Spontaneous tremors, take 2

Previously on this blog, yesterday’s posting “Explorations in narrative medicine: spontaneous tremors”, a report on an 1/10 incident of intense stomach-ulcer pain followed by an attack of spontaneous tremors — wracking shakes in response to deep feelings of cold within the body.

This abbreviated story — abbreviated in fear that another attack might be imminent, a fear that was, alas, well-founded — included no account of the sequel to the tremors: deep exhaustion from coping with the tremors, followed by an exhausted sleep. Then awakening to a body aching everywhere, barely able to cope. Something to eat, then back to bed for some actually refreshing sleep, and arising again for the remainder of a very low-key day (which is where I am right now). In the end a tremors attack consumes two entire days.

Yesterday’s attack was free-standing; it was an ordinary morning   (admittedly, I was writing on spontaneous tremors, in some haste) until I had a premonition of coldness and then a full attack, from which I’m slowly recovering today.

Now, in more detail, from the notes I scribbled along the way.

The night before, sleeping 7 pm to 3 am, up to take my thyroid tablet, after which I must wait at least an hour before eating anything. I made tea, read mail and Facebook, began assembling materials for a posting on a Bob Eckstein cartoon.

At 4:30, the premonitions of coldness appeared, and my heavy velour bathrobe was no match for the tremors that followed. I went back to bed, still wearing the bathrobe, under heavy covers, shaking spectacularly in agony. Eventually the exertions wore me out, and I fell to sleep in exhaustion.

Woke at 7:30 am, aching in every part of my body (and afflicted as well by extravagant bunion pain brought on my an osteoarthritic reaction to the very low air pressure — I could barely walk; the air pressure and the reaction have since improved some). Slowly assembled a granola breakfast and then went back to sleep, this time sitting up in a chair.

Woke again at 10:30, finally feeling whole again, but very wary. Very wary. Eventually, at 12:30, warmed up a small cup of soup for lunch, with a mandarin orange for dessert. And here I am. This posting is my project for the day, it seems; Bob will have to wait yet another day.

I am fearful of another tremors attack, and of a narcoleptic episode, either of which could appear unbidden. Meanwhile, I’m in the midst of an episode of aphonia, loss of voice (it sounds like largyngitis, but there’s no infection; or like from injury from overuse, but I don’t stress my voice). This again appears to be another auto-immune affliction, one that manifests itself in episodes that appear, and then pass away, spontaneously. Very distressing, because I can’t sing during aphonic episodes

(Digression: the literature I can find on aphonia classifies everything that results from neither infection nor injury as psychogenic, calling for the services of a clinical psychologist. I believe my aphonic episodes are nothing of the sort. The current episode will pass away as mysteriously as it appeared, and then I’ll be singing again.)

To recap. Two attacks of the spontaneous tremors recently:

— tremors #1, following on severe pain from a stomach ulcer

— tremors #2, today’s, free-standing, just welling up

Now return with me to a earlier series of attacks, in which they were part of my body’s reaction to ferrous sulfate tablets for iron-deficiency anemia, a well-known side effect from some of the medications on the market.

The background (a lot of it really unpleasant), extracted from notes at the time.

On 2/8/10, sudden upper-intestinal bleeding, with copious vomiting of blood and copious bloody stools. To Stanford Hospital, stabilized and given 4 units of blood. Released with prescription for iron tablets, starting on 2/11, one a day; to 2 on  2/18, to 3 on 2/25. Stomach cramps began almost immediately.

Then 3/16, episode 1: stomach cramps for hours, then chills, then exhaustion, then slept for many hours.

3/25, episode 2: felt “really tired and mentally dull”; stomach cramps for hours, chills, cognitive confusion, exhaustion, vomited lunch (no blood, food obviously not digested at all), wrapped myself in many warm layers, slept for 12 hours; next day, cut iron tabs back to 1 a day

4/15, episode 3: as before, but starting after an early dinner; 5 hours of cramps; vomited dinner (as before, no blood, food clearly undigested) from 11-12:30, chills, then exhausted sleep under covers until 7

4/19, episode 4: as before, beginning after lunch; no vomiting, but cramps and then chills; slept 12 hours

5/1: last iron tablet, with sequels as before; by 5/5 I felt normal again (but had lost 30 pounds)

Each episode took two entire days out of my life (I have no record, or recollection, of how I managed my teaching at Stanford during this time).

But the chills, as I referred to the tremor attacks back then, I recall quite vividly.

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