesterday evening. After two-hours of almost unimaginably fierce hiccups, the situation was starting to seem rather dire. Although hiccups were the focus, this was ultimately an acute pain problem, like being poked in the belly … when you have appendicitis. Honestly, I’ve never been so worried about him.

Several common hiccup cures had already failed. We needed more. It was time to get creative. But I didn't start Googling, because I had something better: I had you guys. I had the fine PainSci audience.

Higher quality hiccup cure anecdotes to the rescue

Last summer I (weirdly) did a post about my favourite hiccup cure, the "resistance straw." It’s an interesting thing, but not helpful in itself for this patient: dad did not have one, couldn't fake it, and in any case probably couldn't do the necessary strong swallowing. But my Facebook post about the straw attracted a surprising number of hiccup cure suggestions from my very savvy readers. I swung into action, mining the post comments for every suggestion, and then I prioritized them by their plausibility and their practicality.

This is what you do with experimental treatments! ou do the things that make the most sense and/or are the easiest first.

☝🏻 USEFUL LESSON ABOUT PAIN MANAGEMENT!☝🏻

Once I had my prioritized list, I started feeding them to my parents via messaging, one after the other, while they got to work trying them.

Here’s are the suggestions I sent, barely edited for clarity…

  • Okay, this is what I have. Most of these were delivered with emphatic testimonials, some with more credibility and detail than others. It occurs to me that the hiccup dysfunction is very serious here, and so it may require MORE of whatever cure might normally work. So to the extent that they can be performed without worsening pain, it’s probably worth repeating them 3-6 times each, as feasible. Now, roughly in order of practicality and/or plausibility...
  • "cold spoon to the uvula" Riiight. Okay? Weird but easy! Might even be soothing?! Apparently taught to the commenter by “an old anatomist”, FWIW.
  • "just pursing my lips and breathing in by restricting the intake of air through pursed lips" I find it hard to take this one very seriously… but obviously not hard to try. In this situation, I would give it a good couple minutes at least.
  • Boosting blood CO2 (hypercapnia) by breathing in a PLASTIC bag. This one is quite plausible and is easy and safe to try. Hypercapnia definitely affects some kinds of hiccups. The story (from a smart source, a good “friend of PainSci”): “There’s an even easier way out of hiccups — at zero cost. Learned it from my uncle, who studied medicine in Brazil in the 50s. Anesthetized patients with hiccups were a pain, so they needed to get rid of it ASAP. Method: breathing in a PLASTIC bag, small enough for you to get to hypercapnia (get higher blood levels of CO2). You have to hold the bag REALLY tight around nose and mouth to prevent air from escaping, and if you have troubles with dizziness, it’s advisable to sit down for it. As soon as it gets uncomfortable, mostly after 4-6 breaths, you can stop, the hiccup will be gone. I don’t know what this does to the phrenic nerve, but it works 100%.”
  • Now for the most sensational one! This is a genuine medical crisis, so I am not going to shy away from suggesting this one, but... wow, WEIRD and "very personal." But also easy and actually credible, actual science: "Digital rectal massage." 😳 The formal case study won an Ignobel Prize!

An interesting list! Especially that last item! Those were the most promising options. Several more were too dependent on deep breathing and/or swallowing to be good candidates in this situation, but I suppose we would have moved on to try them if necessary. But it wasn’t necessary, because…

One of those worked

And it was the one I would have bet on: inducing hypercapnia by breathing into a plastic bag quickly did the trick! It was quite impressive.

Safety Note: Obviously there could be some danger with this method. If he’d had low O2 or was struggling for breath, we likely wouldn’t have dared. (On the other hand, if he’d been in that state, he would’ve been at the hospital.) But he was supervised, with no possibility of getting stuck, and a matter of only just a few breaths. Perhaps there was still some risk… but I think not treating those hiccups was also a risk.

I have rarely been so relieved. For my father, I think the relief was probably about as intense as relief can get. Not that he was (or is) out of the woods otherwise… but ditching those hiccups was a genuinely big deal.

Our eternal thanks to that commenter — you know who you are! Hi! *blows kisses*

But more generally, thanks to all of you for being an impressively smart and helpful audience and community.

Warm Regards, Paul Ingraham
PainScience.com Publisher