“The IBD Day”: Getting diagnosed as a college student

It was September 23, 2010. Fall Quarter of my third year at UCSD. I was really excited for the new academic year! I always get very enthusiastic at the start of a new quarter. (I do try to maintain that enthusiasm throughout the quarter, though admittedly, it slowly becomes tired enthusiasm!) The exposure to different courses, different instructors, and new material channels my excitement for learning and growing as a student – and in the most wholesome way – as a person. It remains an adventure that I continuously seek, open to the gifts and surprises of the future, regardless of any challenges they might bring. My motto has always been: Do. Not. Give. Up.

I remember that day very vividly. My younger sister, Z, and I have fondly coined it as “The IBD Day.” I remember what I wore and what I ate for breakfast. I remember placing my backpack in the living room soon after waking up and checking that all the essentials were in their respective places. The pencil pouch, the laptop, the notebooks, the charger, the water bottle and lunch, and the snacks to get through an eight-hour day. “I got it all covered,” I thought. Or so I believed. Most importantly, I remember how I felt that day. I woke up feeling a little nauseous and brushed it off as back-to-school nerves and anxiety. I was more lethargic and tired. I remember chiding myself, “Maybe you just didn’t get enough sleep? It’s just anxiety. Relax.”  Yet, my stomach felt different. There were painful pangs and it felt tender. Sore, even. But again, I dismissed it due to nerves. It was not going to ruin my first day of Fall Quarter. I was determined to have a great, fruitful day, and start the quarter strong.

I somewhat begrudgingly removed myself from my covers and got out of bed at 7 a.m. I started on my morning routine: brushing teeth, washing/cleansing/moisturizing skin, combing hair, while trying to ignore the pangs in my stomach. “Menstrual cramps?” I thought to myself. No, no, that’s wrong. It’s way too early. “What did I eat last night?” I realized I was combing my hair a bit too hard as I got lost in my thoughts.

“Hey, what do you want for breakfast?” My sister H interrupted my thoughts. She had just woken up as well – we shared a room. She was sitting in the middle of her bed as she usually does after waking up. Her brow furrowed, “What’s wrong?”

“Nothing,” I lied. “My stomach just hurts a bit,” I corrected myself. “Oh, maybe you’re hungry, you should eat something,” she insisted. That is my sister for you. She has a very mom-like persona. Anytime you are not feeling well, she has a follow-up question, or questions sometimes. “Well, have you eaten? What did you eat? See, there you go. You haven’t eaten anything!” H declared. She truly is the best.

“Alright,” I reassured myself, “Let’s try some food then!” Here is something important you need to know about Middle Eastern breakfast. It is, well, different from the traditional American breakfast cuisine. Breakfast is more savory than it is sweet (it can be sweet, don’t get me wrong, but most often it is savory). Pita bread is a major staple in the Middle Eastern diet. Pita bread is usually accompanied with some kind of cream cheese spread, walnuts, sliced tomatoes and Persian cucumbers, perhaps home-made mascarpone and jam (my mother is a connoisseur of jams – she will take any some-day old fruit and make it into a jam). And of course, black tea. Breakfast is not complete without tea. Ask any Iraqi, and they will vehemently affirm it.

Well, where does this story go? I proceeded to have breakfast and managed some small bites of pita bread with cream cheese. Couldn’t even touch my tea. Just mere minutes after eating, I felt bile rising in my throat and strong stomach cramps. But I so wanted to ignore it – it was my first day of Fall Quarter after all.

Oh, to be young and hopeful. All in all, great trait to have, right?! Such optimism. But in my case, sometimes over-optimism belies fears. I think many can relate to that as well.  My symptoms that day became increasingly frightening.  And as you can guess, they ultimately led to a diagnosis of inflammatory bowel disease.

At this point I am not going into the details of my IBD story, but here are some important ideas, skills and abilities that I’ve learned along the way. Each one has come from experiences that could be entire book chapters of their own. I hope you find some light in them as well.

  • Listening to my body. If you are bleeding from an orifice you are not supposed to be bleeding from – that should be a red flag! (no pun intended). It took me three weeks to build up the courage to see a doctor, but when I did, I was so relieved. Still scared, but at least I was able to share that fear.
  • Talking about poop with minimal discomfort. No one wants to talk about butts (well…), rectums, rectal bleeding, diarrhea, and any other crimson-faced topics. These are very embarrassing things to discuss — but only if you make them so. It can be uncomfortable, but everyone at one point in their life has had a bad episode of diarrhea or food poisoning and had to let a parent or other family member know what’s going on. So, to a certain extent, everyone has talked about their bowels! So, can we just have a friendly conversation about our bowels, please?
    On a more serious note, talking about my symptoms, openly and honestly, with my family and doctor led to better communication and understanding. Letting someone know when you are having a bad day is so incredibly important! I think it plays a pivotal role in mindfulness and positive mental wellbeing.
  • Asking questions unapologetically. If I can count the times I didn’t ask my doctor a question because I was afraid it might be deemed “stupid,” well, it could have probably paid my premium!
  • Learning to talk about my illness. Or even writing about it (I have been working on this piece for some time now!). I have always been a private person and talking about something so personal to me has felt somewhat invasive. I think my biggest fear stemmed from having my illness associated with my abilities. My lifestyle and physical capabilities certainly have changed from my pre-IBD days, but they do not define what I can accomplish. I am fatigued most days, I get sick easily, I have to make smart choices about eating habits during a flare, and my outings are based on finding the closest restroom. It is an adjustment. Not easy by far, but they have become part of who I am. In the best way possible.
  • Writing about chronic illness. There are misconceptions and truths. I would like to continue writing about chronic illnesses, particularly IBD, within the realm of mental health, medication side effects and access, nutrition, and more. I believe if you open the floor for discussion, people can come together to problem-solve and that is when the best solutions come about.

Next I will be writing a three-piece series on mental health. I look forward to your feedback and discussion!

Nour Al-Timimi is a Marvel enthusiast, avid hiker, and work-in-progress baker! In her spare time, Nour enjoys reading, writing about various topics and issues, and conversing about the latest science discoveries. She aspires to visit as many museums, waterfalls, and cafes as possible (in no particular order)! Nour has her M.S. in Global Medicine from USC Keck School of Medicine.