As the nausea started to grow, so did my obsession over resolving it.

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Medical record related:
* Get them to give me a release to fax to Chapel Hill Peds.
    * Their fax: 984-215-5942
    * Then call her back to let her know: 984-215-5900. Kirstin, or ask for medical records.
* I have a Lucy Summary (XDM format, CDA format)
* I have a full history (XDM format, CDA format)
* These contain PDFs (I also have printed a PDF)



Description:
* Original symptoms: 
    * 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, but definitely past year):
    * For the past year and a half, I have had a lot of stress
        * Because I have a small startup with a couple employees.
    * I usually slouch in my chair, I don’t sit up straight. 
    * Almost every day: 
        * Mini-wheats with milk for breakfast
        * Breakfast sandwich or skipping lunch (often would skip lunch)
        * Dinner of pasta with red sauce.

* 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. 
    * 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.
    * 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. Definitely think I’ve been constipated for the past 24 hours or so. Haven’t been able to get much out. 
    * November 16th: stomach pain and nausea has gone down a lot since.
    * November 19th: felt a bit uneasy, having a lot of gas and a couple soft stools. 
    * November 28th: 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.
    * November 30th: forgot to take nexium, felt fine the next morning.
    * December 11th: stopped taking nexium regularly.
    * December 17th - 21st: had 2 cases of feeling it a bit, but hard to distinguish from 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).
* Second wave timeline:
    * January 10th and 11th: feeling it again, pretty bad.
    * January 12th: went back on nexium. 
    * January 17th: started using lactaid milk. 
    * January 19th: started hurting in mornings so much that I don't want to get out of bed.
    * January 20th: had urgent diahherea in the morning, and lots of burping all day. 
    * January 21st: started controlling diet significantly: banana, sandwich for lunch, and Mac N Cheese for dinner.
    * For the past 3-4 days, it's started to affect me during the day too. 
        * Can't concentrate on anything but the pain.
        * Feeling depressed while the pain is occurring. 
        * Feel like I can't figure out the pattern, that there's nothing I can do to stop the pain.
        * Scared of endoscopy, etc. 


Notes: 
* There's yellow spot on my leg. I thought it was a bruise from soccer.
* The periods of time where it doesn't hurt as much appear to coincide with vacations home to NC/taking time off work (e.g. weekends).
* For a long time, especially after eating, I feel like I need to induce myself to burp, so I swallow air and burp (can demonstrate). 
    * Actually, more like it, I feel like I need to clear my throat constantly. This has been very long standing.
* Also, 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. 
* 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. 




Result: 
* What should I do? 
* When should I feel better by? 
* Should I see a primary care doctor if things persist? 
* Are there complications of an endoscopy? 

His thoughts: 
* A stomach ulcer
    * Alarm symptoms would be: weight loss, black stool (bleeding from stomach), vomiting, inability to make it through meals.
* Gastritis (could caused by Advil, another cause is H Pylori)
    * Note: he didn't order the H Pylori test though.
* Eosinophilic esophagitis
* He does think an endoscopy would be helpful at this point.



Plan:
- [x] Try to schedule endoscopy for NC time, if not, schedule for some time in SF
    - [x] Dr. Liu says that he can't schedule me one there because he doesn't have any remaining connections in NC.
- [x] Start taking new medicine tonight. Take every day. Should see improvement in 4-5 days. 
- [x] Call Liu and ask if I should check the H Pyori. Do blood work tomorrow morning after waking up in the morning. 
- [ ] If not better in two weeks, go through with endoscopy.