Prime Minister Abe and Me
Yesterday, Japan’s longest-serving Prime Minister, Shinzō Abe, announced that he was stepping down after almost 8 years in office. This is not the first time as Prime Minister he has resigned due to health reasons. The first time was in 2007 after one year in office. I’ve detected a sense of derisive snickering among some of the reporters reacting to Abe’s announcement, ridiculing him for quitting due to a mere sour stomach or abdominal cramps. This, unfortunately, is a common reaction among people unfamiliar with the ravages of intestinal disease and thus turn to poo jokes to allay their sense of discomfort.
It is far more serious than that.
Shinzo Abe has ulcerative colitis, an autoimmune disease mainly afflicting the large intestine, marked by raging inflammation, bloody stools, and loss of the ability to absorb nutrients from the food you eat. Abe’s body is literally devouring itself. Despite what I may think of his politics, I understand his suffering: In early 1999, I was hospitalized with ulcerative colitis and very nearly died. Here is my story:
“99 out of 100 people in your condition would have died by now.” These are words that you never want to hear from your doctor, let alone when you’re only 35. It was April 26, 1999, and I had just been released from the hospital. Earlier that month, I had to be carried into the hospital after collapsing at home with severe ulcerative colitis, and there I would stay for three and a half weeks. My doctor and his team of nurses tried every pharmaceutical option available to them as my condition entered a vicious repetitive cycle of mild improvement followed by a sudden worsening over and over again. I was on an intravenous feed the entire time to keep me hydrated and to administer the mix of drugs prescribed by my doctor as he fought to save me. My immune system was crumbling, reaching its worst one night when I awoke in a fever and the nurse came in to check on me during my first week in the hospital. I could see the horror on her face that told me instantly how grave my condition had become as I now had both viral and bacterial infections ravaging in my body. How did I ever end up like this at such a young age?
I first started experiencing symptoms of ulcerative colitis in the summer of 1998 when I was working as a management consultant for PricewaterhouseCoopers. Every week on Sunday night, I would take the red eye from San Francisco to Philadelphia, arrive at six in the morning, go to my corporate apartment to sleep for an hour, and then head off to a 12 to 16 hour work day as an instructor training newly hired consultants on software applications. You can imagine the embarrassment as the first signs of colitis began to show. I often found myself standing in front of a classroom of 75 people and having to go to the bathroom RIGHT NOW in the middle of a lecture, only to have to go again RIGHT NOW just a few minutes later. My publicly unsustainable behavior continued for several weeks as I struggled to maintain my bi-coastal workload.
One time on a flight back from Philadelphia to San Francisco, I was wracked by a fever that frightened one of the stewards enough to ask if I was OK when he saw my greenish face as I headed to the cramped forward cabin toilet for the 5th time that hour. Once I crammed myself inside, there was a rude knocking at the door. When I finally came out, an older woman was impatiently waiting right outside the door. “You’re not the only one who needs to use the bathroom, you know!” she hissed as I stumbled out. I was too weak and ashamed to set her straight and tell her that I would love to not present such an inconvenience to her. Frankly, I was so fed up with having to go to the bathroom so often that part of me almost agreed with her.
Beginning in the fall of 1998, I began my strange journey to find a cure, not to mention a diagnosis, for what was happening to me. The first doctor thought that I might have hemorrhoids, and had me kneel on the examining table while he tilted the table to an almost 45 degree angle. He then pumped air into my rectum so that he could better see inside to remove the (non-existent) hemorrhoids. The second doctor also looked into my rectum during an excruciating exam, announced that I had ulcerative colitis, and left the room to write out a referral to a local gastroenterologist. I just had to see the instrument that he used to perform my exam, so I took a look under the blue cloth lying on the instrument tray. There, glinting coldly in the fluorescent lights of the examination room was an 18-inch long chrome-plated steel tube about a half-inch in diameter! I shuddered to think if I had known beforehand that the doctor was going to insert a metal pipe into my behind, I would have probably run screaming from the room!
I tell you these stories to illustrate how awful and seemingly ridiculous the patient experience can be in search of a cure. When I finally got to the gastroenterologist, he quickly said that, yes, I did indeed have ulcerative colitis, and prescribed an anti-inflammatory pill, called Asacol. My symptoms cleared up miraculously! I stayed on this medication for a few months and then I asked my doctor if I could go off of the medication. I was still young and the thought of taking any medication long-term was foreign to me.
It was now February 1999, I was off my meds, and I felt good. I remember the last Sunday when I was still healthy that year; I was playing with our friends’ three-year-old son, and he kept putting his fingers in my mouth. Maybe that’s how I got contracted flu; I am sure my immune system was already in decline by that point. I was still eating meat and I especially enjoyed a large coffee every morning with a generous pour of half-and-half. Cheese was another favorite comfort food. I had no clue of the way these foods were damaging my body. When I left my home in the Bay Area for my client’s office near Sacramento in March 1999, I started having fevers again and couldn’t work. I thought that I just needed rest.
After a week I felt marginally better, so I made the decision to drive the 100 miles back to the Bay Area and sleep in the comfort of my own bed. Navigating Friday night traffic on the I-80 while drenched in a clammy feverish sweat was probably a foolhardy decision, but I just wanted to be home. I spent another week in bed with fevers, naively thinking that I was getting better. Finally, on the morning of April 1, 1999, I collapsed from exhaustion on the floor of my bathroom. I couldn’t move as my wife frantically called my gastroenterologist and asked what to do. He immediately told her to get me to the nearest emergency room. This began the last steps of my convoluted journey into the modern American medical system, at its best and its worst.
For the most part of my three and a half weeks in the hospital, dedicated professionals cared for me with compassion and skill. Then there were the others, the ones who made me pray for a time when I could be healthier and be free from depending on people for my state of health. There was the lab technician who laughed when I asked for a lead shield for my groin when I was X-rayed to see if I had an unappetizing condition called toxic mega-colon (I did not). He said, “It’s not like you’re going to have any kids,” based, I assume, on the likelihood of my recovery. There was the weekend nurse who poked and prodded my arm for 15 minutes with a needle trying to get my intravenous needle inserted. I finally had to tell her to leave the room and get the head nurse to finish the task competently. Then there was the colostomy doctor who appeared in my room one afternoon, looked at my abdomen, told me I’d have to have my large intestine cut out, and have a permanent small hole in my abdomen where a plastic bag would be attached to collect my feces. He then turned on his heel and left the room – a consultation lasting all of 3 minutes that could have affected my health and sense of well being for the rest of my life.
I did make it out of the hospital eventually, but not before being put on an aggressive, long-term pharmaceutical regimen which included cyclosporine, a very potent immune system suppressant often given to organ transplant patients. My treatment was so aggressive because it had to be in my dire condition. I had come uncomfortably close to death and my gastroenterologist needed to intervene with every tool he had available to him, even if the drugs he was using sent my blood pressure skyrocketing (there was a period it measured 200/150!), forcing me to add Ramipril to my pharmaceutical cocktail.
I’ve told you up to now about my medical journey back to health, but what about my dietary journey? That, too, is fraught with bumps and detours and reversals. My wife and I first participated in the 10-day McDougall Program in January 2006. Initially, I was shocked to see people in the class who had been in prior McDougall Programs, lapsed into old unhealthy eating habits, and then came back to the Program to get back on track. I remember thinking, “How could these people start eating meat or dairy after being in THIS class for 10 days with Dr. McDougall showing again and again how bad a non-plant-based diet can be?” Well, I soon found out.
I was apprehensive about returning to the outside world after being in the safe, organized enclave of the McDougall Program with its 3 prepared vegan meals a day. The hardest part was how to handle myself in group settings, especially when food plays an important part of socializing. I felt like I was cutting out a part of my life by eating the McDougall way. I made it almost 9 months of eating 100% vegan before I started sliding little by little. By early 2008, I was pretty much back to my former unhealthy eating habits. I had become that person who went from McDonald’s to McDougall and back to McDonald’s. I was ashamed, but not enough to change my ways.
Fortunately for me, my wife wanted to enroll in a special study weekend that Dr. McDougall held in March 2010. At first, I was not going to join her in Santa Rosa for the weekend because I was too embarrassed to face Dr. McDougall after being in his 10-day program, attending several special study weekends, and even joining him in Costa Rica a couple of summers ago. Was I a sham? Did I not really understand and respect what Dr. McDougall had told me repeatedly about the hazards of our modern high-fat, highly processed diet? Fortunately, I ultimately decided to join my wife for the weekend, and something wonderful happened: I had been looking at eating a plant-based diet in the wrong way. I had thought of a vegan diet in terms of subtraction (giving up dairy and meat) instead of addition (better health and more energy). Once I realized that one simple thing, it’s been surprisingly easy for me to adhere to a plant-based diet.
It’s been 22 years since I first became seriously ill, and I am feeling better than I ever have. I stayed on my colitis medications until March of 2010. In June 2010, I underwent a colonoscopy that showed me to be completely free of any signs of ulcerative colitis. When the pre-op nurse asked if I was taking any medications for colitis, and I said “No,” her eyes widened with amazement. That reaction alone made all the bumps in my path to where I am now fade into nothingness.
Shinzo Abe will likely face a similar path as I did in seeking his path to good health. Ulcerative colitis is, again, something that most people don’t understand. Any talk of bowels leads some to make giggling jokes. Most people just want to avoid the topic altogether and run from the room. But for the colitis sufferer, nothing else matters. It is an often lonely and always depressing battle. It is in that sense that I wish Abe a speedy recovery.
(Photo credit: BBC)
