The Never-Ending Cycle of IBD

By Selan Lee from the United Kingdom

Many things in life are cyclical: the seasons, fashion trends, and the moon’s phases. The one thing we all hope isn’t cyclical is illness. Who wants a never-ending cycle of health and disease? But for those who are chronically ill, it is an unfortunate truth that I previously thought I had accepted - until three months ago.

Three months ago, the symptoms that had started it all returned: frequent diarrhoea, bloating, gas and nausea. In retrospect, stress seems to be a determining factor in my cycle of Crohn’s. My first flare was during the final months of my A-levels - a set of exams that would determine my future according to my 18-year-old self. My second and current flare began two weeks before my graduation and coincided with the final interview for a job I desperately wanted to pass. Unfortunately, the consequences of the stress-inducing circumstances were also cyclical. I severely underperformed in my exams and panic-attacked my way to a re-sit the following year. I didn’t pass the interview and was faced with ending university without a stable job to move on to. Healthwise, like the first flare, I was admitted to the hospital soon after graduation.

Maybe because I had experienced five years of relative good health since my diagnosis, I thought I had accepted the chronic nature of Crohn’s. Despite becoming resistant to a few biologics - I went to university, sourced and worked in a consultancy for my placement year, attended my first concert, joined a panel for young adults with IBD and was able to socialise with friends and family without much concern. My brief period of normalcy had blinded me to the fact I hadn’t really accepted the cyclical nature of my condition, and to be honest, no one with IBD or a chronic illness does.

I remember when someone asked during a panel how people with IBD cope, and the members and I all said hope helped us to cope. Naively, I equated coping with accepting. That’s far from the truth. I can cope with my biologic no longer working as there will be another one. I can cope with waiting for the night shift doctor to prescribe paracetamol for my abdominal pain. I can cope with forgoing foods and situations that will worsen my IBD. But I can’t accept that this will happen again. Understanding and coping are one thing, and acceptance is another.

How can I accept that I will progress through life feeling alone because of my IBD? Like I am sitting on an ice floe floating past all of life’s possibilities. Maybe it is pessimism talking, but living with IBD can be akin to the myth of Sisyphus. Many of us will spend our lives pushing the boulder of IBD to remission - with some, like me, falling back to flare. But maybe, in the words of Albert Camus, I will achieve happiness in this absurd repetition and be satisfied regardless of the outcome. Then again, Captain Raymond Holt says, “Any French philosophy post-Rousseau is essentially a magazine.” [1] - so I will wallow in my pessimism for a while. I might be able to see the brighter perspective of Camus and Terry Jeffords once my new meds prove to be successful.

References

1. “Brooklyn Nine-Nine” Trying (TV Episode 2020) - IMDB. (n.d.). IMDb. https://www.imdb.com/title/tt10322288/characters/nm0187719

Featured photo by Frank Cone from Pexels.

Stressing about Stress: When Living with IBD

By Maria Rouse from NC, USA

“I’m so stressed.” As a young adult just starting graduate school and recently graduated from undergrad, this common refrain often echoes through hallways, classrooms, and study spaces as a steady hum. Just saying it can create some relief for the stressed person, since putting out into the world that you are stressed is still often stigmatized in academic and workspaces that prioritize competition and elitism. But for a lot of people, especially neurotypical and non-disabled folks, the thinking about stress or the health impacts of it largely ends there for all intents and purposes. 

However, for chronically ill people and particularly those with autoimmune diseases like inflammatory bowel disease, thinking about stress quickly compounds on itself and becomes meta: it is so easy to become stressed about your stress knowing how negatively it will impact your health. And it goes without saying that this extra stress is not exactly great for keeping Crohn’s or ulcerative colitis flares under control either.  

The primary mechanism through which this works physiologically is that when people with IBD are stressed, perhaps due to a traumatic life event or school/work burnout, our brains release a stress hormone called corticotropin-releasing hormone (CRH). CRH sends a signal to our adrenal glands to release another group of hormones called glucocorticoids. Glucocorticoids, in turn, then send signals (e.g., colony-stimulating factor 1) that direct immune cells to the intestine that increases the production of tumor necrosis factor (TNF) that causes increased intestinal inflammation. And then boom, before you know it and can manage it, you are in the midst of a flare.

I have often found myself jealous of the relative simplicity of stress for people who do not soon become physically ill from its effects on their body. While chronic and/or severe stress generally has negative consequences for peoples’ health down the road (e.g., increased risk of cardiovascular disease, development of chronic conditions such as diabetes), your average person generally does not regularly grapple with these long-term health outcomes on a daily basis until they become acutely present potentially years down the line. There is a privilege in being able to be stressed without being stressed about being stressed. On the other hand, with IBD, folks are more likely to have to grapple with a stressful flare on top of the current stressful situation they are facing. Simply put, when it rains, it pours. 

A lot of the well-intentioned but poorly thought-out wellness initiatives now prevalent in workplaces and academic settings will tell you to take deep breaths or practice self-care (what that really means, I still am not sure) to help manage your stress. Anyone with an autoimmune disorder or chronic illness knows, however, that these stress management techniques do not remotely even cover our needs. Stress prevention often needs to be much more comprehensive and planned out in terms of prioritizing activities by the number of spoons (amount of energy) you have that day, consistently getting adequate sleep every night, giving oneself grace and flexibility for not being super productive because of fatigue or a random resurgence of symptoms. It involves taking extra care to avoid chronic condition flares, to the degree we have control over them (i.e., stress levels), early and often. 

There is nothing we can fundamentally do to change the fact that having a chronic illness or disability often comes with negative health impacts from stress, which is an inevitable part of life. What we can support changing, however, is the status quo around stress management from something discussed as part of wellness initiatives aimed simply at placating students, employees, and community members seeking greater work-life balance, to an approach of stress prevention. By involving more preventive and intentional techniques (i.e., managing energy levels proactively, intentionally planning ones diet to avoid inflammatory foods), stress prevention can benefit not only the chronically ill and disabled, but also the broader population; as chronically ill and disabled people, we can change the landscape of stress into something that is more intentionally and thoroughly broached in our communities, and by doing so, work to alleviate the stress of being stressed. What is beneficial for those who need accommodations is also beneficial for all.

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Sources

1.  https://www.scientificamerican.com/article/see-how-stress-affects-inflammatory-bowel-disease/

   
   2.  https://www.mayoclinic.org/healthy-lifestyle/stress-management/in-depth/stress-symptoms/art-20050987#:~:text=Common%20effects%20of%20stress,%2C%20stroke%2C%20obesity%20and%20diabetes.

Featured photo by Pedro Figueras from Pexels.

The Art of Living in the Moment: A Personal Reflection on Life with Crohn's Disease

By Yeabsira Taye Gurmu, Addis Ababa, Ethiopia

Living with Crohn's disease has been a journey filled with ups and downs, but one of the most valuable lessons I’ve learned is the art of living in the moment. Early on, I was consumed by worries about my symptoms and the unpredictability of my condition. I often found myself dreading social events, fearing a flare-up would ruin my plans.

In the midst of pain or fatigue, I remind myself to pause and focus on the here and now. Simple practices like deep breathing or taking a mindful walk in nature help ground me, allowing me to appreciate the beauty around me. Each moment—whether it’s a warm cup of coffee, a shared laugh with a friend— becomes an opportunity to connect with life, rather than merely endure it.

Flexibility is key. Plans may change, but spontaneity can lead to unexpected joy. Embracing these moments, whether it’s a last-minute outing or simply enjoying a quiet afternoon, reminds me that life is happening now, not just in the future I fear.

Building supportive relationships has been essential. Sharing my journey with understanding friends and connecting with others who have IBD fosters a sense of belonging and comfort. These connections remind me that I’m not alone and that it’s okay to lean on others when I need support.

Ultimately, living in the moment while navigating IBD is about finding peace amid uncertainty. It’s about celebrating small victories, practicing gratitude, and recognizing that even in the struggle, there is beauty to be found. Each day is a new opportunity to live fully, savoring the present despite the challenges that come with chronic illness.

Featured photo Sergey Guk from Pexels.

Why Finding Your People Matters

By Maria Rouse, N.C., USA

It took me nearly 15 years to begin finding community as someone with inflammatory bowel disease. It was a very lonely 15 years. 

I try not to be so hard on myself, since I was first diagnosed with IBD when I was 10. There is not much in the way of accessible peer support for youth with IBD, especially at that young of an age. It was not an option I ever realized could be possible through my health system, and social media as a platform for peer support was just beginning at that time.  

My inability to find community led to a false perception of singular failure. I was the only person my age that I knew with IBD, and consequently internalized ableism spread malignantly within my mind and began marring my conception of myself. 

With the stigma associated with IBD, it is also not something you typically share about yourself with other kids on the playground, or even when you’re getting to know people during orientation at college. I have met several friends that I only much later learned had IBD. 

Ableism is a key motivating force in keeping us silent from sharing our stories and lived experience with others. Ableism is part and parcel of patriarchy, colonialism, racism, sexism, or most of the negative isms that still permeate society. It encourages us to remain alone in our journeys as chronically ill people. 

In a system that often tries to force us to act individualistically and hide our unique qualities for the sake of its imposed and exalted definition of success, building disability community is a light in the darkness. It is in itself an act of resistance and radical vulnerability in a society aims to police abnormality and difference. This can make us believe that our challenges and needs are uniquely too much, when nothing could be further from the truth.  Community reminds us of our humanity as chronically ill people. 

In any setting, making new connections and friends can be terrifying, particularly if you have felt so alone and different all your life as a person with a chronic illness. It can feel especially vulnerable to join a support group discussing such sensitive topics as disordered eating and body image with a whole new groups of people. But forming community through a group such as CCYAN is so worth any initial awkwardness or difficult topics. 

The reality is that peer support is not just about you, although it often is cathartic and restorative to know we are not alone and to learn how others managed the difficulties that IBD created in their lives. Peer support is also an act of advocacy, allowing disabled and/or chronically people to take up space when so often our voices are not heard. Building community is an act of advocacy for yourself and also others who may still face barriers in sharing their experiences. 

In short, don’t wait years to engage with peers who have IBD. Make time for that peer support group meeting, attend that advocacy event, or connect with peers over Instagram. There are typically more obstacles for chronically ill people to engage with peers, whether that is being immunocompromised or having limited spoons or energy. However, engaging with other IBDers in whatever format is accessible to you is well worth the effort. Life is truly all about connections, and the ones you make with those who have very similar experiences as you can be some of the strongest bonds you will experience. You never know what can come out of it, and how the world could be changed for the better. 

Featured photo by Darrel Und from Pexels.

Cathartic Crohn's: A Patient’s Reflection on Stickman - The Vicissitudes of Crohn's by Artist Spooky Pooka

By Peter Park, TX, USA

The experience of extreme abdominal pain that feels, quite literally, gut-wrenching and it comes the debate in my head: Should I go to the hospital or not? In peristaltic waves, I wonder “Can I just bear thru it? I really dont want to go to the hospital.” It’s not just a hospital stay. It’s taking time off work. It’s bothering family to transport and take care of me at 26 years old. It’s wondering when I’ll ever be normal again. These thoughts and feelings are no stranger to me when I experience an abdominal flare, and I am sure it may sound familiar to you as well. Perhaps artistic expression can capture some of the emotions and thoughts we experience in our time of distress. 

Spooky Pooka is a professional illustrator and artist from Brighton, England and a Crohn’s patient and captures his view of Crohn’s disease through this piece. I encourage you to read through his poems and artistic pieces. Of his amazing work, I want to highlight a few pieces that stood out to me:

From the section, Quod Me Nutrit Me Destruit “What Nourishes Me Also Destroys Me”

“A blind conspiracy of T-cells

A dissonance within, a mute fluttering

The dolorous baying of ravenous entrails

The moxi drawn from reticulated limbs

And the world shudders down under black wings

To void all memory

To disgorge all resonance

To vomit all in exegesis of viscera”

Without having spoken to the artist myself, I will not attempt to predict what he was thinking. So, I will speak to share why I found this so fascinating as a medical student who suffers from Crohn’s Disease. The “blind conspiracy of T-cells” is exactly how autoimmune disease behaves. In normal function, T-cells use markers on cells to identify what’s our body marker vs a foreign body marker (which has to be eliminated). In autoimmune disease, that self body marker can be confused with a foreign body marker and cause T-cells to attack normal healthy tissue. In IBD, this happens within the GI tract. A “blind conspiracy” leads me to believe that T-cells act on their own accord, led by misleading signals, and hypervigilant to any suspicious activity. 

Words like “dissonance within”, “to void all memory”, “disgorge all resonance”, “vomit all in exegesis of viscera” describes a state of body that is so critical of itself, ready to eliminate any imperfection or any disconnection from the true self that it destroys the entire body. It reads as if the T-cell is a delirious warrior who once was a hero of sorts in his right. But now, this T-cell warrior has lost his way, driven mad by his rage, and killing his own people in frenzy. 

The piece captures the human skeleton with a deer skull and antlers kneeling while holding its belly as old weeds spill out. The background shows perhaps floating T-cells with human eyes. It captures the visceral pain of an abdominal flare - a posture I personify with too easily. It also captures the despair against the T-cells in their march for self-destruction. It seems nothing can escape itself. 

Despite this grave depiction, Spooky Pooka ends the graphic series with a final poem that implies a sense of hope. In the section Dolor Hic Tibi Proderit Olim “Some Day This Pain will be Useful to You”, it is the ending lines I reread over again.

“The tree’s womb may regurgitate old souls

If only for one moment…

It may grow flesh like life”

I’m not sure what it means. I’m not sure why it fascinates me. Perhaps I am desperate to find meaning and purpose behind my suffering. That my abdominal pain will somehow manifest as strength in my nearly malnourished body. Or that my constant fatigue and uncontrolled bathroom breaks is somehow a sign of strength. During my hospitalizations, when I was most alone, I would think that “maybe suffering is just pointless suffering.” 

But this poem and the picture behind it gives me hope. Like branches of a tree, my suffering can extend out and reach out towards others. To grow from untreated soil and serve others who will walk the same path. A hand to hold in suffering together. 

Featured photo by Soonam Wooeser from Pexels.

Check out the inspiration for this post on Spooky Pooka’s website.

We are all pandoras, each with our own boxes - but we all have hope.

By Selan Lee from the United Kingdom

Suppose you live in the UK and have any interest in inflammatory bowel disease (IBD). In that case, you will likely have recently seen news articles in which researchers from University College London, Imperial College and the Francis Crick Institute announced they had found a section of DNA present in 95% of people with IBD, which causes an excessive immune response and consequently inflammation.[1] This news has been greatly welcomed by many in the IBD community here - myself included. However, the feelings the announcement generated are weirdly reminiscent of a conversation I recently shared with others with IBD.

Last month, I met with members of the Young Adult Advisory Panel - a fantastic group committed to helping Crohn’s and Colitis UK meet the needs of the IBD young adult population. As we walked to the social venue, the conversation led to how we each coped with the often tumultuous nature of IBD. It soon became clear that the common thread for all of our coping methods was hope. Some hope for research breakthroughs. Others hope for a reduction in flare symptoms, and a few hope for a good blood test result. 

Living with a chronic illness can quickly diminish hope for many and unfortunately lead to poor mental health. Research suggests that around a third of individuals diagnosed with a life-changing chronic illness will experience symptoms of depression.[2] But, as so many of us with IBD will tell you - hope is never truly extinguished. 

Over the years, hope has taken on several names—the indomitable human spirit, desperation, or perseverance—but it has never disappeared from the human consciousness. Unfortunately, IBD and chronic illnesses have also been present in humans’ lives for an equally long time. But instead of looking at this longstanding relationship as parasitical, I rather see it akin to the prevalence of the myth of Pandora’s box throughout history.

We all know of Pandora’s box, a myth that warns of unchecked curiosity and disobedience when Pandora unleashes evil into the world when she opens a box left in her care by the Gods. Despite all the horrors she releases, hope remains and enters the world, providing humans with the resilience necessary to live in a world filled with such evils. This story has been used for many reasons: to curb curiosity and provide hope. We’ve all faced bleak circumstances where we have relied on hope to see us through.

Life with IBD is no different. We have all faced negativity in some form with IBD - whether that be a medication failing to work, health professionals denying you agency or being limited in your capacity to spend time with friends and loved ones. But like Pandora, we know that there is hope, and with that hope, in the words of Martina Sazunic, we use that hope to “build a ladder” and make the best of our respective situations to reach what we are hoping for. Thus, we are all Pandora.

We all are Pandoras, each with our own boxes, living with the negativity wrought by these boxes—but we all also have hope. So, while that breakthrough in research might, in some eyes, look like a minor step forward in the ambiguity of IBD - it is also a reminder that hope is what empowers us to continue advocating for better lives with IBD. So, from one Pandora to another, hope is in your box - don’t forget that.

References

1. Gallagher, J. (2024, June 5). Major cause of inflammatory bowel disease found. BBC News. https://www.bbc.co.uk/news/articles/c1wwdd6v2wjo#:~:text=A%20major%20cause%20of%20inflammatory,excessive%20inflammation%20in%20the%20bowels.

2. Professional, C. C. M. (n.d.). Chronic illness and depression. Cleveland Clinic. https://my.clevelandclinic.org/health/articles/9288-chronic-illness-and-depression

Featured Photo by Pixabay from Pexels.

Moving

By Zahraa Chorghay, CA, USA

skin stretching like tarp over pillars made of bones

if the turtle carries its home on its back

why do I writhe to make home of this body?

on the cove, the colony of sea lions basks together

skin and blubber resting against each other

lazy afternoons with my family

sprawled on the couch, we swap stories and laugh

on the streets, lilac-coloured flowers erupt on branches

jacaranda petals dancing gently in the breeze

on the dance floor with my friends

music flows through us, bodies swaying to the beat

on the beach, ocean waves crash into the sand

salty water meeting the earth again

my head on his shoulder

nested against each other, joy coursing through our veins

though the cormorants can soar far and wide, they live in groups

but this solitary bird flew far from her roost

(with rotting insides threatening treachery, always)

now gliding in the deep blue skies, untethered by sea or land

will she be lost forever to the wind or someday find her perch?

Going From 0 to 100: The IBD Rollercoaster

By Maria Mutka, N.C., USA

I was planning on writing this article about the meaning of IBD community support in my life. But as all IBDers and folks with chronic illnesses know, sometimes the best laid plans have to change based on how you're feeling. 

I recently had a wakeup call from my complacency during the longest remission of my life. My biologic medication has done such wonders for not only my daily quality of life, but the impact of my ulcerative colitis on my body. I will never forget my doctor's amazement at my last colonoscopy a couple years ago when they were unable to identify any active disease. 

When they said they could no longer see any ulcers, I was on cloud nine. Apparently, hundreds of ulcers that had taken root in my digestive system had vanished. A true miracle drug. Since I started my biologic medication a few years ago, I have had occasional hiccups, but my symptoms were 95% reduced from what they had been. 

Due to a switch in my modality of medication, from an infusion to an injection pen, I have had some delays in receiving the medicine, largely due to a lengthy prior authorization process (nothing new for many IBDers and folks with other chronic illnesses). Because of this delay in getting my treatment, I started experiencing my old pattern of symptoms, seemingly back with a vengeance.

Nausea, near vomiting, extreme cramping, frequently going to the bathroom - the works. Maybe it was just because I haven't had these symptoms in a while, but I truly felt the worst I have felt in a couple years - at my lowest of lows health-wise. 

This was undoubtedly compounded by my recognition of the precarity of my health, the delicate balance that my health rests on daily in managing my IBD that I had neither realized nor accepted. Just by going a week without my medication, slightly spicy foods that I have come to enjoy on occasion since my remission knocked me for a loop. Having these symptoms after being only seven days overdue for my medication put me in disbelief - how could my ulcers and inflammation be all gone, as my doctors had told me? My ulcerative colitis seems to have been barely there, perhaps hiding underneath the surface, waiting for one slip up or mistake in receiving my medication to rear its ugly head.

Now I can fully acknowledge that experiencing some of these symptoms for a little while is not much in comparison with what I've experienced in the past, or what others often go through. I am extremely grateful to have access to the medication I need to maintain my health and quality of life. But I cannot again take for granted how close I can be at any given moment to another flare. Even when I have been doing extremely well for several years on a medication that clearly is highly effective for me. 

These moments are important reminders of the truly unpredictable and chronic nature of the disease, and how, even when you are doing everything you can to maintain your health, it's ultimately not always up to you. It is, however, a lot easier to deal with emotionally if you take the journey one step at a time and prepare yourself to experience the one thing that IBD can predictably be: unpredictable.

Featured photo by Digital Buggu from Pexels.

That is my partner, Crohn's.

By Selan Lee from the United Kingdom

Hello, we haven’t yet been introduced,

My name is Selan and that over there is my partner - confused?

Many do get a little surprised at our coupling,

But once you make the acquaintance of Crohn’s - they tend to cling.

How did we meet? Well, I can’t quite remember,

It might have been in a GP office, an A&E cubicle or before all of that in December,

You see, it is quite difficult to pinpoint when we exactly made our first encounter,

But whenever it was, I definitely floundered,

I couldn’t go to school or even sit down without Crohn’s interrupting,

It seemed my body, my energy, and my mind were all suffering.

I’m not going to say the beginning was fun and joyful,

Our relationship back then was awful, painful and stressful,

It took an incredibly long time to find myself in this partnership and I’m definitely not the same person I was before,

But now simply existing is no longer a chore,

No - now we have a rapport.

We’ve got our strange little milestones to mark our progress,

First concert without major toilet-related distress,

Was Harry Styles in Wembley with me wearing a blue dress,

The first fizzy drink to not cause a tummy gurgle,

An ice-cold Coke without a single audible burble,

Going on six years and passed our wood anniversary,

And I can say our partnership has mellowed considerably,

I can’t guarantee the future will be as smooth as we are now,

But knock on wood - I’ll manage that flare and its symptoms somehow,

Because that’s how I’ve made it thus far,

By looking forward and making light of the medically bizarre,

The fiery inferno of emotions Crohn’s once blazed,

I can say looking in the rear-view mirror of hindsight - is now a smoky haze,

Crohn’s will never leave, and I will never leave it,

As I said before - once it finds you it tends to stick,

But since the day our union was christened in that lone hospital room,

I’ve built the resilence, dark sense of humour and grit to see hope bloom,

So… allow me to reintroduce,

That is my partner Crohn’s disease who is a recluse,

We still occasionally squabble and argue on if we go out,

But I’m definitely in control - without a doubt.

Featured photo by Marcelo Chagas from Pexels.

Confronting Crohn's Disease as a Young African Woman: Challenges and Opportunities

By Yeabsira Taye Gurmu, Addis Ababa, Ethiopia 

My journey with inflammatory bowel disease (IBD) began in my late teens,  when I started experiencing debilitating abdominal pain, diarrhea, and  unexplained weight loss. At first, I tried to dismiss the symptoms,  attributing them to a common stomach bug or something I had eaten. But  as the weeks turned into months, I knew this was something much more  serious.  

Navigating the Health care system  

Getting an accurate diagnosis was perhaps the biggest hurdle I faced. In Ethiopia, access to specialized gastroenterology care and diagnostic tests like colonoscopies is extremely limited, especially outside of the major cities. It was difficult and time consuming to obtain an accurate diagnosis of Crohn's disease, even then. Diagnostic tests like colonoscopies and endoscopies were difficult to come by; there was a long waiting list. During this time, my health only continued to decline, leaving me in constant pain and with debilitating fatigue. Watching my body deteriorate as doctors struggled to diagnose the problem, I recall feeling powerless, ”It was an extremely frustrating and isolating experience."  

Grappling with Limited Treatment Options  

Once I finally received the Crohn's disease diagnosis, I then had to confront  the daunting challenge of finding effective treatments. The older medications, such as steroids were relatively accessible, but the newer biologic therapies recommended by my gastroenterologist were simply unavailable at the time and are presently financially out of reach. 

Confronting Cultural Stigma  

On top of the medical challenges, I also had to confront the cultural stigma surrounding my condition within my community. Some traditional medicinal practices view digestive disorders as a result of spiritual  imbalances or curses, rather than a legitimate medical issue. There were times when I felt a great sense of shame and isolation. The fear of judgment and discrimination made me avoid social gatherings and hesitant to share my diagnosis. This only compounded the mental and emotional toll of living with a chronic, often-misunderstood condition.

Finding Strength in Community : A Hopeful Future  

Despite the daunting obstacles, I refused to give up. I sought out support from local patient advocacy groups, Crohn’s and Colitis Ethiopia. Where I connected with others facing similar struggles. Together, we are working to raise awareness about IBD and lobby for improved access to essential medications and specialized care. 

Today, while my Crohn's disease remains a constant challenge, I am better equipped to manage my condition and live a fuller life. I continue to share my story, in the hopes of breaking down the stigma surrounding IBD in African communities and inspiring others to persist in their own battles. My journey with Crohn's has been arduous, but it has also made me resilient,  empathetic, and determined to create positive change, I reflect. "I may not be able to control this disease, but I can control how I respond to it - and that gives me strength to keep fighting."

Featured photo by Abuti Engidashet from Pexels