THE DIGESTIVE DIGEST - Atlantic Health System

THE PEDIATRIC IBD CENTER AT GORYEB CHILDREN’S HOSPITAL
THE DIGESTIVE DIGEST
Spring 2013
PHYSICIANS
Joel Rosh, MD—Director
Barbara Verga, MD
Tamara Feldman, MD
Peter Wilmot, DO
Oren Koslowe, MD
Alycia Leiby, MD
Maria Perez, DO
Denesh Chitkara, MD
PEDIATRIC NURSE
PRACTITIONER
Stephanie Schuckalo, RN, MSN, APN
NURSES
Ruth Irizarry, RN, BSN
Annette Langseder, RN, BSN
Ellen Romain, RN, BSN
Meredith McCluney, RN, BSN
Kate D’Addio, RN, BSN
REGISTERED DIETICIAN
Diane Duelfer, MS, RD
SOCIAL WORKER
Charlotte Intile, LCSW
OFFICE MANAGER
Sheryl Giacomaro
ADMINISTRATIVE ASSISTANTS
Carol Pitt
Tina Jimenez
Lindsay Gallardo
Ellie Smith
MEDICAL ASSISTANTS
Tyreema Muhannad, CMA
Ashley Sparling, CMA
FROM THE DIRECTOR
Volume 4, Issue 1
DR. JOEL ROSH
Using Our “Gut Feeling” to Treat IBD
I have often been intrigued by common sayings that tell so
much in so few words. Whoever coined the term “gut feeling” was at
the cutting edge of understanding how our bodies work as psychosocial factors clearly affect the functioning of our GI tracts.
An important aspect to GI function is the biological interaction
of our nervous and immune systems. All of us have a “nervous stomach” (another insightful saying) as our gastrointestinal system has
more nerves than any other organ system outside of the brain. In
addition, the GI tract has a usually well-orchestrated immune system
that is partly under control of these nerves. There is emerging research that demonstrates a two way dynamic between GI immunity and our psycho-social state. As a
result, inflammatory conditions such as IBD, which stem from a loss of tight control
over GI immunity, and our psychosocial wellness, are intimately tied together by this
interaction.
While medical treatments for IBD are designed to target and decrease inflammation, there is growing evidence that stressful life events can directly increase inflammation. This can become a vicious cycle through the newly recognized “Systemic
Inflammatory Response Syndrome (SIRS).” Many of the chemical messengers of
inflammation have a direct effect on the brain leading to anxiety and depression. In
addition to affecting mood, sleep pattern and appetite can also be affected. This
leads to a decrease in overall sense of well-being, leading to stress which can increase inflammation and thereby complete the “circuit.” SIRS and the resulting adverse effect on mood increase disease activity while decreasing quality of life.
At our IBD Center, we recognize this critical interplay between biology, psychology, and sociology. Our team (your team!) includes physicians, nurses, a dietician, social workers, psychologists and psychiatrists all skilled in addressing the biological, psychological, and social interplay that is always present in any child and their
family affected with IBD. As we head into our new IBD facility this summer, we want
to remind you to feel free to take advantage of this holistic approach—and we are
always eager to hear your suggestions on how to improve upon today.
FREE IPHONE APP TO MONITOR YOUR IBD
FREE TRACKER TOOL FOR CROHN’S DISEASE AND
ULCERATIVE COLITIS FOR YOUR IPHONE
GI Buddy can help you and your health care team see how inflammatory bowel disease
(IBD) may be affecting you. Together, you can work to improve your IBD management and
quality of life. Features:
Log your symptoms.
Stay on top of your IBD treatment.
Record the foods you eat.
Monitor your overall well-being.
Get your total health picture in customized reports.
Eileen Ficula, CMA
For more information, visit www.ibdetermined.org/
tracker.aspx
The Digestive Digest
Page 2
I WALK FOR MY SISTER...
When my little sister was diagnosed with IBD a year and a half ago at age 10,
many questions ran through my mind- “Why did this happen? Will she ever
feel better? Is there a cure? Why her and not me? How can we fight this?” This
last question became the most important one to me because I was so angry
and wanted to fight back....I just did not know how.
Thankfully, my family found the “Take Steps for Crohn’s & Colitis Walk” and it
helped us, myself in particular, gain a sense of control. This event gave me the
opportunity to help my little sister as well as 1.4 million other adults and children afflicted with this horrible disease. We chose to participate in the Liberty
State Park Walk last June and it was both moving and memorable. I walked
with my sister, our family and our good friends. We laughed and shared experiences with many others bonded by this common thread. The stories of others
struggling provided comfort and the stories of those in remission gave us hope
and strength. It was such a positive day and I am proud to say our team, Love
Our Laura, raised $12,000!
I still get sad from time to time knowing that this will be a chronic condition for
my sister. However, she is presently doing remarkably well and I am thankful.
Every day with the help of funding from events such as these walks we learn more and more about this disease and what it will
take to defeat it. The walks not only raise money, but they also raise awareness and bring people together and when people
stand together the fight is much easier!
The walk we will be participating in this year is on June 2nd in Liberty State Park and we cannot wait!
Please go online today and support a walk...any one. Go to the CCFA website, click on “Get Involved”, drop
down and choose “Take Steps.”
Thanks! ~Kayla Brady (Laura’s sister)
Helena Lindner
age 11
Here is a picture of Helena performing with the Springfield Community Children’s
Choir in January. Helena has a passion for music—she plays flute, piano and she
sings. Singing is something that gives her great joy! She also sings in the Temple
Bnai Or Children’s Choir. It is such a pleasure to watch her perform. She has truly
blossomed as a result of her involvement in music and it has given her a great deal of
confidence. I just love this picture of her because you can really see the look of comfort
and pride on her face! As a parent there is just no better feeling than to see your child
thrive in such a positive way!
Helena’s Mom, Hillary
The Digestive Digest
Page 3
Sc ho ol n o tes: pleas e no te turn aro und time fo r sc ho ol n o tes is 1 w eek.
50 4 Plans f or f all: the deadline to s ubmit sc hoo l fo rms & 504 p lan req ues ts is Au gus t 1s t.
This allows sufficient time for them to completed before the start of the school year.
Get your forms in early via RelayHealth or fax to (973) 290-7365.
Please note: forms submitted after August 1st may not be completed in time for the start of school.
Thank you for your understanding and cooperation.
IT’S CAMP TIME!
Camp Oasis
When?
Where?
Who?
Who else?
August 12 – 17, 2013
Camp Nock-A-Mixon in Kintnersville, PA
Kids entering grades 4-11 in fall 2013
Leaders In Training: entering grade 12 in fall
2013
Want to volunteer?
minimum of 19 years old
A LIFE CHANGING EXPERIENCE
You wouldn't know it from looking at them, but all these kids
have Crohn's disease or ulcerative colitis. Yet at Camp Oasis,
they're just kids:
~ Trying new things
~ Making life-long friends
~ Hearing stories that sound familiar
~ Having the time of their lives
A FUN PROGRAM
At Camp Oasis, there are activities for every interest:
~ Swimming, boating, and fishing
~ Visual and performing arts
~ Ropes course, archery, and outdoor adventure
~ Individual and team sports
~ Special events
There is also plenty of time to relax and share the best medicine of all -- Laughter!
A SUPPORTIVE COMMUNITY
Camp Oasis also provides:
~ 24-hour on-site medical supervision by physicians, nurses,
and other healthcare professionals with experience treating
children with IBD
~ Dedicated and understanding counselors, many of whom
have IBD themselves, who are carefully screened and trained
~ An environment where campers realize they are not alone
in their struggles, and can let their true selves shine through.
SAMI’S EXPERIENCE AT CAMP
(19 years old)
“Camp Oasis is magical. Somewhere in between my
co-counselor and I jumping through our cabin’s doors to introduce ourselves to our girls and the incredibly painful goodbyes, I found a family. One of my greatest concerns going to
camp - and one that kept me from considering camp early on
- was that camp would force me to define myself by my disease. After all, only tweens and teens with IBD are eligible to
apply. I can’t say enough against this notion. I worried that
camp would make me a cookie-cutter IBD patient, but instead
it gave me confidence and incredible memories that have
pushed me to want to make a difference.
If you think Oasis is for babies, if you think you’re
too mature or too well-adjusted to go to camp, I understand.
I remember the feeling all too well. You are strong and you
have the makings of a young leader, but that’s only more of a
reason why you should consider a week at Oasis. You may not
realize it now, but Oasis will make you shine even brighter. ”
(for Sami’s full article see Digestive Digest Volume 3, Issue 4)
Visit www.ccfa.org, click on the drop down menu “Get
Involved” then “Camp Oasis” for more information and
applications.
The Digestive Digest
Page 4
WALKING TOWARD A CURE
“Take Steps, Be Heard for Crohn's & Colitis” is CCFA’s largest fundraising event
which raises awareness for the more than 1.4 million American adults and children
affected by digestive diseases like Crohn's disease and ulcerative colitis—that’s one
out of every 200 people!
The funds you raise through Take Steps will help support patient programs, enhances professional education efforts, and propels critical research for cures. In the past
four years, they’ve brought together over 100,000 people and raised close to $32
million to help further their mission.
Belmar Walk………………………………………….Sat, May 4th (location moved to Middlesex County College in Edison)
Liberty State Park Walk (Jersey City)……………..Sun, June 2nd
JOIN OUR TEAM: “Bellies Are Our Business”
As employees of the Pediatric Gastroenterology Division at Goryeb Children's Hospital, we take pride in the care
we provide to over 700 of our patients with Crohn's and ulcerative colitis. This year, our division will be participating in
the Take Steps for Crohn's & Colitis walk to help show our support for our patients and their families. Take Steps is
CCFA's national walk and the nation's largest event dedicated to finding cures for digestive diseases. We hope to raise
money for crucial research, bringing us closer to a future free from Crohn's disease and ulcerative colitis. Over 1.4 million American adults and children are affected by these digestive diseases.
Your donation will help support local patient programs, as well as important research projects. This cause is very
important to our division and we appreciate your help as we fight for a cure!
In addition to donating, you can join us at the event as a member of our team. There will be food, music and
kid's activities. The more money we raise, the closer we will be to making life more manageable for patients who live with these diseases every day.
Please join our team or donate to our efforts to support CCFA in finding a cure!
The link is http://online.ccfa.org/goto/belliesareourbusines
MEET YOUR TEAM
We’d like to introduce and welcome Shannon, our new registrar, to the 2nd floor in the
Goryeb Children’s Hospital.
About me: I live in Byram township with my parents, my 18 year old brother, Kevin, and
my dog, Sam (a cockapoo).
What I love: spending time with family, kayaking, hiking, mountain biking, and going
down to the shore.
My future goals: after attending Sussex County Community College for two years I hope
to further my education towards a nursing degree.
I am looking forward to meeting all of you at Registration Desk #3!
Shannon O’Brien
The Digestive Digest
Sammi Nigro, 15 years old
Page 5
S
am was diagnosed with Crohn's
disease just after she turned 12
years old. The diagnosis came completely out of the blue! In midNovember, she developed a fever and
no appetite for a few weeks that just
wouldn't go away. After a few weeks
and visits to a few infectious disease
specialists, her pediatrician suspected
that it might be something GI related,
so she sent us to see Dr Rosh. He examined her and was pretty sure it was
Crohn's (or possibly a ruptured appendix). A CT scan confirmed that she
had a massive infection in her intestine. She was immediately admitted
to Goryeb for IV antibiotics. After a few days they sent her home
with a PICC line so she could continue the IV antibiotics at
home. The fever came back a few days after going home so she
was back at the hospital, then came home just in time for
Christmas. She went to school for a week, then was back at the
hospital after an MRI showed that the antibiotics weren't curing
the infection.
So, as Dr Rosh put it, "Surgery is going to be your best
friend." She had surgery to remove about a foot of her intestine
at the terminal ileum. She handled everything like a trooper. Her
surgeon said that he wished all of his patients were like
her! The day following her surgery, although she was in a lot of
pain, she got out of bed and walked around as much as the
nurses would allow. She came home 5 days after surgery and
hasn't let anything stop her since! She finished out
the club volleyball season as soon as her surgeon
cleared her to go back. Today she plays volleyball for
her high school team, as well as on her club team.
J
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S
t
I
n
G
O
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D
B
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12
Years
old
RelayHealth (www.relayhealth.com) is an online, free, secure & encrypted website that our office is using to
communicate online. We cannot send any emails without using Relay Health. Preps and information regarding all procedures are only sent through Relay Health.
This helpful website can be used to update your physician (non-urgent only) on your child’s
condition or request:
refills (refills are processed quicker with Relay Health)
letters, camp forms, lab and radiology prescriptions
results
No one else is able to access any of your information & your email address is never shared or sold. Many
families have told us how efficient and what a time-saver RelayHealth has been.
It’s easy, it’s fast and it’s free!!!!
Thank you to those who have already joined. You are helping our office to run more efficiently for you.
The Digestive Digest
Page 6
HIGHLIGHT ON OTHER SUBSPECIALTIES
Goryeb Children’s Hospital offers more than 100 board-certified physicians in 20 pediatric specialties. Along your journey, there may be an instance in which you will need to see another specialist for an issue associated with IBD. In every issue, we will focus on one pediatric specialty. In
this issue, we will highlight:
Child Life Specialist
Kate Santagato, CCLS
Certified Child Life Specialist
I have been working as a Certified Child Life Specialist (CLS) at the Goryeb Children’s Hospital for 5 ½ years. I have a BA in Psychology from Rutgers University and am currently attending Montclair State University for my Masters in Counseling. My role as
a CLS is to help make the hospital a better place for kids through the use of age-appropriate play, teaching, distraction, and support. These opportunities can promote coping and normalization within the hospital environment, as well as make it a little more
fun!
In the Day Hospital, we have movies, video games, iPads, crafts, and games which help make our patients’ experiences more comfortable while they are getting Remicade or having a procedure/test. Through medical play children are able to become familiar
with their hospital surroundings and express fears or misconceptions. In the Day Hospital, we have stuffed animals with IVs and
various monitors, so that patients have the opportunity to see what they will be experiencing themselves and it allows them to play
with the equipment in a fun way and ask questions.
I got married in November 2012 to my husband, Sean. During my free time, I enjoy running, reading, spending time with family
and friends, and fixing up our new home!
The Digestive Digest
GOOD EATS
Page 7
FROM DIANE, YOUR DIETITIAN
Eating for Immunity
C
an nutrition really affect your immune system? Our bodies are amazing systems with multiple pathways performing complex tasks endlessly. “Even a small nutritional deficiency can affect the body’s ability to stay healthy”, states Heather Mangieri, R.D an Academy of Nutrition and Dietetics (AND) spokesperson. In good times we have enough reserve for those minor
indiscretions to not wreak havoc on our immune system. Sometimes, when we neglect our nutrition or are exposed to unhealthy environments, our immune systems become weakened.
A
strong immune system does not necessarily guarantee we can fight off every bug out there, but it certainly helps to start
with a good defense. Which foods should one eat to strengthen the immune system? If you review the recommendations in the media you will know that protein, vitamins, minerals and antioxidants top the list.
P
rotein is an essential part of the body’s defense system. Protein cannot do its job
without first having adequate calories from carbohydrates. Our brains function only
from glucose, which is broken down from carbohydrates. The three major anti-oxidant
vitamins include beta-carotene, vitamin C and vitamin E. Beta-carotene helps prevent
infection by keeping the skin and tissues in the mouth, stomach, lungs and intestines
healthy. Vitamin C triggers production of immune-boosting antibodies and vitamin E is
an antioxidant thought to provide a boost to the immune system. In order to absorb fat
soluble vitamins A, D, E, and K the body requires healthy fats from oils, fatty fish, nuts
and avocado. Zinc and selenium are minerals that combine with vitamin E to help improve the functioning of the immune system. Antioxidants neutralize free radicals and protect cells that help to bolster the
immune system. In addition, one cannot write an article about nutrition and the immune system without mentioning the
benefits of green tea, spices (including ginger, turmeric, oregano, cayenne and garlic), omega 3’s, and probiotics found in yogurts.
H
ow can one be assured they are not missing any one nutrient? Step up to www.MyPlate.gov . By following the plate icon
at each meal that includes a healthy fat and choosing a carbohydrate and protein food for each snack, you can be assured
of receiving all the necessary nutrients working together to strengthen your immune system. Food is by far the method to
use to ensure adequate nutrition. Avoid supplement use unless recommended by your MD or RD. Mega-dosing without a
good reason can conflict with other medications or body chemistry. Good Eats!
The Digestive Digest
Page 8
What’s Team Challenge?
Crohn’s & Colitis Team Challenge is a half marathon training program that sends people – all-expenses-paid – to
exotic locales to participate (run or walk) in a half marathon.
Participants commit to raising funds to help find cures for Crohn’s and colitis, and the Foundation provides training to them and provides them with fundraising advice and assistance. When participants meet their fundraising
goal, the Foundation covers the costs of traveling to the half marathon.
About training
Training takes place at a local venue on the weekends
Participants are trained by professional run and walk coaches as a group
Training lasts approximately 16-weeks and participants build up endurance to complete 13.1 miles
About fundraising
Participants are given a free easy-to-personalize web site
Staff provide expert fundraising advice and assistance
About race weekend
Participants travel as a group to the race
They experience the city and celebrate with their team at pasta and victory parties
Right now, we’re recruiting people to run and walk in one of our four destination races this summer:
Virginia Wine Country Half Marathon – June 1, 2013
Chicago 13.1 Half Marathon – June 8, 2013
Kona Half Marathon – June 23, 2013
Napa to Sonoma Half Marathon – July 21, 2013
For more information contact:
Ashley Chandler
Work: 732-786-9960 ext. 4
Cell: 646-276-7217
Email: [email protected]
www.ccteamchallenge.org
The Digestive Digest
experience
A parent’s perspective &
Page 9
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Team New Jersey!
Kindest Regards,
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Mother & Daughter Racing for the Cure
Justine & Jill Markman
I am excited to be coaching again for New Jersey's
Team Challenge Summer Season. This is my third
season running with Team Challenge, and I have
been a long distance runner for over 20 years. I
have participated in 5K's, half and full marathons. I
understand what it's like to be a runner with obstacles, as I have had Ulcerative Colitis for the last 15
years. I live in Watchung with my husband and
two children. They are all very supportive of my
passion for running and particularly my efforts to
fundraise for CCFA. My daughter also suffers from
UC, so we participate or organize some sort of
fundraiser for CCFA annually.
Left to right
Justine Markman and her mom, Jill
Markman.
Justine will be running in the Chicago race in June.
Of all the races I have trained for and completed,
the Team Challenge races I participated in have by
far been the most rewarding and definitely the most
fun. I particularly enjoy coaching. Helping our
team members to reach their goals and enjoy the
team spirit of training and race weekend is amazing.
I can't wait to see all of you cross the finish line!
~Jill Markman
(See Digestive Digest Fall 2012 Volume 3,
Issue 3 for more on Justine’s races. Follow
tabs to the Peds GI page at
www.atlantichealth.org).
Jill Markman in Team
Challenge’s 2012 Race
in Virginia.
The Digestive Digest
Page 10
The Digestive Digest
Page 11
RESEARCH ROUNDUP
An important part of what our IBD center strives for is to be a leader in advancing knowledge of IBD on
the global level. Our efforts in these research endeavors is ongoing and while we have several exciting projects in
development, we would like to summarize for you our current active studies.
1. Predicting Response to Standardized Pediatric Colitis Therapy (PROTECT Study)
The goal of this study is to improve our understanding of why children develop ulcerative colitis and why some children respond better than others to currently used medications. This is a multicenter study in USA and Canada. It is sponsored by National Institutes of Health (NIH) in coordination with Connecticut Children Hospital and Emory University. Currently enrolling patient’s between ages 4-17 years whose doctor believes he/she has ulcerative colitis.
2. Effect of Targeted Therapy on Self-Efficacy in Pediatric Patients with Newly-Diagnosed Inflammatory Bowel Disease
This study is investigating the effect of family and individual counseling at the time of diagnosis of inflammatory bowel disease
for those ages 8-18 years within 30 days of diagnosis [sponsored by private donor].
3. IBD Registry
This is a long-term prospective, observational research study to assess the natural history of IBD, treatment regimens, clinical
outcomes, and quality of life outcomes in newly diagnosed pediatric patients within 30 days of diagnosis. To be enrolled, patients must be less than 16 years of age at the time of diagnosis.
4. A Randomized, controlled trial of Yoga in Pediatric Inflammatory Bowel Disease
This study is conducted to determine if a structured yoga program, in addition to standard medical therapy, improves health
related quality of life in pediatric patients recently diagnosed with IBD. Ages of enrollment: 10-17 years of age. The patient will
be randomized into one of two groups, answer questions, attend 12 yoga classes, and complete follow-up questionnaires
[sponsored by private donor].
5. A Multicenter, open labeled study to evaluate the safety of Entocort (budesonide) in children with Crohn’s
This is a 12 week study to investigate the safety of Entocort in pediatric patient’s age 5 to 17 years with mild to moderate
Crohn’s disease. Must be able to swallow pills.
6. Qualitative Research to Develop a Patient Reported Measure for Pediatric Ulcerative Colitis
This study involves an interview with the patient and/or parent that are audiotaped to document symptoms of patients with
Ulcerative colitis. This study involves 2 visits: Visit 1 involves interview with patient and/or parent that is audio taped to document symptoms of patients with Ulcerative colitis and an explanation of how to use the new electronic diaries that will be taken
home and completed for 2 days and 2 nights. Visit 2, is a phone interview and mailing back an electronic diary. Patients must
be between the ages of 5 and 17.
7. A Multicenter, Prospective, Long-term Observational Registry of Pediatric Patients with Inflammatory Bowel Disease
This is a prospective registry to collect data over the next
20 years to record and compare current therapies that
O
T
D
E
children with IBD are receiving. Supported
by Janssen (the manufacturer of Remicade), those
S
CLO
ENTLY
S
R
T
R
N
U
E
C
M
enrolled must be less than 16 years of age
but there is an option to continue collecting data
NROLL
NEW E
into adulthood. This is a nationwide study
of 5000 patients (2500 patients receiving Remicade
and 2500 patients not receiving Remicade). Currently enrolling patients with UC.
8. Risk Stratification and Identification of Immunologic and Microbial Markers or Rapid Disease Progression in Children with
Crohn’s Disease:
The goal of this study is to identify certain biomarkers
in the body that help to identify those children with
ED TO
S
O
L
Crohn’s who are at risk for developing disease-related complications soon after diagnosis. This
C
TLY
NTS
URREN
E
C
M
L
L
is a multicenter study in the USA and Canada. It is sponsored by CCFA in coordination with
NRO
NEW E
Emory University. No new patients to be
enrolled.
The Digestive Digest
Page 12
ADAM’S HIGHWAY OF LIFE
Below is the college application submitted by Adam Greene to the University of Richmond.
everal years ago, I got stuck in a traffic jam on the Highway of Life. I saw brake lights on
the cars ahead, warning me of a slowdown. Something was not right with my body, but I
just kept going. There were so many things that kept me busy and focused elsewhere,
with school, homework, sports, and having a social life that I just thought that the red lights would
ease up and the traffic flow would improve. Little did I know that the red lights ahead of me were
a warning, and before I could make any sense of what was happening, my life came to a
screeching halt!
I was diagnosed with Crohn’s Disease, an illness of the intestinal system. In 2007, I certainly did not know what it was and I sure did not know where it had come from. I could still attend school and complete my homework, but I just was not feeling myself. I hardly had any appetite and I lost interest in some of my favorite things, such as having dinner with my family, playing tennis, and spending time with my friends. Having no familiarity with the early symptoms of
this illness, instead of tuning into the traffic report to see if I could get around the jam, I drove
S
right into it.
Complications that developed made me realize the severity of my illness. My body was not absorbing
nutrients properly. This malfunction was affecting my growth, bone density, and causing me to lose weight. I was hospitalized and required two surgeries to clear an infection. The time I spent in the hospital was easily the worst time of my
life. I had trouble sleeping at night and could hardly move without feeling pain. Everything seemed to be going downhill
and just about every ounce of optimism left me. I missed Halloween that year, my favorite holiday at the time, and I
found it difficult to even think about picking up a tennis racquet again. Looking back, I would say that I was
definitely frightened and feeling very sorry for myself.
When I got out of the hospital, I was tutored for several weeks until I regained my strength and
could return to school. Finally, I took back my place on the highway, but this time in the right lane, going
slowly. I found that I could gradually start rolling along again, adding back my activities one at a time, until
I was again going at full speed.
However, my experience taught me a lot about myself, as well as about life. I now know that I have to heed the
red lights up ahead and listen to what my body is trying to tell me. I am fortunate to have a reliable AAA - my family and
a team of medical experts that keep my engine well-tuned. I have learned the importance of remaining hopeful and persistent. Flares are common with this illness, but as long as I am persistent in following my health regimen and hopeful in
knowing that things will get better, I can avoid a break down. As I have gotten older, I have found that with adjustments
to my medication, diet, and proper rest, I can go the distance. My new attitude, knowledge of my illness, and yes, periodic tune-ups, have enabled me to keep up with my studies, win two tennis county championships, volunteer in my community, and work during the summer.
I travel a little more cautiously these days. College will be a road trip that I look forward to as my life journey unfolds. I cannot always predict whether or not the road ahead will be free of twists and turns. I may not know if the red
lights ahead are signaling a slow down or if they are warning me of a major traffic jam. Sometimes the traffic reports are
not always timely. Despite where the road may lead me, however, I am determined to make the most of my journey.
Adam Greene, Senior at Westfield High School
University of Richmond Class of 2017
FEEDBACK
Please take a minute to send me an email and let me know your thoughts. What do you want to see more of? What did you
wish we included? We love to announce your child’s accomplishments so please continue sending me pictures, stories, artwork, tips or information that you have learned. They are inspirational to many of our families...remember we have “newly
diagnosed” families along with our veterans of many years. Send all submissions to email below.
To view past issues of The Digestive Digest, go to www.atlantichealth.org and follow prompts to Goryeb Children’s Hospital
to Pediatric Gastroenterology and click on “Newsletters.” Or you can click on the link: http://www.atlantichealth.org/
goryeb/our+services/pediatric+gastroenterology+and+nutrition/connect/newsletters
Editor & Writer: Stephanie Schuckalo, RN, MSN, APN ([email protected])