Acid Nightmare

This weekend I had the most prolonged and painful episode of acid reflux that I’ve ever experienced. It started mid-evening on Friday during a meal with friends at the Lahore Kebab House on the Commercial Road, when I started to feel the familiar sensation of constriction in my chest as food seemed to be struggling to make it from mouth to stomach. A few sips of water didn’t do much to relieve things and soon I found myself back on familiar territory: the pavement outside whichever restaurant I happen to be in, drooling into the nearest handy gutter.
It’s not pretty. When the food doesn’t go down, the mouth produces more saliva to try and lubricate everything into submission. However, when your oesophagus has become impassable, the only effect is that the saliva fills up the rest of your gullet until it reaches the back of your throat. This is when you start retching, to avoid drowning in your own spittle. This, in turn, sends your oesophagus into panic mode and it clenches tight, ensuring that the piece of meat, or chick pea, or clump of rice, is staying firmly where it sits.
While all this is going on, you experience a feeling rather like being stabbed in the back with a knife while having a mild heart attack. Heartburn is all about excess production of acid, which has left the confines of your stomach and ventured northwards up your oesophagus. The former is designed to handle it, the latter isn’t – hence the burning sensation. You’d think all this acid rising up your tubes would melt the stuck food away, but it doesn’t seem to work like that.
The funny thing? Excess stomach acid can often be triggered by stress. But, of course, when you’re choking, salivating, retching, burning and being stabbed repeatedly from all angles, a therapeutic bout of relaxation is the last thing on your mind. The concept is clearly some kind of cosmic joke; one of which I’ve been the punchline several times over the past few decade. This happens to me a couple of times a year – interestingly probably every other time is in a restaurant – but it has never been this bad.
Normally, after two or three hours, I feel a little slip inside and a sense of blessed relief as I realise that the stuck thing has gone down and that equilibrium has been restored. This time, I didn’t. It calmed down a bit, but was still in effect three hours later when I had to drive home. Luckily it was a fairly short drive, though I didn’t quite manage to make it to the house before having to stop on Blackheath for another retch and a coughing fit. (Fortunately there were no police cars in the vicinity, because someone pulling up rapidly, jumping out of the car, appearing to throw up, getting back into the car and driving on would probably have looked quite suspicious around an hour after the pubs had closed on a Friday night!)
I got home and things weren’t feeling any different. I couldn’t even drink water, which was what really started to concern me, and the drooling hadn’t abated. I was scared to go to sleep, worrying that I might end up drowning myself. I paced up and down, watched a bit of Big Brother, surfed a few sites, made a half-hearted attempt to do some breathing exercises and occasionally tested my ability to drink. Around 4am I found that I could take very tiny sips of water and, exhausted, went to bed.
I slept fitfully and woke early the next morning, to the sound of roadworks starting outside our bedroom window at around a quarter to eight. To be fair, we’d been notified of this the previous week and in all the “excitement” of the previous night I’d forgotten to close the window. I wandered down to the kitchen feeling very dehydrated, took a swig of water from a bottle on the side and promptly deposited it straight into the sink in a rather impressive demonstration of projectile retching. This was quite a shock, because in all my other instances of acid reflux the symptoms had never continued into the following day.
Saturday was a nerve-wracking and uncomfortable day. At first I couldn’t lie down or even sit without the heartburn returning. By mid-morning I could sip water again, but anything approaching normal swallowing was still impossible. I was more functional than the previous evening and so I spent a lot of the day in the garden, soaking up the sun with a book in my hands. My attention was torn between what I was reading and what I was thinking; frankly only the calming presence of Mrs Hg kept me sane. I was able to keep down small spoonfuls of Gaviscon (antacid medicine) but my mid-afternoon attempt to drink half a cup of potato and leek soup (very bland and of a thinner consistency than the Gaviscon) ended in failure. I’ll spare you the details, as I’ve probably given you more than enough information already.
We went for a walk around 5pm and I started to feel more comfortable. Returning home just after 6pm I tested my water-swallowing ability and it was still very poor. I wandered around the house feeling more and more spaced out. Eventually, just before 7pm, I felt so tired that I no longer cared what happened and I crawled into bed. I woke up again around ninety minutes later intending to stay up, but within five minutes all I wanted was more sleep. The next time I looked at the clock it was just after 9am the following morning. I wandered downstairs, tentatively sipped some water and was overjoyed to discover that everything seemed to be working again. I held off food until the mid-afternoon, when I was immensely happy to find that it didn’t seme to be a problem any more.
So, given that what doesn’t destroy me makes me stronger, what strength can I gain from this? A salutary lesson, I think. This incident relates to a known medical problem of mine, for which I’ve previously been given preventative advice:

• Lose weight (to reduce the pressure on the stomach that can cause the acid to start rising);
• Reduce or eliminate stress (which can cause excess acid production);
• Eat a balanced diet and avoid alcohol and spicy foods in particular (which can both irritate the digestive system);
• Get plenty of sleep (part of the stress-reduction thing and also good for general bodily repair);
• Exercise regularly (partly to keep the weight down and partly to improve metabolic rate);
• Drink plenty of water (aids digestion and also fills the stomach to help avoid over-eating).

Generally I act on most of this advice apart from the “no alcohol and spicy foods” rule and generally I seem to be OK. Last week, looking back, was one where I broke almost every single rule. I had a hectic week at work, starting early and finishing late; consequently I slept very little. I had no time to buy or prepare fruit; I ate a large chilli-based meal every day (twice on one of the days) and probably put on two or three kilos. As I was frequently running in and out of meetings during the week I drank lots of diuretic coffee and very little water. I managed to fit in a swim on Tuesday morning before work, but that was all.
Basically, I did everything wrong. By comparison, the previous week had been a model of excellent diet, high fluid levels, reasonably adequate sleep and a couple of early-morning swims. Whilst not entirely unstressful, it certainly hadn’t been as challenging as last week. It’s amazing how little time it took for me to make myself ill, though I can’t say that I didn’t realise what I was doing. Even at the start of the week I had a very definite sensation that it was going to be a tough one and that if I could just make it to Friday evening I would sleep right through Saturday morning and then immediately run to the organic section of the supermarket for some restorative fruit and veggies.
This is all terribly self-absorbed, isn’t it? I’m not writing this post for you though, dear readers. This is one for me to read again in a few weeks’ time and then to re-read at frequent intervals after that. This is one to remind me that there are things that not only do I enjoy doing (swimming and eating well, for example) but which are absolutely essential to my health. To encourage me to actively build them in to my daily and/or weekly schedule rather than squeezing them in if I have time amongst all my other commitments. To prompt me to recall that I can only run on empty for a very short time. To evoke cautionary memories of a very worried man, pacing up and down at 3am, wondering why the hell he hadn’t made a few extra seconds to drink a glass or two of water, hadn’t had the foresight to leave work that bit earlier, hadn’t gone to the pool a couple of times rather than having a lie-in.
Sounds very stupid of me and very simple to remedy. How could I have accepted this state of affairs? Well, there’s something in that short-term mode of living that I seem to love, whatever its long-term consequences. While I’m not keen on the notion that we’re all dependent on something in these addiction-obsessed times, I know that my fondness for adrenaline-surfing exceeds healthy limits and that (for the nth time) I need to Do Something About It. It’s exhilarating, but there’s always, always a price to pay.
In the immortal words of The Primitives: “Don’t slow down, you’re gonna crash…”