I have spent several nights in emergency rooms the last few days. My faith in the ability of the medical system to diagnose serious medical problems is rapidly declining.
UPDATE: Progress. It does appear to be an ulcer; at least, Carafate, which coats the stomach lining, protecting it from acid, is allowing her to do well enough to sleep. My guess is that there was a complex interaction here:
1. Severe nausea and stomach pain almost entirely at night. Reason? Stomach empties out, and acid attacks the lining.
2. Once nausea and pain are part of the equation, and keep happening, stress causes more stomach acid to be produced, aggravating problem 1.
3. Nausea makes food unattractive. So the stomach is now empty most of the time. Loop back to problem 1.
4. The anti-nausea medicine they gave her on E/R trip 1, Zofran, seemed to cause a panic attack. And what does panic cause? Stress. Loop back to 1.
5. Nausea and pain prevent sleep. Concern about not being to resume classes on Wednesday, and the uncertainty as to what was really the cause, causes stress. Loop back to 1.
6. A poor choice of food once she was really hungry caused the stomach to rebel, causing nausea and pain that were probably not related to the ulcer. More stress; return to 1.
I feel so bad for her. At least there is a three day weekend so that I stay home and nurse her back to health.
I don't mean this as criticism of our family physician or the four emergency room doctors. This was a complex constellation of symptoms and feedback loops. I am not sure any of them figured it out in full; I was only able to see the feedback loop in its broad form because I know my wife so well.