A COVID rarity: persistent hiccups

One of the first rules of journalism is you never write about yourself, but when COVID-19 infected two employees at the Hancock Clarion, including this writer, and gave me a symptom that is exceptionally rare, I decided I’d do something almost as rare and write about myself.
Although I had every symptom in the Centers for Disease Control’s list, the one that was most prevalent is also the most rare: persistent hiccups.

I tested positive for COVID-19 on November 20 and initially felt fantastic, to the point that I spent the next day mowing the lawn and blowing endless leaves. That didn’t last and I began having fevers and chills and I barely left the sofa. I was taking Azithromycin and Dexamethasone, which didn’t seem to do much.

When I began hiccupping on November 25 I laughed them off even as my girlfriend Jamie said it could be a rare symptom of COVID-19. Even if it were, it was just hiccups and it was annoying at most, I said, and plus it would only annoy her, whom I was going to visit since she was the one who’d given me the virus and was the only person I was allowed to be around. I did a breathing trick to stop the hiccups, but it didn’t last long, and it was becoming an annoyance, but no more than usual hiccups are.

When Thanksgiving rolled around I still had hiccups and I realized that they were doubling, where many of them would be two back-to-back. More annoyance, but still not much more than the fact that they wouldn’t go away, which meant I couldn’t really sleep. I also had high fevers. Jamie set alarms to give me my medicines throughout the night and to use a hammer massager on my back, which initially seemed to help before it didn’t any more.

Soon the hiccups began to stack even more, up to eight times in a sequence, which meant I couldn’t breathe until they were over. Jamie took me to the emergency room, where they gave me an IV drip of diazepam and took chest x-rays and released me. The hiccups stopped until I was walking out to the waiting room. I left with a prescription for Ambien that never helped.

Then things got worse. The hiccups morphed into something more akin to seizures that seemed to freeze my diaphragm for several seconds at a time, which was happening around once a minute. A couple of times it led to vomiting.

I was not sleeping and I was beginning to not make sense, talking about how each hiccup was a message and that if I just turned my phone off they might stop. Another time the hiccups were boxes and I tried to explain that if we simply had fewer boxes I’d have fewer hiccups.

By November 30 I’d had five days of hiccups and my sister Georgia, who’s a pharmacist, came to pick me up and brought me home and stayed with me. On the way home she decided that if I had more than 10 of my little seizures in a 15-minute span that she’d take me to the emergency room. She counted 14, so she took me to a different ER, where they gave me prescriptions for pantoprazole and baclofen. Neither one helped.

She called my doctor and suggested a different medication that she’d seen work on a patient with COVID-19 who had severe dry heaves, so soon I had a prescription for Thorazine, which was unavailable at most pharmacies. She had to call several until she found one in Owensboro that was closing before she could get there, but they agreed to stay open until she got there.

Finally on December 3 the hiccups stopped, eight days after they began. I’d lost about 20 pounds, but I was finally able to sleep.
My sister believes that if I’d been alone I wouldn’t have had the energy to get up to take my original medicines, which weren’t working anyway, and that it’s very possible my untreated fevers would’ve run amok. My sleep deprived state and a seizing diaphragm along with occasional vomiting could’ve been a very bad combination.

Hiccups as a primary symptom of COVID-19 are rare enough that they’re not included in the CDC’s list of symptoms. In fact, a case report released in April of this year is still the only other case I could find online.
Printed in “The American Journal of Emergency Medicine” on April 17, 2020, the report is titled “Persistent hiccups as an atypical presenting complaint of COVID-19” and tells the story of a 62-year-old man in Cook County, Illinois who had four days of persistent hiccups as the main symptom of the virus.

“To our knowledge, this is the first case report of persistent hiccups as the presenting complaint in a COVID-19 positive patient in emergency medicine literature,” the report says.
Online searches and calls to medical personnel didn’t yield any more information about hiccups and COVID-19, but it can be dismissed by some, like a worker at one of the emergency rooms who came in and said, “So you didn’t go to work because you have the hiccups?”

Then again, if it’s as rare as it seems, maybe only I and an unnamed 62-year-old in Cook County really needed the information in the first place.  By Dave Taylor
dave.hancockclarion