A Five Step Plan to Prepare for the Stress of School

August has always been my favorite month of the year. The word itself feels warm and seems so full of light. Summer is winding down, many of us have been able to do things we never have time for during the school year. We've been able to spend loads of time with friends or family, gone on vacation to somewhere new and exciting, explored some new DIY projects, or tackled a task from our ever stagnant To-Do list. We might even be exhausted from all the fun and relaxing times we've had that the thought of summer ending, is naturally bittersweet. August is our last month to ourselves. When August 31st comes around, classes are just around the corner. Now, I don’t mean to scare or worry you that you are running out of time. You still have plenty of time to relax and prepare. (But tick tock..)

This September will mark my own re-entrance to school after taking a year off. In May of last year, I graduated with my Bachelors and will be going back as a re-entry student to study DIETETICS! I am so excited you guys, you don't even know! Even though it's only been 15 months since I was in college, I feel like the mom who rediscovers herself and goes back to school after x number of years devoted to others. But this is MY time to shine! My heart is so full of excitement and intrigue for the new topics I'll be learning about and the career path I am headed towards. I have had 15 months to decompress from all those days spent studying, non-stop, on end and will be reattending with renewed energy and outlook. Because I know how stressful college life can be and the added stress of taking care of a chronic illness, I want to share some of my own insight on how to prepare for another school year.

After having a few rough semesters and thinking about this new year, I decided to do some research on how to prepare yourself mentally, emotionally, and physically. Many of the tips I found were in reference to another stressful life event, but they still hold potential for alleviating the stress experienced in school. Stress is stress, right? And when you have an inflammatory disease, a part of keeping your disease in check is taking the right precautions around stress management. So whether you are ready to get a move on or still trying to deny the fact that summer is ending, here is a five step plan to get you started.

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Step 1: Use this last month of summer to really get to know yourself, on every level. Try to understand how you deal with stress by thinking about your past. Think back to a time when you were dealing with a lot of stress, maybe even in the midst of a flare-up, and ask yourself: How do I tend to perceive about the situation? Do I react to the stress or work through it? Are my thought tendencies self-deprecating or more self-righteous and determined? How did I feel physically, emotionally, and mentally? What was I missing? What could I have done differently?

Try this writing exercise! Like you would write a story, write down what was happening during a time you were being pushed to your limits. Bullet-point every obstacle and bold everything you tried to overcome the situation, even the failed attempts. Then, like how a writer outlines a storyline, write out how you would resolve the story. Include who and what from your life you would need and when you would use them. Keep this as a guide or for inspiration!

Step 2: Plan ahead, for EVERYTHING and keep yourself accountable. It can be helpful to set up a plan for yourself ahead of time. Whatever makes yourself more productive, make a promise to DO THOSE THINGS! Get tasks done early when you are feeling well and full of energy, so you can rest when you are not. Prioritize what is most important in your life. Stick to a routine or try new things. Think about how much you need to do to be successful and what kind of effort that will take. Then start to build up your plan around these thoughts. Being accountable for yourself and the work you must accomplish ahead of time will save you in the long run.

Try this writing exercise! Make a promise to yourself for the new school year. Write down a few things you want to strive for, big or small. Then display it somewhere you will see every now and then as a nice reminder. This will keep you centered and focused on what you want to achieve and how you will do it. Here are some examples: "I promise to make good decisions for my health and well-being. I promise to make my bed each morning. I promise to do what I can, when I can, and not judge myself when I cannot."

Step 3: Be the responsible person you and your body deserve! Make responsible decisions when it comes to food choices, workload, and managing stress. A part of developing a successful plan is sticking to it! If you know about your own unhealthy habits that can impact your ability to manage stress, then take steps to reroute them. Start with replacing bad habits with positive ones.

Step 4: Have a de-stress plan when life starts to get tough. By having something set in motion ahead of time, you can comfort yourself knowing you've prepared for this! So whip out your de-stress kit and get to it! Here are some ideas to get you started:

• If you feel yourself getting anxious, stop for a moment. Practice deep breathing and positive inward thoughts or commit some time to a guided meditation. You may feel more calm and refreshed afterwards.

• Set up a routine to decompress after a long week (take a warm bath with a glass of wine, settle in with your favorite book with a cup of delicious tea, or just take a nap - but use this last one sparingly)

• If you struggle with eating healthy, staying away from trigger foods, or staying on a grocery budget then try your hand at food prep. Taking your Sunday afternoon just for this task can be relaxing in itself and can yield some great benefits. Say goodbye to wondering what your next meal will be and ordering too much take-out!

• Write a letter to yourself to read when the going gets tough. I did this in the depths of a my lowest moment and it allowed me to pull myself out of an emotional rut to refocus on happiness and success.

Step 5: Pick yourself up when you fall. If you fail, a normal part of life, then you will need to brush yourself off and try again. Don't blame yourself, don't blame your shortcomings on your Crohn's or Colitis, and don't project your failures onto the universe. These tendencies will only allow you to harbor negative feelings about yourself or your past. Practice accepting things as they are and moving on with a more determined attitude. Find out where you might have went wrong and correct any bad behaviors that may have caused you to fail. Are your Netflix binge habits infringing on your study time? I know mine have before. Learning is all about finding what works for you and readjusting. This includes finding what works well in your own study habits. Try out some new ones if the old ones get stale.

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Whatever your plan ends up being, make sure that it is true to YOU! Incorporate everything you know can work and don't waste your time on what doesn't. I promise to

What strategies help YOU manage stress?

Bone Broth: Nature's Multivitamin

It seems that #guthealth has become popular in the wellness space over the past year or so. With more awareness of IBS, Leaky Gut, SIBO, and many other bacteria imbalances in the gut being displayed through the media, there has been an increase in remedies that are bound to “fix” all gut issues. I am an advocate for taking preventive, healing measures to get to the root cause and work towards better overall health - not necessarily relying only on medication. However, these so-called remedies are not a “cure-all.” While diet plays SUCH a significant role in gut health, but there are far too many factors that contribute to overall gut health that are often overlooked. In terms of IBD, chronic inflammation is exactly what it sounds like – chronic. Those who are facing this issue often try several things to help tame inflammation and improve their health, but there is not one “cure” that will work for everyone. Many things can trigger inflammation, and those are different for each person. Common examples include: food sensitivities / intolerance, stress, hormone imbalances, and mental strain. All of which can cause added irritation and stress to our system which results in inflammation and often the inability to turn off our “fight” mode.

While stress is a main component of a suppressed immune system there are plenty of other factors that influence the lining of the gut itself - factors such as prolonged exposure to antibiotics, inflammatory foods, toxins, etc. Eventually, if the impact of these factors pile up, the lining of the gut can suffer and result in permeability issues that may cause excessive inflammation due to malabsorption of food and minerals.

One thing I am currently working on in terms of my Crohn’s Disease is repairing the lining of the gut. Due to years of antibiotic treatment, inflammatory foods, and chronic stress, the lining of my gut has taken a toll and is not as impermeable as it should be. I am planning on writing a separate post about my current protocol, as well as the lifestyle changes I am implementing, but for now, I would like to talk about two things I have added into my routine and their role in digestive healing.

There is a chance that either in your research, scrolling through social media wellness accounts, or talking with your doctors, you have heard about bone broth. Many healing diets such as GAPS and the Specific Carbohydrate include this as part of the beginning protocol, and for a great reason! Nutrients and minerals in bone broth are essential to improve and heal the lining of the gut. These nutrients help decrease inflammation, balance good / bad bacteria ratios, and increase the immune response. Bone broth is nutrient-dense, easy to digest, rich in flavor and boosts healing within the entire body – what’s not to love!

What exactly is Bone broth?

You may think of broth that your mom used to have you sip when you were sick as a kid, typically what is used in homemade soups. However, bone broth is much different – it is nutrient-dense, thicker, and in my opinion, SO much better. Bone broth is the result of steeping the entire bone remains of the animal (beef, lamb, pork, chicken, etc.); including the bone, marrow, tendons, ligaments, etc. By including all of these components, the amount of nutrients found in this broth is significantly high compared to regular broths. Simmering using the “nose to tail” method of the animal protein source enables the bones and ligaments to release healing compounds like collagen, proline, glycine, and glutamine that are transformative for your health (1). Bone broths contain minerals and essential amino acids in forms that are easy for our body to absorb. Some of the minerals included are; calcium, magnesium, phosphorus, sulfate – all of which are often sold as pricey supplements and used to reduce inflammation, joint pain, and arthritis.

It is important to be mindful of the kind of bone broth you are consuming. Meaning, not all store-bought broth is created equal. If you’re not going to make your bone broth at home (from scratch), it is crucial to check the ingredients of what you are purchasing in the store! Like many other products, manufacturers like to sneak in monosodium glutamate (MSG), which is recognized as a meat flavor but is actually a neurotoxin – and as mentioned earlier, toxins affect the gut! When looking at the ingredients list, you should seek out whole, organic ingredients such as the bone broth (filtered water and animal bones), organic vegetables, and minimal spices. Try to stay away from added preservatives because to reap the full benefits of bone broth it is best to consume it in its most natural form – as our ancestors would have prepared it!

Overall, bone broth is a great place to find all of the valuable amino acids, collagen, gelatin, and trace minerals. There are dozens of different nutrients found within bone broth, many of which can’t be obtained easily from other commonly eaten foods! I am a firm believer in using food as medicine and consuming as much nutrient-dense food as possible. Broth is one of the easiest ways to check those nutrient boxes off without having to consume a massive pile of veggies in one sitting! By regularly drinking bone broth, or using it in recipes, you can promote healthy gut integrity while reducing inflammation and permeability. Now let’s dive into some other benefits from regularly consuming bone broth, shall we?

1. Protects Joints

I’ve already mentioned the anti-inflammatory properties that broth has due to the nutrients. But one of the BEST components found in this broth? Collagen. Bone broth is one of the world’s best sources of natural collagen – a protein found in vertebrae animals; in their bones, skin, cartilage, ligaments, tendons, and bone marrow. Collagen is very beneficial for the growth of hair, skin, nails, and bone health (2).

As we get older, our joints naturally experience depletion resulting in loss of flexibility. Supplementing with collagen matters because as we age, cartilage diminishes. As the broth simmers, animal parts release collagen and it becomes readily absorbable to help restore cartilage.

Another valuable component in the stock is gelatin. Gelatin acts like a soft cushion between bones that helps them move smoothly without friction. It provides the building blocks that are necessary to form and maintain strong bones. Significant amounts of both collagen and gelatin form and reform connective tissue to help take the pressure off of aging joints and supports healthy bone mineral density. It’s never too early to start taking preventive measures to make joint pain less problematic as you get older!

2. Boosts Detoxification

As I have previously mentioned, in our Western World, the average person is exposed to a variety of environmental toxins, pesticides, artificial ingredients and chemicals. The human body is amazing in terms of having its own means of detoxification from heaving metals and other toxins. However, it has a hard time keeping up when it is flooded with large amounts of chemicals. Much like if you were to procrastinate and become swamped with homework, you’re suddenly overwhelmed and may not perform your best on the task at hand. Bone broth is considered a powerful agent in detoxification because it helps the digestive system expel waste and promotes the liver’s ability to remove toxins. It also helps to maintain tissue integrity and improves the body’s use of antioxidants.

Stock contains potassium and glycine – both of which support cellular and liver detoxification. By supplying sulfur (especially with added vegetables, garlic, and herbs) and glutathione, an agent that lowers oxidative stress, detoxification is boosted. Glutathione helps with the elimination of fat-soluble compounds, especially heavy metals such as mercury and lead. It also aids in the use of antioxidants, the absorption of various nutrients, and with liver-cleansing functions! With the increased intake of essential minerals that bone broth stimulates, the minerals act to remove toxins by stopping heavy metals from attaching to mineral receptor sites. If they can’t bind, they can’t mess with our systems!

 3. Supports Immune System Function

I have briefly mentioned at various times the permeability of the gut lining, inflammation, and a suppressed immune system. All of which contribute to multiple issues with what would generally be a healthy inflammation response.

Leaky gut syndrome occurs when undigested particles from foods seep through tiny openings in the weakened intestinal lining and enter the bloodstream. The immune system detects these invaders and becomes hyperactive to regulate the body. The hyperactivity increases inflammation and leads to dysfunctions all over, not just in the gut where the primary issue lies. The immune system releases high levels of antibodies that cause an autoimmune–like response and begins to attack healthy tissue. Individuals that already have a compromised autoimmune system, such as IBD patients, may suffer considerably more damage from a response because the system believes the particles in the bloodstream to be much more of an invader than a conventional system may.

Bone broth is observed to be one of the most beneficial foods to consume to restore gut health and therefore support immune system function and healthy inflammatory response. Collagen, gelatin, and the amino acids proline, glutamine, and arginine help seal the openings in the lining and support what is known as “gut integrity” – the intactness of the lining of the intestine to maintain its structure and function.

The amino acids and anti-inflammatory benefits create a perfect atmosphere for powerful immune-boosting to occur!

4. Good for the Gut

Bone broth stock is easily digested and soothing to the digestive system, unlike many other foods, which can be challenging to break down. Those with food sensitivities and intolerance (such as wheat or dairy) already have a hard time consuming many foods that may be considered “inflammatory.” Therefore, it is essential to look after the integrity of the gut, so vital nutrients are absorbed to support other bodily functions and overall health. After all, food is only useful if we have the means of absorbing its nutrients.

Bone broth has also been found to help heal the lining of the gastrointestinal tract. Critical components for digestion support that are found in bone broth include - collagen (proline / glycine), gelatin, and glutamine. Although there are many other beneficial minerals contained, these are most helpful to many IBD patients that have difficulty successfully digesting and passing bowel movements.

A healthy digestive tract consists of a single, tight layer of epithelial cells, a thick mucus layer, and a diverse group of microbes (bacteria in the gut). Gelatin is a significant component when it comes to the lining of the digestive tract because it supports a healthy lining of mucus within the system. The water is absorbed within to help maintain the layer of mucus that blocks gut microbes from the intestinal barriers. By drawing fluid into the intestine, the motility of the gut is improved, and healthy bowel movements are supported.

Collagen is another important component because it contains two essential amino acids: proline and glycine. Proline is necessary for the formation of collagen, and glycine works to improve digestion by increasing gastric acid secretion. Studies are currently being conducted and have shown that individuals with IBD, mainly Crohn's, are more likely to suffer from low stomach acid (3). Because the proper pH of the stomach signals the continuum of the digestive cascade, many people with low stomach acid face difficulty processing meals efficiently.

Summary

I know that was a lot of information, some of which may not have processed the first time reading it through - but that’s perfectly okay! Luckily you don’t need to know the names of all the essential amino acids found in bone broth to reap the benefits. I included this information because I know when I am learning about a new “supplement” that can improve my health, I’d like to know exactly how it works and why it is good. Many others like me enjoy doing their research to learn more, but others enjoy knowing the benefits, plain and simple!

So, another run down. When taken consistently, bone broth is exceptionally nutritious and works diligently to repair multiple components of your digestive tract. In addition to this, benefits are often seen through support in joint and bone health, hair / skin / nails, and detoxification processes of other organs within the body. It truly is impressive how functional this food is - hence, the nickname “nature’s multivitamin!”

I highly recommend giving this a try, whether you buy it from the store or experiment with making your own. I believe it’s wonderful! I drink mine first thing every morning, and it’s become something I look forward to - some people drink coffee, I drink bone broth (with an added scoop of collagen)! I hope you found this article informative and it piqued your interest to try something new, or reintroduce something back into your routine!

Stay Lovely,

Erin

Advocating for Your Illness in the Workplace

A word with health advocate, Samantha Reid

The CCYAN fellows recently had a chat with IBD blogger and health advocate, Samantha Reid, to discuss her take on managing IBD in the workplace.

CCYAN Fellows Leah Clark, Erin Ard, and CCYAN founder,
Sneha Dave, video-chatting with Samantha Reid

In February of 2010, Reid received a surprise that she never anticipated for during her birthday celebration. Three days after she turned 18, she was diagnosed with Crohn’s disease and began her adult life with questions, concerns, and ultimately, an ambition to help others with her disease.

Reid has had her fair share of experience navigating her Crohn’s disease both in college and work. Majoring in english in college and working as a communications director at her previous job, Reid gained a solid foundation in writing, communication, and outreach. Now, her job allows her to focus on health and advocacy in the professional environment. Currently a digital director for the nonprofit organization, Patients for Affordable Drugs, she strives to change policy to lower the price of prescription drugs. Patients for Affordable Drugs is a patient organization, and Reid actually started there as a patient, so her peers understood her illness and created a safe environment for her to work in. Reid understands, however, how fortunate she is to be working in a flexible environment that meets her accommodations.

“I realize the fact that I’m even able to disclose my disability to my boss and coworkers is a privilege, and not everyone has that ability.”

Reid went on to encourage those with IBD to “play it by ear” and do what one feels comfortable when discussing their health with their boss and coworkers. Disclosure can not only be an important step in establishing a safe work environment, but it can also be used as a learning opportunity for your peers. “It allows me to be more open and it allows my supervisors to be more open as well; it creates a space for dialogue,'“ Reid explains.

Along with being the digital director, Reid also has a successful blog, Sicker Than Your Average, that she frequently shares experiences with IBD on. She explains how her presence on social media has helped her with IBD advocacy with her work. “For all of my adult working life, most of my coworkers have known about my illness by default. Whether they know because they follow me on social media and see my advocacy work or they know because I’ve had to postpone a meeting because I was sick, most of them know.” Reid expressed how important communication upfront can be when tackling IBD at work. Giving your boss and coworkers a heads-up when sensing a flare or preparing for many doctors appointments can not only give you a sense of ease with planning, but also can inform your peers about the severity on an issue. With invisible illnesses, it can be hard to truly express how important your health is when other can’t see your pain.

“When it comes to asking for accommodations, communication is key. Any workplace that would be retaliatory about me needing accommodations is NOT somewhere I would want to work.”

Sometimes IBD can feel as though it is getting in the way of performing your best at work.
It’s important to remember to do what feels comfortable to you and prioritize your health.

Communication is not only good for planning for the future, but it is good for setting up workplace accommodations. Accommodations are there to alleviate any hardships put in place because of your illness. These can include having your office desk closer to a bathroom or having options to work from home. “In my current position, I have an agreement with my boss that I can work from home every Friday. Because of my Crohn’s, I struggle with extreme fatigue, so even having one day a week where I don’t have to get dressed up and commute saves so much in terms of my energy levels,” Reid explains. She said it makes an enormous difference to her and she feels valued at a workplace that can accommodate to her needs.

One topic that Reid discussed when advocating for yourself in the workplace is the drive to, in a sense, redeem yourself to your coworkers when you are feeling healthy. It’s understandable to feel pressure at work to perform well, especially when you feel as though you are slacking because of your health. Missing work because of appointments, hospitalizations, and just sick days in general can cause one to feel inadequate in their job performance.

“For me, when I am feeling well, I probably overcompensate at work to prove myself. No one asks that of me, but I know it’s important to gain that goodwill while I can so that when I fall into a flare, people are more understanding.”

What’s important is to realize that it is okay to take time for yourself to get better. For many IBD patients, health is a number one priority, and people will be understanding of that. Showing your boss and your coworkers, when you are healthy, that you can do your job right and well is completely fine.

With all the advice Samantha Reid gave the CCYAN Fellows, it’s clear that she is a remarkable IBD advocate and presence in the community. Her constant dedication to IBD awareness is shown through her work and her attitude towards life. Her insight on what to do and what not to do when it comes to advocating for your illness is the workplace comes from years of experience. Making efforts to communicate effectively with your boss and peers, setting up boundaries and accommodations to meet your health’s needs, and putting your health first when necessary are all great ways to help those with IBD navigate their work with ease. We at CCYAN hope those in need can use this advice and pursue their career goals without feeling held back by their diseases.

The CCYAN Fellows would once again like to thank Samantha Reid for taking the time to discuss this topic, and they look forward to seeing more of what she does in the future with health advocacy.

Samantha reid

Samantha Reid is an exceptional health advocate and role model in the IBD community. Her insight on advocating for yourself in the workplace not only those with IBD great advice, but also sheds light to important issues on workplace accommodations for all. For more information on Samantha Reid and places to connect with her, check out her social media and other platforms

Blog | Instagram | Twitter

Cooking with Crohn's - Gluten Free Strawberry Shortcake

With the summer heat, comes the summer treats! Watch this video of CCYAN Fellow, Leah, makes a delicious gluten free strawberry shortcake following the two recipes down below. It's important to stick to your own dietary needs to feel free to accommodate the recipe to your liking!

Recipe for Shortcake

• 1 1/2 cups gluten free all purpose flour

• 2 3/4 teaspoons baking powder

• 1/4 teaspoon salt

• 2 tablespoons sugar

• 3/4 cup heavy or whipping cream

• 1 large egg

Instructions

• Preheat the oven to 450°F. Line a baking sheet with parchment paper and set it aside.

• Mix the flour, baking powder, salt, and sugar together in a large bowl.

• In a separate bowl, beat together the cream and egg. Pour the wet ingredients into the dry ingredients and mix to form a cohesive dough.

• Scoop the dough in 1 1/2-ounce balls onto the baking sheet; use the palm of your hand to gently flatten each to about 2" to 2 1/2" diameter.

• Brush the tops of the shortcakes with cream, and sprinkle with coarse white sparkling sugar.

• Bake the shortcakes for 10 to 12 minutes, until they're risen and baked all the way through; break one open to make sure.

• Remove the shortcakes from the oven, split, and top with berries and whipped cream. Store, well-wrapped, at room temperature for several days; freeze for longer storage.

https://www.kingarthurflour.com/recipes/easy-gluten-free-shortcakes-recipe

Recipe for Whipped Topping

• 1 cup (8 fluid ounces) heavy whipping cream, chilled

• 1/2 cup (58 g) confectioners’ sugar

• 8 ounces cream cheese, at room temperature

• 1 teaspoon pure vanilla extract

• 1/8 teaspoon kosher salt

Instructions

• Transfer 2 tablespoons of the cream to a small bowl and set it aside. In the bowl of a stand mixer fitted with the whisk attachment or a large bowl with a handheld mixer.

• Place the remaining cream and beat on medium-high speed until soft peaks form.

• Add the confectioners’ sugar, and continue to beat until stiff, glossy peaks form.

• Transfer the whipped cream to a separate, large bowl and place in the refrigerator to chill.

• In the same bowl, place the cream cheese, vanilla, salt and reserved 2 tablespoons cream.

• With the whisk attachment, whip the cream cheese mixture on medium-high speed until light and fluffy.

• Remove the whipped cream from the refrigerator and add half of the whipped cream mixture to the cream cheese mixture, and whisk to combine.

• Add the remaining whipped cream, and fold it into the filling carefully until combined.

https://glutenfreeonashoestring.com/gluten-free-fruit-pizza/

What to Know When You Care About Someone With Crohn’s Disease

By Erin Ard

Chronic illness can be easy to ignore if you aren't the one living with it, but when you start to see how it affects a person you care for, it can strike a cord in you too.

When you meet someone with a chronic illness, it's natural to be curious about their life. You may even feel compelled to a) make their day easier, b) ease their pain, c) see their worth, or d) just help them feel comfortable. And if you want to lift the weight of living with a disease, choose all of the above.

Having IBD myself, it is THE. MOST. AMAZING. feeling in the world having someone who wants to know more and take care of you. So I must commend you for making it as far as reading this post.. You are ONE of FEW who would stick around someone with such a debilitating disease!

This topic has been on my mind for a while now. And when I started writing, I noticed how challenging it was to explain how this disease can affect someone. Experience with IBD is so diverse and can change so fast! For instance, in this moment I would say, "You really don't need to worry about me!" Because in reality, my own Crohn's has been in remission for years with only a few minor complications and I've made big strides in accepting my disease. I can go without thinking about my Crohn’s most days, but that doesn't mean these feelings of security have always existed and won't change in the future. Maybe your person is in the same boat, still it is invaluable to know what could happen. Whether you are a friend, family member, or lover, I want to help you understand the fundamental struggles, how it can affect someone (mainly by using myself as an example), and what you can do.

The first thing to know is that every person with the disease is unique and handles it differently. Some people want to be taken care of, while others may hide their struggles from you; so it's kind of up to you to know your person - I'm sorry I don't have all the answers! Thought, I can promise that anyone with a chronic health issue does not want to be characterized by their disease nor feel like a burden. It poses a challenge to balance helping them feel better and making the disease a big deal. If they choose to let you into that part of your life, that's great! It is too easy to discredit the harm it can impose. My first piece of advice is to have an open mind. Even though you won't be able to fully understand how it affects their body, mind, and lifestyle after reading this; you can keep learning.

 Before I jump into the nitty gritty of it all, we should go back to basics. Whether you just met someone with IBD, have know about the disease for years, or have it yourself it can be helpful to know how the disease works. With Inflammatory bowel disease (IBD), our immune systems get a little confused and end up attacking the healthy tissues causing inflammation along our digestive tract. IBD is a blanket term for the two most common forms: Crohn's disease and Ulcerative colitis. There are many commonalities between individuals who live with IBD. The most common symptoms are abdominal pain, fatigue, fever, and the infamous diarrhea. IBD can be classified from mild to severe depending on symptoms, e.g. frequency of diarrhea, abdominal pain, fever, weight loss, anemia, bowel obstruction, and more! IBD itself does not limit your life expectancy, however, it can lead to some life-threatening complications. And symptoms can be kept under control with medication, thankfully, allowing people to live normal lives whilst their disease is in remission.

The day-by-day symptoms and risk for complication in combination can be very draining for someone, both physically and mentally. Not only are these symptoms tiresome in their own right, but can bring about mixed feelings - fear of flare-up recurrence or inability to find a bathroom, worry over not knowing what you can or can't eat, embarrassment of symptoms, and maybe denial of the pervasive hold it can take on your life. Even though my disease is in remission, it takes constant maintenance to feel in control of my body's health.

Much of my knowledge comes from learning about my own Crohn's symptoms and how it has impacted my day-to-day life. So I will try to describe what to look out for when caring for your person and their IBD.

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It's a daily struggle. IBD is a hidden illness, making it hard to understand what kind of struggles we endure because they can't be seen. If your loved one says they don't feel okay but look fine, trust them. They know their bodies better than anyone. I know for myself, every once in awhile I have shooting abdominal pains, discomfort from something I've eaten, unreliable energy levels due to fatigue, joint pain, sensitivity to temperature, and recurrent symptoms close to my Remicade infusions. Usually on bad days, I take it easy on food I prepare for myself and the activities I do.

Tip: Have patience and learn to enjoy a few more Netflix movie marathon nights than usual.

It's a love and hate relationship with food. With Crohn's we have our own food triggers, which can be devastating to our digestive systems and send us running to the bathroom. Unfortunately for us, there is NO SINGLE ALL CURING DIET PLAN that can help us. We really just have to figure it out on our own since triggers differ from person to person. I get a lot of questions like, "Can you eat this?" "Or what can you eat?" and the answer isn't very simple. I can eat just about anything I want most days, but if I'm feeling off or it's getting close to my next infusion appointment - I take it easy on the hard to digest foods. I try to eat as healthy and balanced as I can while still getting the same sense of satisfactory indulgence as anyone else. For instance, I would love to eat an entire pan of brownies (and have gotten close a few times) but this would lead to me feeling like sh** the next day; as it would with anyone I feel. If you switch this desire I hold for brownies during a flare-up, it gets a bit more complicated and pretty much impossible. During a flare-up, however, my indulgences subside and I only crave foods that will sustain me without bringing about more harm.

Tip: Expect a mix of eating habits, since our health can change pretty fast. If they are on a strict diet plan, say gluten-free for someone with Celiac or gluten intolerance, get to know what they can and can't eat! It will be a whole lot easier for them if you have a good understanding and they can stop answering the "What can you eat?" question, at least coming from you :). A lot of people also take supplements to make up for the nutrients lost in their diet or from not being able to absorb an efficient amount through the gut. The biggest thing to understand, like with me, is that there are foods we just can’t eat AND there are foods, though you wouldn’t think so, we are still able to indulge in!

Flare-ups are hard to overcome. When the disease is active, you'll see all of the main physical symptoms taking root. A flare-up can last several days to a few years and can limit our ability to perform daily activities; sometimes even landing people in the hospital. During my own flare-ups, my limitations were somewhat subtle. I was still able to attend school and join sports, but my performance level was not where it could have been (this became clear once I achieved remission). After school I would too often fall onto the couch, exhausted from the day. I didn't have a solid bowel movement for months. I would give up and have emotional break downs in the bathroom. I became afraid of food because my body couldn't digest it properly anymore. I missed a lot of school, plans with friends, and family get-togethers. What I did attend, I would be withdrawn, wanting to lay down or be at home. Flare-ups are very socially isolating and can force us to miss out on a lot of what makes life fun :(

Tip: Be your own person and don't feel like you need to spend every occasion we miss out on with us, because we don't want you to miss out either! If your person is not feeling 100% and tries to dip out on plans, be heartfelt and ask, "Are you sure? What is making you not want to go?" Reassure us that not every day will be a bad one. Sometimes we have to stick it out to reach the good moments. In time, when we are healthy again, we will be able to push through what limits us. And help us see the value of little things, even if it's just an evening of Cards Against Humanity  or binging The Office.

We have some tricky immune systems. Many of us take medication to suppress our immune systems to fight inflammation. Some people may get sick more or less often, depending on their medication. When I first started Remicade, it was rare to find me sick with the common cold. However, since my dosage was increased I seem to get sick more often and have a harder time fighting the sickness off. *Insert disappointed emoji *

Tip: Help us take precautions when going out - use hand sanitizer, disinfect grocery carts, and mind your sneezes. Especially during cold and flu season! Maybe consider bringing over a box of tissues and some chicken noodle soup when these efforts fail :)

Everyone has their own self-esteem issues and insecurities. IBD makes us feel a loss of control over our bodies (quite literally sometimes) and can indirectly cause visible changes (e.g. weight fluctuations, inflammation of the skin or eyes, mouth sores, etc.). Complications with IBD may involve j-pouch construction surgery - a major cosmetic change with added stress over maintenance and potential leakage - or bowel resections and scarring. This can also extend to social interactions, like when we have to explain why we can't eat certain foods, obsess over the details with travel plans, or being conscious of our frequent bathroom visits.

Tip: Depending on the person, procedures causing cosmetic changes may not sit very well. All that we ask is you be open and accepting of every scar or medical device. Each one tells a story of our struggles and what we had to face to find strength again.

IBD has it's own added mental health challenges. People with IBD are at higher risk of having anxiety or depression. It is all too easy to get down on yourself when you deal with constant set-backs. With IBD, a lot of the symptoms happen behind closed doors.. Usually bathroom doors. Or in the scope of mental health, you can envision the mental wall that keeps others from seeing your thoughts, feelings, and worries.

Tip: I implore you to keep an open mind. We might need a little extra encouragement when it comes to self-worth, seeing the positive, and enjoying life when our IBD gets in the way.

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Being available and accepting of what we deal with can make such a difference to us. Like I said before, IBD can be socially isolating and I hope this post has helped you to understand why that is. I also want to say that people with Crohn’s or Ulcerative Colitis are the strongest, most ambitious people I know. They deal with keeping their health in check while juggling school, work, friends and family, their goals, AND everything else!

Your person may or may not deal with what I've laid out. Honestly, there is way more that could be discussed on "taking care of someone with Crohn’s" than what I know. Getting to know your person with their Crohn’s lifestyle will have a learning curve. It’s going to take some time and a considerable amount of observational skills to become an expert and if you aren't sure, ask! Just know that you can't do everything for us. You can't take all the pain away or make us healthy. What you can do is keep an open and accepting mind around our abilities. Be patient with our limitations. Help us feel comfortable and emotionally supported when we miss out. And get to know our many qualities in addition to being fighters. To go even further, I respect someone willing to challenge me when I hesitate on getting out of my comfort zone.

Finally, remember to take care of yourself too. Not only can the symptoms be draining on the person with Crohn’s, but seeing your loved one endure such bodily torment could drain you as well. Take time to rest, focus on the good, and keep fighting for your person!

What advice would you give to your loved ones?

An Invisible Illness is Still an Illness

By Erin Dunne

Images from the "Suffering the Silence" web campaign that allowed people to publicly share their experience with chronic illness.

When I was younger, one summer my family was visiting my grandparent's lake house in Indiana. The water was low enough my cousins and I were able to walk out to the anchored raft off the edge of the deck without much swimming or with a life vest. On the way back to the deck I felt a sharp pain in my right foot and felt a piercing sensation with every step I took. My grandmother sat me on the deck to find I had stepped on a large shard of a broken bottle and it was lodged in the center of my foot. I remember bawling from the pain as she attempted to take the shard from my foot but after it was out, I only had a small bruise and a scar. The discomfort I felt in this moment was easily seen by my family members because of my expressions and they could physically see what was causing the pain- but it isn't always this easy with an invisible illness. For many people, without physically seeing the direct source of the pain, it is hard to believe that there is any pain at all. Not seeing the discomfort of an individual doesn't mean that they are not sick. It is not seen by the naked eye, so it is easy to assume that a person is healthy or "normal" when in reality, a person could be having a really bad flare day but "they look fine." Something can be seriously wrong inside of you that only you can feel.

“Just because you cannot see the pain another person is dealing with doesn't make it any less real.”

An Invisible Illness is a chronic condition that is not visible to an onlooker. Examples of invisible illnesses include: Digestive disorders, heart conditions, diabetes, lyme disease, mental illness, etc. The symptoms that are often associated with these illnesses can hinder ones ability to enjoy life and be involved in everyday activities they love- which can be very frustrating. Adjustments are often made to meet the needs of their new, often lower, energy levels and limited ability to move. While medication and treatment plans can help greatly with the physical symptoms, the mental game that can occur due to encounters with others, insecurities, and fighting one's own thoughts can contribute to the pain an individual is already in.

There are times where one may be interacting with others and it seems as though they are witnessing insensitive encounters and whispers from those around them. Comments are often made as to why they are often absent to class, work, and social events. Even comments on ones mood- why they are short tempered, withdrawn, or why they lay around so often (maybe even being referred to as lazy). "Laziness" to an invisible illness sufferer can be just as important as any medication or treatment they are taking to help their symptoms because it is helping their body recover from the havoc that is wreaking within. When explaining how they are feeling to others, it is common to be countered with the comment "but you look so good." Further fueling the idea that capability is based on the way a person looks. All of these small contributions can lead the individual with the illness to question themselves and often look down on their recovery. There have been times I have felt bad for having to cancel plans for being sick- I feel as though I let others down, or I have gotten mad at myself for not being well enough to go about daily activities. There are times I compare myself to others that are in good health and think of when I was able to do similar things but I become upset with the fact that I am unable to do those things currently. While it is easy to automatically go to these negative places, they truly don't help with recovery so what is the point? Focusing on so and so's good health won't make my symptoms any better so why am I wasting my energy on being jealous? It is best to focus on yourself and your needs in the current moment.

These illnesses can only be experienced and felt by the individual that has them- we can try to describe our discomfort to others but it is hardly ever satisfactory. Each day can look different for various people because each person has different degrees of productivity that is possible for them. For me, on a good day I am refreshed from a good nights sleep, am able to eat at every meal and even snack in between, get some form of exercise, and have concentration throughout the day that allows me to get tasks like errands and homework done. Other days I may only be able to do a fraction of these things and witness extreme brain fog that makes concentration close to impossible. There are times where I have multiple productive days in a row or I have low energy days that I often become frustrated with. One of the biggest lessons that I have learned through the years is to give myself grace on the days that I may not be able to get done what I had originally planned.

As I have mentioned before, I am a big advocate of listening to our bodies- it knows much quicker then us if it has been overworked and needs to recover. Giving yourself grace and being kind to your body is key with any invisible illness because we too cannot see what is physically causing us pain. Sometimes we do not even know of what event or substance caused the discomfort but we experience it. If you had things planned for the day and you wake up and don't feel as though you can complete everything, that is OKAY! Do what you think you can handle and be easy on yourself. Move as much as you can throughout the day, be gentle on your gut and nourish your body with foods that you know work best for you, and do something that makes you happy! You know yourself and your healing abilities better than anyone else so you must do what you can to honor your body in times where it may need more attention. It's okay if others do not completely understand or are able to empathize to the degree you wish they could, but it is important that they are as understanding and supportive as they can be. Although it may feel like it at times, there are others in similar situations that understand the isolation that comes with invisible illnesses. It is important to acknowledge that you are never alone in your journey, even in moments where it seems as though you are.

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People could say to those without invisible illnesses that they are lucky they don't have to deal with a disorder. And while I would never wish an illness on anybody, I don't necessarily agree that I am less lucky I have to live with an invisible illness. Are there some days I wish I had never been diagnosed with Crohn's Disease? Absolutely- but those are typically the days that I have become so fixed on the negative that I forget to acknowledge the positives that have come out of my diagnosis. There is always room for growth and I believe that having Crohn's has allowed me to grow remarkably into a person that empathizes for others, I wish to care for and help others because I understand the pain and loneliness that can be felt amidst illness, and I have been able to be a part of a wonderful IBD community. On a more personal level, I have found a love for cooking as I have had to alter my diet to fit my bodies needs, I am more in tune with my body and mind, I understand how to handle low energy/ mentally challenging days, and I give myself grace more than ever before. Yes there are times where it is very hard to handle the insecurity that others don't understand and may judge because they may think I am lying about my pain, but I know myself more than anyone and if I feel the pain, I know it is real- I don't need to validate that to anyone else.

There are many highs and lows of having an invisible illness but I think it is very important to try to find as many highs as possible to make the lows not seem as bad, but also to learn how to handle the low moments better. Life is happening for us, not to us and looking at these illnesses as opportunities for growth can help our perspective towards them remain as positive as possible.

Stay Lovely,

Erin D.

Supporting our Mental Health: Moving past or accepting your negative unconscious thought

By Erin Ard

Happy #MentalHealthAwareness month! AND #CeliacAwareness month! And hey, if you're into it.. #InternationalMasturbation month too!

The month of May is known for quite a few awareness and observance campaigns. Interestingly enough, the main topic I want to address in this post loosely relates to each of these. #NUTS! In mental health, this can refer to your negative unconscious thoughts. For Celiac disease, these can be a great source of protein on a gluten-free diet. And well.. you get it.. But I mainly want to address mental health when you are living with #IBD.

There is evidence that #depression and #anxiety are more common in individuals with IBD compared to the general population. Which makes absolute sense when you think about what we deal with on a daily basis and during a flare. Mental health really becomes a topic of discussion when you put the stress of school into the mix.

I can remember an incredibly stressful time during my semesters as an undergrad. I was juggling 5 paper deadlines within the same week with exams looming in the weeks to follow. I ended up having to sacrifice my social life, sleep, and taking time to care for my body. Not having any time to properly focus on my health added to the stress. It felt like I was failing at life because I didn't have time for myself or my friends and family. Fortunately I made it through this time despite needing to make these sacrifices, but after it was all over I made my health a priority.

During these times, it's easy to fall into bad thinking habits. Our negative thinking habits are hard to shake. A lot of times we don't notice them. These gloomy, self-deprecating thoughts can feel so natural to our personalities or our every day thought processes, but they don't need to be. Thankfully, you can retrain your brain to respond differently when these thoughts pop up and here is one strategy how. Say it with me!

"Awwww NUTS!"

This is a common saying for me that is usually followed by a lot of giggling.. But this word found a whole new meaning when I learned about the concept of NUTs as it pertains to mental health and #mindfulness. When I discovered this lesson, I thought it was so enlightening that I had to share it with all of you!

If you have ever felt held back by your own thoughts, tendencies, or fears. This is for you.

NUTs appear in our unconscious and tend to affect how we think and act throughout the day. They can impact how we view ourselves and our ability to face adverse situations.

These are incredibly personal and can look different to each person. As individuals with IBD, we probably share a few common negative thoughts. It may sound like, "I can't live my life how I want because of this disease." " I won't get through another flare up." "I will never live normally again." or "I hold my friends or partner back."

The gist of the practice is to name these thoughts and evaluate them. Here are my top five negative thoughts (some of which, you might have too) and what happened when I brought them to the front of my consciousness..

1. "I am going nowhere."

2. "My anxiety keeps me from achieving my goals, meeting new people, and finding love."

3. "I am unable to connect with others."

4. "No one is interested in what I have to say, so I won't say anything."

5. "I won't be successful because of my Crohn's."

Saying mine out loud was oddly therapeutic, almost satisfying. Even now, when I read them over the more silly they seem. When I formed that first NUT, the rest poured out in a rush. More and more came to the forefront because so many of these had been piling up over the years. Rather than acknowledging them, I would shove them aside. I tried to ignore them - like if I forgot about them, they wouldn't be true. I ended up delaying my chance for peace of mind.

If I had given them some thought as they arose, I would have realized how much unnecessary power they had. They secretly dominated my mind for several years. How I acted in social situations, dealt with difficult circumstances, coped with certain physical limitations, or processed the aftermath of some high emotional states. It was easy to find myself down a rabbit hole in my unconscious surrounded by debilitating negativity. Because of this exercise, I'll be able to find a way out now.

I can't say that I've completely moved past these negative thoughts, however. Honestly, some of them still give me a pang of discomfort because they were so deeply rooted in my unconscious mind. You might find that some of your NUTs hold a bit of truth to them, but that is still okay. Even if you do find one to be true, can you accept that?

I highly recommend trying this out for yourself! What thoughts could be holding you back or keeping you from seeing your potential? Name the first things to come to your mind and ask yourself, are these true? Do they have to be true? How do they make me feel? And then ask yourself, what would my life look like if I no longer had these thoughts? Be sure to open yourself up to whatever happens in this exercise.

With love,

Erin

A special thank you to the Mindful Leadership Program and Elisha Goldstein for teaching this concept to help others.

Stress, its effects on IBD, and how to handle it

By Erin Dunne

We all have had moments where it feels like everything is happening all at once. Whether that be good or bad, it can be extremely overwhelming. With school and work, it may be projects piling up, exams, or a packed schedule. In our social lives, we may have weddings, plans with friends, and family events that happen within a short time frame. We may think of stress as a superficial, short term feeling that goes away once the chaos has subsided, but that is not always the case. The effects of stress can stay within the body for hours and sometimes days after the stressor has vanished. The intensity of the body's response depends on the individual and how they handle the stressor- either focusing on their emotions, avoiding the situation, or nourishing themselves and acknowledging the issue. It is essential to understand the different types of stress, how each variety can affect the body, and how to handle yourself when faced with such situations. Knowing what to do is not only beneficial for your overall health, but it makes you feel powerful and amazed at the control you can have over the situation!

What is stress and what does it do to the body?

Stress is the body's response to any situation that poses demands, constraints, or opportunity (Riehl, 2019). There are two main types of stress that people face: Acute and Chronic. Acute is short-term and is most common. An example would be daily occurrences such as a project deadline, or being stuck in traffic. Chronic stress is prolonged and can contribute more harm to the body if experienced too often. An example would be involvement in a toxic relationship. When the body detects a threat, the brain activates the sympathetic nervous system which stimulates a response typically known as the "fight or flight response." The sudden release of hormones, primarily adrenaline and cortisol, prepares the body to take action. When the rush of hormones is constant, this can cause a lot of wear and tear on your body. Once the alert phase is activated, the goal of the body is to return to its natural, parasympathetic state with regulated hormone levels.

When in "fight or flight" mode, the body focuses all of its energy into systems that are necessary and shuts off others that are not being used. One that becomes restrained is the digestive system. While there is no direct correlation between stress and IBD, more research has been conducted to investigate the influence of stress triggering symptoms. Ongoing stress can often go unnoticed, but it continues to impact the function of certain systems of the body. Stress is hard on the digestive system, as it affects which nutrients your intestines absorb, and how quickly food is moved. A recent study has found that IBD symptoms may increase because the sympathetic nervous system acts on the lining of the colon and may worsen current inflammation. Evidence has also led scientists to believe that stress hormones may help harmful bacteria reside in the intestines (Norton, 2010).

What causes stress?

This reaction is initiated by the presence of stressors, anything that triggers a physical response. The causes of stress differ for each individual- we all have our unique threshold and perceive situations differently. For example, if there is a presentation that requires the student to talk in front of their class, one person may not mind public speaking and are not worried about presenting, while another student may dread public speaking and feels exceptionally anxious. Of course, not all stress is bad- an example of good stress would be the feelings you may experience before an athletic event. Some common stressors include school, work, busy schedule, traveling, finances, lack of sleep, and poor diet.

How to handle stress:

Generally, there are two types of coping styles; Problem-Focused and Emotion-Focused. People who are Problem-Focused approach the issue head-on, whereas people who are Emotion-Focused tend to lean into distractions and avoid the issue. It is critical to recognize what coping style you tend to resort to naturally so you are more prepared when faced with a future problem. You are also able to understand yourself better! Regardless of your natural response to a stressful situation, it is also essential to know how to take a break amid chaos. Taking a break allows yourself to calm down and assist your body back to its normal state.

Stress reduction techniques can help you find peace and maintain perspective when consumed by pressure. It is vital to find something that appeals most to you- what works for one person may not work for another. Trying out a few different techniques can help you see what works best for you and can quickly become your go-to reaction to stressful situations. Some great things to incorporate into your stress managing tool-kit include: incorporating physical activity, talking and spending time with friends, reading, and baking. Even taking the time to focus on your breathing when you find yourself becoming overwhelmed can help manage the intensity of the stress response. Finding an activity that stimulates rest, clears your head, and makes you happy is one of the most beneficial things you can do for your overall well-being!

How I learned to calm my mind with movement:

Through the years, as I have become more aware of listening to my body and provide for its needs, I have learned the importance of handling stress better. I recognize now that when I experience significant amounts of pressure in a short amount of time, not only do I feel exhausted but I also suffer from an increase in symptoms. If I am under stress for a more extended amount of time, I have prolonged symptoms and discomfort. I have developed habits of practicing yoga, going on walks, and meditation- all things that allow me to slow down my mind and put life on pause. However, I do not only do these things when I'm stressed. They bring me such joy and contentment; I make time each day to do at least one (sometimes all) of these activities!

One of the best things about yoga is that it can be done almost anywhere. I love taking advantage of the beautiful weather and fresh air!

Typically, I start my morning with at least a ten minute meditation which helps me set my intentions for the day. While I have tried to sit in silence and meditate, my attention span is not that disciplined yet, so I use guided meditations from Headspace. If you're interested in practicing meditation, I would recommend downloading an app or finding videos on YouTube- both great resources! Another thing I do quite often is take what I like to call "Mindful Walks." I put on a podcast or playlist and take a long walk, making sure to be present and aware of my surroundings.

My favorite way to relieve stress is through my yoga practice. When I was younger, my older sister and I used to take classes together, and I have been intrigued ever since. Through the years I have leaned into my yoga practice to help quiet my mind and work on connecting my body and brain. At first, I was intimidated by the idea of flowing on my own. I thought it had to be in complete silence or to mellow music, and surrounded by aromatherapy. I soon realized that the purpose of yoga practice was to embrace my own intentions and make the most out of my time. I don't put pressure on myself to have a perfect session because I'm learning and am allowing my body to move the way it wants. Most of my sessions include aromatherapy, the twinkle lights in my dorm, and one of my favorite playlists. Even if it is only taking five minutes to flow, I notice an extreme shift in my mood after a session- I feel renewed.

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In the past, I would isolate myself and push through the pressure until I would eventually crack and break down. In the moment, I may not feel like moving or pausing but I have to remind myself of how I feel afterwards and the temporary rest I am giving to my body. After I am active, I not only feel more relaxed but I feel happier and come out with a better mindset- more motivated, present focused and ready to take on the next challenge.

Stay Lovely,

Erin

IBD Diets: Gluten Free for Crohn's and Colitis

By Leah Clark

Because of the popularity of Hollywood fad diets, the term 'gluten-free' has become more and more popular over the past decade. While not necessarily intending to do so, this trend actually brought great change to individuals suffering from celiac disease, non-celiac gluten sensitivity, and inflammatory bowel diseases. With new food products coming to market and more menu items coming to restaurants, it has provided a new way for people that cannot eat gluten to experience food. As someone that was diagnosed with both celiac disease and #Crohn's disease ten years ago, I can confidently say I know my way around a nutrition label. That being said, not everyone that is on a gluten free diet, or that is planning on starting one, knows what to do. When discussing your treatment plans for your IBD with your doctor, discussing diet changes should not be forgotten. So, is going gluten free right for you?

Bacon, eggs, potatoes...who says living a gluten free lifestyle means giving up your favorite breakfast foods!

What is gluten?

With all these terms of gluten free, gluten sensitive, wheat-free, gluten-friendly, and more, it can be confusing to know what it all means! Isn't flour gluten, or is it any grain? To start with the basics of a gluten free diet, one has to know what to look for. Gluten is the proteins found in wheat, rye, and barley. So when on a gluten free diet, wheat, rye, and barely are the foods to avoid.

How to read labels

Okay, so know that I know what to avoid, what are the necessary steps to ensure that I don't eat the wrong foods? Check labels on everything. Even if you think something may be gluten free, it never hurts to read the nutrition labels. Certain foods don't have labels, such as fruits and vegetables; however, these foods do not consist of any other ingredients other than what they are called-apples, carrots, oranges, etc. Foods that are made with other ingredients, such as cereal, pasta, and crackers, are foods that need to be checked. Luckily, most companies are good about food labeling, so boxes will often say "Gluten Free" or "Contains: milk, soy, and wheat."

However, sometimes there are tricky labels that you need to look out for. For example, the cereal Rice Krispies is not #glutenfree. The ingredients include rice, sugar, salt, malt flavor, and vitamins and minerals. The key word here is malt. Although the other ingredients are okay, the malt flavor is not. Malt is a tricky word because it is not wheat, rye, or barely; however, malt is a derivative from barley. Therefore, Rice Krispies are not gluten free. Words like malt extract, malt flavoring, barley malt, wheat-germ, and non-gluten free oats, are words to look out for.

What foods can I eat?

A good rule of thumb is to stick to foods that are labeled gluten free, or are"natural" foods. By natural, I mean foods that are not made with large amounts of ingredients. A good starting gluten free grocery

list could include:

• Fruit-apples, bananas, kiwi, oranges, grapes, strawberries, raspberries, blueberries, plums

• Vegetables-carrots, corn, green beans, lettuce, spinach, broccoli, radishes, celery, zucchini

• Milk-can be almond, dairy, soy, cashew

• Protein-lean meats, chicken, eggs

• Dairy products-cheese, gluten free yogurt, butter, cottage cheese

• Grains-white or brown rice, gluten free oatmeal, gluten free breads and pastas

Gluten free pizza? Yes please! Restaurants have gotten better at properly preparing gluten free dishes, including delicious pizza, to make it easier for people to enjoying going out to eat.

Gluten free diet can not only be good for your gut, but also for other parts of your body because of how healthy a gluten free diet can be. Many of the foods listed are healthy in their nature, like lean meats, fruits, and vegetables. However, just because something says "gluten free," does not mean it is part of a healthy diet. Sure, chocolate is gluten free, but if all you ate was chocolate, would that be the best way to go on a gluten free diet? Probably not.

But I thought gluten free foods always tasted bad?

A common misconception about gluten free food is that it tastes gross. While yes, there are some bad gluten free food products out there, this is no different than there being bad gluten food. It all depends on your preferences and experimenting with different brands. Making home-made gluten free brownies is not as simple as using a Pillsbury box recipe of 'normal' brownies (although, there are some Pillsbury gluten free baking products that taste great). The point is to try new brands and baking techniques that work for you. I've spent the last ten years of my life finding my favorite brands of pastas, crackers, and bread, and I can honestly tell you, it wasn't I traveled to an entirely different country and tried their gluten free bread that I found my favorite. Gluten free food can taste just as good, if not better, than the food you're used to! It just takes some time and preparation.

How do I know if gluten free is right for me?

Honestly, it all depends on what you and your doctor think is best for you. I had to go gluten free because I was diagnosed with a disease that literally required me to. Yet, I know several people with Crohn's or colitis that have gluten free diets that do not also have celiac disease. In short, if eating certain foods make you feel bad, do not eat those foods! There are other foods I avoid even though they are gluten free, such as popcorn and caffeinated sodas, because I know they upset me. It truly depends on each person and if it is going to help with your treatment for IBD.

Crohn's in College: The importance of understanding flare-ups and your disease

By Erin Ard

I've been living with #CrohnsDisease for 11 years, but even with years of experiences, mishaps, and triumphs, I feel I'm still learning how it affects me. One of the biggest realizations happened recently when I was in college. Around my junior year I had hit a wall. It was becoming increasingly harder to navigate my studies and my energy level was draining rapidly. I had been taking classes year round for three straight years, taking classes in the summer and having heavy, difficult course loads to accommodate my second major and research. Unbeknownst to me, I was actually neglecting my health.

I started consistent Remicade treatments in high school and the difference it made was 100 fold. I went from an underweight, fatigued freshmen to a strong, motivated sophomore. The change was so positively significant that I thought all of my worries about Crohn's were behind me. I could eat good food again! And play competitively in sports! And I carried this mindset into college. I thought my struggle was over and could focus all my energy on school.. And I carried this mindset into college. Turns out I was wrong.

After a few painful semesters I started to realize what was happening. I was starting to get burnt out, I was sleep deprived and running on fumes. I was struggling with my motivation and my anxiety was building. Though seemingly dormant, my Crohn's disease was still affecting my mind and body.

I had ignored all of the signs up until this point. The fatigue and anxiety I felt in classrooms. The random little fevers during an important lecture that distracted me. The joint pain that slowed my walk to class or hindered my ability to exercise. The gut discomfort during an exam that forced me to finish quickly to get the hell out of there. And finally the gut-wrenching pains that made it impossible to walk. Everything added up, but it took me three years in college to see.

Starting my senior year I sought accommodations from our Disability Center on campus, which alleviated most of the worries set in place by my Crohn's. However, I was left wondering.. Why did it take me so long to figure out Crohn's still had a big impact on my daily life?

Essentially, it came down to my personality and one big misconception. During the initial stages, Crohn's had such an emotional impact that I've always tried to shut it out. In shutting it out, I failed to seek out information from outside resources and tried to figure it out on my own. In doing so, this lead to one big misconception around the focal point of Crohn's disease - flare ups.

I never generally understood what they are, their causes, how to help remedy them, and everything else. See, before I went on Remicade I was in a constant state of flaring up. I was unable to get it under control long enough to have a normal bowel movement. Which meant I wasn't able to eat much and I didn't have a lot of energy. I lived off of my mom's homemade chicken noodle soup and mashed potatoes because they were the only meals gentle enough to my gut. Here is what I have learned since then.

Flare-ups are periods of time when the disease becomes active and symptoms reappear. They consist of prolonged symptoms like gut pain from inflammation, diarrhea, blood in the stool, fatigue, and/or weight-loss. How long the symptoms last and the severity of them is different from person to person. Some medication, like Remicade/Renflexis/Infliximab, is specifically used to control symptoms enough to enter remission (i.e. an absence of symptoms or inactive disease), which means no flare-ups! Medication may be combined with other meds or diet restructuring to help keep symptoms under control. Over time, however, the same treatment regimen may not have the same affect. So adjustments in type of medication, dosage or frequency, or further diet modifications may be needed. Here, this whole time, I had thought of my disease as in remission, inactive, and needing no more thought. When in reality, it's going to be an every day effort.

See this article from Very Well Health to learn more about flare-ups and different ways to define remission.

My personal tip is to pay attention to what your body tells you. Focus on whether certain symptoms are still present - do you have gut pain? Diarrhea? Painful bowl movements? Other non-gut related symptoms? Pay attention to how long these symptoms persist and take notes. This might mean your Crohn's or Colitis is still active and it's important to tell your health team. If one thing just isn't doing the trick, there might be additional options to help you reach your potential in healthy living. And if you haven't already, seek out information about the disability center on your campus!

I've recently started to pay more attention to my body's responses. What used to be my response to the question, "What can you eat?" has changed from, "Oh, I can eat anything!" to, "Well.. I'm still trying to figure that out." In all honesty, I AM still figuring it out. Though certain foods don't affect me like they did before medication, they still influence how I feel. And it is my responsibility to make sure I take care of myself by eating the right foods and not the wrong ones.

Be attentive. Always seek a better understanding. Don't be afraid to ask questions or ask for help. And most importantly, take care of yourself!

With love,

Erin

What to Expect at a Remicade Appointment

By Leah Clark

As someone that has been using remicade for the majority of their life with #IBD, I think it's safe to say that I've got infusion days down to a science. Check out this video to see what one can expect on infusion day with remicade and read more about it down below.

When I was first diagnosed with Crohn's disease at the age of 12, my pediatrician recommended that, along with several pills including Prednisone and Pentasa (mesalamine), I start remicade infusions right away. Besides a brief few months this past year without it, I have been taking remicade ever since then. Remicade has worked wonderfully for my IBD, so much in fact that for a few years, I was able to get infusions every 11-12 weeks, instead of the regular 8 weeks. That being said, it did take several years to reach that point with no flares during that time. Now, I understand that everyone's body is different and what works for one person with IBD may not necessarily work the same for another. It's importance to listen to your body and your doctor.

As someone that was only 12 when they received their first remicade treatment, I wish that I would have been more prepared and knew what to expect. I remember my first treatment literally lasted all day because of IV complications, reactions, and a lot of tears being shed. Now that I've been going for so long, I thought it would be great to allow someone else to have that information that I was lacking on my first visit. Whether it be your first time receiving a #remicade infusion, you are going along with someone to support them during their infusion, or you're an old pro at this point, it never hurts to see someone else's experience with remicade. In the video, I go through the whole process of my infusion day, including what to wear, what to expect for vitals, and the entire unedited viewing of getting and IV and starting the medicine infusion.

Hospital visits can be scary, especially when you don't know what to expect. I hope with this, you can feel more relaxed and prepared for your next remicade infusion.

Comfort, Charisma, and Confidence: 3 Tips to Make Dating with IBD Work For You

By Erin Ard

Recently, I've been learning about the many strong women who have made a difference in this world. Those who have lead movements, progressed research, fought their adversity, spoke their truth, and lived their life with passion. In honor of #WomensHistoryMonth, I've been trying to find what this means for me. A single, white, cisgender woman with a voice, a mild physical disability, and a latent identity. What do I have to say?

I've been doing a lot of reflecting lately about what I can offer the #IBD community. I've been trying to think of what tips and/or tricks I live by that could make your day to day life easier. I explored my reflections but I sadly couldn't come up with many. Then I was kindly reminded of something. Though I have lived this fight with Crohn's for some time, I am still amidst my own journey. I might not have the answers because I haven't resided long enough in this level of comfort, which seems to grow every day. I am still figuring out how to catch up from the emotional setbacks Crohn's disease has caused for me and it's okay if you are too. Welcome friend! We can figure this out together.

In truth, I have had a lot of interesting experiences I could speak to, but today I will settle on one I've learned a lot about lately. #Dating.

While this topic might not be central to the life of an IBD patient, it has the potential to really impact our self-esteem and mess with our emotions. I can't say I have extensive experience with dating or have ever made it to the "sweet spot" (when you get past the "What are we?" stage and finally make it official). However, since I've been out of the game I've been using time to learn. I've subscribed to a few newsletters and watched way to many "How To" videos! How to get the man of your dreams, How to not push him away, How to get him back, How to.. How to.. It sounds silly, but it has been SO eye-opening! What was a topic I had zero input in, I now have a LOT to say about.

It's a little humorous how much we struggle over the little things in dating that should be easy. For instance, figuring out how to say the right things or act a certain way to keep someone's interest. I've realized the less we worry about these trivial things, the more successful we could be. You might be thinking, worrying "less" is easier said than done, but shouldn't being our natural selves rather than putting on a façade be the easy part?

This is just one of the many revelations I've had recently about how intuitive the dating world is and how easy we can make it work in our favor. As a woman with Crohn's disease I've had other challenges to contemplate, like how to talk about having a chronic disease to someone I barely know and how to phrase positively so I don't look like damaged goods. Because in reality, we have all learned tremendous strength with having IBD so there is no need for anyone to think this about us.

IBD is a multi-facetted disease that touches many parts of our life. It impairs some of our basic every day functioning, like being able to sit for extended periods of time without needing to use the bathroom. Personally, Crohn's disease has transformed how I go about my day. I've had to make necessary changes for my health, learn to accept my limitations as they are, or find the motivation and means to push past them.

Well, here it is my little ladybugs! Here is what I have learned about dating AND dating with IBD.

First, open up about your IBD when you feel comfortable.

Opening up about your life with IBD can get pretty personal and you might not want to get too personal too quickly. If your date asks you questions about having IBD, be honest, but don't feel pressured to divulge all your deep emotional baggage. Ultimately, deciding when you should talk about life with IBD is up to your comfort level. If you are comfortable with someone and trust their compassion, then feel free! Getting close to someone emotionally is all about balancing each other's efforts. If they give a little, you give a little and vice versa.

Opening up about your life with IBD is different for everyone. Some people are entirely comfortable with airing out their experiences, while others may be hesitant. Some people dwell on the negative, while others would rather focus on positive. It may be easier for others, but we don't need to criticize ourselves for how behind we may feel. Rather we should accept where we are, honor how far we've come, and progress at our own pace.

Second, cancelling a date doesn't have to be a headache if you are charismatic.

Dating is stressful enough and when you add IBD into the mix it can get complicated.

Imagine this: You met someone who seems perfect! They are family-oriented, charming, sensitive, and cute. You are really excited about getting to know them so you set up a date. You talked them into touring the art museum downtown and getting ice cream afterwards. But, you wake up the morning of feeling a little off. Maybe that handful of popcorn at the movies last night wasn't the best idea.. You forgot how much popcorn can set you back and you've been reaping the consequences all morning. So, what do you do?

When you have IBD, situations like this can happen often. This has happened to me quite a few times since I always forget how much my body loathes popcorn. Although my dates were never this adorable!

So, say your date doesn't understand your situation and you aren't comfortable with sharing that part of you yet. If the person is as great as you make them out to be, then they will understand if you need to cancel. Even so, there are ways to cancel a date that won't reflect poorly on your interest. Here is my personal tip, whether you decide to tell them the truth minus the details (you aren't feeling well) or make up a believable excuse (you have an assignment to finish), be cute about it! Tell them you won't be able to do tonight and add something playful, like Hey, I don't think I can meet tonight anymore. Any way we can reschedule for Thursday? I promise I'll make it up to you ;)

This way you still convey interest, make the cancellation pleasant, and give them something to look forward to - seeing your cute self :) If you have to cancel many times, it probably won't continue to work in your favor. You have to figure out what you want to tell the person. If they don't respect that some actions are difficult for you, then they probably weren't the one for you anyways. You deserve someone AS amazing and understanding as you.

Third, it's all about being confident.

If you think about it, what kind of personalities are YOU attracted to? Those who seek out gratification for their insecurities or individuals who are comfortable with themselves and radiate positivity?

Here is my personal tip on getting started with confidence. Practice talking about how IBD affects you. Have this conversation with yourself, open up, be honest and focus on what value it has brought to your life. For me, having Crohn's has brought me closer to my family and friends, it has taught me strength and perseverance, and has given me a purpose. Since being diagnosed I have focused on my overall health and sought out knowledge to help others be healthy and embrace their whole self.

The notion of confidence became more inviting for me once I realized it can be learned. Being confident is an attitude and it is relatively easy to implement if you are proactive in changing your mindset.

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I hope this article can help shift your perspective of dating with IBD to a positive headspace. If you take one thing away from this, I want you to know the key to successful dating is knowing and appreciating yourself. Once you learn how to do this, all of the tedious details we tend to wrap ourselves in won't seem as unmanageable. I can't say enough about how the simple act of being compassionate with myself has helped me grow. I hope to become as strong as the women I've been learning about this month and to pass this strength to all of you.

Each of us is strong in our own way. IBD challenges us to be even stronger.

With love,

Erin

7 Tips For Easing Travel Anxiety

By Erin Dunne

The weather is getting warmer, school is coming to a close and the time for traveling is here! I have been lucky to travel with my family on many road trips and am starting to go off on my own as I get older. I love traveling no matter where I go or who I am with, but I still get apprehensive when planning. Will I be able to eat out? Is there a grocery store nearby? Do I have to take my medication while I'm away? What if I get sick?

Going to new places and being confined in a single mean of transportation can be very stressful and bring out anxiety in people with #IBD. I don't know about you, but being bloated, in pain or uncomfortable is not precisely how I'd like to spend my trip. It's unpleasant enough at home but is even more so when away. Although I have a lot more traveling ahead of me, I have already learned through the years ways to ease my anxiety and make traveling as smooth as possible.

My top IBD friendly traveling tips are:

1. Set up a game plan with your travel buddies:

It's always best to make sure that you and your travel partners are on the same page and at least have a general idea of what you would like to get out of the trip. As someone with gut issues, it's important to clarify any needs that may need to be met while you're away- special diet, bathroom accommodations, etc. Explaining your concerns will not only help your partners understand better but will also put you at ease. By constructing a game plan, you'll have a better idea of what you'll need to prepare for- whether that means packing your own food for certain meals or staying somewhere with multiple bathrooms and a fridge.

2. Research restaurants you can go to:

I'm a BIG foodie so finding the best local places to eat when traveling is extremely important to me. I like to try to stay away from chain restaurants as much as I can when I'm away so I can experience more new places on my trip. By being prepared with gut-friendly places to visit, when the question of "where should we go to dinner?" comes up, you won't have to frantically search for restaurants on your phone while others wait. If you can't find a restaurant menu online, don't hesitate to call and ask if they can accommodate your needs. From experience, most places will be more than happy to work with you to create something you are comfortable having!

3. Stay somewhere with a kitchen:

Eating out for every meal can be expensive, impractical, and not always easy on the gut. With that being said, staying at a place that has a kitchen/ kitchenette can be very helpful and makes it easier to create your own meals. Being able to cook takes out the fear of getting a restaurant induced stomach ache and gives you some control as to what's being put in your body. Before traveling, make sure to search for any nearby grocery stores, so you can pick up some staples and save time.

4. Bring supplements:

Even if you think you can go a few days without supplements, bring them if they help your gut feel better! In my opinion, it's best to be over prepared than under prepared. Making sure you have your medicine and supplements (if you take any) can be stressful. If you're like me, even if you double and triple check that you have packed everything there is still a fear in the back of your mind that you forgot something. Put your medicine and supplements in a place that is both easy to remember and is accessible. I typically put mine in a pill organizer in my carry-on.

5. Pack snacks/meals:

If you have been in an airport before, you probably know that many of the items are often overpriced ($5 for a bag of trail mix that's mostly air? No, thank you). I always come prepared because it doesn't matter if I am stuck on a long car ride, a plane, or just walking around town- when hunger strikes, I need food asap. By packing some of your favorite, healthy snacks, this takes out the chance of settling for something that might upset your stomach. Some of my favorites are fresh fruit, homemade nut mix, and Larabars!

6. Pack your go-to remedies:

Bring some of your most effective remedies to help with any discomfort that may occur while you're away. Have a reusable water bottle on hand to make sure you are staying hydrated (and maintaining the environment). Some of my go-to's include: Bone Broth, Pedialyte packets, Apple Cider Vinegar, and essential oils. Having these items with me when traveling helps me feel at ease because I know that while I'm at home, they help make me feel better and if I am away, they will do the same.

7. Incorporate parts of your regular routine:

Most trips can follow a jam-packed itinerary that can leave you feeling exhausted by the end of the night and wishing for more sleep the next morning. While this may work for some people, others may function better with a flexible itinerary. Even if away, sticking to part of your daily routine can keep you more grounded and feel more comfortable when thrown into the unfamiliar. My morning and evening routines are very set in stone and help me unwind, so I always make sure to implement some of the same activities into my travels. At home, my routines are much more elaborate, but I make sure to take the simple, yet impactful things with me wherever I go. In the morning, I meditate and drink warm lemon water with Apple Cider Vinegar. Before bed, I drink a cup of tea and read or listen to an audio-book.

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Ultimately, recognizing that traveling is never going to be perfect is the biggest help. Life is unpredictable and the best of us get a headache or stomach aches at what seems like the most inconvenient of times. I know it can feel as though you are high maintenance and you may also feel bad for "inconveniencing" your travel partners, but this is very far from the truth. Know that your health comes first and you deserve to enjoy yourself just as much as anyone else- you just may have to take a few extra steps to make this happen! These steps are necessary, and over time you will become more comfortable with whipping out your pre-packaged meal while your friends have take out. A happy gut leads to a happy traveler!

Stay Lovely,

Erin

5 Things to Know Before Flying with IBD

By Leah Clark

Having just returned from a trip across the country, several travel tips about flying with inflammatory bowel disease are fresh in my mind. Whether your chronic condition is active, in remission, or anywhere in between, these five tips can help make traveling with #IBD a lot smoother and ensure that you can be prepared, calm, and have fun on the way.

Flying with IBD shouldn't have to feel like a constant state of turbulence. Follow these simple tips to ensure that your flight is a breeze.

1. Know Your Surroundings

Many people with inflammatory bowel disease need to take frequent trips to the bathroom, and that can be difficult when put into an unfamiliar environment. Fortunately, most airports have bathrooms near every gate, as well as maps that can direct you to the nearest one. If you are concerned that you will need to use a bathroom and do not want to have an accident, try and stay near a restroom until your flight is boarding. Some airports have private bathrooms as well with one stall that can make going more comfortable.

2. Prepare Your Own Food

As someone with a #restrictivediet, I know how hard it can be to find food I can eat at an airport. Airplanes and airports often have processed foods that can be prone to cross contamination, as well as a limited selection of foods that are not nuts, chips, and sugary snacks. If you're like me and need to be cautious about your diet, I recommend packing your own food and keeping it in your suitcase until you are ready to eat it. Just make sure the items follow the TSA guidelines.

3. Pack Medications Strategically

Following a tight #medication schedule can be difficult if the medication is not easily accessible. It's important to pack your pills in a small travel carrier or pill box that can be brought on the plane in a carry-on bag. This way, your medication will be with you at all times and available for you to take it when needed. Be sure to have a beverage on the flight, or purchase one after going through security if you need to drink a liquid with your medication.

4. Choosing the Right Seat

Lucky day when you get a whole row by yourself, but choosing an aisle seat can also be a good choice.

Certain airlines, and depending when you purchase your ticket, will allow you to choose what seat you want on the plane. If frequent bathroom breaks is common for you, I recommend scheduling your flights earlier than later and choosing an aisle seat. This way, you will not have to climb over people or waste more time reaching the bathroom. If you cannot choice an aisle seat, it never hurts to ask the person next to you if they are willing to switch.

5. The Day Before

With IBD, sometimes we overlook some of the basic health necessities that need to be addressed: sleep and hydration. Fatigue and dehydration are not new concepts to us, and it's important not to forget about these when traveling. Getting a good night sleep before the trip, as well as drinking plenty of fluids is very important. It's a good idea to take a nap on the flight (if able) and drink water while in the air, as well, when the travel day actually arrives.

Everyone's IBD is different and requires unique attention and care. It's important to know your body and know how travel affects it. Your IBD should not hold you back from living your best life and going wherever you wish. With these five tips, hopefully you will be better prepared and ready for whatever life in the air has to throw at you.

Love Yourself and Love Others: How I Started Recognizing the Support Within and Around Me

By Erin Ard

In honor of the month of #Love, I decided to write about one of the most important forms. #SelfLove!

Embrace every part of you. Your quirkiness, your sense of humor, your shyness, your health (and that sometimes, you CAN take a good picture).

You've probably heard the phrase "You can't love anyone else until you love yourself." It's said, with good intent, to almost everyone who is trying to find self-worth in another person's eyes. I am no expert on love, so I can't say this is always true. However, I do know that dealing with chronic disease, especially throughout your teen years, can wreck your self-esteem and ability to love yourself. *Ahem* speaking from experience.

I want to share how I learned to accept the terms of my new life, let go of internalized negativity, and love myself as I am. It took me years to recover emotionally from all the changes I faced because I never fully accepted that I had a #ChronicDisease.

I started to take strides in college when I began thinking mindfully about my experiences, emotions, and actions in every situation I faced. Introspection was my first step towards acceptance and being #mindful was my strategy.

I used mindful meditation to reflect on everything in my past and present. I became aware of my thoughts, emotions, surroundings, and accepted them without judgement. It helped relieve my stress as a busy student and appreciate everything around me while living moment to moment. Before mindfulness, I would often dwell on my flaws and insecurities, to the point that I had lost sight of my worth. Now, whenever my mind wanders or spirals, I accept my thoughts, bring light to them, and move on. The simple act of being mindful restored my self-confidence and helped me find my identity outside of my chronic health issues.

A little surprise from my sweet, forever valentine.

As I sit, writing in my old bedroom from high school, I'm starting to reflect on all the love I had even at my lowest. I now recognize the love I lacked for myself and the support that surrounded me from family and friends. My closest friends and family understood me and how the disease affected me. Because of them, I was able to overcome many trying events.

This month, my #mantra has been to love yourself and love others. I've learned that you're never really alone, even when you think you are. There is always someone thinking about you, worrying about you, or just wondering how you are. You will be surprised by the influence you can have on others. As a cute example, take a look at what my little brother made for Valentine's Day!

Remember to appreciate your own strength and the people who continue to support you.

If you want to learn more about the influence of mindful practice, check out this article on the stages of grief in chronic disease.

With love,

Erin

In the Name of Love: The Importance of Having a Support System

By Erin Dunne

Stomach cramps, constipation, diarrhea, fatigue, low FODMAP diet, gluten-free diet, dairy-free diet, little fat, no sugar, no caffeine, MRIs, CT scans, GI exams, Prednisone, Remicade… the list goes on and on. If you have #IBD, the chances of you encountering at least one of these things at some point in your life is very high. Some individuals have what can be seen as "easier" cases; they are put on a single treatment plan that keeps their symptoms at bay and may even lead to clinical remission. There are others that may jump from treatment plan to treatment plan without seeming to find one that ultimately works for them. Each journey of somebody with IBD is unique, and while we can empathize with others and find comfort in similarities we may share, it is easy to feel alone in this adventure. Despite frustrations we may feel at any given point, it is essential to establish strong relationships to lean into and lift us — relationships with friends, family, professors, and ourselves.

Through love, even the impossible seems practical, and with a disease that is so unpredictable, this rationale is comforting.

I have had Crohn's Disease for thirteen years now, and I can honestly say that through the years, most of my strength has been obtained through my relationships with others. For many years, I was one of the fortunate individuals that often did not feel as though I had an illness. I took two pills a day, was not restricted to a specific way of eating, and experienced few symptoms. Compared to my friends around me, the only difference between us was that I had to take medicine at certain times of the day and had monthly doctors' appointments. Despite these minor differences, I still felt isolated from others my age. In my world, I was the only person I knew with IBD and had no idea of the various severities of the same condition. It wasn't until I attended Camp Oasis- Michigan that my eyes were finally opened, and I no longer felt alone in this journey.

My third summer at Camp Oasis. Can you spot me and CCYAN Admin, Sneha?

Throughout my time at camp, I met so many people with different stories, and I was fascinated by every one of them. Not only was it wonderful to be able to relate with others my age but also to idolize the older campers and counselors for how strong they were. I returned to camp for four summers and connected with so many lovely individuals throughout the years that have helped shape my life; some of which I still am in contact with!

I highly recommend trying to include people that have experienced IBD into your support system because not only do you gain more love in your life, but also people that get what you're going through! If you're anything like me and don't have family members or friends that are familiar with the disease, it can be hard to share stories, concerns, even successes without feeling like they're not entirely understood. (Sorry mom for the various bowel movement updates, but thanks for listening!) Getting in contact with others can be very easy! Communities like CCYAN, CCFA, Camp Oasis, and any groups through universities, hospitals are all great places to start. While each story is different, we are far more alike than you would think.

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Although I mentioned earlier that I had considered myself lucky to have an easier time with Crohn's, the past two years have been anything but that. With being on the same medication for most of my life, it stopped being effective and could no longer support the inflammation in my system. I have been dealing with a reoccurring flare since and have gone through various forms of treatment to try to tame my symptoms. At first, I had become more aware of food intolerances, often experiencing diarrhea, severe bloating, and severe stomach cramps. Through trial and error, I have found a diet based on whole foods (vegetables, fruit, fish, poultry, nuts) makes me feel my best but I am still finding things that do not agree with my body (rip mangoes… you will be missed). I am currently taking Humira but am exploring other medication options. Even with all of the changes I have implemented to ease my symptoms, I know I can experience much better and strive to heal my body as much as possible.

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I would be lying if I said I was always hopeful during this process of finding a treatment that my body reacts best to. There have been times I have broken down due to being so frustrated with not seeing or feeling any improvement; sometimes I can feel as though I am my childhood self upon the first diagnosis, scared and alone. At my lowest times, it can be easiest to isolate myself and wallow in my self-pity, but luckily, I have learned that my support group of friends and family, although they can't relate on a personal level, are always there to listen and help to the best of their ability. Being away from home for school, I am not able to lean on my family as much as I would have in the past. Although I have always been independent, it is comforting to know that I have loved ones around that are there for me through my struggles and my successes (never underestimate the power of a hug). I have been blessed to find another form of a family at Spring Arbor through wonderful friends that I love with all of my heart. Even though we have not known each other long, it is as though I have known them a lifetime. They go through my problems alongside me, help me come up with solutions, and act as my parents when I am sick and unable to leave my dorm room.

A few weeks ago, I was experiencing terrible symptoms; I was trapped in my bathroom the majority of the weekend and did not have much of an appetite. My friends knew I was not able to walk to the Dining Commons, so they took it upon themselves to bring me bananas and easy to digest, bland foods. Another day, I had expressed frustration with not having a doctor at the moment and feeling as though my current treatment plan was not working. My friend spent her afternoon going through scholarly articles and websites to find information on healing diets, fixing nutrient imbalances, and alternative healing techniques. Other times, when we are eating out or visiting someones home, they make sure I have something I will be able to eat. To say I feel loved and fulfilled is an understatement! I cannot stress enough the importance of having a support system in your life.

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Whether you're currently dealing with IBD, mental illness, body image, etc, being able to express love for others as well as receive love from them is beneficial for your brain and your well-being! It does not matter what the size of your support system is or who is in it, as long as these individuals support and love you and are positive additions to your life. I hope while reading this you have thought of a few people that are currently in your life that help you each day, even in the littlest way. I encourage you to reach out to them and let them know how much they are appreciated! If you have interest in growing your circle or want to start one, as I have previously mentioned, there are plenty of ways to get involved and meet people from your area, different states, and even around the world. The ladies at CCYAN would love to hear your stories, connect with you and help in any way possible. Feel free to contact me with any questions, or if you simply want to talk!

Stay Lovely,

Erin

New Year. New Experiences.

By Erin Ard

Hi everyone! I wanted to kick off this new year by sharing more about me, my experience with #IBD, and my goals being one of your IBD Fellows!

For a snap-shot of my life, I love creative writing, drawing, vamping up old furniture, and DIY projects. You can usually find me watching a romantic comedy with a glass of wine, playing Mario Party with my roommates, cooking up new healthy recipes from scratch, or camping at my parent's trailer in central Wisconsin. I am terrible at taking pictures, so I rely on my friends to document our adventures. I love everything about fall - the comfy sweaters, jumping into piles of leaves, and pumpkin spice flavored coffee drinks. I found a love for human ecology and nutritional sciences when I attended University of Wisconsin - Madison, #GoBadgers! I have a passion for helping others live a healthy life, especially people living with a chronic disease. I am 23 and I've been living with Crohn's disease for 10 years now.

Crohn's has had a great impact on how I live my life. It has taught me a lot about myself and as much as I like to think otherwise, still affects me today. Many of my symptoms have faded but I can name a few that decided to stick around. Hip joint pain, gut pain, fatigue, random short-lived fevers, anxious thoughts, and more. Although, I'm still trying to figure out if and how Crohn's plays a role in my anxious tendencies.

I've been on Remicade for 9 years, so its normal to see small bruises on my arms from IV tubes and getting blood drawn. One of the many perks of living with Crohn's is having people point out or question my colorful arm bruises :).

Aside from medication, a healthy, well-balanced diet has been my focus since I was diagnosed. I also try to incorporate other practices to make a healthy lifestyle for myself. I have adopted mindful practice to discern any connections between Crohn's and my mental health. It has also been a great way to manage stress, especially while I was an undergrad. I also try to stay fit by doing fun exercises! For me that is yoga, Pilates, dancing, hiking, running, you name it! I strive to keep both my body and mind strong.

Although, IBD will manifest in everyone's bodies a bit differently and everyone will have different life experiences, I believe we can all learn from each other. I don't know many people with IBD and haven't had much of a voice in the IBD community yet, so I joined the CCYANetwork to connect with others and share my views. I am using this platform as a way to connect with you and find peace by bringing this source of insecurity to the surface. I hope some of you will find thoughtful inspiration from my stories.

With love,

Erin

How to Cope With a Chronic Condition at College

By Sneha Dave

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

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

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

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

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

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

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

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

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

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

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

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

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

How to Live With Food Restrictions

By Sneha Dave

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

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

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

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

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

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

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

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

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

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

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

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

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

Julian Kritz: A law student at the University of Virginia

For Julian, it began with a swollen ankle.

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

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

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

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

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

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

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

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

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

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

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