Once things it became clear that we needed some diagnostics, I flew back to NC to have an endoscopy. I didn't want to do it in SF because my family wasn't around to support me (and Tara was very busy with work).

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* I can step through a detailed summary of symptoms and the timeline. 
* Please interrupt at any point with questions. 
* Can I record this so I don't have to worry about writing/remember things?

Description:
* Original symptoms (in September): 
    * Right when I wake up, for first 30 minutes of the day.
    * A lot of pain in throat, around where Adam's apple is. Kind of feels like I need to vomit, but never do. Feels like something stuck in throat.
    * Also pain in stomach, just general pain in the tummy area surrounding belly button.
    * At night before bed, it almost never hurt. Sometimes during the day it hurt, but that was rare.
    * At this point is was only early morning discomfort.

* Lifestyle and Diet (for most of my life):
    * For the past year and a half, I have had a lot of stress
        * Because I run a small company with a couple employees.
    * Almost every day: 
        * Mini-wheats with milk for breakfast
        * Breakfast sandwich or skipping lunch (often would skip lunch)
        * Dinner of pasta with red sauce.
    * For at least past 2 years, I've felt like I need to clear my throat constantly for like 30 minutes after eating. Almost feels like there's mucus back there.

* Particularly bad incidents:
    * It started around September 25th. I had made homemade pizza from scratch that I think I undercooked. I had it 4 days that week, and 3 of them I woke up feeling very bad in the morning. Other people who ate it didn't react the same way though.
    * I thought it was just the pizza, but it continued after I stopped eating the pizza.
    * 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. 
    * 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, but eating dinner seemed to reduce the pain. 
    * 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. 


* First wave timeline: 
    * September 25th. Original symptoms.
    * All of October: experienced it sporadically, made note of particularly bad incidents. 
    * October 31st: started taking nexium. 20mg / day for 1 week. Was taking it every morning.
    * One week later: started taking 40mg every night.
    * One week after that: stomach pain and nausea has gone down a lot since.
    * End of November: went to see doctor. Was feeling a lot better by this point. She said continue taking nexium for 5 weeks. Took X-ray for constipation.
    * Two weeks later (mid December): stopped taking nexium regularly.
    * 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).
* Second wave timeline:
    * January 10th: flew back to San Francisco. Feeling it again, pretty bad.
    * 2 days later: went back on nexium (40mg at night)
    * One week later: started hurting in mornings so much that I don't want to get out of bed, and had one case of urgent diahherea and burping all day. 
    * January 21st: changed diet to see if that would help.
    * ~January 23rd: 
        * The pain began to be throughout the day (constant discomfort). 
        * Pain appeared to worsen after eating: "a broad pain in my stomach, and a pain that extends all the way up to my throat, just below my adam's apple."
        * Started feeling depressed.
    * For 4-5 days late January:
        * Felt like gas pain when lying down to go to sleep.
        * Started taking Dexilant (Jan 24th)
        * Felt constipated. 
        * Lots of burping.
        * Developed hemmroid. 
    * All of February to now:
        * Very occasional: flashes of sharp pain, just under ribs on right and left side.
        * Occasional pain during the day at random times, but really only flares up after eating (10-20 minutes), can last for a while.
        * Been having more naseau than the other symptoms, recently.
        * 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 (starts like 10 minutes after eating).

Other notes: 
* I did go to the doctor about 6 months ago when I had the sensation for hours that something was stuck in my throat, I was trying to cough it up violently for hours. 




Questions: 
* What do you think it could be? 
* What do you think we should do? 
* If Endoscopy
    * How soon could you perform one? 
    * Do you regularly perform them without the sedative? 




Can say that the SF doctor said: 
* A stomach ulcer
* Gastritis (could caused by Advil, another cause is H Pylori)
* Eosinophilic esophagitis
* He does think an endoscopy would be helpful at this point.