My first memory of food is Metamucil. You remember Metamucil? That orange, grainy, gelatinous goop that promised to get your bowels moving through the power of psyllium husks. I remember being six years old, sitting on the bedroom floor of our rented NJ beach house, staring into the bottomless glass of Metamucil, which was getting thicker and more viscous by the second.
“Finish the whole thing”, my mother said, “and then you can go to the beach. But you have to finish it and try to have a BM first.”
I was born constipated. Literally. From as far back as my conscious mind can reach, pooping was a Herculean challenge, requiring so much time and energy that it became an obsession.
For the three decades prior to this diagnosis, I was just “backed up” – resigned to a lifetime of poop-inducing home remedies from prunes, prune juice, and bran to suppositories, enemas, mineral oil, and colonics. But the Metamucil was the worst.
I am not sure how long I sat on the floor of that beach house bedroom before drinking the stuff, my back leaning against the dark wood-paneled wall. I counted the dust bunnies under the bunk bed. I held my hand in front of the box fan to feel the wind through my fingers. I did everything but drink that Metamucil, which by the time my mother returned, had separated into orange quicksand. I can’t say for sure, but she was most likely frustrated; she probably called me stubborn before stomping into the kitchen to deep-six the psyllium sludge. But I wasn’t holding out in an act of defiance. I didn’t drink it because I knew it wouldn’t work. This wasn’t my first time at the Metamucil rodeo.
Some variation of this same scenario played out over and over again throughout my childhood and into my teen years: Administer this poop-aid (Fleet enema, Milk of Magnesia, cod liver oil), wait. Eat this (Fiber One, cabbage, a greasy pork-roll sandwich), wait. Rarely did a poop manifest from this waiting, but my love of books did. Because what else do you do while you wait? You read.
Over the years preceding my diagnosis, I received a variety of medical explanations for my constipation, all of which felt like subtle digs at my character. My pediatrician blamed my “sluggish system”, and recommended a regime of fiber and vigorous exercise. A GI specialist labeled me “anal retentive”, prescribed anti-anxiety meds, and told me to relax. “Try walking around Barnes and Noble…or TJ Maxx!” my mother suggested. “That works like a charm for me.”
I got the message: There was nothing wrong with my colon. It was just lazy. Or uptight. Or maybe my colon was lazy, and my sphincter was uptight? The medical merry-go-round made me feel fractured and detached from my own body – as if we were two separate entities at war with each other. My inability to perform the most basic of human functions for no apparent reason felt like a personal failure. If my gut had no actual medical problem, then the problem must be me. Maybe the doctors were right. Maybe I created the constipation with my chronic anxiety, and my obsession with not pooping just kept the problem alive. Maybe if I treated my colon like a naughty child and gave it less attention, the problem would go away. So, I divorced myself from my body in an act of self-preservation. It never occurred to me that my gut was trying to tell me something – that we were playing for the same team, so we couldn’t keep fighting each other and expect to win.
In her book Gut: The Inside Story of Our Body’s Most Underrated Organ, Dr. Giulia Enders explains: “Scientists are beginning to question the view that the brain is the sole and absolute ruler of the body. The gut’s network of nerves is called ‘the gut-brain’ because it is just as large and chemically complex as the gray matter in our heads.” She also points out: “Anyone who suffers from anxiety or depression should remember that an unhappy gut can be the cause of an unhappy mind.”
The GI doctor made some kind of connection between the mind and the gut, and he wasn’t wrong that I suffered from tremendous anxiety and long bouts of depression. But I assumed my anxiety was causing the constipation, not the other way around. No dosage of SSRIs, therapy, yoga, or meditation seemed to make a difference, which made me curse my lazy dead-beat colon even more. And the longer I went without pooping – sometimes one to three months – the more anxious I became. I would even go through phases of extreme dieting, because I didn’t want to put food into a place from which it would never come out. Round and round the circle went, all the while my colon took the blame. “We don’t just underestimate our gut”, says Enders, “we are ashamed of it.”
I got the message: There was nothing wrong with my colon. It was just lazy.
Or uptight. Or maybe my colon was lazy, and my sphincter was uptight?
The medical merry-go-round made me feel fractured and detached from my own body – as if we were two separate entities at war with each other.
When I met my husband Phil at the age of twenty-four, a crack in the door to another life opened, and a sliver of light shone through. I had resigned myself to a life of chronic constipation, because according to the doctors I had seen, we had exhausted all the treatment options. I assumed they knew more than me, because they were doctors, or men, or simply because they delivered their message with confidence. It never occurred to me to challenge them, or I wasn’t brave enough to do so. But as Phil watched me cycle through the elimination diets, my “dessert” of chocolate Ex-Lax, the aloe vera juice, the colonics, and some mystery powder called Colon Blow, he formed a decidedly different view.
“Your poop situation”, he said, “rules your life. And that’s unacceptable.”
Whereas I had always struggled with self-esteem, Phil had enough confidence for both of us. I saw rules as stop signs; Phil saw them as hurdles to be jumped. Through his example, I began to see what it looked like to be your own advocate, to stand up to authority, to challenge the system. Personal power, I began to realize is about taking action. It’s about getting fired up – for yourself. It’s about movement toward a better life and the belief that you deserve one. It took another decade of searching, questioning, and relentless perseverance before we finally got some answers (and eventually poop).
It was a trip to the ER for what I thought was appendicitis that set the wheels in motion. I was told I had a bowel blockage and extreme pelvic floor dysfunction, which led me to a team of specialists at Hahnemann University Hospital in Philadelphia. For three months, my husband and I drove into Philadelphia for a series of invasive, humiliating tests involving balloons, barium, and biopsies. I joked that every doctor at Hahnemann had given me a rectal exam.
I was finishing up lunch with my two-year-old daughter when the phone rang – it was my doctor calling with the results to my most recent rectal biopsy. I planted my daughter in front of Dora the Explorer, and sat down at my dining room table, covered with unfinished crafts, glitter, and cap-less glue sticks. I tried to focus on his words and not the high-pitched voices of Dora and Boots.
“There are nerves in the colon called ganglion cells”, he explained, “that create peristalsis” – the contraction of the colon that makes the poop come out. “And well… you don’t have any. Or, barely any. There’s an extreme scarcity of ganglion nerves. It’s called Hypoganglionosis, and in my twenty years as a doctor, this is the first time I’ve seen it. The lack of peristalsis has caused the bowel to distend, resulting in a Toxic Megacolon.”
“Toxic Megacolon is a great band name”, I said while scraping glitter glue off the table. “So now what?”
“The only course of treatment”, he said, “is to remove the entire colon.”
My doctor went on to explain the surgery; how, after removing the colon (which is basically the large intestine, an organ that’s five feet long), he would attach my small intestine directly to my rectum. But my mind wasn’t with him; his voice took on the wah-wah sound of Charlie Brown’s teacher. I wasn’t thinking about life without a colon. I was thinking about how long I had managed to survive with a dysfunctional one. It was like waking up from a dream. Slowly his words began to register. I let the shock wash over me; the jaw-dropping truth that something, for all these years, was physically wrong with me. Something that was never going to be cured by my thirty years of home remedies. I let it sink in that I wasn’t ‘anal’ and my colon wasn’t lazy. All those placatory diagnoses were a lie.
Of course, there was something wrong with me. Of course, it’s not normal to go the bathroom once a month, or to have your stomach so distended you won’t wear a bikini, or to spend $2,500 a year on laxatives. Of course. The fact that I had believed anyone who said otherwise suddenly felt ludicrous.
For all those years, I had cursed my dysfunctional colon for not doing its job. Now I was filled with such grief and tenderness for it. My loyal workhorse of a colon, trying to make shit happen for me (literally), chugging along the best it could, like a car with no gas and the emergency-brake on. In what other ways had I disowned my body, dishonored it, dismissed it? What other gut messages had I ignored over the course of three decades? What other external messages did I accept as gospel, simply because they came from someone with perceived authority over me and my insides?
About a month after my surgery, I sat at my kitchen table in the pre-dawn hours, writing. Looking out my window at my fenced-in, suburban lawn, I began to question the big decisions I had made throughout my life, and the driving forces behind them. Did I make choices based on what felt was right, or based on what I thought was expected of me? My sensible, brick colonial house for example, was not what I would consider my style. We bought it because it seemed like a grown-up decision; it was in a family-friendly neighborhood with a cul-de-sac where our kids could ride their bikes. But one day I asked my older daughter, then five years old: “Why do you never ride your bike in the cul-de-sac?” She looked at me with a raised eyebrow and said, “Who wants to ride their bike in a circle?”
Gut decisions aren’t always logical. They can’t always be explained or rationalized. My daughters ask me how I knew I wanted to marry their dad, and my answer – one they consider highly unsatisfying – is: “I just knew.” When I think back to my six-year-old self, refusing to drink that Metamucil, I realize now that, as a little kid, I just knew. That child’s innocent resistance was an inherent response to being controlled; to being told someone knew more about my body than I did. Gag factor aside, I knew drinking it was not the answer, and that I was not the problem. So I stood my ground, even if it meant missing a day at the beach. That little girl did not betray herself. So from now on, I’ve decided that she’s the one I listen to.
Jessica Power Braun’s writing has appeared in the Philadelphia Inquirer, Huffington Post, Literary Mama, and her blog, www.nocigarettesnobologna.com. She lives in coastal Massachusetts with her husband and two daughters.
