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Diagnosed Urinary Tract Infection. Given Antibiotics. Developed Hiccups. Difficulty In Breathing. What Can Be Done?

Posted on Thu, 22 Aug 2013

Question: My husband developed hiccoughs Dec 2011 following inpatient treatment for what the admitting doctor diagnosed as a urine). He was given IV antibiotics, fluids and discharged two days later. He started hiccupping three days later - unable to sleep, eat, difficulty talking, breathing, etc. We were out of town, so I took him to ER which led to a two week hospitalization - including transfers to CCU (afibrilation) and a full battery of tests, scans. He was diagnosed with Renal Cell Cancer and is in treatment for that - but, the hiccoughs continue. Medication, nerve blocks, holding the breath, gagging, accupuncture have not provided relief. He is losing weight rapidly - thirty pounds in four weeks.

Answered by Dr. Jay Patel (2 hours later)

Hi,

I am dr XXXXXXX and I will try my level best to address your concerns.

Based on the information, It seems something is irritating the phrenic nerve, it may be a cancer cells, and the not stoping hiccups are mostly associated with phrenic nerves issues. Some times anticancer drugs may cause the irritation but it hard to figure out the exact cause with limited history details and I do not have any access to his medical records.

The phrenic nerve is the main nerve supplying the diaphragm and the lungs does need the help from phrenic nerve to breath hence the other issue of having trouble can be explained.

Hope it helps, Please feel free to contact me for any concerns, and I will need some reports if you can upload on the question.

Thanks for the query.
Dr. XXXXXXX XXXXXXX

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Jay Patel (1 hour later)

His doctor's theory was phrenic nerve involvement - they tried nerve blocks on both sides, at different times - the first gave relief for about 36 hours, then the hiccoughs returned. The second attempt did not work at all. Are you aware of any other procedure or a specialist for this condition?

Answered by Dr. Jay Patel (13 minutes later)

Hi,

Welcome back, since the phrenic nerve block did work for 36 hours it do confirms that main issue is phrenic nerve irritation.

Their is surgery of the Phrenic Nerve in Treatment of Intractable Hiccup is done in some hospitals. Its know as phrenicotomy , but its very risky and most of the surgeons will not take chances with it. As a matter of fact wrong branch is cut the patient needs to be for even on the ventilation as the lungs will not be able to breath normally. Hence its not offered in most of the hospitals as treatment option.

You may try at local university hospital if they offer such treatment option, sorry I don't any hospital around me does it.

Hope it helps. Please feel free to contact in any other concern comes to mind.

Thanks again
Dr. XXXXXXX XXXXXXX

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar