On a July morning in 2022, Shira Avia Zilberstein had a bone scan, a test when dealing with her type of Crohn’s colitis, a disease in which the colon is inflamed.

Afterward, she and her boyfriend of nearly a year, Emmanuel Cantor, swam in Mystic Lake, in Boston’s northwestern suburbs. Later that night, they went for dinner at one of their favorite restaurants, Oleana, in Cambridge. After they ordered, Mr. Cantor quietly asked, “So this is it?”

Ms. Zilberstein smiled. She agreed it was. Though not quite a proposal, they knew then that their relationship would likely go the distance.

“I knew I could love him on our first date,” Ms. Zilberstein said. “It was a combination of interest and excitement, with a real comfort and ease around each other.”

Like every couple starting their lives together, they didn’t know yet what challenges lay ahead of them.