cellio | fasting while sick

Wednesday I caught the beginnings of the crud that's been going around and started taking Sudafed aggressively to kill it before Yom Kippur, because fasting with a cold would suck. That didn't work, alas. Thursday night/Friday morning I noticed the first of two second-order effects: near as I can tell, the Sudafed -- whose job, after all, is to "make the emissions less bad" -- was having a dehydrating effect. So I stopped that before it could do more damage. The other effect was that the cold was sapping my appetite, when I should have had a large lunch and good-sized dinner on Friday.

It actually wasn't as bad as I had feared. I did make one concession: on Friday I bought a bottle of "throat spray" to deal with the soreness (or at least numb it away), and I took that to shul with me. I reasoned that while this might technically be in the same category as applying lotions, it's not food or drink and it's medicinal, so it was ok. (You spit it out after gargling with it. I would have taken pills if I'd had anything that I knew to work and be non-dehydrating. I wasn't going to experiment.) Beyond that, I took tissues, tried for aisle seats in case I had to run out, and did my best to minimize contact with other people.

Friday at Kol Nidre I was sweating like mad. I know that our HVAC has unintended climate zones and I was sitting on a supplementary chair in a place in the sanctuary not normally used for seating, so I figured I was just in a bad place. It happened again this morning (in a regular sanctuary seat not known to be bad for heat), and only then did it occur to me that perhaps I had a fever. Well, either the fever broke or the AC kicked in at the beginning of the torah service, and I was fine after that. The sniffling was not bad for the rest of the day and my voice is getting less froggy-sounding. Let's hope I've seen the worst of this.

As for the fast, I found that by about hour 19 I had stopped caring. I expected to be desperate for water by then because of the cold (and wouldn't have been too surprised if my rabbi had ordered me to the drinking fountain). But it wasn't an issue. Yay.

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Okay, everything you need to know about Sudafed (and, really any decongestant) can be summed up by noting that it's basically synthetic adrenaline. Yes, really. So all the therapeutic effects and all the side effects...just think adrenaline rush. The GI tract gets short-changed in favor of your flight-or-fight tools; secretions dry up (which is what you want). So you're not hungry, but you are thirsty. Your blood pressure and heart rate go up. You get twitchy, and you can't sleep. And so on.

Do you not get excused from the fasting if you're sick? I know in the catholic church ill folk don't have to do the good friday fasts etc, my parents are forced to take this option..

It depends on how sick, and one's general condition other than the sickness, and so on. In many situations, it's considered preferable to fast while resting at home over eating something and attending services.

I would think that throat spray would count as medicinal, because if you drank even a moderate amount of it it would probably be quite bad for you.

Thanks for the information.

What do they do to the ones that cause drowsiness, since that would seem to be anti-adrenaline? (Extra-strength Sudafed, Benedryl, stuff like that.)

You should do the minimum necessary to deal with the problem, including "live with it" if it's really a minor annoyance. So at one end of the spectrum, if you're, say, a diabetic, not only may you eat but you must, and at the other end, if it's just a minor headache and you can suck it up, you should do so instead of taking drugs.

A lot is determined by individual circumstances -- how severe the problem is for you and what other remedies are available to you. That actually motivates me to go as far as I can, rather than looking for the pass. I know the pass is there if it's really needed.

I'd have to agree; the stuff would be nasty.

I found this while looking (unsuccessfully) for something called "throat coat", which you do leave in. (It soothes; it doesn't numb.) The first couple squirts with the throat spray, before I had the aim down, definitely did "interesting" things to my mouth.

*nods* that makes sense, and I guess you want to do the full fasting thing if you're able.. personally I'd have had water to avoid the dehydration problem, but my system is so fragile I tend to be extra cautious; should have known there'd be sensible guidelines :)

Makes sense thanks.

Many numbing agents can have, as you say, quite "interesting" effects if you miss. ;-)

See, there is a spiritual benefit (which is hard to describe) to doing the fasting, but we do not sacrifice health for mitzvot (with three exceptions). So there's a tension between wanting to try and wanting not to be reckless.

(From what I know of your health, if you were Jewish your rabbi would likely order you to drink water.)

Okay, I don't want to sound condescending here, but lemme explain this. A lot of people conflate antihistamines with decongestants. It's understandable: they're both "cold medicine". But they're very different. Antihistamines are going to block the allergic response: they seal off the H1 receptor site so the allergen can't dock and set off the biochemical chain that leads to your allergy symptoms. (BTW: there are H2 receptors, too: in your stomach, they're responsible for acid secretion. Zantac is an H2 receptor blocker). So if your symptoms are allergy-based, an antihistamine like Benadryl is going to help. But classic antihistamines, of which Benadryl is the archetype, cause a good deal of sedation. Benadryl is even used as a sleeping pill, especially in nursing homes. The newer ones like Claritin (loratadine) and Zyrtec are (relatively) "non-sedating".

A decongestant is a totally different animal: they have nothing to do with histamine, but rather they mimic norepinephrine (a/k/a adrenaline), the neurotransmitter that mediates the "flight or fight" sector of your nervous system, the part that works when you're running from -- or wrestling -- the sabre-toothed tyger. That's opposed to the part that's dominant when you're sitting digesting that tiger haunch, but I digress %^). Decongestants are the "D" in things like Claritin-D and Zyrtec-D. If it's behind the counter, it's probably pseudoephedrine. If it's out front, it's phenyephrine (a/k/a "PE").

"Non-drowsy" cold medicines are simply a decongestant, maybe with some Tylenol or Advil for pain, but no antihistamine. "Nighttime" cold medicines have no decongestants -- which can cause insomnia (think adrenaline rush) -- but lots of
antihistamine and often with a significant amount of alcohol to potentiate it.

Thanks for the explanation. (And it does not feel condescending; don't worry.) I made the foolish assumption that all Sudafeds had the same thing at their core, and I obviously misunderstood Benedryl. (I've heard of people taking it for colds, but maybe it was a "better than nothing" gesture rather than something really effective. I wouldn't expect that to work, given your explanation.)

(Lots of cold and allergy medicines are off limits to me, so I tend to just stick with the things my doctor approves of -- Sudafed for colds and Claritin for allergies. I guess it's been a while since I've read the tiny print listing what's actually in the stuff.)

fasting while sick

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