Chronic hiccups.

Sat 7.24.10

Another day with Dr. Vicky was filled with girls and boys from local schools.  There were a group of school boys with some sort of thrush-like appearance on their tongue and pharynx.   We got to the boy who had it for the longest and suspected that he must have been the catalyst.  Yes, public health. Interesting.

We saw a girl presenting with chronic hiccups for 9 months and chest pain.  The cause: unknown.  Wow.  It got me to thinking: what could cause chronic hiccups? The rest of her exam was unremarkable.  I did some research (just fyi). 

WebMD directed me to “Hiccups” by Garry Wilkes, Director of Emergency Medicine, Bunbury Hospital, Australia.  Hiccups, known as singultus, often affect the left hemidiaphragm.  The longest recorded is 60 years. Cause: a mystery.  Arrhythmia-induced syncope reported as cause and effect.  GERD may cause or result.  Alcohol, drugs, weight loss, insomnia, and emotional distress may contribute to chronic hiccups.  There’s a long differential diagnosis.  So why is this somewhat healthy girl having chronic hiccups? Not sure and I’m not sure if we have the capacity to find out.

In the afternoon, everyone decided to go to a local orphanage to do health education presentations.  For some reason, I felt really tired, so I decided to stay home and do some things I’ve been putting off.  I washed my disgusting safari tennis shoes, cleaned the bungalow, and blogged some more (blogging is hard work).

Later I met up with the others at Hotel Tilapia.  Another nice dinner out in town.  I had fish and calamari masala with garlic naan.  Yum.   Everyone else had been craving pizza and ordered pizza only to be disappointed by the quality.

Deidre and I came back to the bungalow, while others went out for another night in town.  I decided to watch Harry Potter 5 and ended up sleeping late.  This time, I didn’t fall asleep on the couch, but I slept in my cocoon bed.