When my mysterious gastrointestinal symptoms first appeared and were at their very worst
|In 1989, after undergoing a series of tests and a trial bland diet, all prescribed by a gastroenterologist, I was given a diagnosis of irritable bowel syndrome, or IBS. Yet right away it occurred to me the doctor had simply settled on that conclusion because he had tried testing me for everything else—or at least everything he was equipped to test me for—and that was the only answer that remained to him, the only category into which all my symptoms would fit. That makes sense, right? Except the prognosis for it was essentially, "Learn to live with it.” And that just wouldn’t do. I had already tried living with it, and I could not. My symptoms, and my experiences, are difficult to put into words...but I'll do my best.
It actually started around 1986, when I was a junior or senior in college. What began as periodic feelings of gas pain which I simply attributed to stress became, by my first year of college, a cruel and constant indication that something had gone seriously wrong with my insides. Another symptom that plagued me constantly was the unsettling sensation that felt literally as if some large, wormlike creature was crawling around in my intestines. This sensation might have been caused by a combination of trapped gas and intestinal contractions, but it never seemed to move in one direction (i.e., outward) or lead to a feeling of relief (i.e., the ability to pass the trapped gas).
Another distressing symptom that began during college and did not dissipate for several years—actually, this would eventually be my first (and only) symptom to subside for many years to come—began with a feeling of pressure in my upper gut, like I had just eaten more food than my stomach could contain. In fact, that feeling of fullness was also nearly constant. Even if I skipped a meal or two, I still felt full all day, every day. But I knew I still needed to at least try to satisfy my body’s need for nourishment, so I continued to eat at regular times, simply by eating when everybody else did (since, in the absence of hunger, that cue seemed to serve well as my second-most reliable guide). Inevitably, afterward, instead of feeling merely full, I then walked away from the table feeling too-full. Although the pressure in my upper gastrointestinal tract was ceaseless, it wasn’t exactly painful; it would more aptly be described as extremely uncomfortable. Imagine eating several slices of bread and drinking about a half-gallon of water and then doing fifty sit-ups. Well, unlike the feeling that something painful was “trapped” in my lower gut, what was in my upper gut didn’t stay put. Rather, any time I would even slightly increase the internal pressure by, say, bending over my sink to spit after brushing my teeth, or bending over to tie my shoe—or, indeed, trying to sit up—my undigested food and fluid would pour forth from me like milk from a cow’s massaged udder. I wasn’t vomiting, mind you. There was no taste or scent of bile—in fact, the food tasted much the same on its way out as it did coming in (although, as you can imagine, that didn’t make the regurgitation any more pleasant for me), and my insides didn’t need to contract to expel the fluid. It simply appeared that there was nothing holding it back, when the slightest bit of internal pressure was applied, from flowing out through the same passage by which I had taken it in. I later learned that this symptom is termed reflux, and it is blamed on a weak esophageal sphincter, the involuntary musculoskeletal tissue that normally closes after you swallow your food and drink liquids.
These symptoms alone were disturbing to me, to say the least. In addition to my worry over my physical symptoms—not to mention the stress of trying to cope with my first-year engineering classes at Santa Clara University—I found myself repeatedly frustrated and discouraged by the lack of knowledge and understanding I encountered in the medical community. While some care providers truly did appear to have my best interests at heart, I encountered a few others who either responded indifferently to my complaints or, in at least one case, who told me outright that all my suffering was basically a figment of my overactive and neurotic imagination. The particular doctor to which I am referring—unfortunately, the first physician I sought out to help me—said, with a clear lack of patience, “You worry too much. And you should start eating more fiber.” I found these suggestions to be useless and ludicrous; I had already upped my fiber intake to around 40 grams a day, which, to my natural concern, had already begun to worsen my problems by making me lose control of my bowels at very inconvenient times. (Which begs the question: When is it ever a convenient time to lose control of one’s bowels?)
Sometimes the pain that never really left me would cross an invisible threshold and overwhelm me, even making me double over. Although these episodes were certainly not convenient for me, either, at least they would generally occur when I was in or near my dorm room, so I was able to make use of my nearby bed and just crawl in it and lie there, either passing gas as often as my insides would allow, or making frequent trips to the bathroom down the hall (or both), and try to rest until the pain had subsided enough to allow me to resume my day.
My physical appearance began to change, too. Prior to my sophomore year in high school, I had taken to weight-lifting at the suggestion of the football coach. When I discovered that my efforts to satisfy my coach’s wishes and condition my muscles for sports also drew some attention from girls, I was hooked. Quite literally. Perhaps one way to describe my condition is that I was addicted to weight-lifting. Much later in life I learned about something called “Adonis syndrome”, which (at one time, at least) was considered to be a masculine equivalent of the more prevalently feminine tendency toward anorexia nervosa. Those who exhibited Adonis syndrome would become obsessed with refining their muscular appearance, to the detriment of their relationships and other healthy outlets in their lives. To put it succinctly, having a notably muscular physique with little to no visible fat was central to my self-image. But that self-image for which I had striven so hard the previous three years disintegrated before my eyes within the first month after I arrived to live on the SCU campus. Not only did my arms and shoulders and chest shrink, but my abdomen grew. Instead of the V-shape so may bodybuilders covet, I took on a pear-like shape. And I felt powerless to do anything about it. I couldn’t comprehend why, although I continued working out as strenuously as I had before, I was suddenly losing weight and grew weaker and less well-defined. It seemed my body had been possessed by the blob. Looking back, as I am able to do now with a more measured and insightful point of view, my diet probably didn’t help the situation; it may have even helped to perpetuate things to some degree. Although I already created a well-developed and lean physique by the summer of 1987, I was determined, while living on my own at college, not only to avoid the freshman weight gain—also known as the “freshman fifteen”—which I occasionally overheard during mealtime discussions among college females, but to get even more “ripped”. Yet, due to my lack of understanding of proper nutrition and the critically distinct dietary needs of highly active people as compared to mostly sedentary individuals, I made some rather poorly-timed changes to my diet. My plan was simply to increase my intake of protein while dramatically decreasing my intake of both carbohydrates and fats. I have already described the unfortunate consequences of these changes in terms of my physical appearance, which, in concert with my disturbing lack of hunger and all my gastrointestinal symptoms, which, altogether, further dissuaded me from getting enough to eat, which, in turn, further contributed to the detestable changes I witnessed undoing my years of body sculpting.
Finally, my sophomore year of college, when I was living in an off-campus dorm that looked much like the run-down motel in the original Karate Kid movie (but without the swimming pool), it all became too much for me to bear, and the inadequate coping skills available to me just completely broke down. One morning, following a string of increasingly sleepless nights, I was more unhappy than usual because a student staying a few doors down from me had taken and completely consumed my last box of cereal. (I feel a word of explanation might be helpful here. The most effective strategy I had settled upon for encouraging myself to eat was to find things that were both healthy and sweet-tasting. For these reasons, my favorite meal consisted of sweetened, whole grain cereals. The cereal box in question was my favorite brand of granola. It was all the food I had left in my room, and the only thing that sounded remotely appealing to me.) This full-time student and part-time cereal thief happened to be much larger than me, so I was uncertain as to how I should confront him. But I knocked on his door, he let me in, and as he lay in bed, a trace of a lazily bemused smile playing on his face, I did my best to express my anger at his actions. Since his response was not to my satisfaction, i.e., he didn’t jump out of bed and run to the store to buy me a new box of cereal, I had to take matters into my own hands. I walked to the store myself. On the way, I stopped at the school cafeteria to vent my frustrations on my boss. “I quit!” I told him. In my growing anger and paranoid delusion, I even believed he had recently placed a jukebox in the dining area and was playing the Righteous Brothers’ song, “You’ve Lost That Lovin’ Feeling,” solely for me. As he uttered an astonished protest, I pushed him against the jukebox, turned to leave, and headed for Safeway. By the time I reached the Safeway parking lot, my insides were boiling, with a mixture of anger and frustration, humility, the by-then familiar but no less unsettling gastrointestinal manifestations of my still undiagnosed condition, and my utterly exasperating lack of understanding and uncertainty about what the hell was wrong with me. None of my attempts thus far at expressing and releasing this mixture of feelings seemed to have had any effect. I spied a nearby bottle on the pavement. Without another thought, I picked up the bottle and threw it as hard as I could. Then I approached the place I had seen and heard it shatter, I picked up one of the larger shards, and closed my right fist around it. I felt it pierce my skin and cut into the flesh and tissue at the base of my thumb and watched my blood commence dripping rapidly down and onto the pavement. A witness to all of this shouted out from his car window, “You’re crazy, man! I’m gonna call the cops!”
I tried to respond by telling him that I was not crazy (only frustrated) and to explain to him that I was now calm and just wanted to pick up the shards of glass that remained on the pavement due to my unreasonable behavior and, further, that I did not wish to actually harm nor pose a danger to anyone, but before I could even begin attempting to verbalize all of this, the justifiably concerned stranger had driven away. After that, I did the only thing I could think to do. I returned to my dorm room to wrap my heavily bleeding thumb in a wad of toilet tissue. Wearing this makeshift bandage, I strode into Safeway and purchased my favorite cereal, the absence of which seemed to be the root cause of all that had gone wrong with my day thus far. (Actually, the actions of that student I knew to be responsible for my missing cereal may have played a more critical role in the unbalancing of my morning than I realized at the time, but I will explain that in more detail later.) As I exited the automatic doors, I turned to see I had left drops of blood leading all the way back to the cereal aisle. Once I was back in the relative security and quiet of my dorm room, I ate some of my cereal and promptly drifted off to sleep.
Some undefined period of time later, I gradually and reluctantly returned to a state of wakefulness as a loud knocking resounded on my door. I uttered a feeble protest that I was sleeping, but the knocking persisted, so I begrudgingly got up to find out what was so urgent that I was forced to get out of bed to address it. At first I did not open the door but asked who it was. “The police,” I was told. “You need to open the door and talk to us.”
“Why?” I asked.
“We want to help you.”
“You don’t really care about me.”
“Yes, we want to help you, but we need you to open the door so we can talk.”
So I submitted to their demands, and for my efforts I was rewarded with a routine handcuffing, an escort to the back seat of the squad car, and a ride to the ER where I remained cuffed to a hospital gurney until the cut on my thumb could be stitched up, and then transported to the nearest psychiatric hospital, Good Samaritan in San Jose.