First day off zelnorm

12/26 is the first day without zelnorm. Everything ok except at night when food is taking a bit longer to digest. Went to gym for a short elliptical training. Was able to eat 3 rotis in one shot. Tried to sneak in a bit of almond butter. Went for a walk but the burp is 'stuck'. Had a few grapes got a few burps though it is still stuck.
12/26 -morning: semolina with whole fat milk
had a few pancakes
hungry by 12
lunch - had 3 rotis / 1 cup zucchini+ water dal (1 cup) +(went for a walk) on return 1.80 big papaya + 1 dannon.
on return from risa - had 1 cup more milk in the form of carrot halwa.Also took almond butter (half teaspoon). Very well digested
dinner - shallow fried baingan + moong dal (1 cup each) + 3 rotis + almond butter and a few grapes + little bit of pancakes.
weight : 122
12/25 (could not eat lot of calories)
breakfast: semolina with milk
lunch: 3 rotis + rajma + bhartha
tried eating coconut milk + chana dal + gur but felt uncomfortable
Ate activia. Uncomfortable throughout evening
Had almond butter in the evening but very full until 8:40.
Dinner: 2 rotis + bhartha + zuchhini carrots and dal
Gassy and uncomfortable. Had hot tea but slept at 11:30 because gas was causing uncomfortable feeling.
12/24 (similar not enough calories)
Bowel movement still takes 1 hour to complete though not much problem in evacuating. Haven't got to one shot clearance yet.
Get urge for the bowel movement immediately after rising and drinking warm water though.

Ideal bowle movement + visit to Dr T

Ideal bowle movment on 12/19. Pressure in the morning. Done in a few minutes.
To note on 12/18 - felt hungry. Had almond butter also. Almond butter did not create a problem.

Visit to Dr T
He says that in his practice of 25 years he has not seen such effects (weight loss / acidity) due to constipation. So scheduled upper GI tests (gastric emptying dec 27) + capsule endoscopy (jan 3)+ small intestinal motility(may 7).
Also prescribed miralax

Skipping 12/19 food
12/20 bowel movment - not much pressure in the morning .Able to pass stool after a few minutes of drinking lime water. Passed most of the stool. After semolina - able to pass more just in the nick of time to go for the meeting. Not sure if complete evacuation happened.
Not very hungry by 12:00 for lunch. Little hungry by 1:00 pm
breakfast : semolina + milk + 1/2 tbsp flaxeed
lunch : carrot + peas + moong dal + 3 rotis + 3/4 orange
snack : hawaiin papaya
hungry at 7: completed at 8:40 2 katori pumpkin + 2.5 katori mixed dal + 4 rotis; quick digestion after walk ; ate avocado + 1/4 orange at 9:00 ; quick digestion again after walk;
empty again at 10:20

Gas goes away

12/16 - one bowel movement; stools seemed stuck. Lay down until 12:30. Split meals into two parts. Felt hungry during lunch (though a little late)
12/17 - bowel movement (2) - second one did not have pasty stool
12/18 - good and fairly quick bowel movement (completed in 20 minutes)
12/19 - very different kind bowel movement. First appears to be good

12/18
breakfast - semolina with lactaid whole fat (2 katoris)
lunch - ajwain paratha (2) + bhartha + lauki + half orange (to prevent acidity) + half papaya
snack - dan active + half papaya + half orange
hungry at 5:30 pm- yoga
dinner - almond butter (1 tbsp) + carrots(milk lactaid) (before dinner to ward off hunger)
then mushroom peas (milk) + wintermelon based dal + 3 rotis (split into two - 2 roti at 7:00 pm) 1/4 roti at 8:30 ; 3/4 at 9:30
grapes + carrots(milk lactaid)
chamomile tea
Summary: Felt hungry at 5:30 and again at 9:30 pm
Had indications of beginning of acidity at lunch but with less food got prevented
Taking small quantitiy of water after meals.

Gas has gone away. Probable cause is organic whole fat milk OR molasses. Almond butter is fine.

gas formation

Had continuous gas formation from Tuesday - Friday after every meal.
12/12 - gas formation right after lunch ; thought it was possibly due to going after work in the afternoon though took the routine 15 minute walk
12/13 - split up lunch into two separate meals. Gas formation after taking avocado
12/14 - gas formation after taking milk + lauki at night.
12/15 - gas formation after splitting up the meals and then going to work (no avocado). Then ate the rest of the meal at 4 pm. Gas formation continued. Then had orange. Significant lessening of gas


Bowel movement
12/15- first bowel movment good. Second one was slightly difficult. Sitz bath helped. Continued drinking water and ate semolina with milk even though second bowel movement was pending.
Right after first bowel movement not enough pressure for second (though not hungry either). With semolina pressure built up and bowel movement happened
12/14- first and second good bowel movement
12/13 - excellent bowel movement - completed within 10 minutes

Diet:
12/14 breakfast : semolina with milk + molasses
lunch : finely cut eggplant and sweet potato with dal (almond butter 1/4 tsp)
dinner : coconut milk based veggies (squash + sweet potato + mushroom) + dal
also took milk + lauki that caused gas
chamomile tea (2) and ajwain after milk /lauki caused gas. Burning sensation in the food pipe
both lunch and dinner split up into two portions of 2 rotis in first go and then another roti later.
Weight increased to 122.5 (pleasant surprise !!).

gas subsides - magic of eating more frequently ?

Gas due to avocado subsided within 2.5 hours. Was also able to consume a danactive and a chamomile tea. Remained seating for most of the time with a little change of position.
Compare that to eating avocado with food and feeling gassy / burning sensation throughout the day and night. Also the weight reduced by 0.5 pounds as a result.
Need to see a dietitian as it will be a fortnight on zelnorm and not significant increase in weight (if 1 pound gain in 12 days and 0.5 pound loss in 1 day counts).

gas recurrence

12/13 - excellent bowel movement. No dried stool in the beginning. It was in fact oily and the bowel movement was complete in 20 minutes. Went for defecography and passed more stool.
Hungry at 1
Had roasted veggies + cocount milk veggies + lauki + squash + 3 rotis. Decided not to consume fruit in an attempt to eat more times a day. Easily digested
At 3:30 took haas avocado with honey. Immediate gas formation. At 4:30 took chamomile tea. Gas formation reduced.
Is it that haas avocado is causing gas (and a burning sensation)? Very hard to believe. Note that both yesterday and today only haas avocado was teh difference. Earlier avocado used to be the 69 cents one . This was more expensive 99 cents bough from whole foods. Really hard to believe though.
Also is coconut milk greasing the stools ? Need to validate that.

surprise problem

12/12 - Got a good bowel movement after some effort. Felt hungry for lunch.
Lunch included vegetables(carrot / eggplant / mushrooms) in coconut milk and also roasted(carrot /sweet potato / mushrooms) and 1 tbsp of paneer matar and 1 tsp of almond butter and 3 90 cal breads. Felt empty even after that. Took an avocado. Went for a walk 15 mintue like every day. Then drank some water.
Went to work and the gas started. One acidic burp. Burning sensation in the stomach. Pressure in the stomach. Lots of burping but burp seems to get stuck in the stomach.
Danactive seemed to calm the burp but water seems to increase the problem. Continued until evening.
Dinner was same (except paneer matar). Ajwain seemed to help.
Don't know what is the problem. This is definitely not the pelvic floor issue (good bowel movement). It is also not a food issue (didn't have fiber or prune juice or any fermenting food).

scheduling

defacography scheduled for at least a month later. So there is not much except zelnorm.
Also took sitz bath twice. Didn't do it in the tub though

12/6 not pressure in the morning. Felt lucky to get one bowel movement out. Solid (zelnorm like). Had to push but that was to get the stool out. Still felt incompletely evacuated. Second bowel movement happened after eating suji / walking around and taking sitz bath. Pasty stool. Took citrucel after a week (11/29 was the last time that citrucel was taken)
12/6 breakfast - semolina with milk
Hungry for lunch
12/6 lunch - veggies + squash dal + 3 rotis plus avocado + 1/2 papaya
12/6 snacks
kiwi + dannon probiotic
Hungry for dinner
12/6 dinner
3 90 calories wheat bread with oat + eggplant(small fried) + squash dal + grapes + sweet potato + 1/2 papaya

Sent mail to apollo , wockhardt. This is informative link http://www.bio-medical.com/news_display.cfm?newsid=47.
Talked to Dr hetal
She suggested following asanas for strenghteing the pelvic floor

pavank mukta
sarvang asana
halasan
anulom vilom pranyaman(kapalbhat)
dandasan

one more whose name she could not remember but it is essentially bringing your soles of the feet together and then towards yourself and then fluttering your knees as if flying.

levator ani?

driving to sfo and back and then to work / then for medicines / then again for sitz bath and then sitting at work created some pain in the pelvic area. That is a symptom of levator ani. Though both anismus and levator ani are caused by tight pelvic muscles.

12/5 breakfast - semolina + milk
12/5 lunch - 1 roti, bhartha and dal pre sfo. Then 3 rotis lauki and dal + avocado
12/5 dinner - 3 rotis, mixed roasted veggies (mushroom + bell pepper + eggplant) + dannon probiotic
No snacks (guess additional roti compensated for a snack)

Susan: Went over the diet for 20 minutes - the main recommendation was to include more solids / starch (to bind the stool together). Told susan about the yogi tea. Next appt is in Jan
Talked to dr wise at pelvic pain help. Will probably look into his book and also go for eval.

Defacography is delayed due to stan not having me in the system (despite T faxed the docs).

Note: Stool today was stuck again. It seemed to be stuck higher up in the intestines than in the rectum . Passed a good amount in the first movement (zelnorm like - hard and pellets). Still feeling incompletely evacuated. Then passed some more after sitting in the sitz bath. Then pass some more after enema. Finally felt evacuated after enema. Hope these kinds of days are minimuzed

return of intestinal congestion

12/4 night with yogi tea gave an extended but slight cramping(which is welcomed) in the stomach. 12/5 Morning there was a good pressure and a stool was passed. However, the stomach did not seem to be empty. It seems to be blocked in the abdominal region. No hunger in the morning. Compensates for the immense hunger a day earlier. Waiting and watching. Gotta go to biofeedback at 12:30 and therefore lunch at 11:00.

weekend and monday

12/2 dinner was okra in coconut milk and dal got yogi tea and the warm water was good. Took grapes.
12/3 breakfast - suji kheer + half small paratha with strawberry jam
12/3 lunch -okra in coconut milk + dal + gajar halwa
12/3 snack - dannon probiotic - felt full after that
12/3 dinner - roasted vegetables (eggplant + mushroom + bell pepper) + wintermelon dal + 3 rotis + gajar halwa (less due to almonds) + yogi tea at night (feel a slight cramping in the stomach after drinking warm water- motility at work I guess)
12/4 lunch - small three rotis (aata over) + roasted vegetables (eggplant + mushroom + bell pepper) + wintermelon dal + avocado + sweet potato
Surprisinly hungry in the afternoon also. Snacks were two kiwis and half orange and dannon probiotic. Still hungry in the evening
12/4 dinner - little bit of chole + dal (lot) + bhartha with peas(less peas) - three rotis. Then hawaiin papaya (1/2) . Little bit of lauki kheer. Then yogi tea

12/3 bowel movement was pretty good. Woke up with a fullness in the rectum. Was ready to go by the time lime water was prepared
12/4 just like 12/3. Tried best to make use of the biofeedback training
Hope zelnorm continues to be effective.

Visit to Dr Varma

Went to Dr Varma for manometry testing. Found that the technician who was supposed to do the testing Susan is actually also the biofeedback specialist. Also she is the person Dr T will refer to if he thinks biofeedback is necessary. So she is gonna be my solution provider for quite some time.
Failed balloon explusion test again in manometry. This proved that there is at least one problem with the pelvic muscles - I squeeze involunatrily when I should relax.
Initially she said that the results of the manometry will be available in two weeks and that biofeedback can start only in January as she is going on a vacation. My task was to figure out how to survive until January. At 119 pounds and losing 2-3 pounds a week there isn't much space to manouvere.
We were in the parking lot when she called again and surprise scheduled for biofeedback beginning next Tuesday. In ten minutes got a call from smita saying biopsy is all clean and that I can proceed with defecography.
So suddenly the spectre of daily struggle in December disappeared.
The visit unfortunately upset the lunch time. Finally had lunch at 4 and dinner at 10.
Lunch was achari zuchini + yellow squash soup + 3 rotis
Dinner was the coconut milk (with bell pepper + zuchhini + squash) + zucchini left over form morning with 1 roti and small oranage +grapes + half cup milk
Breakfast was semolina + milk (as usual)

Susan also suggested using coconut milk for increasing weight. On more research, I confirmed that it is easily digestible and is acceptable for vata type.
So cocount is a new addition to the diet

12/2 lunch was same as dinner on 12/ -with 3 rotis.
12/2 bowel movement was not good but somehow I was hungry. The possible bad bowel movement was because of the schedule upset the previous day.