An Unspoken Truth: The Reality of Failing Medications

Fear, hesitation, anxiety, curiosity, and mourning are a fraction of the emotions we experience during the diagnostic process. On a personal level, it was easy for me to compartmentalize these emotions as I was only focused on finding a medication therapy that would help mitigate my debilitating symptoms. After my official diagnosis, my GI doctor immediately started me on my first treatment regimen. It felt so liberating finally having a concrete treatment plan that addressed my medical issues, but I was cautiously optimistic about the benefits of this new therapy.  

My very first medication therapy was Mesalamine tablets. This is a very common beginning medication, but of course I never knew that since this was such a novel experience. My doctor reassured me that this specific medication is usually well tolerated, which was why it was my first treatment option. I put every ounce of faith I had into this medication. Daydreaming about a symptom-free life and the liberation that would ensue was a regular occurrence for me. This was all quickly halted, as I soon had to deal with the reality of failing my first medication treatment.

Daydreaming about a symptom-free life and the liberation that would ensue was a regular occurrence for me.

Failing medications was never an option that crossed my mind. I was always aware that medication wasn’t a one-size-fits-all, but how could that happen to me? My dazed sense of optimism paired with a lack of information from my doctor were the root cause. Why was I never informed that failing medications was a common experience among people with IBD? Why was I never given proper mental health resources when dealing with the aftermath of failing a medication? Why wasn’t I prepared? These are all questions that plagued my mind in the aftermath of the failed treatment.

I felt like I had been dealt an unlucky hand. Not only did I have to navigate the world of chronic illness completely alone, but I now had to deal with the process of finding new drug therapies.

I felt like I had been dealt an unlucky hand. Not only did I have to navigate the world of chronic illness completely alone, but I now had to deal with the process of finding new drug therapies. After having a rare reaction to the first treatment, my doctor immediately put me on a immunosuppressive self-injection. My entire life changed after that. Was I now supposed to be afraid of simple illnesses? How susceptible was I? What will happen to me during COVID? Luckily my GI doctor was open and helpful, but the process wasn’t any less traumatic. After starting this home injection, my condition quickly started to improve. After so much turmoil and strife, I finally was able to see light and experience the warmth and security of a “healthy” body. The quality of my life started to improve, and I quickly found my new normal. I was so elated that “at home self-injection” basically became my new middle name. But unfortunately, this did not last too long.

After seeing so much promise, I developed antibodies to my medication. My doctor explained that this meant my medicine was no longer effective, and that I once again failed a drug therapy. I vividly remember the aftermath of that phone call. I was inundated with emotions that I can't even begin to explain or recall. Now, was I supposed to restart this emotionally draining and arduous process all over again?

After voicing my concerns to my doctor, she emphasized that there was a glimmer of hope. Since I responded well to the second injection treatment, I could be put on a biosimilar medication via an infusion. She hoped that this new anti-TNF treatment would continue to improve the quality of my life and symptom mitigation. Getting infusions was going to be a new hurdle, regularly spending hours in an infusion clinic, especially at my age, was going to take some adjustment. The process was terrifying, but I was privileged enough to have an attentive medical team, which included my infusion nurse. After almost two years, I am still on my infusion therapy and have achieved remission. It was a long journey, and I am still dealing with processing everything, but I will be eternally grateful for having newfound security in my health.

Ultimately, I want to stress the importance of transparency. Had my doctor informed me from the beginning that failing medications is a common experience, I don’t believe that I would've had such a difficult transition. I can’t help but to think, “Why aren't doctors more forward about this unspoken reality?”. If I could go back to my newly diagnosed self, I would tell him to prepare for a turbulent ride and to make sure that his anxieties are heard, understood, and validated. It is the responsibility of our medical team to inform us about the different medication processes we will inevitably go through. I believe this transparency will not only breed a more informed patient population, but a less anxious newly diagnosed patient population.


This article is sponsored by Connecting to Cure.

Connecting to Cure Crohn’s and Colitis is a grassroots, volunteer organization that brings together the IBD community with a focus on caregivers and families. Connecting to Cure Crohn’s & Colitis provides community and support for those coping with these chronic illnesses, while raising awareness and funds for research as well.

Guest Speaker: Dr. Tiffany Taft on Medical Trauma

This article is by Savannah Snyder from Canada.

Photo by Karolina Grabowska from Pexels.


Medical trauma is an experience many of us are all too familiar with, whether that be from your diagnosis story, undergoing certain procedures, or just through the experience one faces while dealing with a chronic illness that is as unpredictable and serious as IBD.

CCYAN fellows spent a Saturday morning with the talented Dr. Tiffany Taft talking all things medical trauma. Dr. Taft is a licensed clinical psychologist with specialized training in chronic medical illnesses. She is an associate professor studying the social and emotional impacts of digestive disease and has been a part of the division of gastroenterology and hepatology. Along with this impressive resume, Dr. Taft is a fellow IBD warrior and has Crohn’s Disease.

Dr. Taft’s lecture on medical trauma was an eye-opening experience explaining the medical field of mental health and digestive diseases. To give some background in the field, psychologists first began looking at digestive diseases in 1995, with the first real controlled study focusing on cognitive therapy and self-help support groups in the treatment of irritable bowel syndrome. In 2020, the Rome Foundation GastroPsych was developed. The Rome Foundation is an independent not for profit organization that provides support for activities designed to create scientific data and educational information to assist in the diagnosis and treatment of Disorders of Gut Brain Interactions. The overall mission is to improve the lives of people with functional GI Disorders. Unfortunately, there are not a lot of professionals in mental health interested in this area. Within chronic illness, the main focus is on obesity, cancer, and other areas.

Post-Traumatic Stress Disorder

Post-traumatic stress disorder is a psychiatric disorder that may occur in people who have experienced or witnessed a traumatic event such as a natural disaster, a serious accident, terrorist attack, war/combat, or assault or who have been threatened with death, sexual violence, or serious injury. Subcategories of symptoms for PTSD include trauma, intrusion, such as nightmares or flashbacks, avoidance, negative alternations in cognitions and moods, and marked alterations in arousal and reactivity including feeling on edge and a high heart rate. However, within this definition, there is no mention of chronic illness. Due to this, within the mental health field, post trauma stress caused by chronic illness is referred to post-trauma stress rather than post-traumatic stress disorder.

Inflammatory Bowel Disease – Post Traumatic Stress

There are currently four studies in IBD research surrounding mental health. In 2 survey studies, the first study found 40% of people with IBD have symptoms of PTSD. Comparing this to the rate at which war veterans have PTSD is at 10-20%, the study was redone to ensure there was no bias. In the second study, 797 patients in IBD partners database with the Crohn’s and Colitis Foundation were surveyed and similar statistics were found. The study revealed that 25% of participants experienced PTSD symptoms, a rate higher than we would ever want to see. The highest symptoms felt were nightmares, flashbacks, re-living trauma, feeling keyed up and on edge, and avoiding situations.

Furthermore, it was shown that women are more likely to experience negative symptoms than men are. Also, it is shown that non-white and Hispanic individuals are more likely to experience negative symptoms. Additionally, those with a college education are more likely to experience more symptoms, which can be a marker of socio-economic status in the US. Overall, it is very evident that patients in privileged groups tend to have less post-traumatic stress symptoms.

Dr. Taft reviewed a regression model with staggering results showing that there may be a connection between the post-traumatic stress symptoms such as re-experiencing, increased arousal, avoidance, and full IBD-related post-traumatic stress and hospitalizations and surgery.

Brain Gut Connection

Dr. Taft discusses the possibility that post-traumatic stress in IBD could affect disease, but more research will need to be completed. An interesting question posed is whether people with IBD are more susceptible to post traumatic stress because of their gut microbiome make up. It was shown that war veterans with PTSD had similar qualities in their microbiome as those with IBD. Overall, Dr. Taft was concerned that their microbiome could have changed because of the theory of the stress response and effects of extreme stress happening in PTSD on the immune function. A potential future study in this field surrounds treating people with IBD that have post-traumatic stress and see if their microbiome changes with treatment. This study would provide amazing resources to the IBD community and be an addition to the path of new treatment options.

Treatments & Medications

As of 2021, there are no treatment options for IBD-PTS that have been tested, but it is known how to treat PTSD. The following therapies are very effective for PTSD: cognitive processing therapy (CPT), prolonged exposure therapy (PET), written exposure therapy (WET), eye movement desensitization and reprocessing (EMDR), and trauma focused cognitive behavioural therapy (TF-CBT). Medications used for PTSD are anti-depressants. There are no specific PTSD medications available, and the best outcome with medication is when it is combined with therapy.

Grounding Techniques

Dr. Taft ended off this informative zoom with grounding techniques. Grounding is an amazing way to work through active distress from PTSD. When you engage all 5 senses, you bring your brain back to the present and stop re-experiencing that traumatic event. Although this will not cure your PTS, it is a vital skill that can help although it will take some time and practice to be effective. Some great ideas include listening to music, tossing a ball in the air, holding a piece, eating something sour, or smelling an essential oil.

5-4-3-2-1 Trick:

5: Acknowledge FIVE things you see around you

4: Acknowledge FOUR things you can touch

3: Acknowledge THREE things you hear

2: Acknowledge TWO things you can smell

1: Acknowledge ONE thing you can taste

Overall, this was a very informative session where us fellows learned about the reality of medical trauma in IBD patients and the crucial need for further research in this field. If you want to hear more about Dr. Taft, check out her twitter @DrTiffTaft.

Stelara by Injection: My At-Home Biologics Treatment

Last time I wrote about my biologics treatment for Crohn’s disease, I had gotten my very first infusion of Stelara at Mount Sinai’s IBD Clinic in New York City. A few weeks ago, I was able to administer my own Stelara injection, right from the comfort of my own dormitory in college! As an undergraduate, it was of the utmost importance that I could stay on top of my schoolwork without having to commute for medical treatment in the middle of the semester. 

Honestly, this was my first time doing an injection that wasn’t prepackaged, such as the Humira pen. Instead, I had to poke the needle into my own skin -- a hard ask for someone who isn’t a huge fan of needles. Nonetheless, I was grateful to have a Mount Sinai nurse call me via a telehealth appointment to walk me through the whole ordeal. 

This is what the injection looks like! It’s not too large -- it actually fit right in my mini-fridge from the dormitory. Be sure to dispose of any needles and treatments properly if you’re doing injections on your own.

Notably, it was a hassle to arrange the delivery of my treatment with the various insurance companies. Although I’m fortunate enough to have student insurance through my university, it’s still very difficult (and opaque) to organize Stelara deliveries for IBD patients. This points to larger structural flaws in the healthcare system that often prevent patients from receiving affordable care that they absolutely need, but alas: this is a conversation for another time. 

I chose to administer my injection into my stomach! Other patients opt to have their injections in their thighs or upper legs. I found this to be the comfiest option for me! 

Admittedly, there was a bit of blood after I pushed the needle into my skin. However, I was able to clean this up, and my nurse said that it was not something to be concerned about! One tip I have for any IBD patients on Stelara is to prepare all your materials ahead of time -- that way, you won’t be walking around looking for band-aids or antiseptic wipes during your injection! Another benefit of doing the at-home Stelara injection was that I didn’t feel as groggy or as tired, as I did from the first infusion that I had received. 

All in all, although I definitely was not thrilled about having to inject myself with my biologics medication, this experience reminded me that having such access to healthcare to begin with is such a blessing. I hope that IBD patients feel less lonely in their struggles to adjust to new treatments -- know that you’re not alone and that we’re all in this together! I wish you the best of luck on your treatments; sending you all my love from New Jersey!

Managing Major Life Events with IBD

TW: upsetting emotions, house fire, PTSD, mental health

Every person on earth has to go through the rollercoaster called life, facing major ups and downs during the course of their time here. Having a chronic, debilitating illness does not save you from facing other major life-altering events. Managing these events and getting up every day is a life skill that one builds over time.

In Spring of 2020, as the COVID-19 pandemic ravaged the world, I sat locked up safely in my apartment in New Delhi thinking of what to eat as my refrigerator was devoid of any vegetables or fruits. Delhi was under lockdown, and the few times we were allowed to go out to shop, I would have to go when it wasn’t too crowded (due to being on immunomodulators and with no sign of vaccines), and reach the grocery stores to find all unprocessed stocks of produce gone. I weighed my remaining options and it came down to cooking up hot meals of oatmeal or khichdi. I didn’t want hot meals since the Indian summer heat was well on its way, and all the air conditioners in the home were nonfunctional. 

Because of the pandemic and subsequent lockdowns and curfews Delhi was facing, all services (like the local electrician service) stopped. After many days of desperation in the heat though, I just couldn’t take it anymore. I finally arranged for the electrician to check the air conditioners out. 10 minutes before he was due, I thought of prepping for him to see they were not working. I put one of the air conditioner’s plug into the socket, took the remote and turned it on. A strange and loud whirring noise took me by surprise, and I stared to see what would happen next. About 5 seconds later, I saw smoke rising out form the top, initially thinking it was the vapor from the heat in the room. Another few seconds later, there was a bright yellow light and, lo and behold, a fire had started. My reaction should have been to freak out but I was just SO fatigued and thought “I can’t deal with this right now.” I half-thought about going back to the living room to finish a meal I had just finished cooking for myself and letting the fire be, but reality caught on and I started to freak out when I remembered I lived in an apartment so the fire was going to spread to other homes. 

My reaction should have been to freak out but I was just SO fatigued and thought “I can’t deal with this right now.”

My first instinct was to tell my parents but they were posted in a remote country where most of the popular calling channels were blocked. I tried calling my mother through an app that hanged and would not cooperate. With the call still ringing, I reached for the main door to warn the neighbors but ran back inside to save valuable papers first in the room with the fire. I entered the room to see the thick smoke spreading faster than I could recall what to collect and where it was. Before leaving, I took a deep breath and removed the plug from the socket, turned it off, opened the windows of the room and heaved a sigh of relief the damn air conditioner hadn’t fallen on top of my head. I quickly accepted I needed to leave my valuables, meal and home behind, and ran out to tell the neighbors who called the firefighters. With the pandemic in full swing, the firefighters took a while to arrive and as they opened the main door, a thick cloud of black smoke engulfed us. None of us could see ½ meter ahead of us. The brave men took some time, but eventually extinguished the fire. I was very fortunate to not lose too many valuables, but the entire apartment was left in sticky black soot, with little soot particles falling like rain everywhere around me. It felt impossible to clean up. It was impossible to live there. 

After the fire, the next challenge was to find a place to live. Find a place to live, during a pandemic, with a suppressed immune system – easy. I didn’t have any immediate family in the state, and strict curfew rules made it nearly impossible to travel outside the state. The first few nights after the fire, my amazingly kind neighbors took me in but those nights were rough. For several nights I heard the whirring sound and jumped up to save myself from my inaction. After this event, my extraintestinal symptoms like brain fog and fatigue worsened drastically. Eventually, my cousins from the adjoining state arranged for me to come live with them, taking some time for official permissions.

Before leaving, I felt a responsibility to rescue the apartment and stuff my parents had painstakingly collected over the years from their international postings. With no available cleaning services in sight, I was soon wrapped up in what seemed like an infinite loop of wiping one product after another, only to redo the entire process again as soot resettled on it. The walls looked like they’d had a new black paint job, and soot cobwebs danced at every corner. Yet clean I did, through a physical and mental haze, and managed to wrap everything except the furniture up. I remember having to wash my hands after every new item I touched because the sticky soot made it impossible to clean. By the end of the 3-day rigorous clean up, my hands were very dry and semi-permanently stained black. It took me multiple weeks to rid myself of the stains when I moved to my cousin’s home.  

My mental health deteriorated significantly over the summer. As a result, my extraintestinal symptoms worsened. I was sleeping for most of the hours of the day, and spent the rest in bed. I was so fortunate to have empathetic family members that took care of me and didn’t judge me for my invisible struggles. But I felt I’d had enough and needed a breather. Literally. Multiple times a day, I would feel like my chest was tightening up, my nose felt blocked throughout the day and I lived in a cloudy haze. As services slowly opened up, a mature me didn’t want to dismiss my new symptoms and I immediately booked an appointment with my GI, who recommended some blood tests and we found that everything came back normal. In fact, those blood tests were probably the best I’d had in a long time. But my situation was not getting better, only worse. Ultimately, I managed to get on a one-way flight to my parent’s posting passing through 2 continents and 3 flights, while all international airports were minimally functional. I slept for 14 hours straight after I landed. 

At every step of the pandemic, whether it was arranging a steady stock of medication or food through hoarding culture, fighting a house fire and acting responsibly through the haze, cleaning up (on a one-man team) what resembled a coal mine, or taking my symptoms seriously and arranging to get my illness checked, all with a suppressed immune system, makes me appreciate how far I have come at managing life events.

When I reflect back at this time, I feel incredibly proud of myself and tremendously thankful to my empathetic neighbor and family members. At every step of the pandemic, whether it was arranging a steady stock of medication or food through hoarding culture, fighting a house fire and acting responsibly through the haze, cleaning up (on a one-man team) what resembled a coal mine, or taking my symptoms seriously and arranging to get my illness checked, all with a suppressed immune system, makes me appreciate how far I have come at managing life events. Most importantly, I am proud of the way I got up every single day and faced every new impossible step, keeping my hope alive. My hope was well protected by my kind neighbor who graciously took me in, fed me, and talked me through my experience, and my loving family who did impossible things just to keep me safe and support me through the cloudy aftermath. I’ve learnt that managing major life-altering events like these are possible with individual grit, determination and an understanding support system who stop you from succumbing into a negative spiral. With IBD, a major life skill is prioritizing things you can control in events you can’t. In these trying times, I did my best to keep to my safe foods, take all my medications on time, limit other stressors, and stay on top of my illness by getting it checked and keeping my GI in the loop. In terms of PTSD, I am still very nervous around air conditioners. At this moment, I can’t afford a therapist and so do my best to educate myself on PTSD and healthy relaxing coping mechanisms. 

Being Present: How to Live Well in Times of Sickness

For IBD patients, it can feel as though we are constantly running on a hamster wheel of chronic illness. The symptoms may go away, but they often come back. The fatigue may falter, but soon, your battery is depleted. In the past, I’ve written extensively about self-care and patience with treatments, but I wanted to share about ways that I’ve learned to be well in times of sickness. 

Lately, I’ve been delving further into disability literature and critical theory, attempting to find some sort of theoretical basis for the suffering we undergo as IBD patients. In particular, I have found a great deal of solace in Susan Sontag’s ‘Illness as Metaphor,’ penned in 1978. In this seminal piece, Sontag writes, “everyone who is born holds dual citizenship, in the kingdom of the well and in the kingdom of the sick.” 

To be in good health is fleeting, even when it is taken for granted. Being diagnosed with Crohn’s in the middle of my undergraduate experience has taught me this much. The grueling sensation of grappling with a disability, however, comes with a paired urgency that we must appreciate the good moments as they come. Being an IBD patient has made me more present-minded, aiming to be content with the present rather than being so focused on the uncertainties ahead. 

Taking walks is one way that I incorporate wellness into my daily routine: so important to take breaks and remember what’s truly important! 

Learning to prioritize wellness is no easy feat; it certainly requires a growth mindset. As with anything in life, a learning curve is difficult to adapt to, but prioritizing one’s well-being could not be important. While I’ve written about the importance of accommodations in the post-COVID era, it’s crucial to extend such compassion to ourselves! 

In the same piece, Sontag finishes by noting, “how reluctant we are to admit that there is only one kingdom and some of us simply have yet to travel its rockier terrains. It is inevitable. We will all need care. We will all long for accommodation. Until then, we can choose to what extent we want to indulge the fantasy that wellness is a condition we have somehow earned, instead of an ephemeral luck that is guaranteed to run out.” 


My challenge for our readers is to pause, take a deep breath, and recount what you are feeling at this very moment. In recognizing that we do live in two kingdoms, one of health and one of sickness, we ought to grant ourselves a chance to be present, wherever our lives may take us in the next breath.

A Disease Quartet

This article is by Vasiliki-Rafaela Vakouftsi from Greece.

Photo by cottonbro from Pexels.

My illnesses have shaped my life in ways I did not ask for or want, but it is important that I would not be who I am today without them.

My name is Vaso.

A disease quartet works non-stop to disrupt any notion of normalcy in my life. I was diagnosed with Crohn's disease at a very young age and the diagnosis of psoriasis and psoriatic arthritis followed very soon. Having come to terms with these diagnoses, I hoped that my life would return to normal.

Some years later, at the age of 25, I was diagnosed with adrenal insufficiency. Luckily I did not realize how sick I was then or maybe I subconsciously chose not to think about it. I was diagnosed with adrenal insufficiency in April 2020. No one told me exactly what caused it, I was told that this was probably an autoimmune etiology - my point, I collect them.

That day I learned that high cortisol is harmful, but low cortisol can be deadly. My diagnosis of adrenal insufficiency was not something I easily accepted and I do not think anyone had prepared me for all the upheavals it would bring into my life. It was like falling asleep and waking up in a parallel universe.

In one night, every minute of every day had changed irrevocably. Before the spring of 2020 I had not heard anything about adrenal insufficiency. I was in the hospital, thanks to the privilege of access to modern medicine, I soon had a diagnosis. But what is it like to have a diagnosis that, in a crisis, the result can be potentially fatal?

“In one night, every minute of every day had changed irrevocably.”

Looking back on the course of the diagnosis, I have a feeling of tremendous frustration. But I also remember doctors - who perhaps literally - saved my life. The literature assures that patients with adrenal insufficiency live a completely normal life. I will disagree, at least until the moment this text is written, since after my diagnosis and while receiving replacement therapy, my daily life and functionality have been significantly affected. Adrenal insufficiency had been around for several months when I was diagnosed.

I lost weight for months and I did not know why. For months I had nausea, dizziness, fatigue and many other symptoms. It has been a little over a year since I was diagnosed. I have not yet regained my functionality, but my life is probably no longer in danger, not to a serious degree at least. I have not become "normal" again, nor does the treatment work as well as I would like.

Adrenal insufficiency is a daily challenge in its management.

Every time I am confronted with an event that causes me physical or emotional stress, I ask myself: "In this situation would a healthy body produce more cortisol?". If the answer is "yes", then I take a little more hydrocortisone.

I visited several endocrinologists. Most of me left with a weight of a non-productive appointment, disappointed, I felt like I had wasted more time, that I was in the middle of nowhere again. Many times during this process I felt the "I do not know what to do with you" from the doctors in front of me.

“Many times during this process I felt the "I do not know what to do with you" from the doctors in front of me.”

All of us at some point in our lives experience an experience that defines us, what we say "changes our lives". Usually, such socially acceptable experiences are a marriage, the birth of a child and some more. For me, this crucial experience was when I was diagnosed with Crohn's Disease. The second crucial experience was the diagnosis of adrenal insufficiency, a rare diagnosis that is potentially life-threatening in a crisis, a diagnosis with a disease I had never heard of before.

I felt defeated, as if the world had suddenly stopped. Hope hit a wall with 100km/h, when the doctor said "there is nothing else we can do, you have to learn to live like this". Punch in the stomach! Whatever he said after that, I did not hear.

"Learn to live with it." What did this mean for my life?

My illnesses have shaped my life in ways I did not ask for or want, but it is important that I would not be who I am today without them.

Illness makes you re-examine your life as a whole, your priorities.

The disease leaves you naked and exposed, because anything familiar until then may be a potential enemy. The disease forces you to go deeper into your deeper layers.

I will never be healthy again and that has changed the way I look at things: my body, my health, my relationships, my work and my life. When things get tough, people tend to say, "This is going to pass." But what happens when this is never going to pass?

Homemade Indian Condiments with Lessened Ultra-Processed Ingredients

“A higher consumption of UPS products especially ultra-processed grain foods, fat, sauces and emulsifier/thickener-containing foods was associated with increased risk of CD.” – Dr. Chun-Han Lo from “Ultra-Processed Foods and Risk of Crohn’s Disease and Ulcerative Colitis” at the Digestive Disease Week 2021. Read more on the recap by CCYAN 2021 fellow, Savannah Snyder, here.

 As pointed out by Savannah, while results like this may seem obvious, actual recorded data on specific dietary patterns and their consequences on IBD are limited. This makes studies like this very important in guiding our understanding of how best to manage our unique IBD journeys.

Ever since I was diagnosed with UC, runs to grocery stores have become frustrating tasks for me. Where before I wouldn’t think twice about picking up something cool to drink in the Indian summer heat, or an easy to make pre-made meal for when I was too tired to figure out a whole meal for dinner, I now have to drag myself on through aisles and aisles of excitingly packaged ultra-processed foods. The marketing companies know exactly what they’re doing, because even with food trauma, my eyes often take a while to move along through the cereal, juice, snack and condiment rows. One of the most challenging food break-ups I have is with condiments. I LOVE condiments. Mostly because they’re so versatile and can add on so much to any dish. I especially found it, well, still find it, hard to part ways with hot sauce, but of course that’s dynamite for my body and not sustainable. After shedding some tears *cue tiny violin in the background*, I realized Indian cuisine houses a lot of homemade condiments – they show up frequently on our dinner tables. Most of these chutneys have strong and unique flavors, which can help with boredom from safe foods (if your body allows the ingredients or their substitutes). Below are three of my favorite chutneys – chosen to be as easily replicable as possible around the world, and as easily substitutable in ingredients for different diets as possible (low FODMAP, dairy-free, vegan, gluten free).

 

TAMARIND CHUTNEY (yields 1 cup)

 Ingredients:

Image of tamarind chutney from https://honestcooking.com/khatta-meetha-date-and-tamarind-chutney/

  • 100g dried seedless tamarind OR or tamarind paste

  • 4 dates OR date paste (1 tbsp) OR date syrup (2 tbsp)

  • 30g jaggery OR Molasses (3 tbsp)

  • 1 cup water

  • salt to taste

Steps:

  1. Boil seedless tamarind in water until soft. If using paste, mix with hot water till desired consistency.

  2. Pass through a sieve into a medium bowl.

  3. Add pitted dates/date paste/date syrup and jaggery/molasses. Blend until smooth.

  4. Add salt, as per taste.

 

COCONUT CHUTNEY (yields 1 cup)

Ingredients:

Image of coconut chutney from https://www.vegrecipesofindia.com/coconut-chutney-recipe-coconut-chutney/

  • 1 fresh coconut

  • ½ cup yogurt (dairy free/lactose free as per requirements)

  • ¼ cup roasted and soaked (for 1 hour) chana dal

  • 1 green chili

  • salt to taste

Optional tadka

  • Coconut Oil (1 TSP)

  • Mustard Seeds (¼ TSP)

  • 1 twig curry leaves

Steps:

  1. Cut coconut in small pieces/grate. Put in a blender.

  2. Add the rest of the ingredients and blend.

  3. For optional tadka, heat coconut oil in a pan on medium heat. When heated, add mustard seeds and curry leaves and switch off immediately.

  4. Top off coconut chutney with tadka.

 

GREEN CHUTNEY (yields 1 cup)

Ingredients:

Image of green chutney from https://www.carveyourcraving.com/green-chutney/

  • 150g fresh cilantro

  • ½ lime

  • 1 red onion (small)

  • 3-4 cloves garlic

  • 1-inch piece ginger

  • 1 green chili

  • salt to taste

Steps:

  1. Wash cilantro thoroughly 2-3 times. Put in a blender.

  2. Add sliced onion, garlic cloves, chopped ginger, green chili and blend.

  3. Top with lime and salt to taste.


[The above-mentioned study discusses the role of UPS products in increased risk for CD but not UC. However, other studies have shown an increased risk with UC as well [1] It goes without saying, too, that a higher consumption of UPS products is associated with other illnesses not limited to IBD, and are negative for our overall wellbeing.]

1 https://pubmed.ncbi.nlm.nih.gov/34261638/

Long Term Reminders Of an Ostomy After Reversal

October 2nd was World Ostomy Day, and another reminder of the time I spent with an ileostomy. When you first get an ostomy, there is a lot of information that the doctors and the rest of the healthcare team like to give you. I remember learning about how I would feel, what to expect from recovery, what foods to eat, how to change my ostomy bag, and how to care for my stoma. All of this information was helpful in transitioning smoothly into my new role as an ostomate.  What I think is less common to discuss is how an ostomy influences your life even after reversal. While this information isn’t prioritized, I believe it is helpful to understand the subtle ways you’ll be reminded of your ostomy long after it ceases to be a part of your daily life.

Below, I share some of the realities I’ve experienced as a former ostomate. I am not too far removed from my ileostomy back in 2018, but I have a feeling these will ring true for years to come. I also want to note that I know not everybody is as fortunate as I was to have a choice in my ostomy, and I understand that the experience can be different as a result of an emergency. I hope that whether your ostomy was a pleasant experience or a poor one that I can help to prepare you for what to expect after reversal.

Scars

My current ostomy scar. Results may vary.

One of the most obvious reminders of my time as an ostomate is the scar where my stoma used to sit. That little thumbprint scar is a physical reminder of that period of my life. I’ve heard that people don’t like having scars on their body, but I wear mine proudly. To me, it represents resilience and strength. If you have an ostomy scar, I urge you to search for your own meaning and identity in your scar. When you look at it, let it remind you of how far you’ve come. Try to focus on the positive ways it has changed you, rather than the circumstances that lead you to need an ostomy in the first place.

Foods

When I had an ostomy, one of the things that my healthcare team advised me was to change my diet. In order to minimize my chances of a blockage, I was advised to limit eating too much insoluble fiber. Now, I didn’t exactly take their advice the first time, but after the tragic broccoli green bean blockage of 2018 I certainly started paying more attention. Now, years later, I still search my plate when eating green beans to make sure I haven’t paired them with too much other fiber, even though I know I would handle it fine now. It can be hard to change the diet habits you’ve built with your ostomy, but if your healthcare team tells you that you can make some swaps after your reversal then don’t be afraid to branch out!

Dreams

Now, I can honestly tell you I never expected to be reminded of my ostomy in my dreams, but it happens all the time. My dreams aren’t specifically about my ostomy, but I’ll be plodding along in dreamworld, look down, and there it is! A few theories come to mind about why this happens, but I think that it boils down to identity. When I was an ostomate, I was pretty open about sharing my ostomy with anybody who was interested. I think that this ownership made being an ostomate a core part of my identity, and now my brain still conjures the ostomate version of me in my dreams! 

Takeaways


Depending on your experience as an ostomate, reminders of your time with an ostomy could produce a variety of different emotional responses. I believe it is especially important if you had a poor experience with your ostomy to be prepared for possible reminders of that time. This will allow you to develop a plan to deal with those feelings, and even discuss solutions with a mental health professional. For others who had a better experience with their ostomy, reminders can be a fantastic opportunity to reflect on the growth you’ve made since your time with an ostomy. In either case, I hope you’ve been able to learn a bit about the different ways you might be reminded of your ostomy long after it has been reversed.

Book Recommendation: Exile and Pride: Disability, Queerness, and Liberation by Eli Clare

As I continue my journey navigating the ever-expansive world of chronic illness, I often find that I am always eager to learn more. I feel that increasing the amount of media and literature surrounding disability and chronic illness helps me understand more about myself and my personal journey. While on my search for sociological literature related to chronic illness, I stumbled across an exciting book recommendation, Exile and Pride: Disability, Queerness, and Liberation by Eli Clare. Upon getting this recommendation, I was so excited to delve into this subject matter since I have never been exposed to a book that so openly discussed disability and its intersection with many other identities.

 To put it simply, Exile and Pride is a discussion of disability politics. Writing from a place of experience, Eli engages in a vast number of topics ranging from a lack of visibility to radical queer theory. Eli forces you to question your overall sense of self (in the best way possible) and tries to expand your understanding of what it's like to live with multiple intersecting identities. Grappling with the chronically ill portion of my identity has been an interesting and challenging process; this book gave me the space to self-reflect and better understand not only the different levels of my experience with chronic illness, but my perspective of the overall world in which we navigate.

“I often feel like an impostor as I write about disability, feel that I’m not disabled enough, not grounded deeply enough in the disability community, to put these words on paper.”


Here are some of my favorite quotes from the book: 

“The non-disabled world is saturated with stories: stories about disabled people who engage in activities as grand as walking 2,500 miles or as mundane as learning to drive. They focus on disabled people “overcoming” our disabilities. They reinforce the superiority of the nondisabled body and mind. They turn individual disabled people, who are simply leading their lives, into symbols of inspiration.”


“Laugh and cry and tell stories. Sad stories about bodies stolen, bodies no longer here. Enraging stories about the false images, devastating lies, untold violence. Bold, brash stories about us reclaiming our bodies and changing the world.”

“I often feel like an impostor as I write about disability, feel that I’m not disabled enough, not grounded deeply enough in the disability community, to put these words on paper.”

“The body as a home, but only if it is understood that bodies are never singular, but rather haunted, strengthened, underscored by countless other bodies. The body as a home, but only if it is understood that place and community and culture burrow deep into our bones. The body as a home, but only if it is understood that language, too, lives under the skin. The body as a home, but only if it is understood that bodies can be stolen, fed lies and poison, torn away from us. The body as a home, but only if it is understood that the stolen body can be reclaimed.”

There are countless quotes in the book that are salient to the chronic illness experience. I feel like inadequacy, infantilization, and many other concepts mentioned are felt throughout much of the community. Living with ulcerative colitis is like wandering through a maze, the path will never be clear, but some parts of the journey will be less confusing than others. This book reinforced this idea. We often don't have the luxury or privilege to have access to literature specifically for our community, especially intersectional literature. If you’re looking to understand more about body identity, disability history, personal experiences, oppression, power, and liberation with a few laughs along the way, I highly recommend this book!

This article is sponsored by Connecting to Cure.

Connecting to Cure Crohn’s and Colitis is a grassroots, volunteer organization that brings together the IBD community with a focus on caregivers and families. Connecting to Cure Crohn’s & Colitis provides community and support for those coping with these chronic illnesses, while raising awareness and funds for research as well.

Healing Looks Different for Everyone

This article is by Nathalie Garcia from the United States.

Photo by Spencer Selover from Pexels.


It feels so strange to think just a couple of years ago, I was just a confused kid who didn’t understand their diagnosis or where it would have led me. I’ve had a lot of time to reflect on how far I’ve come in terms of healing.

I feel like something that isn’t talked about a lot is how differently we all heal. I wish I could say I navigated my chronic illness with patience and grace but it just wouldn’t be true.

Some of us heal in multiple stages, take a step backward, maybe skip a few steps forward or go in circles for some time. Somehow, I feel as though there is an expectation for those of us who are disabled to be a vision of a warrior that people without disabilities have created.

Even hearing the word healing, I picture softness, warmth, and calm. As soon as I reflect on it, I see something completely different; I see isolation, cold concrete and stiffness. To have an invisible disability is an entirely different kind of isolation I have ever felt in my life. It’s like people can see me but their eyes just pass through me.

Healing a struggle people can’t see can make you bitter. Angry. Angry at the world. Angry at yourself. Sometimes healing turns into a never ending cycle of anger and guilt for feeling so much hatred for a world who can’t possibly understand you when they cannot even see you.

At one point, healing turned into a lot of reflection and self-forgiveness. It’s strange because somehow having a warmer perspective on what disability was like for me shocked others. How can you be happy after that? I couldn’t live like that. I still don’t know how to feel about some of these words. The more I think about them, the more I realize just how hurtful they are.

Because somehow, no matter what perspective I had of my disability, I could never satisfy anyone. And that was okay.

Recognizing that maybe others were just healing differently or at different stages of healing was so incredibly comforting. It made me realize I was angry once too and that I can’t possibly know if I’m seeing right through others like they saw through me.

Healing…

Because somehow, no matter what perspective I had of my disability, I could never satisfy anyone. And that was okay.

This article is sponsored by Lyfebulb.

Lyfebulb is a patient empowerment platform, which centers around improving the lives of those impacted by chronic disease.

Learn more about lyfebulb