Persevere, by Ariana Aboulafia

Ariana is no stranger to doctors. Like many others, Ariana was born with an immune deficiency, making her susceptible to illnesses such as whooping cough, scarlet fever, and so on. From a young age, she spent more time than a child should sitting upon the crinkling white paper of a doctor’s examination table, cold with goosebumps, wearing only a thin cotton gown, awaiting her next diagnosis. 

Growing up, Ariana could have used such aliments as an excuse not to succeed. She could have labeled herself as weak or run-down, and not have challenged herself to do the things she dreamed of, fearing failure or feeling sorry over the cards life had dealt her.

Yet despite Ariana’s flawed immunity, she chased after the things she wanted, mindful of her body’s needs. She worked hard to earn a full-tuition scholarship at the University of Southern California, where she studied political science, law history and culture, and minoring in forensic science. She exercised and ate healthy. She listened to her body, knowing the differences between the physical ailments versus the emotional wear and tear a student endures when managing such responsibilities. 

During Ariana’s senior year of college, while prepping for law school and readying for her big move to Miami University, one day, out of nowhere, Ariana got a terrible feeling in the back of her mind. The feeling, according to her father, is known as “The Gremlin.” The Gremlin is that voice that echoes in the back of your head. It’s that tight sensation that lives in your chest and in the pit of your stomach. It’s the same feeling you get when walking home alone at night when that voice creeps up and tells you to pay attention, keep your head up, stay off your phone, and be aware of your surroundings.

In the following days, Ariana began to notice something she had never experienced before. Every time she snacked on an apple, had a handful of nuts, or ate a small meal, she’d immediately feel stuffed – as if she’d eaten a hungry man’s portion of a steak and potato dinner. The sudden change in her appetite seemed strange, and it began happening more frequently. Ariana brushed it off for the time being, assuming the change in her appetite was her body’s way of dealing with stress. Between finishing up her senior year of college and planning the move to Miami, Ariana’s schedule was jam-packed. Stress is known to have certain effects on the body, and it was reasonable for Ariana to assume stress was taking a toll on hers. But within weeks of the initial “Gremlin” feeling, Ariana’s desire to eat food in general ceased to exist. Every time she tried to eat, nausea took over. She could barely hold down a glass of water. 

Ariana soon found herself back on the doctor’s examination table. But the diagnosis, once given, left her in a state of confusion. The gastroenterologist had ignored Ariana’s symptoms, classifying her as a “young girl.” Telling her that “young girls like to be skinny.” He told her she was suffering with anorexia, an emotional eating disorder which leaves one without an appetite. With no previous show of signs or knowledge of Ariana’s history, the doctor based his diagnosis solely on Ariana’s age, assuming she struggled with “self-image,” and therefore became convinced she was “starving” herself on purpose. 

Ariana left the office that day feeling perplexed, knowing very well she didn’t have an eating disorder. She ignored the doctor’s evaluation, believing her symptoms were indeed stress-related. She carried on and completed her final semester of college.

The symptoms Ariana was experiencing with her lack of appetite never subsided. She wanted to eat, she was starving, but whenever she did try to sit down and eat a meal, she’d feel queasy and uncomfortably full. The sensation of nausea took over; she was lucky if she could hold down tiny sips of water. Ariana lost an unhealthy amount of weight and returned to the same gastroenterologist for the second time. This time the doctor ordered blood work – which came back normal – and sent her to a psychologist for an evaluation. 

The psychologist discovered Ariana was mentally stable and excused her from any follow-up appointments. 

Ariana considers herself a “good girl.” Growing up, in school and in college, she completed her assignments on time and listened to the teachers. She was attentive in classes, participated in discussions, asked questions, and took advantage of extracurricular opportunities that were presented to her. Ariana had faith in teachers. She had faith in doctors. Both had always demonstrated a genuine care for her. When Ariana was younger she underwent an emergency appendicitis procedure, in which a doctor, in the nick of time, removed her appendix before it erupted, ultimately saving her life. Ariana trusted the system; she trusted that doctors exhausted all efforts to reach a rightful diagnosis.  

And so Ariana carried on, telling her friends and loved ones that she was fine. 

She graduated college, packed her things and moved to Miami, underweight and malnourished, trying to ignore the symptoms and the voice in the back of her head, telling her something terrible was happening to her. 

Within the first couple weeks of law school, Ariana weighed 65 pounds. Without absorbing the proper vitamins and minerals one gets when eating a well-balanced meal, Ariana’s body was shutting down. She didn’t have the energy to study law; she barely had enough drive to move out of bed. At this point, Ariana became certain these bizarre symptoms suggested something well beyond stress. 

She saw a doctor in Miami, who yet again told her she was suffering from anorexia. Ariana felt defeated. She needed help. And no doctor seemed willing to further investigate her symptoms. For the first time in her life, she felt powerless. She was too weak to advocate for herself. Too frail to take care of herself. The system had let her down. She didn’t know what to do or where to turn. 

One morning, Ariana woke up with a new symptom. There was a sharp, sudden pain hammering against her rib cage. The pain was strong; it became difficult for her to breath. Every time she took a breath, it felt like a bubble kept expanding and popping over her rib cage, and she kept gasping for air. She felt immobile, almost paralyzed. It took every last ounce of energy for her to reach for the phone. She texted her friend, who was a nurse. She told Ariana to go to the UM health center and made her promise she would go. The next morning, Ariana went to the University of Miami health care center. This time, the doctor she saw was a woman. She looked Ariana in the eyes and asked her whether or not she truly had an eating disorder. Ariana said no. The doctor believed her. She then rushed her to the ER, where she ordered an immediate Cat Scan. 

Ariana lay in a hospital bed with intravenous fluids pumping through her veins while awaiting the results from the Cat Scan. The Cat Scan results came back two days before Ariana’s 22nd birthday.

SMAS occurs when the abdominal aorta and the superior mesenteric artery collapse over the first part of your small intestine. The small intestine then becomes compressed between the two arteries, which causes a blockage and prevents food or water from passing through your digestive tract. 

Superior Mesenteric Artery Syndromeis so rare there have been less than 500 documented cases, including Ariana’s. 

SMAS cannot be detected through a blood test. And although Ariana’s physical examinations came back normal, SMAS could have easily been detected through a Cat Scan. And if the SMAS would have been spotted early on, Ariana’s treatment would have been more manageable than what she faced at the time of her diagnosis. 

Ariana’s small intestine was completely blocked, leaving her in critical condition. If not for the latest doctor believing Ariana’s condition was potentially fatal and ordering the Cat Scan when she did, Ariana would have lost her life within weeks.

Ariana was rushed into surgery. It just so happened the surgeon on Ariana’s case had performed the same SMAS treatment and procedure once before on one other patient. Surgery was a success, but Ariana’s road to recovery was far from over. Following the surgical treatment, Ariana remained in the hospital for six weeks. In severe cases of SMAS, such as Ariana’s, other complications often surface and require immediate care. Because the SMAS went undetected for so long, Ariana had lost too much weight. She was malnourished and suffered from electrolyte, iron and B12 deficiencies; she required infusions regularly. Ariana suffered from osteoporosis; from being in a hospital bed for six weeks, her bones had become porous, brittle and prone to fractures. She had also developed pancreatitis from either the surgery or the prolonged periods of weight loss preceding the surgery and diagnosis.

After Ariana’s six-week hospital stay, she was forced to take a year off from law school. She continued the vitamin infusions and began physical therapy treatments five times a week, re-learning simple everyday tasks, such as walking and eating.

The hospital stay had saved her life, but after leaving there, it was up to Ariana to pick herself back up and rebuild her life. Doctors had put her on opioids for pain, and when she left the hospital, she had a horrible withdrawal she had to learn how to overcome. Prior to the SMAS, Ariana had always defined herself as a student. She couldn’t believe how quickly her life changed, how quickly she had lost everything, even her own identity.

That year off from school, she had trouble eating, sleeping and walking. Yet, those three things were her sole focus and priority that entire year. While working on improving her health – a few months into her recovery – she grew restless intellectually. She finally realized that she wanted to write a book and share her story. 

Ariana’s book, entitled Life After: My Year from Starvation to Salvation, shares her journey of sickness and survival. The book also investigates the medical industry on a more complex level, revealing statistics with the intent to educate young women on the potential gender disparity of medical treatment, along with the damaging effects ill-treatment can have on female patients.

Ariana is now back to health and pursuing her dream helping others overcome the obstacles that stand in their way. Currently, she is a law student devoted to fighting for members of minority groups. She feels it is her duty to educate and advocate for those who are at a disadvantage, due to their race or financial circumstances, sexual orientation or gender identities.

Ariana’s message is this: 

Listen to yourself. Trust in yourself. Speak up when you know something isn’t right. Speak up when you know something is wrong. And then go change it.  

         You can learn more about Ariana and her journey by purchasing her book here: