An example

■ For Petra B., it didn’t feel that bad at first:

During her afternoon swim at the local pool she had miscalculated the distance to the end of the lane while doing backstroke and had hit her head quite solidly against the wall. The top of her head hurt a bit where she’d bumped it, and it was throbbing, but so what? Still, she couldn’t explain why her shoulder also hurt, had she hit it against the wall as well? She simply couldn’t exactly remember any more. That the lane had ended so abruptly was quite a surprise for Petra anyway. But that had been happening more often recently, being unable to remember things or that she’d done something and later couldn’t really say what had happened. Sometimes she even felt a creeping doubt that this must be the “onset of Alzheimer’s” that everyone joked about when someone in the group or their circle of acquaintances had gone and forgotten something. Otherwise, she felt as sharp and mentally agile as ever. She could remember just about anyone’s telephone number off the top of her head, and always showed up her husband at the crossword. And after all, she was no longer the youngest, and from 40 on that became clearer…

■ Petra B. didn’t go to the doctor; to her, it was really no big deal. And you shouldn’t go making a fuss, she learned that as a child at riding school. She, like all the other children, fell from the saddle now and then, but always got back up on her own. She had never broken anything, but it sure had hurt like the dickens a number of times, and then taken a long time before she could sit and walk properly again. Or when she was on the local handball team as a girl, she wasn’t one to go running off to the doctor as soon as things starting getting a little bit rough, and so she’d sometimes wind up limping home with a swollen black eye from a misdirected elbow.

■ But in the weeks that followed, Ms B. started to notice that things were somehow different, that something must have happened: She began to have headaches more often than before, and they seemed to be developing towards a migraine. She’d seen her mother go through that; for years she had suffered, and was often confined to bed until the pain subsided, which sometimes took several days. The daughter had had no problems of that sort in her life to that point. Petra B. didn’t sleep as well as before, either. Often her nose would clog up, and she’d wake in a panic, gasping for air, which of course left her completely sapped the next day. And as if that weren’t enough: She had been seeing things that weren’t there. Little flies, or gnats, dancing in front of her eyes, but when she went to catch them, nothing was there. And her arms kept falling asleep, that was a real nuisance. Her stomach and bowel were acting up more often too. After meals her belly swelled and she got cramps, sometimes even diarrhoea. Ms B. started removing certain foods from her diet, but that wasn’t the answer; for a while things went well, then new problems arose.

■ She only ever used to get diarrhoea during her period, along with the typical abdominal cramps. Her gynaecologist of now some 20 years had always consoled her with the assurance that the pain would go away “some day.” Petra B. had long stopped asking him when that would be. She had ‘her’ pain every month. Was it because she had had children? After three miscarriages she and her husband decided against having children because they didn’t want to have to go through that again. Her husband opted for a vasectomy.

■ Petra B. became increasingly tired and run down. No wonder, she told herself, after all, she slept so poorly. And the problems with eating didn’t make things any better; in fact, she was losing weight because of the diarrhoea. At some point she decided to talk to her doctor about her complaints. The stomach pains were the biggest of her worries, and she hoped that the doctor could do something about them.

■ The doctor examined Ms B. thoroughly. She noticed the pale complexion and the dark rings under her patient’s eyes and asked if Petra B. had had much stress recently, but it hadn’t been any worse than otherwise. The doctor took a blood sample, had the lab check for inflammations affecting the iron supply and thyroid function, and sent off a stool sample to look for any gastro-intestinal infective agents. She wrote Ms B. off sick for a few days so that she could finally rest up properly, in the hope that everything would improve more quickly as a result.

■ As her sick days drew to a close, Petra had slept more than usual, but she didn’t feel more refreshed. Quite the opposite: she often had to struggle with nightmares which robbed her of even more quality sleep. Her doctor reacts calmly: ‘That’s been known to happen, perhaps its an hormonal change, it’s not uncommon at your age.’ Is this how menopause begins to make itself noticeable? To Petra B., it feels more like she’s really ill. ‘The lab results are all okay, your iron level is a bit low, the inflammation values are up marginally, nothing to worry about. Perhaps you’re just getting over an infection, and by next week everything will be back to normal. Keep an eye on it and come back to see me if nothing changes!’ With these words, the doctor sends Petra B. home. Not a big help, the patient thinks, but what else can she do when there are no results showing what has gone wrong? Petra B. waits it out. Unfortunately, the pains in her abdomen get stronger.

■ The doctor sends her to an allergist. He tests for all kinds of food allergies and other things, leaving red pinpricks up and down Ms B’s back and forearms. Her skin looks like she’s been rolling on roses: ‘There’s the culprit!’ the specialist declares, ‘You react very strongly to eggs, milk and dairy products, wheat and yeast, as well as nuts and several fruits. That would be the cause of your complaints.’ Petra couldn’t really say that she was relieved to hear this. So what now? She has to keep to a strict diet. And what about the holiday she had booked with her husband? ‘Yes, well, you’ll have be more flexible from now on,’ was the doctor’s reply. Petra B. is on the verge of tears. “Flexible” – what’s that supposed to mean? This is an outrage! She struggles to retain her composure. These kinds of situations are new to her, too, everything stresses her out so much more than before. No wonder, what with her nerves still raw and tattered after that nightmare uncertainty about all her stomach pains.

■ They cancel their holiday in France. What would France be without baguette (wheat and yeast), Camembert (dairy product) and wine (fruit)? No, if that’s the case, Petra B. would rather stay at home an try out her new fare. She finds herself back in the organic supermarket and the health food stores, reading the ingredients on every package before setting it in her shopping basket. Her digestion calmed down slowly but steadily after beginning the diet, but then the pains returned. At a loss, Ms B. hurries back to her doctor, who is appalled at her patient’s condition: Petra B. has lost even more weight. New tests and examinations are scheduled. They also perform a colonoscopy. The diagnosis: Colitis ulcerosa – Ms B. has a chronic colitis. The standard treatment with steroid medications ensues, and still she has to keep on her diet. Petra B. is now at the end of her tether. She just cannot believe that she’ll have to spend the rest of her life on steroids, under the yoke of some draconian diet. And in spite of it all, she’d never get rid of all of the pains. Surely there must be some other way? So she set out to see if she could find one.