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Hi Dr Punj, I Have An Interesting Update For You!

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Posted on Wed, 27 Nov 2019
Question: Hi Dr Punj,

I have an interesting update for you!

Several days ago, I was in the store, looking for a fruit juice to buy for a beverage.

Normally I drink organic apple or orange juice. However, I saw something on the shelf that stood out--this was TART CHERRY JUICE.

I decided to purchase this.

. . .

Later that evening, while out with someone, I opened it up and drank about half of the bottle.

What happened next was remarkable. I started getting withdrawal symptoms so pronounced and unprecedented, that for the first time in three years, the following symptoms reversed:

- For the first time, my respiratory rate was not below 12 breaths per minute at full rest. I have experienced quick breath, even while doing nothing, that is back at the range of normal human being.

- For the first time, the reflex to pull hands away from scalding hot water or burning surfaces has re-integrated into my circuitry.

How could this be happening now, and why?

This happened again, even more pronounced, two days later, when I drank some more of the tart cherry juice. Now I was sure: this juice has something to do with it.

According to the research I have done on HE, respiration, and all that, I have accurately concluded that the underlying issue at hand is that of (1) excessive GABAergic neurotransmission, and (2) deficient serotonergic neurotransmission, throughout the central nervous system. Therefore, any rapid change or reversal MUST be as the result of either GABA blockage, or an increase in serotonergic.

I have been using theobromine from chocolate and caffeine from coffee as my main GABA blockers. But besides supplementing L-Tryptophan on occasion, I had no other direct way of increasing serotonergic tone within the system.

. . .

I googled about tart cherry juice.

And what I found, has absolutely shocked me.

As it turns out, tart cherry juice not only contains serotonin--but additionally, it contains specific compounds, unique to the tart cherry, that effectively disable the intracellular breakdown and metabolism of L-Tryptophan--with the resulting increase of L-Tryptohan contributing to a massive increase in both serotonergic tone as well as melatonin levels in the body!

These effect are so pronounced, that studies found that patients given 2 servings of tart cherry slept ONE HOUR EXTRA as a result of the increase of serotonin & melatonin neurotransmitters tone that takes place. (In contrast, the "best" pharmaceuticals available for sleep--Ambien--only adds 12 extra minutes of sleep per night on average for the typical user.)

Tart Cherry Juice is a POTENT serotonergic agent! This increase in serotonergic tone, to my HE and bradypneatic system, caused nearly instantaneous reversals that have lasted for several days already.

This is incredible. Inflammation has returned even more greatly, as for the first time since the poisoning, my abdomen became very swollen and distended as a result of re-enabled inflammatory processes, which now can react to the internal damage by producing the typical manifestations of dissension and pain that were neurally blocked prior to this.

Just wanted to share this update! What do you think?
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Follow up: Dr. Vaishalee Punj (0 minute later)
Hi Dr Punj,

I have an interesting update for you!

Several days ago, I was in the store, looking for a fruit juice to buy for a beverage.

Normally I drink organic apple or orange juice. However, I saw something on the shelf that stood out--this was TART CHERRY JUICE.

I decided to purchase this.

. . .

Later that evening, while out with someone, I opened it up and drank about half of the bottle.

What happened next was remarkable. I started getting withdrawal symptoms so pronounced and unprecedented, that for the first time in three years, the following symptoms reversed:

- For the first time, my respiratory rate was not below 12 breaths per minute at full rest. I have experienced quick breath, even while doing nothing, that is back at the range of normal human being.

- For the first time, the reflex to pull hands away from scalding hot water or burning surfaces has re-integrated into my circuitry.

How could this be happening now, and why?

This happened again, even more pronounced, two days later, when I drank some more of the tart cherry juice. Now I was sure: this juice has something to do with it.

According to the research I have done on HE, respiration, and all that, I have accurately concluded that the underlying issue at hand is that of (1) excessive GABAergic neurotransmission, and (2) deficient serotonergic neurotransmission, throughout the central nervous system. Therefore, any rapid change or reversal MUST be as the result of either GABA blockage, or an increase in serotonergic.

I have been using theobromine from chocolate and caffeine from coffee as my main GABA blockers. But besides supplementing L-Tryptophan on occasion, I had no other direct way of increasing serotonergic tone within the system.

. . .

I googled about tart cherry juice.

And what I found, has absolutely shocked me.

As it turns out, tart cherry juice not only contains serotonin--but additionally, it contains specific compounds, unique to the tart cherry, that effectively disable the intracellular breakdown and metabolism of L-Tryptophan--with the resulting increase of L-Tryptohan contributing to a massive increase in both serotonergic tone as well as melatonin levels in the body!

These effect are so pronounced, that studies found that patients given 2 servings of tart cherry slept ONE HOUR EXTRA as a result of the increase of serotonin & melatonin neurotransmitters tone that takes place. (In contrast, the "best" pharmaceuticals available for sleep--Ambien--only adds 12 extra minutes of sleep per night on average for the typical user.)

Tart Cherry Juice is a POTENT serotonergic agent! This increase in serotonergic tone, to my HE and bradypneatic system, caused nearly instantaneous reversals that have lasted for several days already.

This is incredible. Inflammation has returned even more greatly, as for the first time since the poisoning, my abdomen became very swollen and distended as a result of re-enabled inflammatory processes, which now can react to the internal damage by producing the typical manifestations of dissension and pain that were neurally blocked prior to this.

Just wanted to share this update! What do you think?
doctor
Answered by Dr. Vaishalee Punj (25 hours later)
Brief Answer:
Yes tart cherry is backed by some research

Detailed Answer:
Hi again

Tart cherry is backed by some research which shows its antioxidant and anti-inflammatory contents. Its shown to increase recovery after exercise. It also decreases markers of stress in body. So it is said that it aids in recovery.
Possibly that worked for you.

Increased tryptophan availability by tart cherry is said to result in its efficacy in insomnia. It may increase sleep time and sleep efficacy.

Dr Vaishalee
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
doctor
Answered by Dr. Vaishalee Punj (0 minute later)
Brief Answer:
Yes tart cherry is backed by some research

Detailed Answer:
Hi again

Tart cherry is backed by some research which shows its antioxidant and anti-inflammatory contents. Its shown to increase recovery after exercise. It also decreases markers of stress in body. So it is said that it aids in recovery.
Possibly that worked for you.

Increased tryptophan availability by tart cherry is said to result in its efficacy in insomnia. It may increase sleep time and sleep efficacy.

Dr Vaishalee
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Vaishalee Punj (46 hours later)
Doctor,

Much of my preoccupations still involve my wanting to obtain proof for intestinal perforations. I may approach an MRI center this week with a recently-obtained order, to try to work out a special set of tests.

I am also seeing a gastroenterologist/hepatologist today, to try to secure a diagnosis for HE! Please wish me luck.

Once I can get the right diagnosis, I may re-attempt natural extraction methods such as sauna sweating, and using oils on the skin. Even things such as hot baths, tried recently, seem to bring about moderate (though temporary) retraction of symptoms.

I always appreciate your input doctor! I just realized some of the things you have told me in previous messages have correlated with HE as well; I have updated my reference table included in the original ammonia/HE docs that you read--the list now contains TWENTY supporting pieces of evidence for HE.
default
Follow up: Dr. Vaishalee Punj (0 minute later)
Doctor,

Much of my preoccupations still involve my wanting to obtain proof for intestinal perforations. I may approach an MRI center this week with a recently-obtained order, to try to work out a special set of tests.

I am also seeing a gastroenterologist/hepatologist today, to try to secure a diagnosis for HE! Please wish me luck.

Once I can get the right diagnosis, I may re-attempt natural extraction methods such as sauna sweating, and using oils on the skin. Even things such as hot baths, tried recently, seem to bring about moderate (though temporary) retraction of symptoms.

I always appreciate your input doctor! I just realized some of the things you have told me in previous messages have correlated with HE as well; I have updated my reference table included in the original ammonia/HE docs that you read--the list now contains TWENTY supporting pieces of evidence for HE.
doctor
Answered by Dr. Vaishalee Punj (19 hours later)
Brief Answer:
Yes we can get more tests done

Detailed Answer:
Hi again

Yes we can get more tests done. I am quite sure that we are dealing with chronic HE.

However I doubt about presence of intestinal perforations.
Let's see what shows up on tests. I hope that the tests be minimally invasive to avoid causing more damage. Now whatever shows on tests, we should trust that too.

Dr Vaishalee
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
doctor
Answered by Dr. Vaishalee Punj (0 minute later)
Brief Answer:
Yes we can get more tests done

Detailed Answer:
Hi again

Yes we can get more tests done. I am quite sure that we are dealing with chronic HE.

However I doubt about presence of intestinal perforations.
Let's see what shows up on tests. I hope that the tests be minimally invasive to avoid causing more damage. Now whatever shows on tests, we should trust that too.

Dr Vaishalee
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Vaishalee Punj (2 days later)
Doctor--

I was just diagnosed with bradypnea, and also, with metabolic alkalosis, by my pulmonologist.

Metabolic alkalosis is another factor associated with HE and liver failure.

. . .

I will try to expand on my case and provide more evidence to subsequent doctors, which I will be seeing soon.

. . .

As for the intestinal perforations. This is one of about two points among my presentation that most people find the hardest to understand. But I will point this out: I am *more* certain of intestinal perforations that I am of even my own name. I am more certain of this than of anything else, it is the most evident, apparent dysfunction among the set of various dysfunctions that I have been dealing with.

I will need to go back and sort out a way to present these facts more clearly, so that this is absolutely undoubtable in the mind of anyone who receives all the facts and apparent circumstances of the case. If I have any audience of persons that do not believe intestinal perforations are likely, it is not due to the fact that it is not in fact the case--it is only due to the fact that I have not done sufficient job of conveying the fuller set of critical details that show the truth.

I may likely come back around with a ruler presentation--possibly one that I may do an audio or video recording of, as I am finding it easier for me to be more effective at doing this than by writing alone.

For now, a long story short:

NEARLY EVERY TIME I CONSUME CHILLED FLUIDS, I FEEL THE FLUIDS POOLING UP AT MY PELVIC FLOOR, AND ALSO TRACING DOWN MY INNER THIGHS, AROUND THE KNEES, AND POOLING UP AT THE FEET.

WHEN I DRINK JUICES THAT BEAR A SPECIFIC QUALITY SUCH AS CITRUS OR ANY OTHER DISTINCT "ZING," THIS, TOO, IS FELT DIRECTLY BENEATH THE FLESH AS IT TRACES DOWN AND POOLS AT THE FEET.

ONE EVENING, WHEN EATING CHICKEN COVERED WITH A GRAVY THAT HAD MANY HOT SPICES, AND WAS VERY SPICY, ABOUT 10 MINUTES AFTER CONSUMING THIS, MY SCROTAL SKIN FELT LIKE IT WAS BURNING ON FIRE. A COUPLE MINUTES AFTER THAT, ThE SAME WAS FELT AT THE BOTTOM FLESH OF MY FOOT.

AND, LASTLY FOR NOW...

...One day, I drank pure blueberry juice--which is one of the most acidic juices to drink, as the acids are strong within the blueberry.

An entire bottle of this juice was consumed, with the acidic sting potent in the juice. This, normally contained within gastrointestinal tissue, is safe, as GI tissues are designed to withstand pH extremes.

But anything outside of the GI system is NOT designed to do this.

A few minutes after consuming the blueberry juice, I felt was seemed like BURNING ACID that someone INJECTED inbetween my toes and foot bones.

AND A FEW MINUTES AFTER THAT? AN ENTIRE BOTTOM SECTION OF MY FOOT BECAME NUMB, WITH NEUROPATHY HAVING SET IN FROM FRUIT-JUICE-ACID-INDUCED NERVE-CELL DAMAGE.

THIS NUMBNESS CONTINUES TILL THIS VERY DAY, WHERE I CANNOT FEEL PRESSURE THERE, INCLUDING SHARP STRONG POKES.

This is not a foot problem. It is a torn intestine problem.

. . .

The section above is what I will copy and paste to show doctors, to make clear that there is no mistake or oversight. I really hope that they can wake up.

Thanks for your continued support. What else can I do to make clearer the truth to others which I am already presented to? It is not a "relative" truth--it is an absolute one, where recognition or either prompt or delayed nature can make the difference of either successful intervention or continued neglect, oversight and damage.

After reading the above, how does this change your perspective and assumptions about the intestinal perforations? What other questions do you have for me, if you were to personally investigate more deeply these phenomena and experienced symptoms in order to assess for reliability of the suspicion of assumption that we are truly dealing with intestinal perforation?
default
Follow up: Dr. Vaishalee Punj (0 minute later)
Doctor--

I was just diagnosed with bradypnea, and also, with metabolic alkalosis, by my pulmonologist.

Metabolic alkalosis is another factor associated with HE and liver failure.

. . .

I will try to expand on my case and provide more evidence to subsequent doctors, which I will be seeing soon.

. . .

As for the intestinal perforations. This is one of about two points among my presentation that most people find the hardest to understand. But I will point this out: I am *more* certain of intestinal perforations that I am of even my own name. I am more certain of this than of anything else, it is the most evident, apparent dysfunction among the set of various dysfunctions that I have been dealing with.

I will need to go back and sort out a way to present these facts more clearly, so that this is absolutely undoubtable in the mind of anyone who receives all the facts and apparent circumstances of the case. If I have any audience of persons that do not believe intestinal perforations are likely, it is not due to the fact that it is not in fact the case--it is only due to the fact that I have not done sufficient job of conveying the fuller set of critical details that show the truth.

I may likely come back around with a ruler presentation--possibly one that I may do an audio or video recording of, as I am finding it easier for me to be more effective at doing this than by writing alone.

For now, a long story short:

NEARLY EVERY TIME I CONSUME CHILLED FLUIDS, I FEEL THE FLUIDS POOLING UP AT MY PELVIC FLOOR, AND ALSO TRACING DOWN MY INNER THIGHS, AROUND THE KNEES, AND POOLING UP AT THE FEET.

WHEN I DRINK JUICES THAT BEAR A SPECIFIC QUALITY SUCH AS CITRUS OR ANY OTHER DISTINCT "ZING," THIS, TOO, IS FELT DIRECTLY BENEATH THE FLESH AS IT TRACES DOWN AND POOLS AT THE FEET.

ONE EVENING, WHEN EATING CHICKEN COVERED WITH A GRAVY THAT HAD MANY HOT SPICES, AND WAS VERY SPICY, ABOUT 10 MINUTES AFTER CONSUMING THIS, MY SCROTAL SKIN FELT LIKE IT WAS BURNING ON FIRE. A COUPLE MINUTES AFTER THAT, ThE SAME WAS FELT AT THE BOTTOM FLESH OF MY FOOT.

AND, LASTLY FOR NOW...

...One day, I drank pure blueberry juice--which is one of the most acidic juices to drink, as the acids are strong within the blueberry.

An entire bottle of this juice was consumed, with the acidic sting potent in the juice. This, normally contained within gastrointestinal tissue, is safe, as GI tissues are designed to withstand pH extremes.

But anything outside of the GI system is NOT designed to do this.

A few minutes after consuming the blueberry juice, I felt was seemed like BURNING ACID that someone INJECTED inbetween my toes and foot bones.

AND A FEW MINUTES AFTER THAT? AN ENTIRE BOTTOM SECTION OF MY FOOT BECAME NUMB, WITH NEUROPATHY HAVING SET IN FROM FRUIT-JUICE-ACID-INDUCED NERVE-CELL DAMAGE.

THIS NUMBNESS CONTINUES TILL THIS VERY DAY, WHERE I CANNOT FEEL PRESSURE THERE, INCLUDING SHARP STRONG POKES.

This is not a foot problem. It is a torn intestine problem.

. . .

The section above is what I will copy and paste to show doctors, to make clear that there is no mistake or oversight. I really hope that they can wake up.

Thanks for your continued support. What else can I do to make clearer the truth to others which I am already presented to? It is not a "relative" truth--it is an absolute one, where recognition or either prompt or delayed nature can make the difference of either successful intervention or continued neglect, oversight and damage.

After reading the above, how does this change your perspective and assumptions about the intestinal perforations? What other questions do you have for me, if you were to personally investigate more deeply these phenomena and experienced symptoms in order to assess for reliability of the suspicion of assumption that we are truly dealing with intestinal perforation?
default
Follow up: Dr. Vaishalee Punj (6 minutes later)
Just to be clear, about the chicken with hot spices:

This is scrotal skin--which I am literally holding *inbetween my fingers*--that is felt burning locally at the scrotal skin between my fingers. It is not some neural false reference sensation, or any other such thing.
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Follow up: Dr. Vaishalee Punj (0 minute later)
Just to be clear, about the chicken with hot spices:

This is scrotal skin--which I am literally holding *inbetween my fingers*--that is felt burning locally at the scrotal skin between my fingers. It is not some neural false reference sensation, or any other such thing.
doctor
Answered by Dr. Vaishalee Punj (1 hour later)
Brief Answer:
I do believe whatever you are experiencing

Detailed Answer:
Hi again

I would answer your specific questions here
What else can I do to make clearer the truth to others which I am already presented to?
A CT scan of abdomen and pelvis is mandatory, most sensitive to diagnose the condition among the given radiology methods. Ultrasound of legs and scrotum may provide some evidence. It is quite possible that you get a small tear for some time which heals spontaneously. In such a case we may watch for complications (and not the tear itself) such as an abscess or a bowel obstruction. Even these complications can be visualized on a CT scan.
Since you have weak skin, I think you maybe having diverticulosis. It can be checked with a colonoscopy.
After reading the above, how does this change your perspective and assumptions about the intestinal perforations?
I usually like to believe the patient so that I do not miss a diagnosis. However it should be confirmed with investigations.
What other questions do you have for me, if you were to personally investigate more deeply these phenomena and experienced symptoms in order to assess for reliability of the suspicion of assumption that we are truly dealing with intestinal perforation?
I would ask details about your symptoms including the length of time, prior episodes, recent procedures such as colonoscopy or episodes of infections. Of course drug abuse can cause diverticulosis, so a new doctor maybe made aware about it.

Since you maynot tolerate a surgery well and your perforations seem controlled, the fluid collections that you experience can be drained by a surgeon with the help of interventional radiology guided draining.
If a big perforation is there, then laparotomy is needed. Surgeon is the best person to deal with this. Other specialists will not take this case in their hands. So you should approach the right specialist.

Dr Vaishalee
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
doctor
Answered by Dr. Vaishalee Punj (0 minute later)
Brief Answer:
I do believe whatever you are experiencing

Detailed Answer:
Hi again

I would answer your specific questions here
What else can I do to make clearer the truth to others which I am already presented to?
A CT scan of abdomen and pelvis is mandatory, most sensitive to diagnose the condition among the given radiology methods. Ultrasound of legs and scrotum may provide some evidence. It is quite possible that you get a small tear for some time which heals spontaneously. In such a case we may watch for complications (and not the tear itself) such as an abscess or a bowel obstruction. Even these complications can be visualized on a CT scan.
Since you have weak skin, I think you maybe having diverticulosis. It can be checked with a colonoscopy.
After reading the above, how does this change your perspective and assumptions about the intestinal perforations?
I usually like to believe the patient so that I do not miss a diagnosis. However it should be confirmed with investigations.
What other questions do you have for me, if you were to personally investigate more deeply these phenomena and experienced symptoms in order to assess for reliability of the suspicion of assumption that we are truly dealing with intestinal perforation?
I would ask details about your symptoms including the length of time, prior episodes, recent procedures such as colonoscopy or episodes of infections. Of course drug abuse can cause diverticulosis, so a new doctor maybe made aware about it.

Since you maynot tolerate a surgery well and your perforations seem controlled, the fluid collections that you experience can be drained by a surgeon with the help of interventional radiology guided draining.
If a big perforation is there, then laparotomy is needed. Surgeon is the best person to deal with this. Other specialists will not take this case in their hands. So you should approach the right specialist.

Dr Vaishalee
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Vaishalee Punj (1 hour later)
Doctor,

"It is quite possible that you get a small tear for some time which heals spontaneously."

-Yes, this is precisely the case. I have experienced this reliably. It has been sealing and retearing.

As for a CT scan, they are high in radiation, and can only detect macroscopically-visible manifestations. Because I do not inflame well, there is little to nothing to see.

My best idea is this: an MRI using pineapple juice as the oral contrast agent. This will show whether any of the juice leaves the intestine, which ought to be seen on the MRI clearly pooling up in or flowing through extraintestinal spaces.

"I would ask details about your symptoms including the length of time, prior episodes, recent procedures such as colonoscopy or episodes of infections."

- Most of the details have been included in the C-section youve read, as it is an issue related to the Phenibut issue by means of downstream complication. However, I realize I may need to be clearer on the various points, and reassemble the information so that it is clear to the reader.

"The fluid collections that you experience can be drained by a surgeon with the help of interventional radiology guided draining."

-Somewhat surprisingly, there is apparently little to no need. Between the open exposure to intestinal villa during point of contact, or peritoneal space overall, within a few hours there is uptake of the fluids, presumably mostly in the torso via peritoneal absorption.

I have no idea what happens to the fluids in the legs. I like to think it somehow evens out when I lay down. There is no evident swelling or pooling up of fluids seen from the outside, so the internal pressure may be enough to keep most of the fluids up, or at least cycling thru via diffusion/osmosis across volumes, membranes.

When there is water injected directly under the skin into fatty tissue, the bubble dissipates eventually. This seems to suggest that the cellular network within tissues is reasonably effective enough to absorb fluids from around the environment.
default
Follow up: Dr. Vaishalee Punj (0 minute later)
Doctor,

"It is quite possible that you get a small tear for some time which heals spontaneously."

-Yes, this is precisely the case. I have experienced this reliably. It has been sealing and retearing.

As for a CT scan, they are high in radiation, and can only detect macroscopically-visible manifestations. Because I do not inflame well, there is little to nothing to see.

My best idea is this: an MRI using pineapple juice as the oral contrast agent. This will show whether any of the juice leaves the intestine, which ought to be seen on the MRI clearly pooling up in or flowing through extraintestinal spaces.

"I would ask details about your symptoms including the length of time, prior episodes, recent procedures such as colonoscopy or episodes of infections."

- Most of the details have been included in the C-section youve read, as it is an issue related to the Phenibut issue by means of downstream complication. However, I realize I may need to be clearer on the various points, and reassemble the information so that it is clear to the reader.

"The fluid collections that you experience can be drained by a surgeon with the help of interventional radiology guided draining."

-Somewhat surprisingly, there is apparently little to no need. Between the open exposure to intestinal villa during point of contact, or peritoneal space overall, within a few hours there is uptake of the fluids, presumably mostly in the torso via peritoneal absorption.

I have no idea what happens to the fluids in the legs. I like to think it somehow evens out when I lay down. There is no evident swelling or pooling up of fluids seen from the outside, so the internal pressure may be enough to keep most of the fluids up, or at least cycling thru via diffusion/osmosis across volumes, membranes.

When there is water injected directly under the skin into fatty tissue, the bubble dissipates eventually. This seems to suggest that the cellular network within tissues is reasonably effective enough to absorb fluids from around the environment.
doctor
Answered by Dr. Vaishalee Punj (9 hours later)
Brief Answer:
Your body's physiology is doing a good job

Detailed Answer:
Hi

Exactly absorption of fluids happens when they accumulate within closed cavities like peritoneum. However too much of that can result in fiber formation.
Your body is doing a good job at cleaning up the mess of perforations. So I donot see a need for a surgeon to intervene. I mean what will a doctor do with an ailment that is being taken care by body's natural healing procedures.

You may proceed with an MRI if you are not satisfied with a CT. However I think in USA, they don't easily give appointment for an MRI. With CT, some damage maybe be visible to warrant an MRI.

I am travelling for 3 days, so I will be available for followups after Sunday.
Wish you good health till then.
Dr Vaishalee
Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
doctor
Answered by Dr. Vaishalee Punj (0 minute later)
Brief Answer:
Your body's physiology is doing a good job

Detailed Answer:
Hi

Exactly absorption of fluids happens when they accumulate within closed cavities like peritoneum. However too much of that can result in fiber formation.
Your body is doing a good job at cleaning up the mess of perforations. So I donot see a need for a surgeon to intervene. I mean what will a doctor do with an ailment that is being taken care by body's natural healing procedures.

You may proceed with an MRI if you are not satisfied with a CT. However I think in USA, they don't easily give appointment for an MRI. With CT, some damage maybe be visible to warrant an MRI.

I am travelling for 3 days, so I will be available for followups after Sunday.
Wish you good health till then.
Dr Vaishalee
Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
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Follow up: Dr. Vaishalee Punj (4 days later)
I am going to attempt either upright chest xrays, or the MRI pineapple juice tactic.

Please wish me luck!
default
Follow up: Dr. Vaishalee Punj (0 minute later)
I am going to attempt either upright chest xrays, or the MRI pineapple juice tactic.

Please wish me luck!
doctor
Answered by Dr. Vaishalee Punj (13 hours later)
Brief Answer:
Sure

Detailed Answer:
Good luck for both X ray and MRI appointments.

Dr Vaishalee
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
doctor
Answered by Dr. Vaishalee Punj (0 minute later)
Brief Answer:
Sure

Detailed Answer:
Good luck for both X ray and MRI appointments.

Dr Vaishalee
Note: For further follow up on related General & Family Physician Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Hi Dr Punj, I Have An Interesting Update For You!

Hi Dr Punj, I have an interesting update for you! Several days ago, I was in the store, looking for a fruit juice to buy for a beverage. Normally I drink organic apple or orange juice. However, I saw something on the shelf that stood out--this was TART CHERRY JUICE. I decided to purchase this. . . . Later that evening, while out with someone, I opened it up and drank about half of the bottle. What happened next was remarkable. I started getting withdrawal symptoms so pronounced and unprecedented, that for the first time in three years, the following symptoms reversed: - For the first time, my respiratory rate was not below 12 breaths per minute at full rest. I have experienced quick breath, even while doing nothing, that is back at the range of normal human being. - For the first time, the reflex to pull hands away from scalding hot water or burning surfaces has re-integrated into my circuitry. How could this be happening now, and why? This happened again, even more pronounced, two days later, when I drank some more of the tart cherry juice. Now I was sure: this juice has something to do with it. According to the research I have done on HE, respiration, and all that, I have accurately concluded that the underlying issue at hand is that of (1) excessive GABAergic neurotransmission, and (2) deficient serotonergic neurotransmission, throughout the central nervous system. Therefore, any rapid change or reversal MUST be as the result of either GABA blockage, or an increase in serotonergic. I have been using theobromine from chocolate and caffeine from coffee as my main GABA blockers. But besides supplementing L-Tryptophan on occasion, I had no other direct way of increasing serotonergic tone within the system. . . . I googled about tart cherry juice. And what I found, has absolutely shocked me. As it turns out, tart cherry juice not only contains serotonin--but additionally, it contains specific compounds, unique to the tart cherry, that effectively disable the intracellular breakdown and metabolism of L-Tryptophan--with the resulting increase of L-Tryptohan contributing to a massive increase in both serotonergic tone as well as melatonin levels in the body! These effect are so pronounced, that studies found that patients given 2 servings of tart cherry slept ONE HOUR EXTRA as a result of the increase of serotonin & melatonin neurotransmitters tone that takes place. (In contrast, the "best" pharmaceuticals available for sleep--Ambien--only adds 12 extra minutes of sleep per night on average for the typical user.) Tart Cherry Juice is a POTENT serotonergic agent! This increase in serotonergic tone, to my HE and bradypneatic system, caused nearly instantaneous reversals that have lasted for several days already. This is incredible. Inflammation has returned even more greatly, as for the first time since the poisoning, my abdomen became very swollen and distended as a result of re-enabled inflammatory processes, which now can react to the internal damage by producing the typical manifestations of dissension and pain that were neurally blocked prior to this. Just wanted to share this update! What do you think?