The pain Alexa Scimeca Knierim felt in her abdomen was excruciating, the vomiting and sleepless nights that it produced draining, and figure skating was the farthest thing from her mind.
Even on her wedding day, the pain was almost too much to bear.
It took months before a doctor finally diagnosed her illness, and several procedures to alleviate the pain. And then, it took many more months before Scimeca Knierim joined her husband and partner, Chris Knierim, and began working their way back to a world-class level.
Now, they're getting ready to step back into the spotlight at the world championships.
It's been a long road back for the couple, who were forced to withdraw from event after event. But when they finally made their season debut at Four Continents in January, they showed some of the sparkle that once made them America's top pairs team, and enough promise that they were added to the U.S. roster for this week's pinnacle event in Helsinki, Finland.
''The first time she stepped on the ice, I had to help her. We have a video of me just holding her hand, skating around in circles. We could only skate for 10 minutes,'' Chris Knierim recalled. ''Then she had to go home and take a nap, rest, because she was so drained. That's how it started.''
How it ends is still to be determined.
They are still a longshot to medal, especially considering no American pairs team has finished in the top five since 2006. But you could argue they've won simply by competing.
''I think after what we've been through, things might not feel like they used to. It's not going to feel like it's do or die, like if we don't skate perfect our world is going to end,'' Scimeca Knierim said. ''Our priority is going to be to remain humble and grateful for our experiences.''
Just about every pairs team headed to Finland is dealing with some hurdle to overcome, whether it is mental or physical, and trying to sharpen up with the Winter Olympics just 10 months away.
Two-time and reigning champions Meagan Duhamel and Eric Radford of Canada have struggled all season, sending their confidence into a tailspin ahead of this year's biggest competition.
The German pair of Alison Savchenko and Bruno Massot missed the Grand Prix final after Savchenko tore an ankle ligament. The Russian team of Ksenia Stolbov and Fedor Klimov missed the fall season when Klimov hurt his left leg. Two-time silver medalists Sui Wenjing and Han Cong of China also missed the fall season after Sui had surgery last spring on her right ankle and left foot.
Not surprisingly, that leaves the pairs competition wide open at the world championships.
''We really want to have two great performances,'' Duhamel said. ''We haven't been able to showcase our performances the way we want to this season, so the goal is to have personal best performances in the short program and the free program, and if we do that, we can win a third world title.''
Duhamel and Bradford were third at the Grand Prix final and second at Four Continents, results that would leave most pairs teams ecstatic. But a team that is accustomed to finishing on the top step of the podium left disheartened, struggling to live up to their own expectations.
As a result, Duhamel said they ''went back to square-one.'' They've spent the past several weeks overhauling their entire program, jettisoning the throw triple axel that had only just implemented and working with their coaches and choreographers to make a few more changes.
''We really assessed what's gone wrong this season,'' Duhamel said. ''We both experienced, I guess a state of shock at Four Continents. We didn't expect to have mediocre performances like that. ''
While Duhamel and Bradford haven't come within 13 points of their total from last year's world championships, they are still among the favorites when competition begins with the short program on Wednesday. The free program on Thursday will decide medals.
''You know, worlds last year was so long ago, and so much happens during a season,'' Radford said. ''We had that momentum in 2015, where we had this unstoppable momentum and it was ours to lose. Last year, we didn't have that same momentum and it appeared there were other teams that were going to step up and take the title and surprise, we did it again.
''I feel like it's similar to last year, where we're coming in a little more under the radar.''