ImproveCareNow psychosocial
Better
I'm often asked if I believe ulcerative colitis has changed me for the better.
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It's a tough question. I can't go back in time and see how my high school years would have played out otherwise. There is no me, as I am now, without ulcerative colitis.
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Has ulcerative colitis changed me for the better? The simple answer is no. My disease has not changed me outside of my intestines. I am the same girl with a few extra pills. The more complicated answer is yes* - with the asterisk. It's based on a technicality. No, UC has not changed me for the better, but living with UC has.
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It starts with another girl: one named Tara. She was diagnosed with Crohn's Disease during her second year of medical school. A few years later, Tara had chosen to pursue a career in pediatrics and found herself on the inpatient rotation at my children's hospital in April '08 - the month of my diagnosis and subsequent hospitalization.
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You can guess how this plays out.
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I was the "I'm okay" kid in the hospital. I felt so good on steroids and so relieved to have a name for my disease, my answer to most everything became standardized. Did I want a visit from the art therapist? "I'm okay, thanks." Did I want another blanket? "I'm okay, thanks." It was my standard answer, so if asked if I wanted to participate in a mentoring program, I would have probably answered predictably: "I'm okay, thanks."
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Tara was the mentor this "I'm okay" kid never wanted. She stayed one day after rounds to share her story. A day past diagnosis, I hadn't yet started to think about what a future with IBD meant. Thanks to Tara, I never doubted my potential. From the get-go, I knew Tara's story. If she could continue to pursue her passion with IBD, my possibilities were equally endless. Until I met Tara, I didn't realize mentoring is not an emergency measure; it's a survival skill. Her confidence inspired my confidence.
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Being a good mentor is not about knowing the "right" thing to say or the "right" moment to say it. There will be moments when you don't know what to say, and there will be moments when it's best to stay quiet and just listen. Being a good mentor is not about the story; it's about the storyteller. The best storytellers - and the best mentors - realize that every story matters - and every story can change another story for the better.
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Until I met Tara, I never believed a single patient voice could matter. Clearly, as I'm here blogging, I do now.
To Nudge or to Push
Mother to teenage son:Â âHey, have you taken your medicine yet?â
Son (playing video games): âI will in a minute!â
Mom (wondering whether itâs worth the fight): âYou know, youâre gonna move out in a few years and youâre going to have be able to do this without me telling you. And you know you donât want flare-ups if you can help it!â
Son: âNope, youâll have an alarm on your phone and youâll just call me and keep nagging until I take it. Canât wait for that!â [insert sarcasm]
And, end scene.  Mom walks offstage slowly, imagining how many more times sheâll ask before he takes it, if heâll ever fully be in charge of his body, maybe whether heâll be living on her couch at 40âŚ.
Is this exaggerated? Maybe. But I know many families in this boat. They donât have emergencies, and they get a clean âGood job, no problems this quarter!â during the GI checkup. The child has a good quality of life when it comes to school and sports and social time and⌠itâs because mom stays in charge. Sheâs in charge of the medicine, the questions for the doctor, all the IBD knowledge necessary to lead a good life. Sheâs running this show!
How much should we push our teens to start taking charge and showing responsibility?   Itâs difficult. If we push too little, they donât grow up. If we push too hard, they may retreat and we'll keep doing everything anyway âbecause someone has to.â And by the way, âWhy wasnât that last flare and hospitalization enough to make him wake up and start doing something about it?â
Scary Stories
âIll people are more than victims of disease or patients of medicine; they are wounded storytellers. People tell stories to make sense of their suffering; when they turn their diseases into stories, they find healing.â James Swanton, in forward to The Wounded Storyteller: Body, Illness, and Ethics (1997).Â
My girls love when I tell them scary stories. Not the overly gory kind, never with bad endings, but definitely the kind with those spooky âjust around the cornerâ monsters that, in the end, are shrunk, tamed, made nice, or were never really monsters in the first place.Â
We Need a Bigger Boat

âBut I took my medicine!â
I hear this down the hall from a patient room. Iâve heard this so many times in my work as a psychologist that I immediately begin to assume what is going on in the room. In my mind I imagine the child down the hall is probably being told that labs came back showing little to no medication in her system, even though sheâs on a considerable dose for a serious problem. She has been admitted and sheâs in bad shape; in lots of pain. The medicine they wanted her to take could help her body get better, or at least keep her problem from getting worse. And she is adamant she has been taking it, perhaps also implying she has been taking it every time she was supposed to take it. And⌠the doctor or nurse talking to her doesnât think she is being completely honest. They shake their heads: âBut honey, numbers donât lie.â She then looks to her mother for support but finds, instead, a disapproving look.
Of Villainous Eels and Amazing Strength (or âIâm sexy and I know it!â)

When my daughters were younger, they loved The Little Mermaid, or more specifically the Disney version, with beautiful Ariel, crazy-scary Ursula and, most saliently, her two evil, ever-present eels, Flotsam and Jetsam. In Disney's tale they are menacing, conniving, willing to terrorize beautiful and sweet creatures of the sea. Our girls used to squeal and scream, grabbing my wife and me for safety whenever Flotsam and Jetsam showed up on screen.
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Story of Self | Noel Jacobs

My mother said that when I was in first grade, she knew I would be a psychologist.
I came home from school one day, excited to have my first-grade pictures! Remember those big sheets that you had to painstakingly cut into little squares? I was proud of my pictures and couldnât wait to pass them out.