How to Cope With a Chronic Condition at College

By Sneha Dave

It wasn’t until the last couple weeks of high school that I realized the coming year, my first year of college, I would be on my own. My network of support and my parents would not be nearby.

As I sit in a coffee shop in the District of Columbia, I can't help but reflect on this past year, my freshman year of college. It's a transformative and influential time for most, and I can certainly say that it was more than this for me. I learned how to navigate the waters with my chronic condition, and once again I realized the importance of resilience to tackle both successes and challenges.

After living with a severe form of ulcerative colitis for more than 13 years, this was the first year I did not have my parents with me for every abdominal spasm and procedure. The transition was out of my comfort zone, but it taught me about independence. Below are some of the highlights of the year, as well as tips for living with a chronic condition in college:

Visit Disability Student Services before school begins. My mother pushed me to talk with the DSS services at my school so I could be established before I entered my freshman year. I wasn't too worried about registering with DSS, as I did not feel as though I would need it. In reality, DSS was a critical part of my school year. Registering before school starts is important because, after the beginning of school, there are a number of other things a student will have to worry about. The process is lengthy and it may require several phone calls to a physician's office. One of the perks of registering with DSS is that you can request a single room, which was a lifesaver for me, as I realized with my flare-ups.

Take the time to educate and communicate with your professors. If you've lived with a chronic condition for a number of years, this is probably something you already have experiences with. At the beginning of the year, I struggled with many episodes of inflammation and woke up some mornings with a feeling of paralysis in my abdomen. Subsequently, I missed my 8 a.m. class and lay in bed (in quite a bit of pain, I should add) and emailed my professor immediately. I was lucky, as my professor was always accommodating and willing to share notes, but having an upfront communication made it easier. It's often best to talk to your professor during the second week, after back-to-school commotion has eased.

It's OK not to tell everyone about your illness. The people I spent all of high school with knew of my history of being sick, but in college, almost everyone was a stranger to my illness. The second semester of freshman year I had a medical procedure every week, sometimes twice each week. While I am a huge advocate for people with chronic conditions, I find it challenging to tell people about my condition, because I really don't like the accompanying sympathy. Most of my peers are not aware of the medical challenges I lived with this year. On the whole, it's a good idea to educate your peers, but it can often be repetitive to have to explain every small detail.

Everything will not go as planned. I really struggled with this, as I wanted my freshman year to be pain- and symptom-free. I remember I was put on a high dose of antibiotics, which decreased my inflammation but caused a wave of new symptoms, including severe appetite loss and constant fatigue. Subsequently, I spent some more time getting evaluated at the Cleveland Clinic than I would have liked. I found myself constantly trying to develop time strategies to deal with my chronic condition, taking classes and managing a boatload of extracurriculars.

Don't let your illness be your excuse. The reality is unfortunate, but at the end of the day, very few people will take into account your struggles with chronic health conditions as you navigate schoolwork. I found myself having frequent spasms and still working very hard on a biology test. You may have to make some sacrifices in order to get extra rest or to catch up, but it can be done.

Learn to navigate around dining hall food. There's a way to bypass dining hall food and instead keep a refrigerator with food that you're able to tolerate. I have a very complicated diet, and the dining hall at my university was not able to accommodate my needs (understandably so, as my diet changes every few months). I had my doctor send a letter so that I could provide my own meals.

It's OK to feel alone – and remember, it's all a learning experience. Many of us have been fortunate to have our parents drive us to procedures and wait with us. After having a few visits to the Cleveland Clinic, I was prescribed treatment that required me to see a health care specialist at least

once a week at an office near my campus. I often went to my procedures in between classes and came to my next class half asleep. It was a new learning experience for me, as I did not have family right there with me.

Freshman year was quite a learning experience for transition. While I often felt overwhelmed with my illness, I ended up learning quite a bit with support from a distance. I encourage all college students with a chronic condition to find ways to ensure that your illness will not stand in the way of your goals (something easier said than done, but it is possible).

Content originally created for U.S. News and World Report. Find the original article here: https://health.usnews.com/health-care/for-better/articles/2017-08-02/how-to-cope-with-a-chronic-condition-at-college

How to Live With Food Restrictions

By Sneha Dave

Tips for avoiding off-limits foods your body can't tolerate. Even when your taste buds crave them. 

GOING TO THE MOVIES IS excruciating – not a typical statement for a teenager to make. I can’t ever concentrate on the film, only the sights and sounds of others eating the favorite food I haven’t been able to consume in years: popcorn.

Restricting or cutting out certain foods can be extremely difficult for those of us whose bodies can’t tolerate them. Diagnosed with debilitating ulcerative colitis at age 6, I have learned to navigate a world of dietary minefields. But armed with these strategies, I have learned to combat cravings for things that could wreak havoc in my body.

If you or someone you know is struggling to avoid off-limits foods, here’s what works for me:

1. Find alternatives. After a grueling two weeks in the hospital, a nutritionist visited me at age 12 for a serious talk about my new dietary restrictions. Corn – in any shape or form –was out of the picture, as were many mouthwatering foods such as tacos, pizza and ice cream. The worst part? After reading nutrition labels, nearly everything on grocery store shelves seemed to have the very ingredients I couldn’t touch. So instead of eating those cheese puffs I loved (which had cornmeal) we searched around for a good replacement. Rice puffs, it turns out, taste very similar. It helps a lot to make small substitutions that still keep things “normal.”

2. Visit a health nutrition store. Not everything I used to eat can be replaced with a direct alternative. That’s why I’ve found it helpful to pick out foods I like that don’t cause issues and aren’t substitutions for something else. Many health food stores seem to cater to people like me who must avoid certain foods for health reasons, and tend to sell products with clearly labeled ingredients. It helps to be able to quickly rule out a food before falling in love with it.  

3. If you are going to a restaurant or a party, know your limits. I remember going to several parties and having to practically bite my tongue to avoid foods that looked so good but I knew would cause trouble. I still wanted to be social, and didn’t want to skip events just because of my limited diet. So instead, I found it helpful to eat before the events, which would lessen my cravings for foods my body would sorely regret. I did eat at the events, but picked things that were safe and in bite-size portions.  

4. Learn and understand your body. At times, I wanted so badly to stuff myself with all the popcorn and Mexican food my body could take. Even at a young age, I was forced to understand my body and learn the severe consequences certain foods could have on me. Food restrictions are a lifelong reality for me that change every so often. I know this and have suffered before from ignoring this reality. Today, at age 17, I know it’s important to trust yourself to make the right decisions no matter what situation you’re in, but to identify and avoid temptation triggers.

5. Know you’re not the only one. Being mentally strong is one of the toughest parts of living with food restrictions, especially for people with a long list of banned foods. But there are others out there who are facing the same challenges as you. Being able to connect and network with others is a huge step to being able to adapt successfully to a restricted diet.

6. See a professional. When my diet was at its most restrictive, it was difficult for me to even find online resources with useful guidance. Consulting with a dietitian or nutritionist who could help me plan meals for the week made all the difference, so that my parents and I didn’t have to spend all our time checking products for offending ingredients. The professional also made sure I was getting all the daily nutrients that I needed, which can be very tricky on a restrictive diet.

7. Stay away from dangerous foods. My family was extremely gracious in supporting me through all of my dietary adventures. They basically did the diet with me. This made it easy: “Red-alert” foods were not in my environment and thus cravings became significantly less. If your family or housemates are understandably unwilling to live without their favorite foods, then at least ask them to please keep them out of your sight.

Although food restrictions may be horrific to deal with, they certainly build psychological courage. Throughout my experience with many diets and food restrictions, I have found that with experience, conquering food cravings becomes easier. Over time, the foods that cause you trouble may change as well, so it’s worthwhile to revisit them periodically. You might once again be able to eat that beloved meal. 

Content created for U.S. News and World Report. Find the original article here: https://health.usnews.com/health-news/patient-advice/articles/2015/06/18/how-to-live-with-food-restrictions

Julian Kritz: A law student at the University of Virginia

For Julian, it began with a swollen ankle.

I was a healthy and well adjusted eight-year-old. But then at age 8 my Dad noticed that I had a swollen ankle. It was not the result of any injury and so we went to see a doctor for an explanation. Initially, it was thought to be a sign of juvenile arthritis but that diagnosis was short-lived. I began having additional symptoms that fell outside of an arthritis diagnosis. I began having intense stomach cramps, bloody and atypical bowel movements, and intense nausea and vomiting. Some of these symptoms I self-reported, others I did not. However, there was one symptom that I could not hide from anyone – that of growth failure. Prior to these symptoms, I had been well-sized, perhaps even on the bigger side for my age. That all was to change. I completely stopped growing and for many ensuing years found myself to be the shortest in my grade. The growth failure led us to seek out an endocrinologist, who after reviewing my blood work referred me to a pediatric gastroenterologist. Through a colonoscopy an a biopsy, the GI doctor confirmed what was already suspected; at age 11 I was told that I had Crohn’s Disease.

"In short, I was angry, withdrawn, and in absolute denial."

To say that I responded emotionally poor to the diagnosis would be an understatement. I remember my parents trying to share resources with me about my disease. They tried to get me to engage with kid-friendly educational websites that explained what living with Crohn’s would be like. I refused to even glance at the webpages. They tried to get me to go to a camp for kids with Crohn’s; I rejected the proposition out of hand. In short, I was angry, withdrawn, and in absolute denial. Around the time I began treatment, which consisted of driving forty minutes to receive a Remicade infusion every four to six weeks, I started acting out in school. My disease, and my corresponding smallness, made me feel unbelievably insecure. Compounded with the awkwardness that is middle school, I struggled to form a coherent social identity outside of being the class clown. I became riddled with anxiety and began to suffer from insomnia. I also got in more and more trouble at school, eventually culminating in an out of school suspension my eighth-grade year.

"Struggling to keep up on the field, I found that I could no longer rely on sports as a prime facet of my identity."

As I entered high school I was responding well to treatment (the Remicade effectively induced remission), however I was still struggling to deal with the Crohn’s precipitated growth failure and delayed puberty. Outside of being a class clown, my identity had longed been defined by sports. But when I began competing in sports at the high school level, against fully developed eighteen-year-olds, my small size put me at a severe disadvantage. Struggling to keep up on the field, I found that I could no longer rely on sports as a prime facet of my identity. I had to give up the class clown routine as well; classroom disruptions were no longer seen by my peers as funny. Bereft of identity and still deeply insecure, I turned to partying to connect socially. I began drinking and smoking weed occasionally. By the time I was a senior, the smoking was a daily and the drinking a weekly occurrence. From a Crohn’s perspective I was doing superb, my disease was still in remission and after years of daily growth hormone shots I had finally hit puberty and my growth sport. But from a mental health standpoint, I was in a bad way. I was becoming increasingly reliant on weed and alcohol and other parts of my life began to slip. My relationship with my parents deteriorated, as did my grades and athletic performance.

"Things immediately spiraled out of control and I found myself hospitalized for a few days – not because of anything to do with my Crohn’s but rather because of my poor mental health and addictive behaviors."

Somehow, I survived my senior year relatively unscathed and headed off to college in New Orleans. Free from my parents supervision, my alcohol and drug use increased immensely. Things immediately spiraled out of control and I found myself hospitalized for a few days – not because of anything to do with my Crohn’s but rather because of my poor mental health and addictive behaviors. I limped to the end of the semester but was in so much trouble in school and was in such an unhealthy place that after some serious pressure from my parents, I agreed to go to substance abuse treatment. So, at eighteen, I flew to Minnesota and entered a youth treatment facility. That was the first time that I began to reflect on my childhood and realize how astray I had gone. I swore off alcohol and drugs and began to reconnect with myself. After intense months of self-reflection and rebuilding work, I enrolled in a college in Minneapolis.

Two years later, I graduated from college. I had transformed from the insecure teen. Now, I was a confident and healthy twenty-one-year-old. Not only was my Crohn’s under control (I was now taking Humira) but my mental health and addictive behaviors were as well. After working at a law firm for a year, I was accepted into law school in Virginia and my long-term girlfriend and I moved down there together.

"I wish I could travel back in time to tell that insecure, anxiety-ridden eleven-year-old Julian that everything was going to work out okay."

I am just beginning my first year of law school and am truly living a life beyond my wildest dreams. I wish I could travel back in time to tell that insecure, anxiety-ridden eleven-year-old Julian that everything was going to work out okay. While that is not possible, it is possible to share that message with all the young teens that are today struggling with Crohn’s and subsequent mental health issues.

That is why I am involved with the Crohn’s & Colitis Young Adults Network - to share that message of hope that things do get better. I am living proof.