Oh Honey! You've Never Used an Enema?

It was the summer of 1998. I was 19 years old and had the world in my hands. I'd just moved in with my brother and my boyfriend. I had my first grown up pet, a kitten I'd named Daisy (after Daisy Buchanan from The Great Gatsby). I received the opportunity to complete two semesters of foreign language credits by visiting Germany for a summer study abroad program. I was heading to Europe for the first time. Life was good.

My sweet kitten Daisy

Germany, however, was a bit of a surprise. I'd never traveled internationally, and I had no idea what to expect. After a long direct flight (my first one ever!) from Pittsburgh to Frankfurt it was a haul to get to Bamberg, Germany where I was studying. I did not know what to expect in Europe. For example I had no idea that outlets were different. I was shocked that I couldn't plug in my hair dryer and curling iron. It was cold and rainy the first few days. I was wildly homesick. 

I quickly settled, but the culture shock was real. I didn't love German food (I have become a more adventurous eater but wasn't then). After a few weeks I found that my stomach was upset a lot of the time. I chalked it up to different food and the sheer amount of alcohol I was drinking (a byproduct of visiting a country with an 18-year-old drinking age). I began taking long walks every morning in hopes of my stomach feeling better. 

Posing in Bamberg, Germany, 1998

Touring Berlin, Summer of 1998

I flew back to West Virginia in August and started classes the next day. The stomach issues I'd started experiencing in Bamberg didn't get better. I was having issues with constipation, a strange issue for a (now) 20 year old. 

For several years I'd been working at a jewelry counter at a department store in the mall. Although it could be boring when we weren't busy, I enjoyed the job. It paid well and I was able to buy jewelry at cost. (Bonus!) A few months after I returned from Germany I was at work and began having debilitating stomach pains. My manager sent me home, and my brother drove me to the emergency room.

This was the first of what would be many ER visits for me, and I didn't have the diagnostic steps down yet: IV, fluids, pain meds, CT scan, next steps. This time next steps included referring me to my first gastrointestinal (GI) specialist. 

My first GI appointment was like a punch in the face. I waited for several hours, but the doctor was pretty thorough when I finally got back into the room. She told me she was going to perform a flexible sigmoidoscopy (flex sig) to see if there was inflammation. If you're not familiar with a flex sig it's essentially a colonoscopy that doesn't advance the scope as far. 

The nurse, Judy (I'll never forget her name), handed me two enemas. I asked her what they were for. "Oh honey! You've never used an enema?" she asked me in a deep southern accent. Judy looked like the kind of woman who'd give you a big hug. It helped me not want to punch her in the face.

I looked at her blankly. "What 19 year old has used an enema?" She led me to a bathroom off a procedure room and told me how to use the enemas. The flex sig was then performed without sedation. I had dozens of flex sigs in the early years of my illness without sedation. It was before I realized I could ask for it. The GI doctor diagnosed me with Proctitis, or inflammation of the rectum. I had no idea what that meant or what next steps would be, but she prescribed me some antibiotics. It's also what every teenager wants to hear: your butt is inflamed. 

Dazed I left the office and then headed for an ultrasound to rule out any issues with ovarian cysts. I drank several liters of water until my bladder was painfully full to then have an ultrasound tech poke around. It wasn't as bad as the flex sig, but overall it was a traumatizing afternoon.

A few weeks later my doctor performed a barium enema, the one and only time I've had that test in several decades. A barium enema attaches a tube to your rectum and inserts barium rectally. It's as horrific as you can imagine, and the most painful outpatient procedure I've had. 

Winter break couldn't come soon enough, and I took all the antibiotics I could. The pain was under control by the new year, and my boyfriend proposed over break. By the new year I was definitely ready to party like it was 1999.