The Acceptance and Struggle of a Childhood IBD Diagnosis

Being a kid is supposed to be a whimsical experience that one treasures and wants to have back. We long for those easier, good old days. But, when you are diagnosed with Inflammatory Bowel Disease at the age of 8, those childhood hopes can get lost. 

When I was diagnosed with Crohn’s disease, I did not know what it was. I remember telling my friends and them thinking I kept saying “Crow’s disease” (granted, I did have a speech impediment). Honestly, even I couldn't fully understand what was going on with my body. I felt alone, isolated, and trapped in my body. I felt frustrated because of the lack of support I felt from my peers and the lack of communication that I could provide to the people in my life. I felt confused as to whether I was being too dramatic or if I was really as sick as I thought I was. It becomes hard to trust your body and self when—for so long—your symptoms are not understood. Still today, these emotions can flood my body when I think about my diagnosis or even have to deal with unrelated health procedures. The body has a mysterious memory intact.  

 In response to these events, I have found that I tend to forget things related to it. To be honest, pretty much everything—specifically during my diagnosis phase of life—is most often a blur. Being diagnosed as a child really made me deeply struggle with the faults of reality and mortality and sickness early on. My body is easily triggered by hospitals or doctors. Whether my response bodily or emotional, I cannot immediately make sense of it all at the time. 

I often struggle making sense of my diagnosis. Being diagnosed at such an early age, the disconnect between what was real and fake is hard. How could it have such a constant effect on my life when I forget most details surrounding it?  It can be hard when you are surrounded by so many people who have such an understanding of their diagnosis and can write such beautiful lessons they have learned when most days I do not even remember what age I was diagnosed at. It is so easy to compare journeys, thinking your IBD is not as bad as the next, or that you feel alone with it. But what we can hold is that we don't have to be positive all the time. It can be painful and we can hold both the pain and the lessons we have learned. We do not have to make sense of our diagnoses. There does not always have to be a bright side to everything and that does not make you less of anything. Everyone has their bad days, whether you see them or not. Just remember that it is okay to struggle, it's okay if not everything makes sense, and we are so happy to have you here.

childhood IBD diagnosis

Planning with Crohn's

Stay with me for this one – I promise it won’t be as boring as it sounds! If you immediately switch off when you hear the world ‘plan’, or indeed ‘regime’ or ‘strategy’, you’re not the only one! There are, however, benefits to planning when you live with a chronic condition like Crohn’s Disease – and more importantly, if your plans become routines, then they’re more likely to become second nature, and you’ll find yourself doing those tasks subconsciously. Here, I will share some of my planning tips, which you may just find helpful. It’s all about finding what works for you so that you can manage to fit in all of the things you want to do, despite your health condition(s).

planning with crohn's

Smartphone apps

There are tons of smartphone apps available to help you keep lists, plan activities and so on! I keep it fairly simple, making use of macOS/iOS Calendar, Reminders and Notes (or the same apps on other operating devices). The calendar function is ideal for noting down all of your appointments. This helps for looking to the future, but also looking back at when and where different events occurred. The reminders app is an absolute lifeline for me. I have separate folders for different activities (e.g. university, health, work, voluntary commitments and so on). I add in activities, and a date/time (or location) reminder. This definitely helps me to keep track of everything that I need to do. If I didn’t, I would definitely forget! From a health tracking perspective, this is ideal as a reminder for booking in my next vitamin B12 injection which takes place every three months, as well as for when I need to ring up my doctor to arrange routine blood tests, when I need to self-inject my treatment, and when I need to order my repeat prescription. You may think that you’ll remember everything, but when you are busy with ‘life’, on top of ‘brain fog’ which many of us can relate to, it’s easy to forget. I know I have done that in the past, particularly when it came to self-injecting my treatment. I would remember that I need it on Tuesday for example, which would be the two-week dose period. However, I would have a busy day at college, would forget when I came home, and then in bed at night, I would suddenly remember, and think ‘I’ll have it tomorrow’. But then tomorrow became the weekend, and before I knew it, it may be a whole week later and I still hadn’t given myself my injection. I knew that was no good, but I just needed to do something about it – which I did!

Finally, Notes are brilliant! Again, I have different folders for a whole variety of different items. ‘Health’ is one of those. I use notes for keeping track of how I have been feeling, as well as for noting down points to discuss with my healthcare teams. I also use notes to keep track of discussions held with healthcare professionals, either face-to-face or over the phone. It’s just another good way to have information at your fingertips to help with your care, while the discussions are still ‘fresh’ in your head. 

Scheduling in rest days

We all know what it’s like to live with a condition like Crohn’s – we have so much robbed away from us. As a result, when you are feeling on the better side, you will naturally try to fit in everything that you can. I know that I have been there! Though sometimes, it really doesn’t pay off. That’s why I try to give myself time and space to just ‘do nothing’ – because I know that’s what my body needs. In pre-pandemic times, I would avoid booking in too many back-to-back travels, so that I always had some time to recover. In the current climate, I do my best to block off certain days where I’ll have meetings, keeping overs ‘free’ to do work at my own pace, and also take it easy. It’s all about being in control, as much as possible, so that you give your body (and importantly, your mind) the time and space to breathe.

Leaving the house with everything that you need

Phone. Wallet/purse. Keys. Mask! The list goes on – but it’s really important to have everything that you need to hand. As well as the usual items that most of us require these days, I also have supplies in my backpack and car for every eventuality. This includes painkilling tablets and gel, anti-spasmodic tablets to help with cramps, laxative tablets if I notice a blockage, anti-diarrhoeal tablets if the opposite happens, lactase enzyme to help me digest products containing lactose and the RADAR key to access locked accessible toilets. This list can go on and will depend on personal circumstances. I always find it best to have everything stored in one bag, so you can ‘grab and go’. It may feel excessive, but you will thank yourself later on when you’re not caught short.

Knowing your triggers and avoiding them

Although everyone is different, we all have some kind of trigger which can worsen how we feel. For me, I know that stress is a key trigger for worsening symptoms. That’s why I try to minimise stress as much as is practically possible – although that is much easier said than done! That’s why you’ll generally see me planning to do work well in advance of deadlines, for example, and seemingly ‘being on top’ of everything. In reality, it’s much harder to do, and I do find myself rushing for deadlines still – but at least I have minimised that as much as is practically possible. I am also my own worst enemy. As a perfectionist, I place huge amounts of pressure on myself to succeed and to do everything to the very best of my abilities. While it’s a good quality to have, it isn’t when it impacts on your health. So, it’s really important to be kind to yourself, and to re-evaluate your workload if you find yourself totally swamped and feeling ill. Nothing is worth more than your health.

Do you have any other planning tips which help you to live with your condition whilst getting through life? Let us know in the comments and on social media! 

planning with crohn's

There is No Right Way to Live with a Chronic Illness

I saw a quote the other day that said “There is no right way to live with a chronic illness,” and I immediately knew I needed to talk about it. Honestly, I want to get it tattooed on my forehead and shout it from the rooftops because everyone needs to hear it. 

“Oh, you have a chronic illness and you eat that?” 

“Oh, you have a chronic illness and you drink that?”

“Oh, you have a chronic illness and that’s how you workout?” 

The answer to these questions?

There. Is. No. Right. Way. To. Live. With. A. Chronic. Illness. 

There is no one right way to live. Period. 

Unfortunately, yet realistically, there can be  judgement within the chronic illness community at times. The same can be said for life in general. 

And here’s what I have to say: IBD, and everything in life, is so incredibly individualized. What works for one person might not work for another. What works for me may not work for you. What works for you may not work for your neighbor Susan or your cousin Jack and vice versa. 

Nobody should ever be shamed or put down or made to feel inferior or less than because of the decisions that they make in doing what’s best for THEM.

To think that there is one set way to live, one set way to eat, one set way to move your body, one set medication to take or not to take is to ignore an entire world that exists outside of your own.

When you really think about it, how cool is that life exists in so many different forms? How fascinating is it that I experienced this day differently than you? How awesome is it that we can find common threads that weave us together while still being uniquely ourselves? 

So, the next time someone hits you with, “Oh, you have *insert condition here* and you do *x,y, and z*? I could never.” 

Tell them how happy you are that they have found what works for them, how happy you are to have found what works for you, and how beautiful it is to simply be human.

Explaining Chronic Pain

This article is sponsored by Gali Health.


chronic pain

One of the most troubling and tricky feelings of the human condition is pain. It’s the body’s warning signal that something is wrong. It always seems to show up unexpectedly. It’s the world’s worst party guest. Seriously, it could at least bring a party gift, or an extra bag of chips and salsa to share. Instead, it interrupts the flow of midnight ragers and days of routine alike. Pain is the ultimate consumer. It takes, absorbs, and swells, without giving any of itself up. To make it even more complicated, pain comes in more hues, flavors, and shapes than can be counted. Pain is a universal experience, but the experience of pain is unique to each individual. 

There is round, smooth, aching pain that rolls around the body all day. There’s sharp, jagged pain that cuts, stabs, and leaves a metallic taste on the tongue. There’s pain that shapeshifts. It howls like a werewolf, then sizzles like the sting from an insect. I could go on, but the list of the types of pain is again endless. That said, living with a chronic illness like IBD means tasting an entire buffet’s worth of pain types. Despite the fact that pain is so specific, and individual, people often try to measure and compare pain. As a chronically ill individual, it can be frustrating to have your pain compared, and rationalized by others. For instance, people will often compare the abdominal pain from ulcerative colitis, or Crohn’s disease to a stomach ache. In reality, chronic pain is much different from everyday pain. 

When the pain from chronic illnesses is compared to pain from other illnesses, a large part of the context is ignored. Patients with chronic illnesses and pain have to confront pain oftentimes on a daily basis, and manage pain oftentimes without a totally effective treatment. The pain from a stomach ache, or a stubbed toe will eventually fade, and if it doesn’t, there is generally an effective treatment available. With a chronic illness, no such treatment necessarily exists. There is no timeline for recovery from the pain. Instead, it can be endless and unclear with multiple trials of various treatments required in order to find relief. In essence, chronic pain has no end deadline.

Despite this, the chronically ill often live normal lives everyday. Patients and pain sufferers go to college, go to work, and even to social events despite their pain. It’s especially important to remember this, because for all of its flavors, pain can be quite invisible. Dealing with pain is a challenge, and a burden, but millions of people around the world surmount the obstacle of pain everyday. Accommodations for patients make living with this weight easier, and enable us to be more active members in our communities. Still more work needs to be done to improve the quality of life for those dealing with pain. The compassionate way to treat the chronically ill, is the most inclusive way and the way that eliminates the disadvantages of the disabled. In the future, I hope all pain is treated with the utmost consideration and care for the individual. After all, if that was the case, there would be a lot less physical, and mental pain in this world.


Gali Health

This article is sponsored by Gali Health

Gali Health is an AI-based personal health assistant app helping people with inflammatory bowel diseases (IBD) proactively manage their condition. Gali gathers knowledge from daily interactions and health monitors to tailor support and information to your specific IBD experience.

What to Expect When a Loved One Gets Diagnosed with IBD

Navigating an IBD diagnosis is not easy. It can be messy and emotional and very tiring. The person diagnosed with IBD will be feeling many emotions, probably all at once. But it’s not just hard on the diagnosed individual; it can be very hard on their loved ones as well. It can be difficult to figure out what to expect and what to say and how to act when you find out someone was diagnosed with Crohn’s disease or ulcerative colitis. Hopefully this article will provide some insight into what to expect when that diagnosis happens. 

The first few hours and days after your loved one gets diagnosed with IBD can be very confusing. You are processing their diagnosis, while trying to be there for them as well. While everyone processes it differently, there are likely some common reactions you can expect. Here are a few things to keep in mind:

  • Be prepared to simply be there for them. Whether they want to talk about it or not; whether they want you to accompany them to appointments or infusions; whether they want someone to sit with them while they are sick. And even if they don’t want any of that, make sure that they just know that you will be there if/when they do. Be there for them when they are ready to talk to you. Tell them you are there if they need anything and be ready to back it up with your actions. There is nothing worse than empty words. 

  • Be prepared for them to become experts on their own bodies. They will become very familiar with their symptoms and will likely know when something is not right. Learn to trust that. If they tell you they think something is wrong, don’t try to argue with it. 

  • Be willing to learn with them. For me, I read up a lot on my diagnosis. I read others’ stories, I read articles, I read medical journals. And I wanted my friends and family to understand some of what I was learning. So, be willing to read the articles they send you. Educate yourself on their disease. Don’t be afraid to be educated. 

  • Be ready for the hard days. The days when their medication isn’t working. The days when their Prednisone is making them miserable. The days when they are in the hospital. Not every day will be hard, but some will be. So be prepared when they come. Remind your loved one that it won’t last forever. 

  • Also be ready for the good days! The days when they find out they’re in remission. The day when they try a food they haven’t been able to eat in a while and it goes well. The days when they feel like themselves. Just as the bad days come and go, the good days will come, too. 

  • Be ready for the doctors’ appointment. Especially when your loved one is first diagnosed and they are working to get control of the disease, there will be a lot of doctors’ visits. There will be ER visits and hospital stays. There might be infusions they have to go to on a regular basis. They may or may not want you to come. Be ready to support them either way. With COVID, they may have wanted you to come and you may not be able to. If that’s the case, try to get creative with ways to make them feel like you’re there. FaceTime them, call them, text them. Do something to make them not feel so alone. 

  • Ultimately, be ready for a journey. It isn’t always easy and there will be really hard days. But your loved one is now part of a community that is welcoming and ready to help when they want. There will be people that they can relate to and that can understand them in ways that someone without IBD can’t understand. Encourage them to reach out to people they see on social media. Encourage them to ask questions and not be afraid to speak up. The IBD community is a great one and people are always willing to help! 

Navigating a loved one’s IBD diagnosis can be a daunting thing. It is a lot to process and there is a lot of unknown. But by just being supportive and being attentive to your loved one, things will probably go a lot better than you expect them to. 

diagnosed with IBD

My IBD Life - Ode to Despair

I sat down to write this article with the intent of describing some personal experiences with my family and friends during a period of progressing sickness that eventually led to surgery. It’s very hard for me to segregate various aspects of that time. I was struggling on many fronts. Everything seems so intertwined. I probably would have managed better, if the only thing I had to worry about had been my health. Sometimes, I wonder if I could live through that again. The worst parts of that period were the nights. Serially failing medications had brought me to a point where I was living with severe chronic pain and total incontinence. Every night I would go through a sequence of muffled crying, screaming, and dancing, to wither and end up on the floor like a lifeless body. I did that deliberately to tire myself out and fall asleep. Every night it was the same routine. Some nights, the urge to end it all was too strong to resist. I dreaded the nights and took up a night job to cope. I thought if I forced my mind to concentrate on a job, it would help with the pain. I’d suffocate at work, and even had “accidents” at work, despite wearing diapers. Everyone around me in my home or outside was oblivious to what I did to myself in my room in the dark. My coping mechanisms bordered on the psychotic.  I would strangulate my body parts to make them numb. I would try to substitute the pain with another kind of pain by using an excessively hot pad. The pain was too much. The blood was too much. The nights were too long. The thing that hurt more than the pain was that every medication would make a mockery of my attempts to live. Early promising results followed by a rapid decline leading to increased symptoms were a pattern. At my core, I’m not a very hopeful person. My life circumstances have molded me into a deeply introverted and pessimist personality. My mind constantly tries to simulate everything that can go wrong and I try my best to put control measures in place. With this disease though, I was helpless. I read vehemently, but I was not a doctor. I forced myself to cultivate hope with every new medication. However, I always ended up dejected. Sometimes, I felt like a bloody soldier struggling to stand straight, kneeling on the ground against his sword, and waiting for all of it to get over.

As I started reminiscing those nights, my intents changed. I wanted to describe that cycle of hope and consequent despair to someone. It resulted in me writing a poem which I’m sharing here. 

They tell me the war is over and we won.

They tell me that the night is at last, gone.

They tell me the sun’s rising on the horizon.

They tell me, they tell me it’s a new dawn.

They tell me the same things again and again.

And each time they say it, I believe them. 

I hide from my fears, behind a translucent curtain.

Weak ropes of hope bear the weight of my pain.

Soon it all comes crashing down to the ground.

And I see them again. The blood-hungry hounds.

Dread sets into me as they approach and surround.

Every inch of me bleeds. My screams resound.

And when it’s all over, I look down from the edge.

Frail, pale, broken, and defeated, after the rampage.

No antidote to my ailment, my soul feels caged.

Desperate, I am prepared to embrace the only escape.

“Stop! Don’t!” I hear a voice break the silence.

I recognize the voice. It’s them. Once again.

They praise my resilience. Talk about Providence.

Promise me there’s a reason for my existence.

They look to infuse me with hope and faith.

They tell me tales of the fierce and brave.

Why then I don’t believe what they say?

Oh! It’s because, soon after ...

They tell me the war is over and we won.

They tell me that the night is at last, gone.

They tell me the sun’s rising on the horizon.

They tell me, they tell me it’s a new dawn.

There was a time when I tried to capture my pain in words. I was better at writing then. With time, the writing started to feel like a futile exercise. The nights never went away.  Instead, I now try to repress those experiences in some corner of my brain as I have done with other traumatic incidents that I have lived through.

My doctor once told me that there were only 2 patients other than me under his care, with a severity of disease that was similar to mine. I felt sad, but then I realized it’s a good thing that more people do not go through such experiences. However, I’m sure there are enough like me in my country which has a population of 1.3 billion, but I’m not sure if everyone is as lucky as me. The mental health of patients with Inflammatory Bowel Disease has never been a priority in the Indian Healthcare system. It’s time that we begin to provide holistic support to young adults with inflammatory bowel diseases to enable them to manage this disease better and come out of the experience with as little residual trauma as possible. 

Please stay safe and take care. See you next month. :)

IBD life

IBD and Anxiety

IBD and anxiety

When you are first diagnosed with Inflammatory Bowel Disease you learn quickly that the brain and gut function as one. They are deeply connected. Even if you don’t have IBD, you can look to feelings like butterflies in your stomach when you are nervous, excited, or in love. IBD has given me the superpower of identifying an instinctual trust of my gut. One thing you commonly hear when talking about how to manage your IBD is that you have to manage your stress levels. Since the brain and gut are so connected, the chances that a flare up will occur when you’re stressed are high. Truthfully, being able to manage your stress is a very privileged thing to be able to do and that’s a conversation that needs to be had. Outside forces and systems of oppression exist heavily in our world today. We are not functioning in a world that allows you to thrive and prioritize both your mental and physical health. For most people, there is always a tremendous amount of stressors that you cannot escape. Things like finances, unstable households, going to school, and working all cause a great deal of stress. 

Today, I want to specifically talk about how managing stress levels and IBD feels increasingly impossible when you have clinical anxiety and/or PTSD, as these are so often linked with IBD. 

I was diagnosed with IBD at a young age. My physical health was always prioritized over my mental health. This was more pronounced, I think, because mental health is not a thing that is necessarily often invested in for young children. As a child, it was very difficult for me to identify what I was feeling and what triggered these feelings. Specifically, with my anxiety, I did not know what a neutral state of mind meant. I didn’t know what my anxiety looked or felt like till around my sophomore year of college. After going on anxiety medication for a bit, I was able to understand what intrusive thoughts were and how they occupied my life. 

The baseline for my anxiety is intrusive thoughts, but it can also manifest itself in different ways just based on the things I am doing in my life at the time. For example, my anxiety can manifest itself in ways such as crying in social settings, having an obsession with time (i.e. constantly looking at the clock or leaving hours early for events), and, when things are more extreme, staying in my room for days on end. For me, it is so important to specifically state how my anxiety manifests because for so long I did not know what it meant. I think it is important that we normalize talking about everything that anxiety can bring with it, not just generalizing or downplaying it. So often, I think anxiety is talked about in very loose terms and given very simple fixes for how to “handle it.” This, in return, can oftentimes belittle the situation. 

When these more intense and intrusive moments occur, my IBD flares up. So, I often question how I am to manage my stress when I often cannot control my anxieties. In the past, I would become stressed when I experienced my anxieties because I did not know what was wrong. Now, they still stress me out, even though I know that it is anxiety. 

For me, and I think many others, anxiety is something that I have to constantly cope with on the daily. If I am not ten steps ahead of it, it will simply swallow me whole. 

IBD and anxiety can feel overwhelming and scary, but what has helped me is knowing that I am not alone. Having these two conditions together is not uncommon, and what feels very isolating and full of despair is not the case. Medication has helped me in the past and therapy is a forever process for me. I also keep a bullet journal of coping skills I have used in the past - identifying coping mechanisms that worked and ones that did not. This list gives me a place to turn to when I feel as though nothing could help and it's easily accessible. I have also found solace in being in a community of people who understand. Explaining anxiety or IBD to someone who has not gone through it can be very exhausting and this goes for many other varying identities as well! When I do find the energy, making art is another space for me to process my anxiety, whether that be through a conceptual piece or just painting a canvas with one color over and over again.

What are ways you cope with your anxiety?

Judging Symptoms with Crohn’s

Sometimes, it feels like all gastro symptoms are inflammaotry bowel disease (IBD)-related… especially being symptomatic with IBD for so long. However, it’s not always case – which can cause a great of confusion, as well as making life just that bit more complicated!

As well as Crohn’s disease, I also have gastroesophageal reflux disease (GERD), irritable bowel syndrome with constipation (IBS-C), an internal rectal prolapse and lactose intolerance. I was diagnosed with Crohn’s disease in 2008, after several years of experience gastro-related symptoms. So, at that point, I assumed that everything I had experienced was the result of Crohn’s. What I failed to realise, and what wasn’t explained very well at the time, was that I also had GERD. I was suddenly prescribed all of this medication, without being properly informed of the purpose of each different medication.

Over time, and with the right treatment, I became more informed, and I was able to get my Crohn’s disease under control, to the point where I was deemed to be in clinical remission. This was concluded by considering blood tests for inflammation (CRP and ESR), colonoscopy and gastroscopy results, small bowel MRI scan results and faecal calprotectin results, each of them done at different frequencies over different periods of time. This happened gradually over a few years, and in the process, I learned more and more about my body. However, I began to struggle with more gastro-related symptoms, which I initially thought were a Crohn’s flare, but soon realised were not exactly the same as before my Crohn’s diagnosis. I felt bloated and constipated, I had abdominal pain, and I was passing mucus. It became clear that I most likely had IBS-C. The problem I found with IBS was that there was no quick and easy fix for it – not that there has been a quick and easy fix for Crohn’s disease, but at least I was able to take some treatment which helped control the inflammation. With IBS, I felt very much in the dark. Recommendations were an anti-spasmodic to relieve cramping, laxatives to ease constipation, and avoiding foods which seemed to make me ‘worse’. I watched what I ate very closely, and soon identified certain green vegetables as a trigger, as well as milk products, which I tried to reduce. 

Little did I know, but the milk products weren’t just a trigger for worsening my IBS symptoms, but I was also lactose intolerant. I was diagnosed in 2015 – some seven years after my Crohn’s diagnosis. This only happened after one doctor felt there was something else going on and decided to test for lactose intolerance and Helicobacter Pylori infection – and thank goodness they did! I’ve managed to cut most forms of lactose completely out of my diet since, and when I can’t, I have found a lactase enzyme supplement I can take immediately before eating or drinking something containing lactose, to help me avoid those unpleasant symptoms.

I thought that was going to be it when it came to gastro problems. Then, something else came along! Originally blamed on my IBS-C, I noticed I was struggling more with constipation, despite eating a balanced and healthy diet, and doing everything else ‘right’. A couple of healthcare professionals didn’t really acknowledge my perspective, and just said I need to take laxatives permanently – something which I do take, but often feels like a ‘quick fix’ or ‘cover the wound with a plaster’, without understanding the underlying reason for these changes. Many blame IBD, plus IBS for constipation, without necessarily looking further. It sometimes feels as though assumptions are an easier option in the medical world, but not for those of us living with these symptoms. Moreover, I had observed changes beyond those I had learned to notice by living with IBD and IBS-C. 

Cutting a very long story short, I ended up going for a proctogram which revealed I had an internal rectal prolapse – which is basically when your rectum folds in on itself. It wasn’t the most dignifying procedure – much like most gastro-linked investigations. Dignity often goes straight out of the window! However, this finding did explain the sharp shooting pains I had been having in my rectum, as well as the mucus I had been passing, the ‘fresh’ blood I had noticed, and why it sometimes felt as though there was a physical obstruction – because there was. The verdict was ‘there’s not much we can do’ – something I think we’re all too used to hearing. There are surgical options, but they come with risks and they more or less said they would not be considering that option for somebody of my age. So, I was sent away with pelvic floor exercises, and the notion that ‘I just have to live with it’ – which I do. At least I received an answer for the symptoms I had been experiencing, even if I don’t have an answer as to ‘why’ I have a rectal prolapse. My current hypothesis is that it is something to do with hypermobility, which has consistently been overlooked – but that’s a whole different story!

All of these different symptoms, and the conditions subsequently diagnosed, have taught me so much. I have learned to really listen to what my body is telling me – which is not easy but does improve with time. I’m not always right, but my judgement certainly seems to be stronger now, after all of these years with IBD, IBS-C, GERD, a prolapse and lactose intolerance. I am much better at distinguishing as to ‘what’ is causing ‘what’ – although it’s impossible to always be ‘right’! You just tune into what you are feeling, almost like detective work. You place pieces of the puzzle together to help you build the picture of what you think is happening. Your previous experiences and your observations guide you, alongside being proactive in terms of knowing clinical indicators, recognising new triggers, stressors or symptoms, and then being proactive in seeking the right input from the right healthcare professionals. It comes more naturally after years of having to take things into your own hands to get answers. For example, I now know that the abdominal pain and cramping that I frequently experience is when I am perhaps a little constipated as a result of IBS-C and my internal rectal prolapse; so I adjust certain parts of my diet and take additional laxatives when I begin to notice patterns changing, early on. Likewise, the ‘whale’ noises and ‘washing machine sensation’ immediately indicate that I’ve consumed something containing lactose without realising – like the time I ate a gorgeous cheesy pizza, and then realised I hadn’t taken my lactase enzyme… I suffered for the next few hours! 

These conditions, in one sense, sensitise us to be more receptive to how our bodies work. I don’t think I would have been as knowledgeable or as ‘switched on’ as I am if I hadn’t been diagnosed with them – and I wish more people recognised this, particularly certain healthcare professionals. I often have grievances with professionals who rely solely on certain clinical indicators for disease remission. For example, those who just use CRP as an indicator as to whether you are in remission or not. This has happened to me in the past when I was evidently in the middle of an IBD flare, but at that point in time, I was not confident at self-managing my health. As it turned out, my faecal calprotectin was off the scale, and so some additional treatment helped me out immensely. What did I learn? Nobody knows my body better than myself. Healthcare professionals can help me the most when they listen to what I am saying, acknowledge my expertise, and then work with me to identify what is really happening, and then plan with me as to what to do to help manage symptoms so that I can get on with my life, and most importantly, have a good quality of life. So, when anybody questions what you are thinking or feeling, remind them of this point, and hopefully, they will change their approach so that it is supportive, rather than a hindrance.

crohn's symptoms

Thoughts on IBD in the Workplace

IBD in the workplace

Please provide your most recent job history. Done. Proceed to the next page. Do you have a disability that you would voluntarily like to disclose? This can include autism, blindness, cerebral palsy, missing limbs, autoimmune conditions like lupus, gastrointestinal diseases like Crohn’s disease or IBS…I blinked, and stopped. What did I just read? 

In the past, I had always checked No, I don’t have a disability or history of disability. But now, as I start to look for Physician Assistant (PA) jobs, I can’t ignore the fact that I live with ulcerative colitis (UC) and flares can rear their ugly heads even when I take the best care of myself. I never had to sit and ponder this question before. Because of the way disabilities are viewed by most people, stigma swirls around it, leaving previously unaffected people like me unaware and uneducated about progress being made and the struggles still faced in the workplace. Disabilities are commonly viewed with negative connotations - several of my coworkers and other colleagues that live with chronic illness and/or disabilities have highlighted this and spoken powerfully against this negativity. Living with a disability doesn’t mean that you don’t have as much to offer. The people I’ve met through the chronic illness and disability community are some of the most resilient, creative leaders I know. We face our challenges and continue living and advocating against all that is physically or mentally against us - we have to draw incredible strength and grow up sooner and in ways that most others don’t. 

IBD in the workplace

However, I still struggled with multiple emotions as I sat, mulling my thoughts, stuck on this page of a job application. I have never considered myself as a person “who has a disability.” I felt guilty - would those with disabilities think that I don’t support them since I don’t want to group myself with them, giving myself another label that’s often viewed as weak? Am I misrepresenting those who do have disabilities because my UC has been so mild and I am largely functional? I felt that I don’t belong in the “disability group”, but I also can’t deny that I have a chronic illness that can be disabling in a variety of ways. I definitely consider myself lucky and blessed, but I know that my UC can change throughout my life and potentially become more difficult to control. I struggled to work through these thoughts, but then thought about how my growth this year from being more involved with advocacy has given me tools to advocate for myself and to continue learning from this community. 

My options were: 

  1. Yes, I have a disability, or have a history/record of having a disability

  2. No, I don’t have a disability, or a history/record of having a disability

  3. I don’t wish to answer

What should I choose? It had to be either #1 or #3. I couldn’t lie - I was more afraid that it would not go over well if I did get the job and had to bring up my UC later to my employer. But then, if I marked “yes”, could that jeopardize the chances of me getting interviewed or getting a job? I’ve heard awful stories about those who hid their disability from their employer because they knew it would affect them being hired or even interviewed. Luckily, I was working with another healthcare provider who had been diagnosed with lupus over the past year and was also learning how to navigate her chronic illness in the work environment. I asked her what she thought and we ended up having a candid conversation - I realized that if marking “yes” caused me to not get an interview or a job, then that job wouldn’t have been supportive enough for me anyway. Perhaps this is my stubborn streak coming through, but I hope that working in the medical field will hopefully make potential employers more understanding. However, I know that the stigma that encircles chronic illness and disability still permeates the workplace, and this fact will stay on my mind throughout my job search. 

In the end, I did mark “yes.” It is more important to me to have the chance to advocate for myself and be supported rather than hiding my diagnosis out of potential embarrassment or fear of how I would be treated because of it. Maybe this will backfire, but by being up front about my UC, I’ll feel more comfortable in my workplace. I hope that I’ll be supported enough to communicate any issues I’m having or if I do end up needing some sort of accommodation in the future. I’m very excited about applying for jobs and starting this new chapter in my life and career as a PA, but I still have much to learn about disability in the workplace. I hope by learning to navigate these waters, I can help others who may be in the same situation - questioning if they fall into the disability category or not, wondering how they should approach disclosing (or not disclosing) their condition to their employer. Since the US just hit the 30th anniversary of the Americans with Disabilities Act, I also plan to continue to educate myself and learn more about the disability community in conjunction with chronic illness. We should never have to choose between our career and our health, and I hope I can join many others who are working to make this a reality for all who are affected by chronic illness or disability. 

Emotions and IBD

Emotions and IBD

There are a lot of emotions that come with the diagnosis of any chronic illness, or even any major life change. But laying on the operating table, under the haze and fading twilight of the anesthesia medication exiting my veins, I felt nothing. The echoing silence of the room was heavy all around me. I expected to feel an overflowing stream of emotions flow over me, but instead the most striking sensation of my diagnosis was emptiness. It could have been the drugs dulling my system and my perception of the world. Yet, over time, I’ve started to think that the cause of the void-like feeling around my diagnosis was something incredibly real, and not artificial. The feeling of change is oftentimes so big that it feels like nothing. 

In that hospital room, so much had changed with a simple test. The scale of the moment was beyond comprehension. My parents and I communicated without words, because anything that could have been said would have failed. All the periods, letters, and adjectives in the world would never be enough to frame that point in time. So, somehow and instead, I just knew that I had ulcerative colitis without being told. Shock, and the whole experience, was such a surreal feeling. To know that something has snapped, or broken, or ended, but to be unable to directly confront that realization is off-putting. It was easier to not speak the change aloud, because to speak it into the world would make it extra real. 

In the weeks after my diagnosis, it was as if a light switch had been switched back on. All of the fear, grief, and anger I had missed earlier suddenly now surrounded me. The trauma of illness is such a widespread and varied experience, but it can be difficult to describe and discuss. It’s isolating to feel different, and to feel like you’ve lost a piece of yourself. Health is something that most people take for granted or don’t think about. So when it’s taken away from you, its absence becomes the dominant part of your everyday life. The shift in my lifestyle to one focused on health had a significant impact on my mental health. I was in an environment, my freshman year of college, where everyone seems to be testing the limits of their independence. Thus, to feel completely dependent on my unstable day-to-day health felt unfair and tragic. 

It’s a challenge to have the energy to battle painful, and draining symptoms on a daily basis. I learned that adjusting to my illness, and all of the treatment that comes with it, was a major part of my healing journey. On top of that, I realized that acknowledging the emotions I was experiencing was an important part of accepting my illness. It’s normal and natural to be angry, to grieve, and even to be nostalgic for your life prior to diagnosis. In fact, for me, it was the first step towards opening up and connecting with others in the chronic illness community. My experiences, feelings, and my relationship towards my health has been full of highs and lows. Most of all, I’ve learned that the negative and positive emotions I’ve encountered from dealing with illness are all valid. They’ve helped me grow, learn, and evolve as an individual. Every journey is different, and that is perfectly okay.

emotions and IBD

Life Hacks: How to Break Up with your Favorite Foods

By Rachael Whittemore

Photo by Sydney Troxell from Pexels

Photo by Sydney Troxell from Pexels

Just like that - we’re well into summer and I almost can’t believe it. Even though it feels like it’s been 10 years since January, I’ve thoroughly enjoyed all the fresh food that comes with this season. The days are longer, the fruit and veggies are ripe and I don’t feel weird about wanting to eat some version of a salad daily. I’m even starting to learn how to garden! (TBD if anything makes it though!) However, as I think about some of my favorite summer foods, it also reminds me that for many of us living with IBD, it’s very possible that our bodies can’t handle some of our favorite foods anymore. After being diagnosed, we probably searched the internet for resources and advice on what to eat, what to avoid, and somewhere along the way we learned that what might work for you might not work for me. 

My co-fellow Lucy published a wonderful video last month about how she has learned to thrive with her dietary restrictions and how she’s managed her “break up” with things like dairy. Because having different perspectives can be helpful to all of us living with IBD, writing this was very important to me. I also felt led to write this because if you have met me, you know how much I LOVE food. Cooking food for others and sharing it provides a huge sense of community for my family and me as it does for many others. Certain foods are tied to family by culture, tradition or memories, and it can be a challenge to really stop eating foods that may have been fine before. It also may take time, especially if they were a large part of your diet pre-IBD. Here are some tips for getting away from IBD-problem foods and to find joy in what you can eat and let it nourish your body. 



1

Work on accepting that you and this much-loved food and/or food groups just don’t get along.

Living with chronic illness requires us to work through a lot, both physically and mentally. Accepting that we have a lifelong illness is hard in so many ways, especially one that can be unpredictable, embarrassing and frustrating. Accepting that I can no longer eat certain foods I love is difficult too, and we shouldn’t be embarrassed to mourn giving up parts of our pre-IBD life. For me, accepting that something isn’t working for me or my health helps me move forward as I try to live my best life. 



2

The short-lived happiness of eating said food(s) is usually not worth what comes later.

I have personally struggled with this in my journey to give up milk and cheese. I realized that I was likely lactose intolerant in college when I decided to do a month dairy-free. I didn't have IBD yet, but milk and cheese products had always given me issues. There are times when I fooled myself into believing my sensitivity wasn’t that bad, but as I have gone through extended periods of not drinking milk or eating cheese, I feel so much better. No pain, no constipation, less flares and much less bloating or gas.

 

3

Silver lining? There could be a certain way you can handle said food(s) or food groups.

If you can’t do cow’s cheese, maybe goat cheese works. In my case, I can usually handle regular yogurt without problems, and I will eat small amounts of it with fruit and nut butter to give my body some calcium and ~good bacteria.~ Maybe if certain veggies bother you, try cooking them waaaay down and adding to a favorite dish you like, or cooking them with no seasonings and adding them into something like a smoothie. I love to use baby spinach and greens this way! Other times, you may just decide it’s best to avoid something altogether.



4

Helllooooo substitutes!

The wonderful thing about living in an era where people are more aware of food allergies or sensitivities is that there are more and more substitutes for common food groups that you may need to eliminate.  Non-dairy, soy-free, gluten-free, grain-free, nut-free, egg-free, vegetarian, vegan...I know this list goes on and there are many I don’t even know about yet. I have recently tried oat milk and love it because it’s a little creamier and great for coffee and it’s far more sustainable than my usual almond milk. In terms of a vegetarian cheese (no lactose but does have casein), I thought all hope was lost until my roommate introduced me to this almond cheese. It’s my favorite affordable non-lactose cheese and even comes in a pepper jack flavor that’s awesome. Here’s a few links to other things I regularly substitute based on my current diet: my fav oat milk, mac n' cheese, yogurt (with dairy, dairy-free and lactose-free), almond and coconut milk yogurts.

5

Find blogs, Instagram accounts or online recipes that cater to your dietary needs.

This is something else that has been great to have on hand in our digital age. Especially during quarantine, I’ve been trying some new recipes and looking at ways I can eat the things I love without missing the things I had to give up. Sometimes you find some handy, simple tips that you end up carrying with you on your IBD-food journey. Like, who knew that coconut milk and cream created a great base for non-dairy ice cream? If you want a great online account to check out - my co-fellow Rachel Straining has an amazing blog and Instagram: @thenoglutengirl. Give her a follow and check out her amazing yogurt bowls, baked goods and realness about her journey with Crohn’s. 



6

Sorry, not sorry.

One of the most important things to do when you’re working on giving up or decreasing consumption of a food is to stick to your guns. It becomes much more challenging when you’re eating out with others and during the holidays. As tempting as it is to eat things you like and not feel like a burden to others, it’s so important that you don’t let this pressure get you down and cave (but I’m definitely guilty of this!). I’ve learned that being real about what I can and can’t eat works out both ways in the end - your body will thank you and you feel confident in the choices you’re making for yourself. You may not realize it, but it empowers your own self-advocacy. :) 


These are a few tips just to get you started, but know that all of us living with IBD have gone through this or are still working through it. Sometimes our food tolerances change, and as frustrating as it can be, search for opportunities to try something new or create a new version of something that you miss that still tastes amazing. I empathize with you and understand the frustration of trying to find foods and a diet that works for your needs. IBD makes life harder sometimes, but I know so many people who rise to meet all the challenges they’re faced with. Breaking up with some of your favorite foods may not seem like a big deal, but I’ve been there and I’m still there sometimes. You have no idea how much I wish I could eat chips and queso! Especially if you’re newly diagnosed, take each day at a time and I hope you can find the silver lining one day and laugh at all the times you thought eating *said food* was ok and ended up in bed at 8 pm because of it.

Grieving with Crohn’s

By Simon Stones

CCYAN - August 2020 Simon Stones Image.jpg

I have experienced some loss over the years, none more difficult and painful than in 2019, when I lost my mum to pancreatic cancer. The pain was indescribable, like nothing I’ve ever experienced. In the weeks and months that followed, I had to adjust to the fact that overnight, my life had immeasurably changed. I now had to adapt to a totally new way of life – one which felt uncomfortable, unfair, and at times pointless. 

During these times, I was reminded of the grief people experience after receiving a life-changing diagnosis, like inflammatory bowel disease (IBD). Naturally, this type of grief is somewhat different to the grief experienced when a loved one dies, but it is still a form of grief. You are grieving the loss of your pre-diagnosis life... and it’s an important, and necessary process which you must go through. 

Grief strikes each person differently. After all, we all have our own, unique ways of dealing with challenges and heartache in life. A friend recently sent me a surprisingly accurate analogy of grief, which hit the nail on the head. It shows that for most people, grief of a loss, whatever that loss may be, never leaves a person completely. The loss never goes away, but it may change over time. 

Imagine your life as a box. Inside the box, there is a ball, which is the grief you feel, as well as button which when pressed, causes pain. During the early days after your loss, everything is new. Everything is raw. The ball of grief is overwhelming, and so large, that every time you move the box... that is, every time you try to move through your life, the ball of grief cannot help but hit the pain button – constantly. This represents that initial experience of loss – when you can’t control or stop the pain that you are feeling. It is just relentless, no matter how much others try to support and comfort you. At this point in time, it feels as though the pain is unrelenting, and will be like this for the rest of your days. 

However, over time, the ball starts to shrink on its own. As you go through your life, and as the box moves, the ball still rattles around inside the box. However, because the ball is now smaller, it hits the pain button less often. In one sense, you may feel that you can go through most days without having the pain button hit. However, when the ball does hit the pain button, it can be completely unexpected – and hurts just as much as it did during the early days of your loss. This could happen when you’re in a particular place, such as at the hospital, or when listening to a piece of music that reminds you of your life before your diagnosis. It could be anything that is personally meaningful to you. 

As time passes, the continues to shrink and with it, so does the grief for the loss we have experienced. However, we never forget the loss that we have experienced. We must acknowledge that there will be days when the ball does hit that pain button, and when it does, we must be kind to ourselves. 

“We must accept sadness as an appropriate, natural stage of loss.” 

Upon reflection, it’s quite easy to see how this analogy somewhat resembles the process we go through after loss. I’ve certainly seen it after the loss of my mum, but also thinking back to when I was diagnosed with Crohn’s disease. I’ve also observed this with other people I’ve met along the way living with a variety of chronic health conditions. However, the process isn’t straight-forward – nor something we can plan for. It’s personal for each and every one of us. 

In 1969, Swiss-American psychiatrist Elisabeth Kübler-Ross introduced the five stages of grief model. The model describes how people experiencing grief go through a series of five different emotions: denial, anger, bargaining, depression and acceptance. While the model has received criticisms, Kübler-Ross said that she regarded these stages as reflections of how people cope with illness and dying, rather than reflections of how people experience grief. What is certain is that these stages are not linear and predictable. 

Let’s start with denial. Can you remember the thoughts that went through your head when you received your diagnosis? Denial is an entirely normal reaction to rationalise those overwhelming emotions that we experience. You can almost regard denial as your human defence mechanism to when you receive that shocking news, and when you begin to think about what you have lost. 

Then there’s anger, which often consumes our souls once the denial starts to diminish. As the pain of the realisation sets in, and as your senses begin to heighten to your surroundings, those feelings of intense frustration and grievance set in, as we start to search for blame. For some, the anger may build up internally, whereas for others, their response mechanism may to be to lash out at everyone and everything around them. 

Along comes bargaining at some point. You know, the stage where you think, ‘What if...’ This serves a really important purpose – and often a temporary escape from the pain you’ve been experiencing. For there may just me small, tiny glimmers of hope, amidst the chaos and despair. 

There’s also depression. In the past, I’ve sometimes felt scared of the term – or rather, the label that can exist in society. But what’s unnatural about depression in these circumstances? It is an entirely rationale and appropriate response as you deal with a great loss. From the intense sadness, to the overwhelming lack of motivation, poor sleep and altered appetite – it’s all part and parcel of dealing with something as colossal as life-changing diagnosis. Again, the experience of depression will vary between every individual, and indeed within yourself, depending on ‘where’ you are at any given moment in time. 

Finally, there’s acceptance, although it’s certainly not ‘final’. Here, you succumb to the reality of your loss, and understand that no matter what you do, nothing can change that reality. This doesn’t mean that you are ‘okay’ or ‘happy’ with the loss that you have experienced; however, it does mean that you are getting your head around it, and are learning to live your life, albeit different, in the best way possible. 

I have no doubt that so many people living with IBD can relate to these different stages and emotions – which can often feel like one big mess, sometimes happening concurrently, and most certainly in a disordered, confusing way. There will always be days when you think, ‘I’ve had enough of this’ – I know I still have those, but they are less frequent as time goes by, and as I learn to adjust to present life. It’s a bit like being out at sea. Sometimes, the sea feels calm, and you can see the beauty in the world. At other times, the waves overwhelm us. When you feel like this, just remember to swim and look for dry land. It’s all we can really do. 

CCYAN - August 2020 Simon Stones Quote.png

The Invisible Rights of Persons with Invisible Disabilities Act of India

disability.png

On July 26, 2020, the United States celebrated the 30th anniversary of the Americans with Disabilities Act (ADA). I’ve known about the ADA for a few years now, and I think that it is a great thing! From an outsider’s perspective, what I admire the most about the ADA is its wide scope. The list of medical conditions that can be evaluated for disability benefits seems exhaustive and as inclusive as possible. Disability is very difficult to define in precise terms as it can be a very personal experience. Hence a policy like the ADA which has a wide scope of application should be adopted by every country that wishes to protect the interests of the disabled. 

The Rights of Persons with Disabilities Act (RPwD Act) is the Indian equivalent of the ADA. The full text of the Act can be accessed at http://www.tezu.ernet.in/PwD/RPWD-ACT-2016.pdf. The RPwD Act is introduced to be “An Act to give effect to the United Nations Convention on the Rights of Persons with Disabilities (UNCRPD) and for matters connected therewith or incidental thereto.” The definition of a “person with disability” adopted by the Government of India is the same as mentioned in the Convention - “a person with long term physical, mental, intellectual or sensory impairment which, in interaction with barriers, hinders his full and effective participation in society equally with others.” India was one of the first countries to ratify the convention. We did it in 2007. But the RPwD Act came into force only in 2016, and it is yet to be implemented by all the states of India. 

Leaving aside the poor implementation of the Act, the list of conditions that can qualify someone for disability benefits is very short and includes only 21 conditions, most of which are visible disabilities. People with these conditions are evaluated and given a disability certificate that mentions the extent of their disability as a percentage. This percentage determines the extent of support they can receive from the government. The RPwD Act lists all the rights and entitlements of a disabled person. It also lists various measures taken by the government to protect the interests of people with disabilities which include reservations for disabled persons in various areas like employment, education, land allotment, and developmental schemes. 

Ever since I began graduate school, I’ve had to speak up on several occasions for receiving appropriate accommodations. In these discussions, to highlight the seriousness of my condition, I often bring up the fact that patients with Inflammatory Bowel Disease (IBD) who satisfy certain conditions, and patients with ostomies receive Disability Benefits in the United States. However, since the Government of India (GoI) does not recognize ostomy/IBD as conditions that qualify someone for disability benefits, the university is not obliged to provide me any support. A couple of my friends suffer from multiple chronic conditions but do not receive any disability benefits, because they’re not disabled legally. 

The definition of a person with a disability as mentioned in the UNCRPD and adopted by the GoI is a dynamic one and hence, policies that are meant to benefit the disabled must be dynamic too. However, to my knowledge, there is no mechanism in place to extend the list of disabilities. Compared to the ADA, the RPwD has a very limited scope of application. Speaking as a young adult with IBD, most of us do not have insurance. We face difficulties in gaining and maintaining employment. The same is true for education. Our condition is treated as a taboo. Every aspect of our life is affected by our condition, and for those with ostomies, the problems get magnified. Is this not what a disability is defined to be? A person with a missing toe is 10% disabled according to the disability evaluation guidelines. A person with a missing colon is 0% disabled. Makes sense, right?

The GoI has recently published the draft of the National Policy for Rare Diseases 2020. The World Health Organisation (WHO) defines a rare disease as an often debilitating, lifelong disease, or disorder with a prevalence of 1 or less, per 1000 population. However different countries have different definitions. In the United States, a rare disease is one with a prevalence of less than 6.4 per 10000, and in Japan, the parameter is 1 per 10000. India on the other hand has no such parameter because of a lack of data which is due to a lack of proper health infrastructure that would enable such data collection. The draft mentions government support for the treatment of certain treatable conditions with an upper limit of INR 15 lakh or roughly 20000 USD. The government does not plan to provide any support to those with long-term conditions, citing a lack of resources, and recommends setting up digital platforms for donations. India spends less than 4% of GDP on healthcare. A lack of resources does not seem like a justifiable reason for refusing to support those with chronic and rare conditions when the fact is that India has one of the lowest expenditures on healthcare globally. 

Coming back to the topic of disability - will people with rare, untreatable, lifelong conditions, receiving zero support from the government, be able to participate in society as effectively as others? Are they not disabled as per the definition adopted by the GoI? The fact is that the RPwD act is itself disabled. It does not do justice to the millions of people suffering from many conditions that impact the quality of life, social participation, and academic and professional outlook. The fact is that most patients struggle to fund their treatment because chronic and/or rare conditions often require expensive medications and with limited or no insurance coverage, the battle to survive and stay alive is the one that most are fighting. Education, employment, and social integration are not even in the picture. 

The exceedingly slow pace of healthcare reforms and the lack of support for people with various chronic conditions that severely impact their lives makes me sad. I don’t know when the situation will improve. If in 2020, a country like India, which has ambitions of being a superpower says that it doesn’t have enough resources to support its citizens with rare chronic conditions and has a list of disabilities that includes only 21 conditions, what hope can I have? I also feel like the general population has never considered the problem of healthcare seriously. It has never been an issue during elections. So I guess, it’s us who are to be blamed. There’s a lack of unity among patient communities too. How do you rectify all these? Honestly speaking, I’m a naive person. The only thing that I can say is it shouldn’t be that difficult to come up with a system that ensures equal and unhindered access to opportunity for people, irrespective of their health condition. From my vantage point, I see a lack of motivation amongst our leaders, the healthy, and the abled population to work on issues related to the healthcare sector. I hope the situation improves in the future.

India celebrated 74 years of independence on 15th August, but young adults with chronic conditions like Inflammatory Bowel Disease are yet to be liberated from various shackles that bind them to the ground and hamper them from living a free, independent, and fulfilling life. 

That’s all from my side this month. Sayonara!


Frustration

By Samantha Rzany

Sam is an independent artist,  check out her Redbubble website for IBD stickers or you can message her on Instagram at Samantha.rzany

Sam is an independent artist, check out her Redbubble website for IBD stickers or you can message her on Instagram at Samantha.rzany

It’s easy to sit and write about the positive things I’ve learned from life with a chronic illness. I can talk all day long about my journey and what it’s been like for me. I have no problem sharing details about my symptoms and side effects and the physical symptoms of my disease. But what is hard is to be honest. I find it difficult to admit just how hard it is to live with ulcerative colitis. 

Anytime I share with someone that I have a chronic illness, they often apologize. I tend to quickly brush it off and say that it’s okay and then proceed to share the numerous opportunities I have gained from my illness. But it’s not okay. And I’m not okay. Living with IBD is hard. Every single day. It is frustrating. It is exhausting. And it’s just not fair. 

As a 22 year old, I want to be able to go to my 4-day-a-week-job and return back home each day without feeling so absolutely fatigued that all I can do is lay down in bed until I have to leave the next morning. I want to be able to enjoy my three day weekends and spend time with friends and have fun. And I’ve certainly tried to do that. And it starts my week off horribly. I start my work week with my energy below 0. 

I find the spoon theory to help me explain this really well. Each person starts out with a certain number of spoons. For a chronically ill person, the number of spoons is significantly less than the average person. Every single activity (going to work, hanging out with friends, running errands, etc.) takes some of those spoons away from you. And it is very hard to refill your spoons. So when I spend my weekend hanging out with friends and having fun, I start my work week out with no spoons. I very quickly go into the negative. Until my only option the following weekend is to sleep all day everyday. 

It’s an incredibly frustrating cycle. The absolute fatigue from doing very normal things is debilitating. And people just don’t understand. They see me as lazy or a typical “millennial” who just wants to get money and do no work. But it’s not the case. I want to work. I want to go back to grad school. I have so many ambitions for my life. But I am limited. 

It’s frustrating that the medication that is putting my IBD in remission causes so many issues. I find myself seeing specialist after specialist to fix issues that all stem from one medication and one condition. I have to see a neurologist for the migraines I get. I have to see a dermatologist for inflammation in my scalp and rashes on my hands. I have to see an optometrist for inflammation in my eyes. The list goes on and on. I often joke that I’m a 22 year old in a 60 year old’s body. But the sad thing is that it’s truly how I feel. And it scares me. If this is how I’m feeing at 22, what will I feel like when I’m older? When I am 60? 

I don’t like sharing what it’s really like living with IBD. I don’t want people to pity me. I don’t want to burden people with how hard it is. I don’t want my close friends and family to be scared or upset for me. So I often put on a brave face and share my story and hope to empower others to do the same. But life with a chronic illness, especially at 22 years old, is hard. It’s frustrating. It’s exhausting. It’s overwhelming. And many times, it is incredibly lonely. 

I’ve only had IBD for about a year and a half. So I’m pretty new to all of this still. I know there will be times when it gets harder and times where it gets easier. And I’m sure I’m not the only one feeing like this. The frustration, the exhaustion… it doesn’t just go away. But I have found that talking about it helps. Talking to my family and my close friends. Sharing with those in the IBD community what I’m feeling. Even though it doesn’t take away my disease, it makes me feel less alone. 

How Writing Helped Me Come to Terms with My Chronic Illness; How Finding Your Thing Can Help You Come to Terms with Yours

By Rachel Straining

Image from iOS (2).jpg

As I’m sitting here now, I’m writing this in the notes app on my phone. 

I remember in high school when we had to write our college essays. Mine came to me at 12 o’clock on a random Tuesday night as I was trying to fall asleep. I couldn’t shut my brain off, which is usually a thing that tends to happen to me in the very moments when all I want to do is shut my brain off. I knew I’d have to get my thoughts out somehow, otherwise they’d consume me to the point of no sleep. I rolled over and grabbed my phone from my bedside table. I opened my notes and watched my fingers tap, tap, tap as my mind led the way. I wrote the first draft of my college essay that night on my phone. 

Now, as I sit here, writing this on the notes app on my phone, I can’t help but think about how finding a way to put my thoughts into words has changed my life and helped me come to terms with my chronic illness. 

When I was in 4th grade, I was diagnosed with generalized anxiety disorder. I had a hard time articulating my feelings. I would cry, a lot, but I wasn’t able to explain, or even understand, the “why” behind my tears. 

I was put into therapy and eventually handed a pen and paper. A narrow ruled notepad that didn’t feel so narrow at all. Rather, it felt like an open, honest gateway into a mind that at times felt all too confusing to make sense of. 

If I was upset about something, I would write it out. If I was upset at someone, I would write them a letter. Whether or not these words were ever shared was up to me, but the simple fact that writing gave me a way to process and work through my emotions was something I never had - something I wanted to hold onto forever. 

Then, when my world was flipped on its axis and I was diagnosed with Crohn’s disease, I stopped writing. I stopped talking about how I felt and I stopped writing about it. Even though every piece of me was breaking inside, I wanted to forget and pretend like I didn’t feel anything. Everything hurt. My heart ached and so did my body. I wasn’t numb at all, but I wanted so badly to be. So, in an effort to try and shut everything off and shut everything out, I put down my pen, threw my paper into the trash, and forced my heart to go cold to freeze time. 

I didn’t process the fact that I was chronically ill. I refused to. I studied or drank or exercised or ate away my emotions. I suppressed any kind of feeling, any kind of pain, any kind of grief, letting my emotions build up inside of me like a volatile eruption just waiting to happen and destroy everything within its wake. And then I flared my sophomore year of college and there was no way I could continue down the life path I was headed if I wanted to have a chance at living. 

I found an old notepad in one of my drawers that year and I watched the life before me change as I began to use my words again. I watched myself begin to open up again, no longer bottling up emotions that so desperately needed to be let out, no longer letting things eat me away inside until I felt so hollow that I became a shell of a person. I watched myself begin to connect with others by using words to which they could relate as a way to bridge the gap between loneliness and understanding that had once felt too scary to cross. In writing, not only did I find my true passion, but I also found my true acceptance. 

Especially when living with a chronic illness, one of my biggest pieces of advice is to find that thing you can turn to when you need it most. Something that will always be there for you, even when you try to push it away. It doesn’t have to be a person and it doesn’t have to be a tangible possession. Just something. For me, it’s sentences and paragraphs and poetry and prose. It’s putting my thoughts onto paper, or onto the notes app on my phone, and finding solace in the way writing helps me make sense of my truth when I find it too hard to verbally speak. 

Whether it’s the way a good song can make you feel heard or the way a good book can transport you to a different place, we all have something. We all have that one thing that both steadies and ignites our heart.  When you hold onto it, and when you harness your power through it, you’ll start to feel like you can finally take on the life that stands before you - one word or one note or one story at a time.  

Navigating Diet Culture with IBD

By Amy Weider

Image from iOS.png

Growing up food was always a celebration for my family. Food was how and why we would come together and build traditions. We would eat lobsters for every New Years to signify good luck and we'd come together to break the claws and soak them in butter. I remember watching my mother make us a classic midwestern casserole on a weeknight and the Food Network was never not on in the background. Food has always been such a critical part of my life. It brings me joy and memories. So when I started getting sick around 9 years old my relationship with it was forced to change. I began to have severe stomach pains and was unable to hold any food down. The first instinct when someone is having intestinal issues is to always investigate diet. My loving mother quickly made the switch to all-organic everything, bland food, and no more sugary drinks. At 10, I very quickly had to change what I ate and go on intense diets. It was hard for me, as food is such an important part of my life and a means of joy. But nevertheless, my family supported me through it and we went through the motions. Gluten-free for a bit, dairy-free, liquid-based only, we tried it all. 

Alas, nothing worked. I was still, if not more, sick and constantly exhausted. Once the diets failed, I was given a colonoscopy and ultimately I was diagnosed with Crohn’s Disease. My Crohn's Disease was not fixed by a diet. In fact, no Inflammatory Bowel Disease (IBD)is caused or cured by food. Diet can help with inflammation or regulation of the disease, but diet also affects every IBD patient extremely differently. Most often, this is not how it’s portrayed and it’s hard for folks with IBD to carry the weight of the assumption that there is a one-size-fits-all cure. Ever since I first became sick, I have had people tell me constantly that if I ate a certain way I'd be fixed and that it is my fault I developed such nasty health problems. Hearing these things as a kid made me aware of diet culture very early on. 

Diet culture is the world we live in. It is everywhere. Diet culture can be defined as the patrolling of people’s weight under the guise of health, while it is really about control, shame, and reinforcing eurocentric skinny body standards and eating trends. Concrete examples of diet culture are folks labeling certain foods as “good” or “bad”, or the shaming of others for not eating the “right things.” Diet culture and the weight-loss marketplace is a $70 billion industry. There is no way of avoiding these harmful tactics of major companies marketing off of your body’s imperfections and longing to achieve the societal standard of a femme body. It becomes very difficult to balance the thin line between diet culture and a change in your nutrition for your health’s sake. Specific diets that are used to help manage IBD are often glamorized as the “new, hot trend that will make you drop ten pounds quickly!” There needs to be a greater understanding of how privileged it is to merely treat these diets as fads. They are often highly inaccessible, expensive, and fail for those who are just casually attempting them. But for others, for example those who have Celiac, this isn’t an option for them. There is so much nuance that is frequently overlooked when prescribing diets and there needs to be more attention given to diet vs. health and nutrition. The mask that is diet culture can very quickly take over one’s life.

When you Google “Crohn’s Disease” you cannot miss the slew of diet suggestions for anti-inflammatory foods or titles like “Gluten-free Fixed My Life!” Hearing people make statements like “you could cure that by eating ‘blank’,” has become a huge trigger for me. My relationship with food has had its rocky times, but it’s still a place I find deep comfort. Comments like these stem directly from diet culture and the invalidation of lived experiences. There is no right way to have Crohn’s Disease. Everyone’s life experiences differ greatly and the main lessons I’ve taken away from mine are to be open, ask questions, and not push assumptions onto others. Open a space for folks to guide a conversation about their dietary restrictions and needs if that’s what they want. NEVER suggest a new diet to an IBD patient unless you are their medical provider. Trust me, we have heard everything.

5 Things I Have Learned from Life with IBD

By Samantha Rzany

pexels-pixabay-371285 (1).jpg

Living with diagnosed ulcerative colitis for about a year and a half now, I am realizing that I have learned quite a bit from this journey. While I often wish I did not have UC, I am grateful for the opportunities and growth it has provided for me. I do not believe that I would be who I am today without having to go through the struggles that stem from being chronically ill as a young adult. 

  1. Your health is one of the most important things in your life.

    It is more important than grades, or accolades, or how many social outings you can go to each week. As a perfectionist who constantly strived to push myself to do my absolute best and be my absolute best, the concept of all of those things taking a back seat to health was really difficult for me. But when you are at your sickest – in pain and in and out of doctor’s offices and hospitals, you quickly learn to appreciate the days and weeks when you are healthy. And working to maintain that health becomes a higher priority. For me, I had to realize that other things were less important than feeling physically and mentally good. 



  2. Don’t push yourself.

    Your body is already working double to do the everyday things that healthy individuals take for granted. Your body fights so hard to just get up and do normal day-to-day things. It has to work so much harder than a “normal” body to do “normal” activities. Oftentimes, you will feel fatigued after simple tasks. You might not be up for things that your friends are capable of. You might know you can’t eat certain things at places your friends may want to go. And it is hard to not want to push yourself to do these things in order to keep up. But you don’t have to push yourself. You don’t have to convince yourself you may be fine if you try this, even though the past 10 times you weren’t. Which brings us to the next lesson…



  3. Learn how to say no.

    There will be times you can’t eat certain things or can’t do certain things. And that is perfectly okay. Good friends and family will understand that and not treat you any differently. But sacrificing yourself to please others is never necessary. You’ll have days when you are too tired or too sick to do certain things. And that is perfectly okay!! Certain friends or family members of yours might not understand. They might not accommodate you or the things you may need. But the people who love you and are kind and understanding will work to accommodate you however you need. They won’t be offended when you have to say no to things. Some might even try to find other activities or restaurants that you are up for! These are the people you want to keep around. But there is no shame in having to say no to people or activities. Saying no means you have enough self awareness and understanding to know what you can handle. 



  4. Know your limits.

    You have to learn what you can and can’t do – both when you’re flaring and when you’re in remission. Know what you can eat, how often you can go out, and how much you can do every day. You will have your limits. And those may change every week or every few days. They certainly will change between when you’re healthy and when you’re sick. And it’s important to work to keep track of what those limits are. It may mean only going out once or twice a week and getting together with friends/family at your place other days. It may mean not being able to go to certain restaurants when you’re flaring because you can’t eat anything there. It might mean feeling up to go out and being an hour into it and feeling too tired or sick to keep going. All of that is perfectly fine! You just have to know what your body is capable of and not compare that to anyone else. 

    And most importantly…

  5. Give yourself grace.

    There will be days you’ll get frustrated. You’ll be sad and angry. You’ll be hurt by how people respond and sometimes you might just want to feel normal again. But you have to learn how to give yourself grace. Your body is capable.  Even when you were at your sickest, you made it through. You are strong and brave. And you need to give yourself grace. When you have to say no to things or aren’t feeling up too what you used to be able to do, you have to give yourself some grace. Comparing yourself to others your age will never be beneficial. Instead, remind yourself of how strong you are and how much you have overcome. Allow yourself to put yourself first sometimes and make your health a priority. 

Hair Loss

By Rachel Straining

Image from iOS (4).jpg

Hair loss was something I never expected at the age of 22 until I found myself staring in the mirror, crying at my reflection. 

I knew the stomach pain. I knew the sharp, stabbing aches. I knew the nausea. I knew the fatigue. I eventually even knew the PTSD. But I didn’t know about the hair loss. 

Telogen Effluvium, they called it. It took me a while to figure out how to spell it let alone understand it. Telogen Effluvium - the medical term for temporary hair loss that occurs after your body undergoes serious stress, shock, or trauma. The words stress, shock, and trauma barely begin to cover what my body went through almost a year and a half ago. 

When two of the worst flares I’ve ever experienced happened back to back, one after the other, I lost weight rapidly. I couldn’t eat. I couldn’t sleep. I could barely breathe. I could barely even make it up the stairs without holding on to the railing for dear life and support. 

Shortly after, that’s when my hair started to fall out like I’ve never seen it fall out before. In clumps. In the shower. In my hands as I held seemingly endless strands of hair that I never thought I’d lose. 

I have always struggled with feeling beautiful in my own skin and my own being. Truthfully, growing up, I had always placed an immense amount of importance on my appearance, and my long locks had always felt like a kind of comfort blanket. “Hey, at least I have good hair,” I would say as I picked every other inch of myself apart. Watching my brittle hair fall in my boney hands as I stood in the shower with hot water and tears streaming down my face felt like the final blow to my already withering self-worth. 

I wouldn’t put my hair up. I couldn’t. Not in a bun, not in a ponytail. No matter how hot outside it was or how humid it got. If I tried to, I would immediately break down at the sight of empty, bald patches of hair that were once so full. 

Hair loss is not something that many people, especially many young adults, talk about, but it’s something I’ve come to realize that many have experienced. It is an external, physical side effect that also comes with its own host of internal, mental battles. 

You can say it’s “superficial” and you can say hair “doesn’t matter,” but when your illness continues to distort your self-image and self-confidence time and time again in ways you never thought imaginable, it is hard. It is really hard. It is traumatizing. It is difficult to fully understand unless you’ve been through it. No feelings we endure are trivial, no battles are to be invalidated. 

As someone who has gone through it herself, I am here to tell you you are allowed to feel it all, and anyone who says otherwise can come talk to me. You are allowed to be angry and sad and upset. You are allowed to cry, you are allowed to mourn what you once had, but I also want you to know that I refuse to let you give up on yourself. 

In the moments when you’re standing in front of the mirror or standing in the shower, I know how much of a battle it can be to feel good about yourself, to feel like yourself, to feel like you are complete with bare patches revealing your skin. 

However -

In a society in which it has been so wrongly ingrained and instilled that part of one’s worth is to be found in one’s physical appearance, I want you to know that your worth is not found in the hair on your head or even the freckles on your face. Your worth is found in the way you make other people smile and in the light that you bring to this world simply just by being in it.  

And yes, yes your hair will grow back as you heal. And you will heal. And healing will be a roller coaster of emotions with both mental and physical twists and turns, but the bravest thing you can do along the ride is to embrace who you are inside at every step of the way. 

The bravest thing you can ever do is choose to accept yourself every time you feel as though you can’t. 

Advocating with Crohn’s

CCYAN - June 2020 Simon Stones Image.jpeg

Life has a funny way of working out. It certainly doesn’t feel that way when you are diagnosed with a condition like Crohn’s disease, or going through a flare, when there seems to be very little to look forward to… but things can and do change.

Twelve years ago, I could never have imagined that I would be doing what I am doing right now. I was devastated when I was diagnosed with Crohn’s disease at the age of 14, which on top of my existing juvenile arthritis diagnosis, felt like another hurdle that I may not be able to overcome. Fast forward to 2020, and my outlook on life is very different, with those awful and challenging experiences fuelling everything that I do.

We’ve all heard the age-old advice of spending your time doing something you love. Growing up, I never realised that this would happen through patient advocacy – but it did. Even going back to the early 2010s, I had never heard of the term ‘patient advocacy’, and I had certainly not met any other advocates doing what I, and so many others now do. When I discovered it, there was no stopping me.

“If you do what you love, you’ll never work a day in your life.”

My patient advocacy journey began in 2012, when I was invited to become the first young person’s representative on a national clinical studies group for arthritis and other rheumatological conditions in the United Kingdom (UK). The invitation came from my former paediatric rheumatologist, who I met while attending a young person’s ‘meet and greet’ event at the hospital. At this point, I had been under the care of adults for around 12 months, so this was an opportunity for us to meet other young people in adults, while also being able to chat to those still under the care of the paediatric team. It’s hard to believe that this was only the second time that I had been in the presence of other young people with arthritis – the other time being in 2010, at the age of 16, when the hospital held an information day for young people. I had gone through the majority of my childhood without meeting another young person with arthritis or Crohn’s disease. It’s hard to believe it, but in the days when social media hadn’t really taken off (but when MSN Messenger was a thing), it was pretty difficult to be able to have a conversation with somebody else who ‘understood’. Having been presented with this new opportunity to help embed the voice of young people in research, I jumped at the opportunity to get involved.

I attended my first meeting in December 2012 in Manchester, down the road from where I live and where I was studying. I didn’t know what to expect, other than I had over 50 pages of material to digest ahead of the meeting. Thankfully, I was able to meet an experienced parent who was in a similar role to me on the group, but instead representing the patient and not-for-profit organisation voice. She was a huge source of help, inspiration and reassurance when I was sat in a room with over twenty of the most experienced, talented and ‘famous’ healthcare professionals and researchers in paediatric rheumatology from across the UK. While they were all lovely and made me very welcome, I found the experience totally overwhelming. I struggled to ‘understand’ what my role was, and I really didn’t appreciate the value of my experience, thoughts and ideas – which are the very insights needed to make research and care better for other people, like me.

As the years passed by, I met more and more researchers, healthcare professionals, and other individuals, who invited me to join different meetings, projects and activities. I was genuinely excited by the opportunities presented, and the realisation that I could help to make a meaningful difference because of my experience of living with chronic conditions since childhood. Looking back, this phase of my life was the one where I felt I ‘moved’ to that final phase of accepting my conditions, looking beyond the limitations and realising my value. It’s where I evolved into a strong, able and confident advocate for myself, and others, in every possible situation.

The majority of my patient advocacy was and continues to be within the world of rheumatology. I feel as though I have an allegiance with rheumatology – it’s where it all began, and I’ve come full circle if you wish! I also expanded my reach to chronic, long-term conditions more broadly, particularly focussing on the voice of children and young people, with a variety of different organisations and projects. The one area I felt I would like to ‘do more’ in was in inflammatory bowel diseases (IBD). This began with contributing to different articles and news pieces about IBD, before I branched out to a few different opportunities where I have been able to share my experience and help shape research and other activities for the community. One example was as part of an Immunology global community advisory board for a pharmaceutical company wanting to make a positive change to how they engage and involve the patient community. More recently, another new avenue identified was the CCYAN 2020 fellowship, which has been a wonderful experience.

People often ask ‘how’ I get involved in such advocacy work, and the answer is always because of ‘connections’. People I have met – either at conferences, other meetings, through fellow patient advocates, through healthcare professionals, and through social media, believe it or not. Getting yourself known is really important, and there are so many ways to do that. Platforms like WEGO Health (https://www.wegohealth.com/), Savvy Cooperative (https://www.savvy.coop) and of course CCYAN and the Health Advocacy Summit (https://www.healthadvocacysummit.org) are fantastic places to start, regardless of ‘where’ you are on your advocacy journey. The beauty of advocacy is that you can do as much or as little as you want. For some, advocacy is not for them – and that’s absolutely fine. For others, like me, advocacy is a part of daily life, where you quite literally live and breathe it – which is incredible. There really is no right or wrong. If you want to help and change things, then you should. There are plenty of people and organisations out there who can help you on your way too. You have your advocacy veterans, you have your advocacy newbies, and everyone in-between – each with a wealth of information, experience and talents to share. I can guarantee you that you will learn something from everyone you meet – I know I have, and that is often the best part of the job… meeting new people, constantly learning, and forging lifelong friendships, often out of pain and heartache. There’s something particularly beautiful and poignant about that.

As I look back, on what has now been eight years in patient advocacy, I feel incredibly blessed to have had the opportunities that I have had. It certainly hasn’t been ‘easy’, especially on top of living with chronic conditions, studying, caring for relatives, and also trying to enjoy some downtime – but it has all been worth it. For every person living with a condition who has felt less isolated… for every researcher who has changed the way they think because of something I have said… for every policy decision which has been informed by the insights I have shared… that is what matters. Everything else is a bonus. A very special, and emotional bonus came in 2019, when I was informed that I had been nominated, and selected as a finalist in the Shaw Trust Disability Power 100 2019 - the list of 100 of the UK’s most influential people with a disability or impairment. In October 2019, I was invited down to London for a reception at the House of Lords in Westminster for the launch of the publication, which was such an incredible honour. During the event, I was reminded of how fortunate I have been to be able to do what I do, when so many others are unable to do so – and that is exactly why I advocate. I advocate for those with no voice. I advocate for those who are trying to find their voice. I advocate for those who don’t have the strength or energy to fight right now. I advocate for those with a voice, to amplify and support it. Never, ever forget that your voice matters.

If I could give my younger, less experienced self some advice, here’s what I would say:

  1. Your experience is invaluable. You have been through some difficult times, but you’ve made it. You have so much to give, and so much good to do in the world because of what you have been through.

  2. Don’t be afraid of speaking up, speaking out, and challenging others. It takes some confidence to be able to articulate your thoughts and present them, especially when what you have to say goes against the norm. If you’re thinking and feeling it, the chances are that you aren’t alone. Be brave and get your message out there.  

  3. Embrace unknowns, challenges and critique. You aren’t expected to know everything. If you aren’t sure, say so, and then use that as an opportunity to learn and grow. If you are challenged about something that you say, it can feel as though it’s a personal attack, but in most cases, it’s not. It can feel disheartening to hear others disagree with what you think, and it can be upsetting if what you say is not embraced. Feel free to have your moment of anger, but then pick yourself up and move on – you’ve got this.

  4. You don’t have to say yes to everything. Far too often, I have been a ‘yes’ person, succumbing to often unrealistic requests for me to contribute to different tasks. I’ve done this because I wanted to help and make a difference; however, it has sometimes impacted on my physical and mental health, as well as my time. You are able to say no and should exercise your rights to do so. The people you are working with should understand, and if they don’t, you may wish to re-evaluate whether they are the right people to be working with.

  5. You won’t necessarily get on with everybody you meet. This is also another difficult one for me. I am a natural people pleaser, wanting to ‘get on’ with everyone. However, just like in reality, we aren’t compatible with every other human being – and that’s okay! There may be those where relations are kept purely professional, while friendships may be forged with other advocates you meet That’s part of life. Don’t feel ashamed or worried if those feelings arise.

  6. There is space in the advocacy world for you. If you see other patient advocates and organisations occupying the space and think that you shouldn’t be encroaching on their territory – then get those ideas out of your head! You are just as entitled to be involved as everybody else, and don’t let the minority stop you from showing up. You are likely to come across certain figures who may believe that they are the only ones who should be active as patient advocates, but trust me, they’re in the wrong. The whole ethos of patient advocacy is to promote and protect the interests of patients and their families. As far as I am concerned, the more advocates we have, the better! Position yourself within communities who stand together to lift each other up. That’s where you want to be!

CCYAN - June 2020 Simon Stones Quote.png

Crohn’s in College: Perspectives from a Former D1 Student Athlete

By Rachael Whittemore

Erin and I met in a serendipitous way - I was flaring and having a rough day at work, so I had to switch places with someone at work so I could sit instead of running around in surgical dermatology. She had come in for a triage appointment. We were talking and I made a joke about my stomach and she replied - “oh, I totally understand that, I have Crohn’s.” It couldn’t have been more perfect. We laughed about our IBD and bonded over our love for UNC. I also found out she would be starting a job at the clinic soon! She became a part of our “PA pod” and a beautiful friendship began. Erin is someone who gives her all in everything and is a light to anyone she meets. Like everyone with IBD, her story is unique and she has found a way to truly thrive in spite of it. She graciously offered to answer some questions about life and her journey with Crohn’s disease.

We both share a love for missions and travel!

We both share a love for missions and travel!

Tell us a little bit about yourself. What are you up to right now and what plans do you have planned for the next year? 

Raised on a farm in rural North Carolina, I graduated from my dream university (UNC-Chapel Hill) back in 2017 and have stayed in this lovely city ever since. After graduating, I traveled some and then landed this sweet medical assistant job where I became Rachael’s trainee. I am still gaining experience hours in the clinic, with plans to apply to Physician Assistant programs next summer. Along with working full-time, I have been pursuing a second degree in Public Health from North Carolina Central University. My hope is to join public health education and community outreach into the way I practice as a Physician Assistant one day. 

Working as MAs together at Central Dermatology.

Working as MAs together at Central Dermatology.

What was it like being in college and starting to experience IBD symptoms during a time that is often deemed “some of the best memories you will make?” How was this affected by you playing a sport? 

Overall, my first year of college was pretty miserable. As a first year student athlete, having my first true flare within the first month of training was about the worst timing it could’ve been. I had experienced some fatigue and abdominal pain throughout my senior year of high school but, with the stress of starting college courses and the physical toll softball was taking on my body, the pain and exhaustion was consuming. I had no idea what was going on with my body and why it seemed to be betraying me. I couldn’t perform athletically the way I had before and no one believed me when I tried to explain how I was feeling. In their defense, I didn’t know how to advocate for myself since I didn’t understand what was happening. Nevertheless, I still felt isolated from my teammates, coaches and friends. It looked like I was some freshman who came in lazy, poorly prepared physically, and mentally weak. In reality though, I was struggling to get out of bed in the mornings for weights. I slept on any bench I could find in between class (even if it was for only 5 minutes). My body constantly ached and I’d be back in the weightroom or on the field before I ever felt any recovery from the last training. I’d clutch my stomach at night from the pain. The majority of the time, I felt awful physically and, in turn, felt awful about feeling so weak and letting my team down. It was a difficult time for me. 

How long did it take for you to get an official diagnosis? Was it difficult? Did you have any issues with providers not taking you seriously?

From my first symptoms back in high school to the beginning of sophomore year at UNC, it took over two years and five different doctors to diagnose my Crohn’s disease. This journey was definitely one riddled with frustration and hopelessness at first. I knew my body felt off but after having three different doctors tell me things like, “It’s just a stomach ache, suck it up,” and “Well, if your primary care provider doesn’t think it’s anything, I don’t either,” I decided that I must be crazy and I just had to deal with the pain. When the flare hit me hard at UNC, I went to another doctor to reevaluate for a fourth opinion. After a lot of advocating, he finally tested some labs through blood work. The results showed that I had severe iron-deficiency anemia but the cause wasn’t looked into any further. I remember offering up that maybe it was related to the significant, recurring abdominal pain I’d been experiencing but that was quickly brushed off. My diet was adjusted to help increase my iron intake, but I felt worse as the diet consisted of all the foods that (I now know) cause my flares. It wasn’t until after I had to medically retire from the softball team at the end of my freshman year that I went to see my fifth and final provider. She sat with me, listened to me, and fought with me to find an answer. Within about a month or so, I finally had my diagnosis. The diagnosis proved to others that my struggle was real, but more importantly, it finally gave me a chance at finding some peace. 

DYYTURFLSHLMKQB.20170309165940.JPG

What advice would you give other young adults with IBD who may have been seriously playing sports prior to their diagnosis?

I would love to encourage my fellow IBD athletes that this diagnosis doesn’t have to mean an end to your athletic career. I was blessed in that, by my senior year, my Crohn’s was in remission. I laced up my cleats and wore that Carolina jersey proudly for a final season. Was my experience the same as my teammates? No, my conditioning had modifications and some days I had to listen to my body and rest. But who cares? There’s no shame in that. In fact, it’s even more incredible that we’ve been provided the opportunity to compete and perform at that level despite our adversities. I found immeasurably more joy in my sport that final season and realized how much I had taken it for granted before. No matter how much we pour ourselves into our sports, we are not entitled to perfect batting average, fielding percentage, or even health. Sometimes, we get to be creative and find ways to integrate back into our sport or even just an active lifestyle. If you are able to continue athletics, I highly recommend having an honest conversation with your coaches and teammates about expectations and trust. Don’t be afraid to advocate for yourself and your health. If you aren’t able to continue your athletic career, I grieve with you and that loss. I understand the identity crisis that ensues as soon as you are no longer an athlete, however, so much growth comes out of this season of life. I encourage you to shift your hope into something greater than a sport. 

18768461_10211610759136204_366608277222446094_o.jpg

What advice do you have for young adults who are trying to find their way after their diagnosis? 

First, I’d recommend taking some time to wrestle with the reality of the diagnosis and what this means for you personally. Lean hard into your community because having a support system is so crucial. It can be overwhelming in the beginning but trust me that things even out over time and you’ll start to adjust to your new normal. Once you get your bearings and start looking forward, don’t allow your IBD to define or limit you. There is so much more to you than your diagnosis. In a really twisted way, Crohn’s was potentially the best thing that could’ve happened to me. It caused me to really evaluate my life and my heart. It opened up my eyes to new passions and the desire to pursue them. 

After medically retiring from softball for my sophomore and junior year, I was able to study abroad in Scotland for a semester and backpack around Europe for eight weeks after. I became more involved with a campus sports ministry called Athletes In Action, making lifelong friends and growing deeper into my relationship with God. I began to merge my loves of traveling and Jesus together on mission trips abroad. I’ve even recently been on a medical mission trip back in February, which was especially memorable for me. My heart has never been so full. All of this is to say, there is so much life left to explore and experience in this world. It would be a shame to let IBD take that away from you.

On a recent mission trip in Belize - working as a dental assistant!

On a recent mission trip in Belize - working as a dental assistant!

What advantages do you think living with Crohn’s disease gives you in the real world? Has any reflection changed your perspective on living with a chronic illness going forward?

My Crohn’s disease has given me a certain confidence and purpose for my career path. Before all of this, I wasn’t sure what I wanted to pursue professionally and now I am passionate about becoming a medical provider one day. Even as a medical assistant now, I have been able to relate to my patients on a deeper level when reviewing biologic injections and other medications. Being able to sit with a patient and provide information and counseling from personal experience really helps build trust. While my experience with the healthcare system wasn’t a positive one to start, I’ve since had providers that have made me feel heard and valued. I want to be able to care for others in such a personal and profound way like my medical team has for me. Even if you don’t want to go into the medical field, there are lessons from our experiences on how to treat others that apply to all aspects of life.

I am also grateful for the advantages of endurance and perseverance that I’ve gained. With IBD being a chronic disease and after seven years since my diagnosis, there have been a lot of opportunities to wallow in self-pity. Don’t get me wrong - sometimes there are still days where I’m frustrated with having Crohn’s - but overall there have been so many victories over it. Each time I’ve adjusted my treatment regimen, found yummy recipes in my diet or shared my testimony, I've experienced joy. Celebrate the little things and appreciate the magnitude of what we’ve overcome. Living a full and purposeful life with IBD is possible and I want to empower you to continue persevering to find that. Throughout this experience, I’ve been shaped into the woman I am today and it has provided me the capability to handle all that will come in the future.