Who Pooped in the Sonoran Desert?
This is the story of my Crohn’s Disease diagnosis, starting with misdiagnosis and arriving to the present day, 9 years after symptom onset and 1 year into remission
I was diagnosed with Crohn’s disease in in January 2019, my senior year of college. I had studied chemical engineering for my bachelor’s, and had planned to take a gap year between the bachelor’s and PhD to serve in the Peace Corps for 1 year. I had been accepted from the interview stages, and only needed to pass the medical clearance in order to be confirmed as on my way to teaching chemistry to middle-school-aged students in Ghana.
I was going to need to write a special appeal and get a note from my psych providers. At the time, having had a psychiatric hospitalization in the prior 5 years and current weekly therapy, it was “extremely unlikely” to be cleared. I had been diligent in my treatment plan, was stable on my meds, and had the support of my psychiatrist to continue through the clearance process. (There’s a story for another time in the frequency of mental health treatment being disqualifying from certain jobs, while having the same mental illness untreated leaves you eligible for that work and thus discourages people from seeking care.)
I expected that the mental health rigamarole would be the largest hassle, and that I would pass the physical with flying colors. I had been a Division 1 varsity athlete for two years, and I had no known medical conditions besides a mild case of exercise-induced asthma.
I arrived for a physical with my special Peace Corps form, and it was a very rigorous form for the physician to fill out. She asked me seemingly endless and repetitive questions, and I gave her a quick “no” for all of them, until she asked if I ever had blood in my stool.
Me: “Oh yeah, all the time. It’s not a big deal, though, it’s bright red” (I had been told my our team’s sports physician that my bleeding was from a hemorrhoid, which can cause bright red blood, as separate from dried, black blood which means the bleeding originates higher up in the GI (gastrointestinal) tract)
Dr: “Alright, what about stool consistency- what’s your frequency of diarrhea?”
Me: “I have mostly liquid poop.”
Dr: “How long has this been going on?”
Me: “Probably 6 years”
Dr, a little surprised: “Oh… I think I need to refer you to gastroenterology just to make sure that’s nothing before I can say you’re cleared on this form.”
The diarrhea started junior year of high school, the blood my freshman year of college. The blood was from what the Sports Medicine physician had misdiagnosed as a hemorrhoid, and that actually was a skin tag from a chronic anal fissure. The skin of anus had an open tear that, at the point of the Peace Corps physical, had been open for three years. Another tear on the opposite side of the anus was starting to open as well, each tear with two of its own skin tags- one on either side of the tear.
(I’ll write a post in the future about how to identify skin tags as separate from fissures. It’s hard to know if I would have gotten care sooner if I had known it was a fissure instead of a hemorrhoid, but the information available is limited, so I hope that by writing out my experience with skin tags and their maintenance, someone else might be able to access care sooner.)
I ended up never needing to appeal the psychiatric portion of the medical clearance because a diagnosis of Crohn’s Disease was already an unappealable disqualification. The diagnosis came about a month after the first gastroenterology appointment, when the colonoscopy showed severe ileitis, which is inflammation of the ileum (the final stretch of the small intestine).
I’ve now been in remission from Crohn’s for over a year. In general, I am not bothered by Crohn’s symptoms, but there are some foods that I still avoid. Dried fruit gives me a lot of trouble, and I last had a foray into dried mango on a trip to New Mexico with my partner. We had gone for a run together, and I had to end my run early to peel off from the trail and have some really ugly bright bile-yellow and blood-streaked diarrhea. I came back to the hotel feeling embarrassed and gross, still reeling from some of the abdominal cramping.
The next day we were in the gift shop of the Sandia Peak Tram, and my partner came upon a book called “Who Pooped in the Sonoran Desert? Scat and Tracks for kids.” It had descriptions of different scat to show kids how to identify which animal it came from. My partner walked over to me, big smile on his face and said, “Who Pooped in the Sonoran Desert? I know! It was Abby!” :)
For now, this is what remission from Crohn’s looks like for me. I have some tips and tricks for symptom management, but even with all going well, I still have little slip ups. I’m thankful to have a supportive partner and to be comfortable laughing about some of the more upsetting symptoms.
The book cover that most recently brought me humor in a time of bad symptoms
The featured photo for this story is one that I took on a different run in Albuquerque. I think it’s a really nice photo, so I’ve put it here for you to see again if you’d like :)
When I’m upset (from Crohn’s or really anything), I find a lot of serenity from being outside. I hope that putting a nature photo that I’ve taken as the thumbnails on the blog posts helps readers get a taste of that serenity, too.
