Hello, Snackers. This piece gets uncharacteristically personal, as you have probably guessed from the title.

If you’re not up for a long essay on chronic illness today—or if you are my parents, hi—please feel free to skip this one and read something lighter and less personal like this recent post on official state foods or this one on the overlapping evolution of waffles and technology or pretty much anything else from the Snack Stack archives.

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I want you to know something but I don’t want you to worry about it.

I’ve thought those words thousands of times over the last 30 years. They’ve looped in my mind on dates, in the workplace, with my kids, with friends, at random events.

I’ve rarely said them out loud, partly because I know the attempted warning will instantly put people on edge. There’s no good way to say, “Here comes an uncomfortable conversation!” But there’s also no good way to say, “Hey, by the way, my body is a broken vessel that has been reassembled with packing tape that might not hold. It’s rarely an issue anymore, but if things get bad, it can get weird and messy. So … Watch out!”

That’s not something you say in polite conversation.

But I want you to know this so you’re not too alarmed if things fall apart.

I mean, look, it’s not actually a big deal. Everything’s fine! Well … not really. Yes and no.

Anyway. What were we talking about?

Right, Sport Shakes.

* * *

Sport Shakes, if you’re unfamiliar, are the original prepackaged protein shake, or at least one of the first. The company’s website claims the product goes back 40 years, long before every gas station in the USA had a cooler full of similar beverages. They come in cans, eight ounces and ready to drink. Chocolate, vanilla, strawberry, and cappuccino. The logo is the same one I remember from the early 1990s, when I started drinking them at the age of 12 or so.

The logo, you’ll note, shows a person running. Every letter of every word slants forward, and if you were possibly confused about any of this messaging, the little flexing bicep and battery icons at the bottom are there to emphasize the point: this stuff gives you ENERGY and STRENGTH and POWER.

Search the internet and you’ll find plenty of broad-brush histories of protein shakes and other sports drinks. Most of them are SEO-driven content posted on bodybuilding and exercise websites, which merely underscores the intent of the product: this stuff will build your muscles to superhero size. A site called Barbend has a piece that, as far as I can tell, has real research behind it, or at least it cites some legit-seeming sources. It traces the origins of protein powders to the nineteenth century, but says they didn’t really take off as a commercial product until the “golden generation of American bodybuilding,” in the 1960s and 1970s:

It was Blair’s protein powders that bodybuilders and weightlifters coveted during the 1960s. Blair was one of the first fitness manufacturers since Plasmon in the early 1900s to produce a milk protein powder. Mixing his protein powder with raw milk and/or cream, Blair claimed that his supplements produced the anabolic effects many would associate with anabolic steroids.

Blair’s advertisements spoke of 20 to 30-pound muscle gains in a relatively short period of time solely using his protein. In some quarters, people indeed claimed that Blair’s protein powder was more effective than anabolic steroids.

Sport Shakes were a clear outgrowth of this trend, a mass-market version of the powders. They weren’t quite as intimidating and hardcore, but they gestured toward the same general goals of helping fitness fans get buff. They were of a piece with Gatorade, which entered the market in 1966 but didn’t become a true cultural phenomenon until 1991, when Michael Jordan started endorsing it, and Powerbars, which were created by an endurance athlete and debuted in 1986. The products were both functional and aspirational, selling calorie-rich fuel alongside an illusion of being just like the pros.

For me, in the early 1990s, Sport Shakes did not represent dreams of supercharged athleticism. They represented getting through everyday life.

* * *

The trouble began with vomiting, bloody stools, loss of appetite, fatigue, and probably some other symptoms I’m forgetting. I don’t like to think about it.

My parents took me to the doctor, who sent me to various specialists, who did endless tests. After all those scans and scopes and blood draws and whatever else, the pediatric gastroenterologist diagnosed me with Crohn’s disease and prescribed prednisone. The meds turned my cheeks into balloons but helped stabilize my insides. I started to have more good days than bad. Kept up my schoolwork, kept playing sports.

When the Crohn’s flare-ups happened, and even when they didn’t, I often had a hard time keeping food down, or eating enough in the first place. The gastroenterologist recommended a nutritional supplement called Nutrament and another called Peptamen, which were sold ready to drink in squat cans made with thick metal. We bought them from the medical supply shop on the main commercial drag of our neighborhood. Peptamen came with little flavor packets you could mix in to improve the taste; if you stirred them into Nutrament, I discovered, it made the whole thing kinda curdle. Both drinks were, in my memory, chalky and unbearably clingy, leaving a film on every surface of my mouth.

I just looked up the two products. They’re still around. Nutrament is billed as a specialized sports drink, with a website featuring lots of italicized text and an oddly-cropped photo of the crotch area of someone participating in an unidentified sport. Peptamen is squarely in the medical realm. Its homepage lists a variety of selling points, starting with this: “The only peptide-based formula with enzymatically hydrolyzed 100% whey protein to help with tube-feeding intolerance.” Above that text, dominating the page, is a photo of a 70-ish couple sitting on the front porch of a row house, the railings and columns painted white but clearly showing signs of wear. The man is in a wheelchair, the woman is hugging him around the neck, and they’re both wearing sweaters and wistfully gazing into the distance. There’s a melancholy edge to their expressions, and the whole tableau feels like the end of a sad movie. You can practically hear Frank Sinatra crooning “My Way” on scratchy speakers in the background.

Back in the 1990s, as I trudged to and from that medical supply store, both Nutrament and Peptamen occupied the same bittersweet category in my mind. They were doctor-mandated drinks that signaled something was wrong with me. I associated this sort of declining health only with old people like my grandparents and the tragic grade-schoolers I’d seen in the newspaper, kids in hospital gowns who had awful, terminal diseases like cancer, and who, the articles said, had their final wishes granted days before they died.

I didn’t check either of those boxes—I wasn’t that old or that sick. I could pretend to be like all of my friends. Except, of course, when I couldn’t.

A friend on my soccer team, who had seen a health-class video about the dangers and signs of steroids, noticed my yellow eyes and asked his mom if I was juicing. One day at school, I didn’t make it to the bathroom quickly enough and a kid named Steve spotted me throwing away my soiled underwear, then loudly asked me about it on the bus home. There were classes and events missed because of all those medical tests.

But most of the time, as long as I always knew the location of the closest toilet and remembered to drink my Nutrament or Peptamen, I could present the illusion of being just another seventh-grader who wore knockoff Zubaz and was an adequate outside midfielder. This was all I wanted, all any kid wants: to fit in.

During my body’s calmer moments, which could last weeks or even months, I was able to switch to Sport Shakes. My god, the triumph of those moments. The relief. They were cheaper, tastier (still too thick and too artificial, but still better than the medical-grade sludge), more readily available, and—best of all, by far—just a regular drink I could sip in front of my friends, with no questions or looks.

Sport Shakes required no explanation. They saved me from conversations about poop and vomit or the concept of chronic illness with a group of curious middle-school peers. They let me turn off that voice in my head thinking, “I want you to know something but …”

* * *

I don’t recall exactly how long the Nutramen-Peptamen-Sport Shakes chapter of my life lasted. Maybe just a year or two, maybe more.

The ups and downs of Crohn’s stayed steady throughout high school. A couple of weeks of misery followed by a month or two of calm, before stress or some other trigger made the whole cycle start back up. I was often terrified of socializing, both because I was naturally shy and because I didn’t want to end up spending an hour in the bathroom and then having to answer questions about it. But I did my best to highlight the shyness, preferring a reputation for social awkwardness to a reputation for gastrointestinal distress. I had my own key to the teachers’ bathroom but made sure none of my classmates saw me use it.

When I had colonoscopies, my guts always looked like some sci-fi underworld, red and angry, but the diagnosis from all the tests was usually, “Well, let’s keep an eye on it.” There was plenty of stuff to think about, but nothing overly concerning, not yet. “Boring is good!” my mom would say. You don’t want to be medically interesting.

Less than one month into my freshman year of college, my insides felt like they were exploding—I’d felt all kinds of pain before, but nothing like this. I went to the emergency room in the small-town hospital, where the doctors diagnosed probable appendicitis. The on-call surgeon happened to be the head surgeon from the largest hospital in the state, who drove down, cut me open, and immediately realized my colon had ruptured. I have no doubt he saved my life. I woke up with a colostomy. I was no longer boring. I was the guy who had disappeared from campus and then, weeks later, came back with a bulging, smelly bag on his belly.

As it turned out, nobody really cared. My health was still an uncomfortable topic for me, but now my friends knew about it and, with the marginal boost in wisdom one acquires between high school and college, they were supportive and didn’t make it a big deal.

The surgeon reversed the ostomy a few months later, this time at the big hospital in the city, but there were many other trips to the small-town medical center near campus over the next few years. For a while, I also had to get supplemental nutrition from an IV line at home, setting up the pump and connecting the line to the port on my arm every night. A doctor told me I should be “drinking milkshakes with impunity” and I laughed and thought, well, I guess that’s my new Sport Shake.

Even with my illness now on full display, undisguisable, no one around me cared, which I mean in the best possible way. My shyness, though still a constant presence, started to fade a bit. I had found my people. They knew my limits. They visited me in the hospital when things got bad. I never had to go back to Nutrament and Peptamen, but if I had, my roommates would’ve gladly cleared some space in the tiny dorm fridge, moving the Nalgene full of Dr. Pepper and the moldy yogurt container out of the way.

They knew what they needed to know and they didn’t worry about it.

* * *

In the years that I was sick, doctors or family members would sometimes try to cheer me up by telling me about someone they’d read about who had climbed K2 or done the Ironman Triathlon or accomplished some Amazing Physical Feat, all with Crohn’s or an IV port or an ostomy bag. The message seemed to be: You can do it all, if you just put your mind to it! This, honestly, stung as much as Steve yelling on the bus. It framed accomplishment in the most outlandish terms, quietly taunting me for not getting off my swollen ass and doing something that I had never wanted to do in the first place.

What I wanted, more than anything, was the extraordinary joy of feeling ordinary. The ability to live life on my own terms, even if that just meant going to a party and being able to enjoy a conversation without dreading an explosion from one end or the other. I wanted what Sport Shakes had represented all those years earlier: the best possible boring version of myself.

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* * *

Looking back, I feel lucky and a bit ridiculous. I now understand how privileged I was to have parents with good health insurance, thanks to my mom’s government job, and the means to buy all those cans of supplements and all those rounds of tests and treatments. The disease didn’t kill me or bankrupt my family. And I realize that of course I wasn’t the only kid going through some seemingly impossible but nonlethal misery. But that’s the hindsight of an unremarkable but content 41-year-old, not the in-the-moment perspective of an anxious middle-schooler.

In my 20s, things got even worse, health-wise. We’ll fast forward through that part, rushing through the images of me crying on bathroom floors and in hospital rooms. When I was 28, after yet another procedure to fix yet another problem, the surgeon said, “I think it’s time to finally take it out.”

A friend of mine from college, one of the ones who had been at my side so often, helping me feel whole in times when I saw myself only as a pile of broken pieces, put me in touch with her mother, who’d had an ostomy years earlier. This was what I need to hear: not a superhero tale, but an account of a happy life of swimming, travel, family and work. The dream.

I got the surgery. It was one of the best things I ever did—after marrying my wife and having the two kids who now bring me so much joy and so much everyday parental exhaustion, and who know that Daddy poops in a bag and that’s both kinda different and totally normal.

* * *

Food writing abounds with metaphor, typically a rich text of ingredients and techniques, cultures and tangled histories. When food writers muse about prepackaged foods, it’s often with a scoff, which is amplified into an echoing sneer—or a gushing sales pitch—when it comes to things that supposedly make you stronger, faster, fitter, better. Within this literary realm, what we eat typically represents some combination of joy, wellness for people who are already well, and globe-spanning connection.

But it’s worth remembering that food is sometimes both less and more than all that. We all have something we never want to put in our mouth again, due to a Proustian association of the negative variety, a memory of the bad old days when a certain meal meant survival in some literal or figurative sense.

I haven’t had any Crohn’s symptoms for almost 13 years, a fact that feels astonishing to me. It’s still possible the bad stuff will return—another thing I don’t want to think about—and there are plenty of times when I’m in public or with a new group of people and I can feel my ostomy bag swelling to blimp-like proportions, and I’m tempted again to go, “Hey, listen, I need to tell you something…”

These days, I can eat what I want and do what I want. Every now and then, when I’m at the grocery store, I see Sport Shakes on display and I’m reminded of the solace they offered in those tumultuous times of preadolescent illness. I haven’t had a sip of the stuff in decades, and I have no desire to break that streak. They’re disgusting, but I’m still so grateful to them as a grounding force.

I give the cans a nod and remember the terrified boy I once was, and I think, “I’m still here.” Then I move along with the normal life that Sports Shakes helped me dare to imagine.

Thanks so much for reading. If you like this, please share it. If you or someone you know wants to talk about Crohn’s or life with an ostomy, please feel free to contact me directly at doug@douglasmack.net.

Back to something lighter next week.

—Doug

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