“I did not become a vegetarian for my health, I did it for the health of the chickens.” -Isaac Bashevis Singer

For a long time, my story sounded like something small. Heartburn. Stress. Acid reflux. The kind of thing people shrug off. Meanwhile, I was shrinking, struggling, and quietly organizing my life around the possibility of throwing up.

Sometime in 2008, before I became vegan, I was sitting at my desk at work when a sharp, intense pain hit the center of my chest, right behind my sternum. It felt dramatic in a way that didn’t match the calm of the office. I hunched forward and waited it out, trying to look normal until it passed. When it did, I convinced myself it must have been a fluke. It happened again on my long commute home another day, and I still didn’t have a name for it, so I did what I knew how to do. I moved on.

Years later, in late 2012, a couple of years after going vegan, the chest pain came back. This time it didn’t arrive alone. Heartburn became a regular occurrence. Swallowing started to feel complicated. Food would feel like it was stuck somewhere in my chest, and walking around seemed to help, like movement could persuade my body to cooperate. I started eating less. When I did eat, I needed a lot of water to help get the food down. Over a few months, it stopped staying down at all.

Meals became interruptions. I would take a few bites and then run to the bathroom. When I could keep anything down, I was full after only a couple of bites. I was hungry and nauseated and exhausted, and the worst part was how quickly eating became something I feared.

I finally made a doctor’s appointment. After a few questions, he said it was acid reflux, suggested over the counter Prilosec, and sent me on my way. It didn’t help. I went back and got a prescription strength version. Still nothing. I kept getting worse. Swallowing became harder. Keeping food down became almost impossible. I was starving and tired of vomiting everything I tried to eat.

One night, I went to the emergency room. I hadn’t kept anything down for days and I was losing weight quickly. They did a barium swallow X ray. I couldn’t keep it down, so most of it ended up in the trash can. Eventually, they told me it was acid reflux and to keep taking the medicine.

There is a particular kind of despair that comes from being told you are fine while your body is clearly not fine. Nobody was cruel. That wasn’t the problem. The problem was that the explanation didn’t match what I was living.

I tried to research alternative remedies and foods that might help. None of it made a difference. Driving, shopping, working, everything became a battle to not throw up. I ran to the bathroom more and more. The number on the scale dropped, and my world got smaller.

I made an appointment with a different doctor. She barely looked up from her laptop and referred me to a specialist. I got a pamphlet and chose a gastroenterologist. She was a grandmotherly, no nonsense Colombian woman. That choice changed everything.

That was the beginning of the string of endoscopies I would endure. Two were done two days in a row, with a night in the hospital in between. I briefly woke up during the second one and heard the doctor and nurses working to remove something orange lodged in my esophagus. Someone said it was a piece of carrot.

This was spring 2013. I last remembered eating carrots around the holidays.

After each endoscopy, I would feel a little better. I could eat and keep food down. But it was always short lived. Soon, I would be back to not even keeping my own saliva down. I remember looking in the bathroom mirror during a round of vomiting and breaking down in tears. I wasn’t getting answers, and nothing I tried helped. I had lost about 25 pounds and I looked like a skeleton. My clothes were falling off of me. I bought shorts that were a size 6. I’m tall and usually hover around a size 10 or 12 depending on the store. Even as a teenager, I was never a size 6.

In July of 2013, I went in for what would be my last regular endoscopy. My doctor removed so much impacted food that she sent me to the regional hospital for testing and for other specialists to evaluate me. She was concerned I was at risk for aspiration pneumonia.

When the EMTs came to transport me, they nearly tossed me onto the gurney. They were used to moving much heavier patients. I joked to ease the tension, but it also felt like proof of how much I had faded.

I stayed in the hospital for two days, getting sustenance through an IV. My throat was raw from the procedure earlier that day. That night, a nurse added an opioid painkiller through my IV so I could sleep. I understood immediately how easily a person could become dependent on that relief.

The next day was a lot of waiting between two tests ordered by another specialist. On the way to the first one, a hospital social worker stopped to chat because I might be able to eat the next day. I mentioned I was vegan, and the response drifted toward protein, as if that were the obvious explanation for everything. It was well meaning, but it landed like so many comments do when you’re already struggling. It wasn’t about listening. It was about fitting you into a simple story.

The first test showed what I had been feeling all along. I had to swallow barium while standing behind an X ray machine. I could see the screen. My esophagus was extremely wide but narrowed sharply at the point where it met my stomach. There was barely a trickle of liquid getting through. Most of it pooled back up. It was shocking to watch my body fail in real time.

The next test, esophageal manometry, was rough. A flexible tube is inserted through one nostril and threaded down the esophagus to the lower esophageal sphincter, the LES. It measures how the esophagus moves and how the LES behaves. The tube got stuck in the first nostril they tried. They pulled it out and tried the other side, which went a little smoother, but it still felt endless. For the next 15 to 20 minutes, I had to swallow liquid and then a thicker gel like substance while the machine recorded what happened with each swallow.

As I was wheeled out of the exam room, I saw the results on the screen and asked what they meant. The nurse said I had no muscle movement.

The next morning, a new doctor came in and gave me a diagnosis. Achalasia, a chronic condition where the nerves and muscles of the esophagus no longer function properly, and the LES doesn’t relax the way it should to let food enter the stomach. It’s rare, with about 1 in 100,000 people diagnosed annually. I had the symptoms: weight loss, difficulty swallowing, regurgitation, and chest pain. The cause isn’t fully understood, but one leading theory is that it may involve an autoimmune process, where the body attacks nerve cells.

There is no cure for achalasia, only treatments that make living with it easier. I was given three options: Botox injections, pneumatic dilation, or a Heller myotomy. I chose dilation, an endoscopic procedure that expands the LES so food can pass into the stomach.

Once I had the dilation, I could finally eat relatively normally again. I gained the lost weight back, with a little dismay when the last few pounds returned too.

I still have trouble swallowing sometimes, but I manage. I still get excruciating chest pains, esophageal spasms, every so often. Carbonated drinks can help ease the pain. Taking magnesium when things flare up helps me too. Mostly, I have learned that a chronic condition doesn’t end. It becomes something you learn to live alongside.

So what does this long story have to do with veganism.

Vegans can get sick too. Chronic illness does not care about your ethics. Now that I know what I have and I know the early signs, I’m fairly sure it started back in 2008. A vegan diet didn’t cause it, and it didn’t cure it.

There are health benefits to eating more plants, and many people do feel better, sometimes dramatically. Some conditions improve with diet and lifestyle changes. I would never dismiss that. But veganism is not a magic bullet, and wellness is not proof of moral worth. I have seen conversations about veganism and health turn into admonishment and shaming, as if illness is a personal failure, as if the right foods can guarantee safety. I refuse that framework.

I’m not going to hide that I have a chronic condition. I’m not going to be shamed into silence. For me, as an ethical vegan, it has always been about the animals more than health. I use oil. I eat alternatives. I love trying new vegan products. I’m not interested in being a perfect vegan. I’m interested in being a consistent one.

If you’d like to learn more about rare disorders, check out the National Organization for Rare Disorders. For more information and resources on achalasia, visit the Achalasia Awareness Organization.