Athletes pride themselves on pain tolerance, but as Azahara Munoz learned, such toughness/vanity can be dangerous.
This was December 2016, and Munoz, the LPGA Tour's 2010 Rookie of the Year and the Kingsmill Championship's co-leader, was at home in Florida. First, it was searing stomach pain, followed in short order by vomiting and diarrhea.
Gastroenteritis, Munoz surmised. This will pass.
"Then the next day I was in so much pain," Munoz said Thursday after an opening-round 65 at the Kingsmill Championship, "but I thought I was in so much pain because I was puking so much. … I could barely walk."
Munoz called her mother in Spain, who offered an instant diagnosis: appendicitis.
Munoz wasn't convinced. Her pain was widespread, not solely in the lower, right side she associated with the appendix.
Mom insisted and threatened to visit the family doctor in Spain to describe her daughter's symptoms.
"I was like, 'I'm not going to make my mom go to the doctor in Spain,' " Munoz said. "So I went to the doctor and straight (into) the ER. I got really lucky. It didn't burst or anything."
A surgeon removed the appendix laparoscopically, concluding Munoz's second medical trauma in four months.
The first involved a far more obscure condition, and only this spring did Munoz feel comfortable sharing her story. The subsequent outpouring has not only encouraged her but also affirmed a decision she viewed as a public service.
Munoz, 30, is young and successful. She was the NCAA individual champion at Arizona State in 2008, led the Sun Devils to the 2009 national team title and won the LPGA's 2012 Sybase Match Play event. She finished among the Tour's top 10 money leaders in 2012 and '14, has won five times on the European Tour and represented Spain at the 2016 Rio Olympics.
But for years, "I was feeling like crap. … Ever since I can remember, I (had) been so tired, so cold, and then lately, it was getting really, really bad. So that's when I kind of started noticing. I had so much anxiety. I thought I was stressed out. When I started losing my hair and everything, I thought it was stress. I was like, 'Man, I'm really struggling.'
"So I went to the dermatologist, and she's the one that knew it right away."
This was September 2016, and the diagnosis was Hashimoto's disease, a condition where your immune system attacks the thyroid gland. Fatigue, hair loss and sensitivity to cold are among the myriad symptoms, according to the Mayo Clinic's website.
Munoz treats the disease with a synthetic thyroid hormone, vegetarian diet and fitness regimen. The results are promising.
She hasn't missed a cut this season, stands 14th on the money list and is No. 51 in the world rankings. Last month she finished second, four strokes behind Brooke M. Henderson, at the Lotte Championship in Hawaii.
During interviews in Hawaii, Munoz first revealed her battle with Hashimoto's. She doubled down on the LPGA Tour's podcast and earlier this month shared her story with pictures and words on Instagram.
The response has been overwhelming, from fans and those coping with Hashimoto's.
"So the reason why I wanted to write it is because I think so many people probably have it," Munoz said, "and they just don't know. They say, 'Oh, I'm tired. I'm tired.' That's why I said not feeling good is not normal. You should feel good."
Marred only by an opening-hole bogey, Munoz's 6-under-par 65 Thursday is her season-best. It matched her first-round score here in 2014, when she tied for eighth.
After our green-side chat, Munoz headed for the clubhouse and a salad at the players' buffet. Quinoa she'd prepared in the morning was stashed in her bag to complement her lunch.
"People actually can't believe it," Munoz said of friends' reaction to her new diet, "because I eat a lot and I love everything. I'm one of those that when they say, 'What should I cook for you?' I mean, you could cook anything. …
"So people couldn't believe that I actually stopped eating meat (and fish). But I feel like because I like everything, I don't mind so much. Now (some) people … don't understand it. They literally think the only thing you eat is broccoli. …
"I love everything I get with sweet potatoes. I'm one of those that like to mix everything, so I like to mix a few legumes, sweet potato, avocado, and a lot of veggies."
Diet and medication have allowed Munoz to practice more consistently, which has produced more consistent performance. Dating to last August, she has made 19 consecutive cuts.
She's not yet the player she was in 2012 and '14, but the progress is heartening.
"I have my days," Munoz said. "Sometimes I'm a little tired, but nothing — like, I'm a million times better. Every now and then, I might have one of those days if I push myself a little too much. But other than that, it's so much better."