Hiccups or something worse?

I swear, my son is always going to be the kid I worry about.  Just seems weaker, more fragile, and weird things always happen to him.  He had a soccer game on saturday, in the freezing rain.  He seemed ok.  Cold, but not tired or anything.  When we got home he had a bath, played in the tub for awhile, then made him some hot chocolate.  While drinking the hot chocolate - after 1 marshmallow and just a few sips (about 45 minutes after we've been home, so he was definitely warmed up) he started clutching his chest.  I couldn't figure out why.  He was bracing his hand on his chest, so I thought maybe he bumped his hand.  Turned out he had these really deep, painful "hiccups".  They didn't come out of the mouth and sound like a hiccup, but you could see his chest moving really hard, like a severe hiccup.  He was in pain, and wincing and his heart felt like it was racing.  I got him in the car and started driving to the hospital.  They eased up on the way, and after we got there they stopped.  So we didn't go in.  I called the doctor's after hours nurse line instead.  They didn't have a lot to say, but said to call back if it happened again.  When we got home he played and ate and acted fine.  About 3 hours later he started the "hiccups" again.  He wasn't eating or anything this time, was just playing.  Came out of nowhere again.  I was in the shower at the time, getting ready for a wedding.  But my husband said he calmed down quicker and it wasn't as bad.  Lasted less than 20 minutes.  I figured well, when I get the hiccups, I often get them several times in a day, so maybe that's all it was?  So we got ready and went to the wedding reception.  It happened a third time after dinner, about 3 hours later again.  This time it was bad again.  One of our cousins who is a nurse was sitting by us.  She said she hadn't seen anything like it.  He was obviously in pain, but he didn't appear to be in distress.  She took his pulse and it was a little high, around 100.  She said she wouldn't rush him to the hospital, but she would call the on-call nurse since he was obviously in pain.  They again lasted less than 20 minutes, and then he was back to himself eating cake and acting like nothing happened.  The on-call nurse again didn't have much to offer. Suggested maybe reflux, gave me some tips on how to stop hiccups, and said if it happened again to call and maybe they could call the doctor for advice.  It hasn't happened since.  He was fine Sunday, and so far all day Monday.
 
I called his pediatrician today, and only got to talk to the nurse.  It was annoying having to talk with a go-between.  The first time she called back she said "the doctor said hiccups are nothing to worry about and it could just be reflux." That's great, except how do I know if they were really hiccups?  These were not normal hiccups!  I mentioned how his diet was changed last week.  We started miralax because he was backed up, and they thought maybe he would start eating better (and gain weight) if he was more regular.  They've also had me giving him a lot more carnation in a day, and changed to whole milk.  This was per the advice of a endocrinologist, nutritionist and GI nurse practioner.  So I tried to relay this back to the doctor (through the nurse). She called back and said it sounded unrelated.  Said that if it happens again, be sure to record what he was doing just before.  Well I can tell you what he was doing just before every episode.  If the doctor would just call me, I can explain it all to her.  But basically as of now, I'm just supposed to wait for it to happen again, and hope that it doesn't.  
 
Has anything like this ever happened to you before? Does this sound like just a flukey thing to you or would you pursue it?  I'm not sure what more to do or say, if it doesn't continue to be a problem.  But it was very unsettling.

 

 I am sorry you guys went through this. I never had to deal with something similar, I just wanted to say I hope it doesn't happen again. I hope the new diet will help him also.

 

Acid reflux is a possibility.  If you think it could be that, start a food log so you can see IF they happen again, if they correspond with certain foods.
 
It sounds to me like you are very worried about it.  If i were in your place, i would at least want to hear from my Dr (personally) as to what she guesses it might be.  I would want to know what things i should watch out for and what is the next step is if it continues.
 
You can try demanding a call back from her.. squeaky wheel gets the oil.  
It might also be worth paying an exam fee to have her undivided attention.
 
You might get better attention if you do not describe them as hiccups.  I think it is probably a good description as you explained it, but hiccups are innocent and you want them to PAY ATTENTION!   If you say, he has had three incidents, his chest was spasming and painful and his heart was racing you will get their attention.
 
Please let us know if they figure out what caused it.

 

sounds like it was regular hiccups - hiccups are a muscle spasm of the diaphragm.  that said the difference in temperature from the hot chocolate probably kicked it off, and then like you said once you get them in a day its more common to get them because the diaphragm is irritated by the pressure in the peritoneal (abdominal) cavity.  I get hiccups EVERY time I eat raw carrots.
 
Intractable hiccups (meaning they don't stop) can be a sign of a small bowel obstruction, but it doesn't sound like that as they were stopping.  Honestly it could be the change in diet as now his bowels are creating more gas and its irritating his diaphragm.
 
in any case, when in doubt call the pedi or take him in…but it may very well just be the dietary/temp changes...

 

I decided to call the GI doctor's office today.  They said it sounded like something called an esophageal spasm.  Which to me sounds like a fancy name for hiccup, but she said it's different.  It could be reflux related, but she said there's no way it's related to the medicine.  I still don't buy that, as it was the only change.  Well that along with switching back to whole milk and giving him 2 cups of carnation in a day - or trying.  He just doesn't drink that much.  But I asked more specific questions about reflux, and I'm starting to self-diagnose him.  He had it as a baby pretty bad.  Now his tummy troubles are more in his tummy, so I wasn't thinking it would be reflux.  When I asked about where the pains for reflux are in children, she said in the tummy, around the belly button.  I said the foods that bother him most, or used to cause problems, are chicken nuggets and french fries.  She said those are classic reflux foods for kids.  She also agreed that reflux can be the reason for his small appetite and slow weight gain.  And I'm also thinking it's related to these spasms.  I hope they don't happen again.  But it may have helped us figure him out finally!

 

I dont know much about hiccups, but one of my DDs has severe reflux.
 
She has been on meds since she was small and has a few other GI related issues. 
 
 
I will say that her reflux does lead to internal pain spasms, sour taste, low weight gain, intolerance of large meals/spicy/etc. She takes Miralax and previciad.
 
Her major symptoms are sore throat, hoarseness, cough (esp at night), pain in her throat (above collar bones) internally, chest pain (mid chest), and frequent gas.
 
She eats NO CITRUS foods and avoids any 'reflux' triggers (too much liquid, spicy, etc).
 
She does get hiccups often as well- likely due to aggrivation of her esophagus.
 
If you think it is reflux as for a PH probe and/or a reflux study or esophagial endoscope to check for cellular irritation.

 

Thanks, this is helpful.  I will look into that.