A huge note which aggregated the timeline of what I had experienced to try to find patterns.

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I think it started about September 25th, when I was eating my homemade pizza, which I definitely undercooked (realized this later). I had it 4 days over the course of a week, and 3 of them I felt very bad in the morning. This is how it all started, and I figured it was because I had undercooked the pizza. Other people who ate it did not have these symptoms though. 

By far, it hurts the most in the morning. It feels like I’m going to throw up. Pretty intense pain in my stomach, just what you would generally classify as tummy. At night before bed, it very rarely hurts at all. Sometimes during the day it hurts, that was rare at first but it's been getting worse (January 2019).

I have been feeling more gassy (flatulence) and I've been burping more.

One particularly bad day was when I had chicken nuggets (from McDonalds) the night before, and had a milkshake and some fries. Felt pretty fine afterward, but terrible in the morning. I had forgotten to take nexium that night (at this point was taking it every morning and evening). I ended up feeling really bad for the rest of the day, but I had skipped breakfast due to the pain, and I skipped lunch too, so my pain basically lasted for many hours. 

Another particularly bad morning (I think) was after having fried spaghetti the night before, which has a lot of olive oil. I was not taking any nexium at this point. 

I’ve also had an enormous amount of stress, because I have a small startup with a couple employees.

It usually hits me in two places: down in my stomach, and right in my throat (around my adam’s apple). Down in the stomach, it just is a dull pain, and in my throat it feels like I’m going to throw up, like there’s food right up there. 

Only occasional diarrhea, it hasn’t been very frequent. Bowel movements don’t appear to make things feel better, but it may be the case that the number of bowel movements has gone down. 

Had sweet potato and pecan pie and plenty of ice cream, and the next morning didn’t have any real nausea. But did have some gas. 

Overall, it seems like my symptoms are worse/return when I don’t eat anything for a while. 


October 31st: started taking nexium. 20mg / day for 1 week (pharmacist recommended going to 40mg after first week). Was taking it every morning.

November 5th: said that it might have started feeling better, but hard to tell.

November 9th: started taking 40mg every night.

November 11th: said I had barely any stomach pain this morning.

November 12th, morning. Felt a bit uneasy in the morning (also had pie and ice cream) but not terrible. Although, definitely think I’ve been constipated for the past 24 hours or so. Haven’t been able to get much out. 

November 16th: Told mom my stomach and nausea has gone down a lot since taking 40mg at night. Might still be there, hard to tell the difference between that and hunger, but no serious symptoms like I was having before. Used to wake up and feel awful for 30 minutes.

November 18th, morning. Felt a bit uneasy, not terrible. Had 3 Twinkies, a hostess cupcake, some and some popcorn the night before. 

November 19th, morning. Felt just a bit uneasy. Having a lot of gas (flatulence) and a couple soft stools. Belching a bit too. 

November 28th: went to see the doctor in NC.

November 30th: forgot to take nexium last night, was flying back to SF and got in at 3am PST. Didn’t feel bad really in the morning though. Generally feel fine. 

December 11th: stopped taking nexium regularly.

December 17th: the closest I felt to it recently was waking up at 3pm after only getting 4 hours asleep from 2am to 6am and then leaving the house and coming back at 11am and then sleeping until 3pm. When I woke up, I felt similar symptoms, but I also haven't eaten much. I felt hungry when I fell asleep at 11am. 

December 21st: kind of felt it this morning, but not terribly bad. Been feeling it a bit more, but honestly it's hard to tell if it's hunger or the thing. It might just be hunger.

January 3rd. For the first time, I did a burp and some food came up. Just a lentil from the soup I had eaten 20 minutes before and a kind of acid water, it wasn’t a heave, it was just a normal burp that produced this. 

January 4th, ate cereal at 12pm. Then ate full meal (soup) at 7pm, was very very hungry. Afterwards, was very burpy. To an unpleasant degree. 

January 10th and 11th: have been feeling it again, it’s pretty bad. I think I need to go back on nexium. 

January 12th: went back on nexium. 40mg. 

January 17th or so: switched to lactaid milk for cereal and other. 

January 19th: I've been feeling pretty bad, I think every morning. I'm really hoping the nexium starts to work soon. It's been hurting enough in the mornings that I don't want to get out of bed. The second I wake up, I'm fine, but after being conscious for about 30-60 seconds, I start to feel the pain.

January 20th: slept propped up, ate Mac n Cheese and French toast the day before. When I first woke up, for the first time in a while, I didn’t feel the pain. It kind of started after waking up in the upper throat, but took longer and maybe isn’t as severe. I did have pretty urgent diahherea though, right in the morning. Lots of burping all day. 

January 21st: didn’t sleep propped up really, ate Mac n Cheese for dinner the night before, ate cereal for lunch, and ate a banana for breakfast. Ate dinner well before sleeping, about 6 hours before sleeping. Woke up and for the first like 20-30 minutes in bed felt completely fine, which is the first time in a week. Definitely felt way better than yesterday. Stomach feeling a little uneasy after dinner, not that bad. 

January 22nd: woke up and had some minor pain, pretty dull. Wasn’t that bad. After coming to work (ate a banana in the morning), my stomach has started to hurt a bit more. It subsided completely by like 1pm or 2pm, though. At 4pm and later, I felt totally fine. Also felt like I was happier and able to work when my stomach isn’t hurting. Tonight: having Mac N cheese but not doing any butter this time, just lactose milk. 

January 23rd: woke up and had some dull pain. Not terrible but definitely present. Thinking I should sleep propped up. Due to this illness, I don’t feel well rested in the morning, and even all day sometimes, and it makes working so hard, it's starting to make me feel depressed. Feeling pretty bad from 10am - 1pm so far, just basically constant discomfort, but I guess it could be because I'm hungry. After eating lunch at around 1:30pm, still feeling discomfort: a broad pain in my stomach, and a pain that extends all the way up to my throat, just below my adam's apple. Even 3 hours later, still feeling this. For dinner, ate broccoli and white rice. Had a spicy chicken sandwich for lunch. 

January 24th: pretty bad pain waking up. Pain in the throat, and occasionally sharp pain in the stomach near the belly button. Almost felt like gas pain. Lots of burping after breakfast. I woke up once or twice in the middle of the night. Saw specialist. Going to take new medicine for at least two weeks. Should start feeling better in 4-5 days. Was having a lot of trouble finishing a bowl of pasta for dinner. Just didn’t feel the appetite for it. Been having more gas today. Been having gas all night.  Started feeling feverish. Woke up in middle of night, feeling feverish, maybe muscle spasms, gas pains. Felt like I needed to force the gas out. 

January 25th: get blood work done. Working does take my mind of the pain, Tara was right. Have been having gas pains more than anything else today, I think. Pain is pretty far below the belly button. Tara has started me on a better diet. Got a headache but was probably unrelated. Felt pretty good at night, no stomach pain. 

January 26th: felt good when waking up, no stomach pain, but did have gas pain. Has has felt hard to pass. Stomach started hurting midday, some pain in throat. Having a decent amount of gas and gas pain. Very burpy as well. Throughout the day, not really much stomach pain, just some gas pain really. Feeling pretty good, was able to get good work done.

January 27th: woke up and having some stomach pain. Feeling very burpy during the day, some nausea as well. 

January 28th: woke up with some moderate throat pain and stomach pain. Had some soft stool at 10am, wasn’t tiny pieces but was loose.   Started feeling better around 12pm. Haven't had as much gas pain today. Felt pretty good for the rest of the day, night was fine. Some pretty big burps after dinner. Also ate very well today: egg for breakfast, saltines for lunch, and rice, eggs, and veggies. 

January 29th: woke up and felt pretty good. Basically no pain? Had a bit of upper chest pain after breakfast, and some light discomfort in stomach. Starting to feel a soar throat at the end of the night, not sure why. I think it’s fair to say that I have had trouble pooping. Breakfast: eggs, a couple saltines for lunch, and oatmeal, an egg, and some cheese for dinner.

January 30th: woke up and felt good, pretty much no pain at all. Just a bit of sore throat, I'd say. Realized Kiran is sick and has a sore throat, so probably that's where the sore throat is from. Not much pain or discomfort after breakfast, just a bit. Started to feel heartburn (in throat) starting around noon, moderate pain. Had 5 pieces of gum. Tara noticed I have scalloped tongue, which I've had for a long time, but never looked it up. Also been clearing my throat a lot since eating. Felt really good for the rest of the day and night. As soon as I layer down, I started having gas pains. I think lying down makes the pains worse. 

January 31st: when I first woke up, I had some burning throat pain, but not really any stomach pain. My suspicion is that sleeping upright would help this. I also think that laying in bed for longer after waking up makes the pain worse. Had some soft stool in the morning, not really diarrhea. Having occasional stomach pain around noon. 4pm, I think my stomach feels 100% fine, may be the first time in a while. I have no pain. Was feeling pretty good all the way up to dinner, feeling a bit uneasy after dinner, sadly. Some stomach issues.

February 1st: basically no pain in the morning even though I slept in, I did sleep a bit propped up. I think any discomfort I’m feeling is probably from hunger because it’s been more than 12 hours since dinner. During breakfast, feel like I got something stuck in my throat again. Some stomach/chest discomfort in the middle of the day, 1pm-2pm. 

February 2nd: some throat pain when I woke up, sadly. Throat pain after eating late breakfast at ~1pm, pretty bad. Also some nausea. Rest of the day was pretty okay. 

February 3rd: throat hurting when I woke up. Some stomach pain throughout the day, it's starting to affect my mood again. I feel depressed because I don't know how long it's going to last. Really having some stomach pain/discomfort from like 2pm - 4. Note: for the last 7 days, I’ve been eating eggs with butter and onion and some Parmesan, oatmeal, and a bit of Gouda. pm at least. 5:30pm, I feel very very sick, nauseous, stomach hurts, throat hurts. Almost feel like I'm going to throw up. Felt pretty bad right after dinner, ate pasta for the first time with parmesan. 

February 4th: throat hurting like it used to in September when I first woke up, some stomach pain. Maybe it’s milk and cheese that’s doing this, because that’s on the pizza, I would eat milk in the mornings, it was in the Mac n cheese, and I started putting more parmesan on my omlets recently, but still it’s not a lot of lactase. It’s also in butter. So maybe cut out: all milk (unless almond), cheese, and butter. Felt nauseous after eating dinner (oatmeal). Feeling bloated and gas pain lying down trying to go to bed. During the night, I woke up at like 4am. I don’t think I fell back asleep for 3 hours. I felt anxiety and some amount of pain, mostly anxiety. 

February 5th: ate a very small dinner last night, and woke up hungry but not really with pain. After eating breakfast, started to feel some stomach pain and throat discomfort. Describing the pain after eating: feel like I need to clear my throat, some difficulty swallowing, kind of feels like my throat is narrow, some pain near the Adam's apple, dull and broad stomach pain above and below the belly button, also occasional nausea (like 10 minutes after eating). I think I'm having trouble pooping, even though I'm eating more fiber. The poop is sausage shaped but lumpy, which seems to indicate constipation. Pretty sure I felt a hemorrhoid when pooping, it felt like a balloon when I was straining to poop (this was a couple days ago).

February 6th: woke up with nausea and throat discomfort. After not eating for a while, I don't have as much stomach pain. It's like I feel better when I don't eat. It's 3pm, and I haven't eaten anything today, and I feel pretty good. Like no stomach pain, no throat pain. I feel a bit hungry but not very. After eating cereal, I felt some stomach discomfort, naseau, and throat discomfort. Same thing after dinner (had pasta with red sauce), felt the same discomfort after eating, but a bit more intense. Hard to fall asleep with the gas pain, decent amount of pain. Straining to poop, couldn't get anything out at night. Feeling the hemorrhoid again.

February 7th: woke up with some nausea and throat discomfort, but just about the same as usual, it wasn't particularly bad. Feel pretty fine around noon, but haven't eaten yet. Didn't feel too bad after breakfast, nothing particularly noticeable. Burping and some stomach pain after PB&J, also something I’ve had a couple times, flashes of sharp pain in the tummy area. Managed to have an easy bowl movement, after some jumping jacks. Ate Mac n cheese for dinner, same discomfort right afterward.

February 8th: felt not too bad waking up. Some sharp pain on left side just under bottom rib, just like day before (which had it on right side). While walking had ear pain in left ear, started getting headache. Saw Michael, and basically confirmed it’s not all in my head: had just finished good work, and was spending time with him, but after eating I felt sick both times I ate, so there’s definitely something real. 

February 9th: Woke up the next morning with nausea as well.  Pooped without difficulty in the morning. Felt nauseous each time after eating. 

February 10th: woke up with some nausea. Felt nauseous after eating as well, and somewhat throughout the day. Haven't really had any gas pains recently, perhaps it was just while I was constipated? Naseau after lunch and dinner wasn't that bad, felt it a bit but it wasn't terrible.

February 11th: had some pain today but it wasn’t that bad. Just a couple times, and the times after eating weren’t that bad. Almost seems like it’s getting better. 

February 12th: have had some light nausea all morning mainly. Having some nausea throughout the plane ride too, but I also didn’t really eat much in the morning. 

February 13th: some nausea after each meal, but it wasn’t that bad. Saw NC GI, felt better after discussing things. 

February 14th: woke up with no pain, really, but after 20 minutes, started to feel throat discomfort, kinda severe. No real pain after dinner or for the rest of the day though. 

February 15th: After eating dinner, definitely had some discomfort in the throat. Lots of burping. 

February 16th: woke up with a headache and congestion. Seems like a sinus related thing. Think that could be affecting things. Nothing of note otherwise during the day. Sore throat going to bed tonight. 

February 17th: woke up and for an hour feel like close to throwing up. Coughing a bit to keep it down. Basically felt that bad all day, intense throat discomfort and some stomach pain. Could barely eat breakfast. Felt like close to throwing up. Day before I had a meatball sub and fell asleep right after, then I had Chinese noodles with cauliflower and snow peas. Lots of post nasal drip it seemed at night. Hard to sleep. Also nervous. 

February 18th: endoscopy went very well. Now going to see a ear nose and throat doctor. Felt good basically all day. Felt like I could work, hang out, see people. Just felt really good all day. Had incredibly intense gas pain right before sleeping late at night. 

February 19th: woke up feeling bad. Mostly nausea, couldn’t get myself to eat, head feels cloudy, feel like I can’t work or do anything. Feel fatigued as well. 

February 20th: woke up feeling not too bad, did call, having almost cold like symptoms. Started LexiPro, vitamin D, and Miralax. 

February 21th: Woke up and basically threw up but nothing came out in the morning. Felt feverish but no fever. Stomach pain basically all day. Lying down may help with stomach pain compared to sitting up? Not sure. Late at night, 12am, threw up my dinner. All just undigested food. Was feeling really, really bad before, feel better after throwing up.

February 22nd: could only sleep an hour. Having hot flashes in morning and feel very nauseous. Tons of stomach noises at night, but I don't have pain. Seems like gas is moving around or something. Very strange, I mean this really makes it seem like it's just a digestive issue.

Intermission: went through some really serious stuff....

February 28th: was feeling fine all day, and couple days before regarding nausea and stuff, then had pizza for dinner and am feeling a bit of nauseaus and having the throat pain thing.

March 1st: Again, was feeling okay in the morning and then I woke up and ate a pretty decent size bowl of mini wheats (pretty quickly) and then I start getting the throat pain and some nausea. Had a very solid and good poop yesterday and today, so it's not constipation. 

March 3rd: trying experiment. Ate 16 McDonald’s chicken nuggets and half a small fries at 4pm. Going to see how it goes. 2am, going to bed, haven’t had any issues at all so far. 

March 4th: tried a McDonalds milkshake around 5pm and 20 chicken nuggets, feel fine at least for now (a couple hours after). 10pm, still feel fine. No issues.

Updates for doctor from first week on Dexilant: 
* What does the bloodwork tell you?
* I'm going back to North Carolina next week. 
    * If I get an endoscopy there, what are the things that they should look for/test?
        * If they see gastritis, will they be able to determine if it's caused by H Pylori? 
    * What should I tell the doctor?
        * Neeraj Sachdeva. 
    * Is there a checklist of biopsies that they'll do, or do they decide what to do? (You said: check for damage to esophagus, ulcers, gastritis, Eosinophilic esophagitis)
* Some things that I forgot to tell you/small updates since 10 days ago: 
    * For a long time, probably past 2 years, I clear my throat a lot after I eat. 
    * Could sinus infections/nasal drainage be affecting things? I have had chronic sinus infections in the past. 
    * I am allergic to dust mites and pollen, and I was diagnosed as lactose intolerant when I was younger, could that be affecting things.
    * For several days after seeing you, I was having pretty severe gas pains as soon as I lie down, and I've been belching a lot after eating. 
    * I do sometimes feel like my throat is narrow, like I just have that sensation when I'm eating/swallowing. 
    * Currently still been having pain throughout the day, some days I have good days, some days I have bad days.
        * More recently, I've been feeling pain more after eating. Throat and stomach.

New plan: 
    * Get a referral to a NC GI from Dr. Bender. 
        * Done, she'll put it in today and they'll call me when it's done. SUBMITTED.
    * Call the SF doctor again asking about the blood tests.
        * Done, she said Dr. Liu should probably call sometime today (probably before 2pm). Wed: he said he will "for sure call me today". DONE.
* Schedule an appointment for as soon as I get to NC. 
    * Should call 30 minutes to 1 hour after the referral is sent to confirm they have it. DONE.
    * Apparently they say that if the doctor requests an endoscopy, I could get one without seeing a specialist first. They said put in a referral request and a request for an endoscopy and they will decide what to schedule based on what's going on. Decided to see a specialist first anyway, so they have full background before doing endoscopy.
    * Should call next day/two days to ask to schedule for an appointment. SCHEDULED.
    * Should be able to get an appointment for next week with a GI doctor. 
    * How quickly can I get an endoscopy after an appointment? At the UNC GI, it would be in March. They do get cancellations, though. Could schedule here and then do Duke if I can get it done sooner there.
    * Called Duke, they're booked until March, but they said they get cancellations all the time, same week (had one Wednesday, Thursday, and Friday this week). So could get one of those easily.
* Scheduled with Durham Gastroenterology Consultants on Feb 13th. Now need to get them all of the medical records.
    * UNC has confirmed they've been sent and received. 
    * SF said that they'll send them today or tomorrow. Said they'll call once they're sent (probably won't be by end of Thursday though).
        * Should call at end of day Thursday just to check in to see if they've sent them. DONE. They sent them over at 5pm EST, Thursday. 
    * Should go to SF office on Friday to pick up the paperwork (anytime except 12pm - 1pm). 
    * Should call Duke to make sure they received the notes from 
* Go to GI appointment
    * tell symptoms
    * schedule an endoscopy
    * discuss endoscopy without sedation.
* Get endoscopy and determine treatment. 
* Go back to SF once treatment is working and feeling much better.

Note: perhaps posture is playing a role. Should stay upright for 3 hours after each meal, no slouching. Going to try this.
Note: should take Nexium at least 1 hour before meal. Going to take when I get home at 5pm, eat at 7pm or so.

Second doctor:
* Should say: 
    * For the past 4-5 days, I've been eating a banana every morning, a small sandwich (usually bacon, egg, cheese), for lunch, and Mac N Cheese for dinner, for consistency and because that's what I did last time I had this issue. I've been using only Lactose free milk as well.
    * I've been taking 40mg of nexium each night, right around when I eat (8pm).
    * The last doctor I saw, in late November, got me an X-ray to check for constipation, but I was fine.
    * On the 23rd, the pain has been in my throat somewhat but mainly a pain underneath by belly button.

First Diagnosis:
She thinks it’s GIRD. 
Could be constipated as well. Could get X-ray. 
Another 5 weeks of nexium, current dosage, 40mg at night. Don’t miss any. 
Not eating 2-3 hours before bed. Stay propped up. Note about caffeine. 
Could take something over the counter to clean out the poop. 
Could have medicine to address. 
What about the constipation. How would I know I was constipated after taking the over the counter? Miralax. 
Let’s get the X-ray done for constipation.