Conversation: How irritable bowel syndrome took over Tim Phelan's life
In 1988, Tim Phelan was an ambitious new college grad with a degree in French and economics. He dreamed of becoming a successful international businessman–but his life took quite a different turn, thanks to his overactive bowels. Through more than a decade of battling what he would eventually find out was irritable bowel syndrome, he lost a job and several relationships, unwilling to discuss his symptoms with anyone and obsessed with never being far from a bathroom. Now 39, he is able to speak frankly about his travails with IBS–and recently did with U.S. News–and has shared lessons learned in a new book, Romance, Riches, and Restrooms: A Cautionary Tale of Ambitious Dreams and Irritable Bowels (iUniverse, $19.95).
How did irritable bowel first hit you?
I'd just graduated from college. I had this great job as a fundraiser at this boarding school up in New Jersey–I was going to get to rub elbows with all of the school's graduates, some of the top movers and shakers. And I thought, OK, I'm on the fast track.
Then three months into this job, this urgency to use the bathroom came out of nowhere, at a very inopportune time. I was at an alumni luncheon in New York. There was salad and prime rib and potatoes, and everything's going along great; I'm doing my best to fit in.
I realize I have to go to the bathroom as the headmaster launches into a speech. This is the guy who has just taken a chance on hiring me. Between me and the entrance to the men's room are 150 people I'm looking to impress. So I ended up sitting there for probably an hour, struggling to batten down my backside. Luckily, I made it through.
Before I knew it, I became obsessed with knowing the exact location of a toilet before I went anywhere. So if someone said, "Hey, let's go to dinner," I'm thinking, "Hmmm, where are we going to go, is there going to be traffic on the way, are we going to get stuck, will there be a bathroom?"
Can you describe how IBS took over your life?
Nobody likes driving during rush-hour traffic. But my concern was for completely different reasons: Who knows, we might get stopped at a light. Or flying on airplanes. I don't have a fear of crashing or dying. My fear is being strapped in a seat and not being able to go to the bathroom.
I was in sales for 10 years. Whenever I went to a sales call, I made a point of taking a route that would have the most bathrooms possible. Before I even left my office, I'd stop two or three times. Then hopefully there was a McDonald's or a convenience store or something, some kind of restaurant or hotel I could pull into. It wasn't uncommon to stop six or seven times in a half-hour before getting to my sales meeting. I make the analogy to an empty tube of toothpaste. It's never really empty. You can always get a little bit more out of it.
Would you say that having angry intestines can make romance harder?
Angry intestines can definitely make it harder. But exacerbating it was my insistence on hiding it. If a girl said, "Hey, let's go across the Bay Bridge, we'll eat dinner over there in Berkeley," I thought, "Crossing the Bay Bridge during rush hour, no way–but I can't tell her why." So all of a sudden, because of your obsession with being near bathrooms and your reluctance to tell people, to kind of admit this vulnerability, you start lying. They start off as little white lies, and then they grow more elaborate and more elaborate. I think that sent a lot of romances right down the tubes.
The thing I kept asking myself for 100 pages of your book was, why didn't you talk to a doctor?
I know! Yeah! First of all, this is taboo. These days you can talk about erectile dysfunction, colon cancer is cool to talk about, but I think IBS has a little bit of that stigma still. And a guy, even if we're totally lost in the car, we're not going to stop and ask for directions. So take that mentality and throw in a taboo topic that's personal and very unmacho, and then it's not hard to see where you would say, "You know what? I'm just gonna fix it myself." Just like you would with a broken sink or something like that.
I think more than half of the people that have symptoms never see a doctor. So, yes, I was dumb, but I wasn't the only one. This is why I wrote the book. I want to say, "Look. Do not do this. Don't let it screw up your life like it screwed up mine."
What brought you to finally talk to a doctor about it?
Finally, after 13 or 14 years, I was dating this girl. I signed up for this trip to Vienna, Budapest, and Prague with her. I wasn't just going with her–it was a group of about 100 people, and we were going to be on a schedule, on a tour bus. And I thought, "Wow, I'm in over my head." So I was facing either a nasty breakup, which the trip ended in anyway, or I've really gotta get some professional help.
How did you learn to manage it?
Ultimately, what helped me was cognitive behavioral therapy. In my case, the main culprit is anxiety. You start worrying about not being near a toilet, having an accident, humiliating yourself, watching your love life and your professional life go down the tubes. And that became a self-fulfilling prophecy. So cognitive behavioral therapy is one way that's been very effective to get that anxiety, which triggers the symptoms, under control.
Part of cognitive therapy is writing down your thoughts. Like, when you have to go on an airplane, you take your assumptions like, "Oh, if I'm on a plane I'm automatically going to have an accident, people are going to laugh at me, I'm going to be humiliated." And then you go through thought by thought and you try to find evidence to the contrary.
At the same time, they're teaching you relaxation and they also do these exposure sessions. You're going little by little to literally face your fears. So you would ride in a car with somebody else. You would sit in rush-hour traffic wearing khaki shorts after drinking coffee. Cognitive behavioral therapy is very goal-oriented–it might be 12 sessions.
Is it all gone? Did that cure it?
No. It's definitely not cured. Different treatments work for different people with different levels of success. I've still got my bad days. If you said, "Hey, let's go on a plane, there'll be no bathrooms, we're going to be on there for an hour," I'll say, "Whew, I don't know. That might be too much." I probably have 95 percent of my life back, but there's still some things that are at least right now maybe a little too daunting. But I'm in much better shape than I was.