1) No stress about the shots - you can always catch up on these, so there's really not a huge rush on that. Many people delay vaccinating their children for lots of different reasons, so a few weeks or months of delay is really not an emergency of any sort.
2) Be glad that Dr. Chitkara refused to treat your kids - it sounded like he wasn't addressing your concerns in the way you felt was best for your babies. A good doctor wouldn't get all defensive and cocky at the mere question of whether there are other possible approaches to treatment.
3) Bryan (your fiance, right?) is really asking smart questions: "why can't we find out what the problem is and then treat the problem... not the symptoms?" So, so important.
4) Look at diet. Constipation at that age is usually a poor reaction to something your child is eating or drinking. I personally would avoid the following foods until my child's stool softened up to where normal, painless pooping returned:
- cow's milk products can really constipate some children (so milk, sour cream, cheese, ice cream, yogurt, butter)
- applesauce
- most bread, crackers, cookies, white rice, etc. - especially anything refined (whole grains are better than refined)
- bananas (if she's eating a lot of these)
And I'd increase these in her diet:
- water (very important to be hydrated enough)
- vegetables like leafy greens (broccoli, spinach, swiss chard, celery, etc.)
- fresh fruits (peaches, pears, mangos, citrus)
- dried fruits (raisins, prunes, apricots)
- prune or peach or grape juice (100% juice)
5) Help her get comfortable, provide pain relief. You say, "Takes her like 45 mins sometimes longer maybe even hours and she just screams." Your poor little girl sounds like she's in a lot of pain! When this happens, have you tried warm baths that come up to just above her belly button, which can help with the discomfort? I'm *not* encouraging long term pooping in the bath, but I think until she can poop comfortably, it's important to help get her as comfortable as possible. Perhaps supporting her during pushing/pooping by holding her in a classic baby pottying position like we see here:
http://www.diaperfreebaby.org/pottypositions.htm?&MMN...
....
I hope some of those suggestions help, and I hope you are able to find a pediatrician who is respectful of the patients AND their parents in his/her practice. It's such a gift to have a doctor who willingly and pleasantly answers questions and concerns, who considers more than 1 way to treat a problem, who will address the *root cause* instead of just throwing meds at something to address only the symptoms and not fix the actual issue at hand.
As a parent, I've found that I really need to educate myself and be my babies' best advocate. Our experience was that our newborn son was incredibly fussy, seemed really uncomfortable, wouldn't sleep for more than 20 minutes at a time, and was gassy. Our pediatrician immediately suggested possible reflux and offered a prescription of Zantac... I was shocked and not comfortable with prescribing meds to my 4 week old, so I asked if he could be reacting to something in my breastmilk, like cow's milk products or soy or eggs. Our ped then said, "Sure, you can try eliminating cow's milk, cheese, yogurt, butter, sour cream, etc.. It's certainly possible that he's reacting to something you're eating." And lo and behold, within 5-7 days of eliminating cow's milk products, my son became a happy happy baby, slept very well, and was comfortable and calm. If I'd just given him Zantac, it may have masked the symptoms of the *real* problem which was that he shouldn't have been getting ANY cow's milk proteins (either via breastmilk or by a formula) because he was sensitive or allergic. So continue to trust your parenting instincts, just as you have been - this should serve you well. :)
I applaud you for digging deeper for solutions to your daughter's constiplation and for expecting more from your pediatrician. Best of luck w/ the pooping issues, and congratulations on expanding your family to 4!