Self-Esteem and IBD

When you have Inflammatory Bowel Disease, you’re forced to deal with a lot of crap—literally and figuratively. Not only are people affected by disease symptoms, but the side effects of certain treatments. The ulceration in your colon might not visible to others, but side effects often do have physical manifestations. Sometimes your self-esteem can take a hit when struggling with side effects like weight loss, weight gain, facial swelling, and acne.

Edema

Dehydration and malnutrition often cause rapid weight loss during a flare. It’s hard enough to keep things down (and keep them in), and when you’re running to the bathroom fifteen to twenty (or more) times a day, fluid and nutrition is easily lost. An IV is the best remedy for dehydration, but, if the body also lacks protein, edema can occur. Edema is the phenomenon of swelling due to fluid retention. So after a drastic drop in your weight, you could find yourself swelling up like a balloon.

Photo via Keck Medicine at the University of Southern California

   

The edema is harder on the body than you’d imagine. When you’re lying in a hospital bed all day with little to no energy, your muscles will dwindle. This makes the swelling feel a lot heavier, making it that much more difficult to get out of bed. It can even cause back pain due to the pressure the swelling causes. I felt like lopsided water-balloon animal; my forearms were larger than my upper arms, and my feet and ankles were puffy. It was a strange sight.

Weight loss

Without an IV, the fluid weight is usually lost within a couple weeks. However, this will bring you back to the equally unpleasant state of being underweight, which is not glamorous in the slightest. I try to gain weight as quickly as possible, but it’s a slow process. It takes me months to get back to my normal weight, and the transition period can be awkward and uncomfortable. I’ve felt discouraged from going out anywhere—even when I do have the energy—because I don’t want to be seen in my withered state. I basically looked like Sirius Black after escaping Azkaban, but not as cool as Gary Oldman.

Moon Face and Acne Rash

On top of the weight fluctuation, the standard treatment to get a flare back under control involves the use of steroids, which come with a load of side effects. As I mentioned in a previous post, a common side-effect of the steroid Prednisone is facial acne, which won’t go away until you’re off the medicine completely. I despise the acne rash, and covering it up with make-up is tedious and only somewhat effective. I imagine most men with prednisone acne probably won’t be slathering cover-up on their face, which leaves them with even fewer options to cope. Along with the red bumps that appear all over the forehead, cheeks, chin, and chest, Prednisone will also cause facial swelling. Some people deal with a rather severe “moon-face.” For me, the swelling is minimal, but definitely noticeable.

Moon Face vs. Normal Face

Yep, that is me on the left, not a chipmunk. As you can see, Prednisone can really make your cheeks puff up. 

All of these side effects can make it difficult for a person to feel confident and happy about themselves, which is important during the recovery process. You don’t feel like going out, but too much reclusiveness can be detrimental as well. If you get hung up on the temporary state of your body, you just make the recovery process even harder for yourself. Even if I don’t feel back at 100%, I try to remind myself that in time I’ll be in a better place, physically and mentally.

TIPS:

• One thing that helps boost my self-esteem during the recovery process is exercise. Go for a walk, run, or just lift some weights at home—you will start to build back your muscles and feel better in general. 
• If you are insecure about being underweight, wear loose clothing. Baggy clothes will make things less noticeable, and odds are strangers probably won’t take any notice anyway—it’s only a big deal to you.
•  Most importantly, do something that makes you happy! Draw, write, play games, or watch some movies—not everything has to be exertional if you are low on energy.

Changes in your appearance always seem more drastic to you because you’re more familiar with your body than anyone else. Sometimes it’s best not to care. You don’t need the stress.

I hope all the other UC warriors out there feel better and stay happy.  

Remission: Weight Gain and the Return to Normalcy

It’s been a while since my last post, and that is because I have been very busy with my fall semester of college and marathons of The Office! Thankfully, I am currently in full remission, and I was able to successfully complete the semester symptom-free. Knowing how horrible and painful ulcerative colitis can be, it is surprising now that I can experience the day as a normal person. No more having to rush to the bathroom or brace oneself for the abdominal pain and cramping—absolutely nothing. Sometimes, I think of my disease and it seems as though it happened to another person. Although the knowledge that the UC could come back is always looming, I stay optimistic. Hopefully it won’t bother me for a good long while. (Or ever, please? That would be great.)

       With remission comes the exciting process of weight-gain! Both times that the UC has flared, I have struggled with severe malnutrition and dehydration. It rapidly takes its toll, and UC can bring even the healthiest body into a state of atrophy. I am proud to say that I have gained back all the 26 lbs that I lost, and I am back at my normal weight! My lowest weight was around 91 lbs.

Before                                            After

However, it’s not as easy as just picking up where you left off and gorging on whatever you want, as outsiders often assume. At first you need to be very careful about your diet. The hospital will usually transition you from a clear liquid diet to a full liquid diet, and then to a diet of “soft foods,” but after that it’s up to you. You have to be careful about what you eat, as fibrous foods can irritate the healing lining of your intestine. Spicy foods and fried/greasy foods should also, generally, be avoided. I find that it’s best to stick with “flare foods” for a while, which are easy on your insides and typically bland. Mashed potatoes, apple sauce, and chicken (thank goodness), are some of the first foods you can reintroduce to your diet. It’s always such a relief to be free from the Jell-O, Gatorade, and soup broth diet. I have found that eggs and white breads are also a good source of food during this transition. (Bagels are your friend!) Fortunately for my taste buds, I also tolerate cheese and yogurt.

Eggs, white toast, a little butter, and Kefir to drink: a typical breakfast.

As for the vegetables, I usually take it slow and add in fiber very gradually. Cooked carrots are some of the first vegetables that I introduce back into my diet. I seem to do well with mushrooms and cooked green beans, too. Eating vegetables cooked and in small amounts is beneficial when first reintroducing fiber to one’s diet. Eventually, after eating well and taking it easy, the weight will begin to come back. Everyone has different food tolerances, and some people have to be careful of certain trigger foods even on a good day.

Unfortunately, for many the symptoms of ulcerative colitis don’t let up. Often people experience symptoms every day, even during time periods in which the disease is less severe. It is frequently a struggle for people to achieve full remission, so I consider myself lucky that my medications were able to accomplish this. 

Here's to staying that way!