1
00:00:04,400 --> 00:00:14,000
Speaker 1: Really, my condition was continuously dropping. None of the treatment

2
00:00:14,120 --> 00:00:17,680
Speaker 1: was working. It got to the point where I was

3
00:00:17,720 --> 00:00:20,800
Speaker 1: actually that to give me nutrition through a tube.

4
00:00:21,320 --> 00:00:24,640
Speaker 2: It was hard because obviously anyone knows that if you

5
00:00:24,680 --> 00:00:27,680
Speaker 2: see blood, it's not a good thing at all, and

6
00:00:27,720 --> 00:00:30,760
Speaker 2: it's not something that's I don't think it's going to

7
00:00:30,800 --> 00:00:31,240
Speaker 2: go away.

8
00:00:31,800 --> 00:00:35,519
Speaker 3: The fear continues to fester. It just becomes a potential

9
00:00:35,600 --> 00:00:37,839
Speaker 3: really dark spiral for some patients.

10
00:00:38,159 --> 00:00:40,880
Speaker 1: I think my lowest point was having that sinking feeling

11
00:00:40,920 --> 00:00:43,520
Speaker 1: of my life is never going to be the same.

12
00:00:48,280 --> 00:00:51,880
Speaker 4: How terrifying would it be to fight an unknown enemy,

13
00:00:52,400 --> 00:00:56,200
Speaker 4: one you didn't recognize and didn't see coming. What if

14
00:00:56,240 --> 00:01:00,959
Speaker 4: that enemy was coming from within a disease even doctors

15
00:01:00,960 --> 00:01:06,280
Speaker 4: couldn't identify. Nearly half of all Americans suffer from some

16
00:01:06,520 --> 00:01:12,240
Speaker 4: chronic illness, and many struggle for an accurate diagnosis. These

17
00:01:12,520 --> 00:01:19,800
Speaker 4: are their stories. I'm Lauren Brite Pacheco, and this is symptomatic.

18
00:01:32,400 --> 00:01:35,200
Speaker 4: Jose Torres has always felt most at home when he

19
00:01:35,240 --> 00:01:40,040
Speaker 4: can express himself, whether it's through music, poetry, or visual arts.

20
00:01:41,600 --> 00:01:43,280
Speaker 1: Ever since I was kid, I used to always draw

21
00:01:43,400 --> 00:01:46,280
Speaker 1: like cartoons, and as I grew up continued sketching.

22
00:01:46,319 --> 00:01:49,880
Speaker 5: Actually went to middle school for art specifically.

23
00:01:49,800 --> 00:01:53,120
Speaker 4: Though Jose was raised by his grandparents throughout his childhood,

24
00:01:53,400 --> 00:01:56,600
Speaker 4: his mother, Araceli, was always a huge part of a

25
00:01:56,640 --> 00:02:00,320
Speaker 4: support system. What kind of qualities does he have make

26
00:02:00,400 --> 00:02:01,240
Speaker 4: him so special?

27
00:02:01,920 --> 00:02:07,400
Speaker 2: He's intelligent, he's sensitive, he's hard working, he doesn't settle.

28
00:02:08,240 --> 00:02:12,480
Speaker 2: He's a very strong person. A lot of people grow

29
00:02:12,600 --> 00:02:16,400
Speaker 2: fond of him really quickly. He's very social, unlike me,

30
00:02:16,480 --> 00:02:19,640
Speaker 2: I'm the opposite of him. But he likes to be

31
00:02:19,720 --> 00:02:22,720
Speaker 2: around people and he likes to help people as well.

32
00:02:23,360 --> 00:02:29,200
Speaker 4: So tell me philosophy, poetry, reading, music, fan artist. How

33
00:02:29,240 --> 00:02:30,480
Speaker 4: did you get into boxing?

34
00:02:31,320 --> 00:02:33,440
Speaker 1: I had a bit of a rough upbringing, so that

35
00:02:33,560 --> 00:02:36,200
Speaker 1: was a way my mother identified was just like, let's

36
00:02:36,240 --> 00:02:41,640
Speaker 1: put that energy to something productive. Boxing was also a

37
00:02:41,760 --> 00:02:44,560
Speaker 1: huge sport just in the home, Like my grandfather growing

38
00:02:44,639 --> 00:02:46,840
Speaker 1: up would always watch like the big fights and whatnot.

39
00:02:47,320 --> 00:02:49,280
Speaker 5: So I was like, yeah, sure, why not? So we

40
00:02:49,280 --> 00:02:50,000
Speaker 5: found a gym.

41
00:02:50,120 --> 00:02:52,800
Speaker 1: I went, had a quick like intro session, loved it,

42
00:02:52,840 --> 00:02:55,400
Speaker 1: and that was it. If I wasn't in school, I

43
00:02:55,520 --> 00:02:57,239
Speaker 1: was likely in the gym.

44
00:02:57,840 --> 00:03:00,400
Speaker 4: And by the time you were a freshman and college

45
00:03:00,440 --> 00:03:01,680
Speaker 4: you were really into boxing.

46
00:03:02,200 --> 00:03:05,880
Speaker 1: Yes, at that point, the idea was My trainer wanted

47
00:03:05,919 --> 00:03:08,520
Speaker 1: to start preparing me to compete in potentially the Golden

48
00:03:08,520 --> 00:03:11,320
Speaker 1: Globes tournament to see how I placed there.

49
00:03:11,760 --> 00:03:14,399
Speaker 4: And at that point, no pun intended, but you ended

50
00:03:14,480 --> 00:03:18,200
Speaker 4: up getting knocked out in terms of health. You know,

51
00:03:18,320 --> 00:03:20,760
Speaker 4: I was saying, your mom must be tough, but I

52
00:03:20,800 --> 00:03:24,720
Speaker 4: should think to a certain extent, seeing you box prepared

53
00:03:24,960 --> 00:03:28,440
Speaker 4: her for what you were about to battle in terms

54
00:03:28,440 --> 00:03:29,080
Speaker 4: of your health.

55
00:03:29,880 --> 00:03:31,959
Speaker 1: My mom's a tough woman, but nothing prepared us for

56
00:03:32,880 --> 00:03:35,880
Speaker 1: that for the bout that came about with my health,

57
00:03:36,040 --> 00:03:41,080
Speaker 1: because yeah, it came out of nowhere. It was just

58
00:03:41,120 --> 00:03:44,240
Speaker 1: a regular day. I probably just gotten back from college

59
00:03:44,280 --> 00:03:47,400
Speaker 1: courses and I went to use the restroom and there

60
00:03:47,520 --> 00:03:51,160
Speaker 1: was blood. So that was the first thing. I was like, Oh,

61
00:03:51,200 --> 00:03:56,520
Speaker 1: that's different. But I didn't tell anyone because I just figured, oh,

62
00:03:56,520 --> 00:03:58,160
Speaker 1: it's stomach bug, maybe it's something I ate.

63
00:03:58,280 --> 00:04:01,560
Speaker 5: It'll go away, it would pass, and it wasn't a

64
00:04:01,560 --> 00:04:02,080
Speaker 5: big deal.

65
00:04:02,760 --> 00:04:07,600
Speaker 4: So initially you just kind of dismissed it as a fluke. Yeah,

66
00:04:07,640 --> 00:04:11,480
Speaker 4: and then when did it next get on your radar

67
00:04:11,560 --> 00:04:12,360
Speaker 4: as an issue?

68
00:04:12,880 --> 00:04:16,480
Speaker 1: So then the blood continued, not frequently enough for me

69
00:04:16,600 --> 00:04:20,040
Speaker 1: to be alarmed, which sounds crazy, but it still occurred

70
00:04:20,960 --> 00:04:23,560
Speaker 1: a few times in the weeks coming up, but then

71
00:04:23,760 --> 00:04:28,960
Speaker 1: I started feeling intense cramping and abdominal pains. But even

72
00:04:28,960 --> 00:04:31,279
Speaker 1: that I kind of just shook it off, still didn't

73
00:04:31,400 --> 00:04:34,560
Speaker 1: say anything to anyone. And part of that is honestly

74
00:04:34,600 --> 00:04:37,559
Speaker 1: like a cultural thing, like within Latin households, we don't

75
00:04:37,800 --> 00:04:41,080
Speaker 1: like going to the doctor typically unless it's absolutely necessary.

76
00:04:41,200 --> 00:04:43,440
Speaker 5: We were like, oh, it'll.

77
00:04:42,640 --> 00:04:45,159
Speaker 1: Go away, it'll be fine, and just growing up, even

78
00:04:45,200 --> 00:04:46,760
Speaker 1: like a tail and all, like, we wouldn't take that

79
00:04:46,839 --> 00:04:49,560
Speaker 1: unless it was absolutely necessary. Like we were just you know,

80
00:04:49,640 --> 00:04:51,960
Speaker 1: natural ways to get rid of fevers and whatnot.

81
00:04:52,440 --> 00:04:53,560
Speaker 5: So I just didn't mention it.

82
00:04:54,720 --> 00:04:58,359
Speaker 4: What is your day to day like at this point,

83
00:04:58,640 --> 00:05:02,760
Speaker 4: is it impacting you're commuting your classes?

84
00:05:03,320 --> 00:05:04,200
Speaker 5: Yeah, one hundred percent.

85
00:05:04,240 --> 00:05:06,320
Speaker 1: I was not able to make it to class half

86
00:05:06,320 --> 00:05:08,800
Speaker 1: the time because at this point also what started to

87
00:05:08,839 --> 00:05:13,239
Speaker 1: manifest was restroom urgency. Frankly so even taking the train,

88
00:05:13,440 --> 00:05:15,640
Speaker 1: because you know, I lived in Brooklyn, my school was

89
00:05:15,680 --> 00:05:18,640
Speaker 1: in Manhattan. I was also working part time at the

90
00:05:18,640 --> 00:05:22,039
Speaker 1: time as well, so it's just I couldn't make it

91
00:05:22,080 --> 00:05:24,640
Speaker 1: to everything. On top of training, I became tired to

92
00:05:24,640 --> 00:05:27,279
Speaker 1: even go to the gym to train. And box anymore.

93
00:05:27,880 --> 00:05:30,599
Speaker 4: You know, I just want to focus on that because psychologically,

94
00:05:30,960 --> 00:05:35,960
Speaker 4: that transition into fear that you need to use the

95
00:05:36,040 --> 00:05:44,080
Speaker 4: restroom into an absolute necessity. It's what the normal person experiences,

96
00:05:44,120 --> 00:05:48,240
Speaker 4: but on volume ten. So it's like getting food poisoning

97
00:05:48,880 --> 00:05:53,680
Speaker 4: out of the blue, and particularly in New York City subways,

98
00:05:54,279 --> 00:05:55,640
Speaker 4: there are no restrooms.

99
00:05:56,120 --> 00:05:56,320
Speaker 5: Right.

100
00:05:56,760 --> 00:06:00,679
Speaker 1: It was definitely a challenge that prohibited me, to your point,

101
00:06:01,000 --> 00:06:03,200
Speaker 1: to go anywhere, Like you had to be aware of

102
00:06:03,240 --> 00:06:05,359
Speaker 1: how long is it going to take me, you know,

103
00:06:05,400 --> 00:06:06,520
Speaker 1: where would the restrooms be.

104
00:06:07,000 --> 00:06:08,360
Speaker 5: But beyond the restroom.

105
00:06:07,960 --> 00:06:11,719
Speaker 1: Issue, just the fatigue, the depleted energy, the pain, like

106
00:06:11,760 --> 00:06:15,000
Speaker 1: there's so many other things that went along with that

107
00:06:15,000 --> 00:06:16,800
Speaker 1: that caused me to not be able to do a

108
00:06:16,839 --> 00:06:17,720
Speaker 1: lot of things.

109
00:06:18,120 --> 00:06:20,760
Speaker 2: When he was in school, I wasn't around, So I

110
00:06:20,800 --> 00:06:23,680
Speaker 2: can only imagine how hard it was for him to

111
00:06:24,480 --> 00:06:27,159
Speaker 2: know that he may have to go and have to

112
00:06:27,160 --> 00:06:30,280
Speaker 2: get off the train or have to rush And it's

113
00:06:30,360 --> 00:06:32,560
Speaker 2: kind of also embarrassing, I'm sure for him.

114
00:06:36,080 --> 00:06:40,039
Speaker 4: It's not something that people can necessarily say, it's not

115
00:06:40,200 --> 00:06:44,760
Speaker 4: something that people can necessarily understand, and it's a difficult

116
00:06:44,839 --> 00:06:45,880
Speaker 4: thing to talk about.

117
00:06:46,640 --> 00:06:49,560
Speaker 1: Yeah, I mean, no one likes talking about restroom issues, right,

118
00:06:49,600 --> 00:06:54,160
Speaker 1: it's almost still taboo. So when someone is experiencing especially

119
00:06:54,480 --> 00:06:55,880
Speaker 1: we don't know what it is. We don't know what's

120
00:06:55,920 --> 00:06:59,480
Speaker 1: happening or having these experiences. It was very difficult to

121
00:06:59,520 --> 00:07:02,640
Speaker 1: communicate due to lack of understanding, and to your point,

122
00:07:02,720 --> 00:07:05,640
Speaker 1: like it's difficult to share beyond the urgency. Even if

123
00:07:05,640 --> 00:07:07,920
Speaker 1: I do decide to go somewhere and I get stricken with,

124
00:07:08,240 --> 00:07:11,360
Speaker 1: you know, a crippling cramp or abdominal pain, then I

125
00:07:11,400 --> 00:07:13,360
Speaker 1: would have to like go crowl up in a corner somewhere.

126
00:07:14,880 --> 00:07:19,480
Speaker 4: Persisting for months on end, the symptoms became impossible to ignore,

127
00:07:19,800 --> 00:07:23,880
Speaker 4: starting to interfere with Jose's life, especially his boxing dreams.

128
00:07:24,400 --> 00:07:28,000
Speaker 4: Instead of focusing on his next training session, he was

129
00:07:28,080 --> 00:07:32,000
Speaker 4: now just trying to make it to class. It reached

130
00:07:32,040 --> 00:07:34,000
Speaker 4: a point where he could no longer hide it from

131
00:07:34,080 --> 00:07:35,840
Speaker 4: his mom.

132
00:07:35,520 --> 00:07:37,800
Speaker 1: And then it got to the point where then fatigue

133
00:07:37,840 --> 00:07:39,040
Speaker 1: started to kick in.

134
00:07:39,320 --> 00:07:40,840
Speaker 5: Fatigue isn't just being tired.

135
00:07:41,200 --> 00:07:43,640
Speaker 1: When I say fatigue, I mean like you literally don't

136
00:07:43,680 --> 00:07:46,520
Speaker 1: have the energy to get out of bed. It's almost

137
00:07:46,520 --> 00:07:50,320
Speaker 1: difficult to explain if you've never experienced it. Just imagine

138
00:07:50,320 --> 00:07:54,320
Speaker 1: if your body was completely drained of any energy or

139
00:07:54,600 --> 00:07:58,040
Speaker 1: will to move, like we can't move if we wanted.

140
00:07:57,840 --> 00:08:01,280
Speaker 5: To, and I was just so exhausted. My mom took notice.

141
00:08:01,400 --> 00:08:03,640
Speaker 1: There was just one day that I just couldn't get up,

142
00:08:03,720 --> 00:08:05,600
Speaker 1: like I couldn't make it. It's a class that day,

143
00:08:05,760 --> 00:08:08,000
Speaker 1: and then my mom was just like, there's something wrong,

144
00:08:08,120 --> 00:08:09,200
Speaker 1: like what's going on with you?

145
00:08:09,760 --> 00:08:12,040
Speaker 5: So then then I finally broke and told her, and

146
00:08:12,080 --> 00:08:12,320
Speaker 5: she was.

147
00:08:12,320 --> 00:08:14,400
Speaker 1: Like, yeah, we need to get you checked because I've

148
00:08:14,400 --> 00:08:15,800
Speaker 1: never seen you like this before.

149
00:08:16,320 --> 00:08:20,160
Speaker 2: He called me over and he was bleeding severely, and

150
00:08:20,240 --> 00:08:21,960
Speaker 2: that's when we rushed to the hospital.

151
00:08:24,400 --> 00:08:27,800
Speaker 4: Tell me what went through your mind. How horrifying was that?

152
00:08:28,680 --> 00:08:32,120
Speaker 2: It was hard because I know that obviously anyone knows

153
00:08:32,160 --> 00:08:34,760
Speaker 2: that if you see blood, it's not a good thing

154
00:08:34,840 --> 00:08:37,640
Speaker 2: at all. I don't think it's going to go away,

155
00:08:37,760 --> 00:08:40,280
Speaker 2: so I kind of knew that it was really serious.

156
00:08:45,520 --> 00:08:49,600
Speaker 4: At the hospital, doctors drew blood, performed a colonoscopy, a

157
00:08:49,640 --> 00:08:53,840
Speaker 4: procedure where a fiber optic instrument is inserted to examine

158
00:08:53,840 --> 00:08:57,960
Speaker 4: the inside of the colon, and administered a barium swallow test,

159
00:08:58,400 --> 00:09:01,959
Speaker 4: where Jose ingested a chalk liquid that made his upper

160
00:09:01,960 --> 00:09:06,080
Speaker 4: gastrointestinal tract visible on X rays. There were so many

161
00:09:06,120 --> 00:09:08,880
Speaker 4: other procedures that they all started to blur together. For

162
00:09:09,000 --> 00:09:12,320
Speaker 4: Jose and as a boxer, I'm sure that you were

163
00:09:12,320 --> 00:09:16,160
Speaker 4: pretty aware of your weight and your body composition. What's

164
00:09:16,160 --> 00:09:17,440
Speaker 4: happening to you physically?

165
00:09:18,200 --> 00:09:21,000
Speaker 1: I'm just getting weaker again, not being able to train

166
00:09:21,080 --> 00:09:23,640
Speaker 1: as regularly or at all. You know, it got to

167
00:09:23,640 --> 00:09:25,079
Speaker 1: a point where I was so fatigued the end that

168
00:09:25,080 --> 00:09:28,320
Speaker 1: I had to stop training altogether. So it was very

169
00:09:28,360 --> 00:09:31,160
Speaker 1: difficult for me to maintain weight on top of not

170
00:09:31,160 --> 00:09:34,040
Speaker 1: being able to exercise, which you know, just added to

171
00:09:34,080 --> 00:09:37,040
Speaker 1: the fatigue. It just became a cycle of one thing

172
00:09:37,080 --> 00:09:39,240
Speaker 1: compounding on the other, compounding on the other.

173
00:09:39,720 --> 00:09:42,800
Speaker 2: He was getting skinnier and skinnier and skinnier and skinnier,

174
00:09:42,960 --> 00:09:45,080
Speaker 2: and it was very difficult.

175
00:09:45,640 --> 00:09:51,400
Speaker 4: That must have been so frightening. What is the doctor

176
00:09:51,480 --> 00:09:53,679
Speaker 4: saying and what does the doctor think it is?

177
00:09:54,720 --> 00:09:59,320
Speaker 5: So they told me that was Crohne's disease, which you

178
00:09:59,360 --> 00:10:00,480
Speaker 5: know karable.

179
00:10:00,840 --> 00:10:02,840
Speaker 1: So getting hit with that at that age, it was

180
00:10:02,920 --> 00:10:05,600
Speaker 1: just instantly like, oh what now, Like what is my

181
00:10:05,640 --> 00:10:07,720
Speaker 1: life going to look like? What does this mean for me?

182
00:10:08,480 --> 00:10:10,080
Speaker 1: I'm still so young, Like, what is the rest of

183
00:10:10,080 --> 00:10:11,040
Speaker 1: my life going to look like?

184
00:10:11,840 --> 00:10:15,800
Speaker 4: Crohn's disease is a chronic condition that causes inflammation in

185
00:10:15,840 --> 00:10:20,520
Speaker 4: the digestive tract, leading to abdominal pain, severe diarrhea, fatigue,

186
00:10:20,920 --> 00:10:25,640
Speaker 4: weight loss, and malnutrition. If left unchecked, it can result

187
00:10:25,679 --> 00:10:29,280
Speaker 4: in debilitating and potentially life threatening complications.

188
00:10:30,160 --> 00:10:33,480
Speaker 2: I started reading about chrones, and I read that it

189
00:10:33,480 --> 00:10:37,160
Speaker 2: could be deadly, it could be just life long. I

190
00:10:37,240 --> 00:10:40,320
Speaker 2: had no idea that they would say, oh, your son

191
00:10:40,400 --> 00:10:43,720
Speaker 2: has a disease and he's going to have issues. It's

192
00:10:43,760 --> 00:10:44,960
Speaker 2: going to change his life.

193
00:10:45,960 --> 00:10:50,360
Speaker 4: Do you remember at that point what your biggest fears were.

194
00:10:51,160 --> 00:10:53,040
Speaker 5: It went back to, like, what is my life going

195
00:10:53,080 --> 00:10:53,760
Speaker 5: to look like now?

196
00:10:54,040 --> 00:10:57,200
Speaker 1: I was still going to school, but struggling because of

197
00:10:57,679 --> 00:10:59,480
Speaker 1: you know, all the symptoms and everything, and being in

198
00:10:59,559 --> 00:11:02,120
Speaker 1: and out the hospital and not the doctor's offices.

199
00:11:02,840 --> 00:11:05,480
Speaker 5: So yeah, it was really my future more than anything.

200
00:11:09,800 --> 00:11:12,080
Speaker 4: Jose had been in and out of the hospital five

201
00:11:12,200 --> 00:11:15,680
Speaker 4: times in just a few months. During that period, he

202
00:11:15,840 --> 00:11:20,920
Speaker 4: lost thirty pounds, drastically changing his appearance and overall well being.

203
00:11:21,640 --> 00:11:24,120
Speaker 4: Even though he now had a diagnosis, the lack of

204
00:11:24,160 --> 00:11:27,160
Speaker 4: a clear treatment plan left him feeling like he was

205
00:11:27,320 --> 00:11:28,240
Speaker 4: just treading water.

206
00:11:29,360 --> 00:11:33,200
Speaker 1: They told me to keep a food diary and was

207
00:11:33,280 --> 00:11:35,320
Speaker 1: just like, if you eat something that makes you not

208
00:11:35,400 --> 00:11:38,880
Speaker 1: feel well, don't need it again. And in my head

209
00:11:38,920 --> 00:11:40,240
Speaker 1: that just didn't make any sense.

210
00:11:41,080 --> 00:11:45,640
Speaker 4: Now, on top of fearing urgency, you have to fear

211
00:11:46,440 --> 00:11:47,800
Speaker 4: everything you're eating.

212
00:11:48,120 --> 00:11:49,920
Speaker 5: Pretty much, because yeah, there was no guidance.

213
00:11:50,080 --> 00:11:51,560
Speaker 1: And in my head, it was just like, all right,

214
00:11:51,559 --> 00:11:53,160
Speaker 1: I'm write down what I eat in a day and

215
00:11:53,200 --> 00:11:55,280
Speaker 1: if I don't feel well, ay, how do I pinpoint

216
00:11:55,320 --> 00:11:58,400
Speaker 1: what is it that I ate that made me feel

217
00:11:58,760 --> 00:12:00,760
Speaker 1: bad or land me back in the hospital?

218
00:12:01,360 --> 00:12:03,600
Speaker 5: And again like what was the long term solution? I'd

219
00:12:03,640 --> 00:12:06,400
Speaker 5: been prescribed to regimen of medications as well at that time.

220
00:12:06,960 --> 00:12:10,960
Speaker 1: It got slightly better, but not not manageable.

221
00:12:11,720 --> 00:12:16,120
Speaker 4: So you have a diagnosis, it is not an optimistic one.

222
00:12:16,840 --> 00:12:20,160
Speaker 4: How do your conditions continue at that point? Is there

223
00:12:20,280 --> 00:12:22,560
Speaker 4: any kind of respite?

224
00:12:23,240 --> 00:12:26,520
Speaker 1: There was a slight break, so like the frequency reduced

225
00:12:26,559 --> 00:12:28,880
Speaker 1: a little bit, the urgency reduced a little bit, but

226
00:12:28,960 --> 00:12:31,720
Speaker 1: there was still the fatigue. There was still the issue

227
00:12:31,760 --> 00:12:35,079
Speaker 1: of what do I eat because I was still regularly

228
00:12:35,120 --> 00:12:37,800
Speaker 1: going back to the doctor or the hospital because of

229
00:12:38,280 --> 00:12:39,560
Speaker 1: severe symptoms.

230
00:12:40,120 --> 00:12:45,440
Speaker 2: So we had to do completely different no skins, you know, blend,

231
00:12:45,520 --> 00:12:52,000
Speaker 2: no seasonings, baked chicken, no fried foods at all, vegetables.

232
00:12:52,160 --> 00:12:55,360
Speaker 2: It just had to be like a very soft food diet,

233
00:12:55,480 --> 00:13:00,400
Speaker 2: nothing cruciferous, nothing that would hurt his stomach, so that

234
00:13:00,640 --> 00:13:02,559
Speaker 2: at least we wouldn't have any flares.

235
00:13:03,040 --> 00:13:07,440
Speaker 4: And that's a huge undertaking because suddenly you're having to

236
00:13:08,000 --> 00:13:12,240
Speaker 4: second guess and think about everything that's going into his mouth.

237
00:13:13,040 --> 00:13:15,600
Speaker 2: Yeah, it wasn't what I want to eat, it's what

238
00:13:15,679 --> 00:13:17,320
Speaker 2: I have to eat.

239
00:13:18,080 --> 00:13:22,040
Speaker 4: The diagnosis offered only a guise of normalcy, a brief

240
00:13:22,080 --> 00:13:25,720
Speaker 4: flashback to life before the symptoms began. But as the

241
00:13:25,760 --> 00:13:29,560
Speaker 4: flare ups returned and grew more frequent, Jose and Rselly

242
00:13:29,640 --> 00:13:32,080
Speaker 4: knew they needed to push for a second opinion.

243
00:13:33,000 --> 00:13:36,319
Speaker 2: As a mom with a child that has a diagnosis

244
00:13:36,559 --> 00:13:39,640
Speaker 2: as severe as that, I didn't want just one opinion.

245
00:13:39,800 --> 00:13:43,360
Speaker 2: I wanted a second opinion. I found a center that

246
00:13:43,520 --> 00:13:48,960
Speaker 2: was specifically for pediatric gesture enterology, and we made an

247
00:13:49,000 --> 00:13:50,520
Speaker 2: appointment and.

248
00:13:50,440 --> 00:13:53,839
Speaker 1: They re ran all the tests and did the blood

249
00:13:53,880 --> 00:13:56,600
Speaker 1: work all over again, and they actually came back with

250
00:13:56,679 --> 00:14:00,000
Speaker 1: a different diagnosis of all sort of colitis.

251
00:14:01,080 --> 00:14:06,960
Speaker 4: So what was that like for you? Somewhat relief?

252
00:14:07,720 --> 00:14:12,280
Speaker 1: It was because when I shared what I was being

253
00:14:12,320 --> 00:14:16,719
Speaker 1: told from my previous doctors. The current doctors that I

254
00:14:17,040 --> 00:14:20,280
Speaker 1: had found that did give me the proper diagnosis and whatnot,

255
00:14:20,840 --> 00:14:23,800
Speaker 1: were also in disagreement with like the food diary thing,

256
00:14:23,840 --> 00:14:25,840
Speaker 1: and they were just like they should have done XYZ.

257
00:14:26,000 --> 00:14:28,920
Speaker 1: And so that gave me confidence in this medical team

258
00:14:29,280 --> 00:14:31,560
Speaker 1: that Okay, this is the team I can trust, and

259
00:14:31,640 --> 00:14:34,920
Speaker 1: let's see what happens here. And they did prescribe me

260
00:14:35,040 --> 00:14:38,920
Speaker 1: a regiment of medications that actually did work, at least

261
00:14:38,920 --> 00:14:39,480
Speaker 1: for a time.

262
00:14:40,400 --> 00:14:43,920
Speaker 4: Altered of colitis is a disease that causes severe inflammation

263
00:14:44,200 --> 00:14:48,240
Speaker 4: and ulcers in the large intestine. In most people, symptoms

264
00:14:48,240 --> 00:14:51,880
Speaker 4: developed gradually that they can be draining and even life

265
00:14:51,960 --> 00:14:56,320
Speaker 4: threatening if not properly treated. It's estimated that nearly seven

266
00:14:56,400 --> 00:14:59,760
Speaker 4: hundred and fifty thousand people in North America are affected

267
00:14:59,800 --> 00:15:03,960
Speaker 4: by this disease. Both Crohn's disease and alsortive colitis fall

268
00:15:04,080 --> 00:15:09,200
Speaker 4: under the umbrella of inflammatory bowel disease. Jose's current gastrentrologist,

269
00:15:09,320 --> 00:15:12,760
Speaker 4: doctor Brian Bosworth, explains the difference between the two.

270
00:15:15,160 --> 00:15:20,080
Speaker 3: Inflammatory bowel diseases are a spectrum of presentations of an

271
00:15:20,160 --> 00:15:24,640
Speaker 3: autoimmune attack by your white blood cells on your intestines

272
00:15:25,160 --> 00:15:27,920
Speaker 3: and when that goes awry, that can lead to more

273
00:15:27,920 --> 00:15:31,800
Speaker 3: white blood cells coming in, more destruction of tissue. And

274
00:15:31,880 --> 00:15:33,680
Speaker 3: in the case of all sort of colitis, it's really

275
00:15:33,760 --> 00:15:36,880
Speaker 3: the surface level of the colon, and so some symptoms

276
00:15:36,880 --> 00:15:41,960
Speaker 3: that patients would get would be bleeding, diarrhea, urgency that

277
00:15:42,000 --> 00:15:43,800
Speaker 3: they have to run to the bathroom right away if

278
00:15:43,800 --> 00:15:46,040
Speaker 3: they felt the urge to go because they were afraid

279
00:15:46,040 --> 00:15:47,720
Speaker 3: that they would have an accident or not be able

280
00:15:47,800 --> 00:15:51,520
Speaker 3: to control it. If that inflammation is not just at

281
00:15:51,560 --> 00:15:54,360
Speaker 3: the surface level on the inside of the bowl, but

282
00:15:54,480 --> 00:15:57,960
Speaker 3: actually is throughout the entire wall of the bowl, that's

283
00:15:58,040 --> 00:16:01,560
Speaker 3: more Crone's disease. It's what we can called transmural through

284
00:16:01,560 --> 00:16:04,360
Speaker 3: the wall, and that can have the same types of

285
00:16:04,440 --> 00:16:08,280
Speaker 3: symptoms and presentation, but it could also have other complications.

286
00:16:08,840 --> 00:16:13,480
Speaker 4: So both would be diagnosed through a colonoscopy.

287
00:16:14,160 --> 00:16:17,680
Speaker 3: Cronesses and ulcer of colitis are clinical diagnoses, and it's

288
00:16:17,680 --> 00:16:21,800
Speaker 3: a combination of the endoscopic view through a colonoscopy, the

289
00:16:21,880 --> 00:16:25,400
Speaker 3: pathologic presentation what it looks like when we take little

290
00:16:25,400 --> 00:16:27,800
Speaker 3: biopsies in the colon, the way that the cells are arranged,

291
00:16:27,880 --> 00:16:31,520
Speaker 3: or even the types of cells, the imaging. So radiology

292
00:16:31,520 --> 00:16:35,200
Speaker 3: studies MRIs or cat scans. In Jose's case, he also

293
00:16:35,240 --> 00:16:37,920
Speaker 3: had a pill camera where he swallowed a little pill

294
00:16:37,960 --> 00:16:40,640
Speaker 3: that took pictures all the way through his intestines.

295
00:16:44,240 --> 00:16:47,240
Speaker 4: That's so much for you to experience at such a

296
00:16:47,280 --> 00:16:48,160
Speaker 4: young age.

297
00:16:48,560 --> 00:16:51,440
Speaker 1: Yeah, I think my lowest point was when the doctor

298
00:16:51,520 --> 00:16:54,440
Speaker 1: told me what they thought it was at that time,

299
00:16:54,640 --> 00:16:57,720
Speaker 1: and then just instantly having that sinking feeling of my

300
00:16:57,800 --> 00:17:00,000
Speaker 1: life is never going to be the same you mentioned

301
00:17:00,000 --> 00:17:02,680
Speaker 1: And my mother earlier, like watching me box was nothing

302
00:17:02,720 --> 00:17:06,439
Speaker 1: compared to her watching me go through this and helping

303
00:17:06,440 --> 00:17:08,639
Speaker 1: me get through it and just seeing me continuously not

304
00:17:08,720 --> 00:17:10,760
Speaker 1: get better and get worse over time.

305
00:17:10,840 --> 00:17:12,880
Speaker 5: And yeah, it was difficult.

306
00:17:13,680 --> 00:17:17,760
Speaker 4: In terms of the mental challenges that go hand in

307
00:17:17,840 --> 00:17:23,640
Speaker 4: hand with IBD, particularly severe cases of all sort of colitis.

308
00:17:24,119 --> 00:17:31,040
Speaker 4: How as a gastroentrologists do you help patients navigate the

309
00:17:31,160 --> 00:17:34,840
Speaker 4: mental aspect because there's a great deal of shame and

310
00:17:34,920 --> 00:17:39,600
Speaker 4: secrecy and guilt and frustration and hopelessness wrapped in one.

311
00:17:40,359 --> 00:17:41,240
Speaker 5: You're so right.

312
00:17:41,640 --> 00:17:45,760
Speaker 3: When they've done studies looking at quality of life, patients

313
00:17:45,760 --> 00:17:49,200
Speaker 3: with crohnes and ulcrapplities have a lower quality of life

314
00:17:49,560 --> 00:17:51,119
Speaker 3: index than cancer patients do.

315
00:17:51,520 --> 00:17:53,160
Speaker 4: Wow, that's unbelievable.

316
00:17:53,600 --> 00:17:55,480
Speaker 3: And part of that is, just like you said, there's

317
00:17:55,520 --> 00:17:58,320
Speaker 3: a shame aspected to it. It's not anything that they

318
00:17:58,400 --> 00:18:02,480
Speaker 3: brought on on themselves, obviously, but what's the primary presenting

319
00:18:02,560 --> 00:18:04,440
Speaker 3: problem while it's running to the bathroom? And that can

320
00:18:04,480 --> 00:18:07,600
Speaker 3: be embarrassing in that perhaps there are certain foods that

321
00:18:07,640 --> 00:18:09,960
Speaker 3: you eat that tend to set you off, or if

322
00:18:10,000 --> 00:18:13,040
Speaker 3: there are other circumstances and you're going through a flare

323
00:18:13,200 --> 00:18:15,480
Speaker 3: to have to run to a bathroom and you feel

324
00:18:15,680 --> 00:18:19,000
Speaker 3: chained to your house right, you're afraid to leave. And

325
00:18:19,040 --> 00:18:22,040
Speaker 3: on the mental health side, we also find that it's

326
00:18:22,040 --> 00:18:25,480
Speaker 3: critically important to work with mental health professionals. So here

327
00:18:25,520 --> 00:18:28,119
Speaker 3: at the NYU Lengo and Funat for a Bill Disease Center,

328
00:18:28,200 --> 00:18:31,919
Speaker 3: we employ a full time psychologist who sees all of

329
00:18:31,960 --> 00:18:35,639
Speaker 3: our patients who need to see her, and it's been

330
00:18:35,840 --> 00:18:38,200
Speaker 3: so impactful to have that partnership.

331
00:18:39,040 --> 00:18:42,159
Speaker 4: Jose starts to grasp the reality of living with a

332
00:18:42,200 --> 00:18:44,879
Speaker 4: chronic disease for the rest of his life. While an

333
00:18:44,960 --> 00:18:49,520
Speaker 4: accurate diagnosis offers a path forward from misdiagnosis. That hope

334
00:18:49,560 --> 00:18:52,440
Speaker 4: is quickly dashed when a life threatening flare up sends

335
00:18:52,520 --> 00:18:53,920
Speaker 4: him to ther.

336
00:18:55,040 --> 00:18:58,159
Speaker 2: He wasn't getting better and I thought I was going

337
00:18:58,240 --> 00:19:02,520
Speaker 2: to lose him.

338
00:19:02,640 --> 00:19:06,520
Speaker 4: We'll be right back with Symptomatic, a medical mystery podcast.

339
00:19:08,440 --> 00:19:13,280
Speaker 6: I'm Cindy Lauber with fellow Concentics advocate chef Michelle Bernstein.

340
00:19:13,560 --> 00:19:17,480
Speaker 6: We'll share our experiences with plaque sariasis with storiatic arthritis,

341
00:19:17,480 --> 00:19:20,280
Speaker 6: and doctor Panico will talk about the possible connection.

342
00:19:20,720 --> 00:19:23,040
Speaker 7: Cocentic sech you can you MAB is prescribed for adults

343
00:19:23,040 --> 00:19:25,880
Speaker 7: with moderate to severe placksorias as three hundred milligram dose

344
00:19:25,920 --> 00:19:28,440
Speaker 7: and adults with active soriatic arthritis one hundred and fifty

345
00:19:28,480 --> 00:19:31,679
Speaker 7: milligram dose. Don't use if you're allergic to cocentics before starting,

346
00:19:31,680 --> 00:19:34,920
Speaker 7: get checked for TB, serious allergic reactions, severe skin reactions

347
00:19:34,920 --> 00:19:37,200
Speaker 7: that look like ecima, and an increased risk of infections.

348
00:19:37,240 --> 00:19:39,480
Speaker 7: Some fatal have occurred. It may lower your ability to

349
00:19:39,480 --> 00:19:41,479
Speaker 7: fight infections, so tell your doctor if you have an

350
00:19:41,480 --> 00:19:44,960
Speaker 7: infection or symptoms like fevers, sweats, chills, muscleggs, or cough,

351
00:19:45,040 --> 00:19:47,480
Speaker 7: How do to vaccine or plan to or if IBD symptoms?

352
00:19:47,520 --> 00:19:51,000
Speaker 7: Developer Warson learn more at one eight four four Cocentics

353
00:19:51,119 --> 00:19:52,160
Speaker 7: orcocentics dot com.

354
00:19:52,160 --> 00:19:53,840
Speaker 3: Slash chef Michelle.

355
00:19:54,840 --> 00:20:03,040
Speaker 4: Now back to Symptomatic a medical mystery podcast. Jose Torres,

356
00:20:03,240 --> 00:20:06,159
Speaker 4: not even twenty one, had been on a roller coaster

357
00:20:06,240 --> 00:20:09,520
Speaker 4: of hospital visits for months on end. He had to

358
00:20:09,560 --> 00:20:13,600
Speaker 4: abandon his boxing dreams and was now struggling to keep

359
00:20:13,680 --> 00:20:17,280
Speaker 4: up with his college courses, often unable to leave his

360
00:20:17,400 --> 00:20:21,879
Speaker 4: home due to the pain, fatigue, and constant bathroom urgency.

361
00:20:22,480 --> 00:20:24,840
Speaker 4: Although he was confident in the new diagnosis a whole

362
00:20:24,880 --> 00:20:34,320
Speaker 4: sortive colitis, long term relief felt out of reach. So

363
00:20:34,400 --> 00:20:38,040
Speaker 4: does life go back to normal for a period of

364
00:20:38,040 --> 00:20:40,080
Speaker 4: time at this point, for a.

365
00:20:40,000 --> 00:20:42,440
Speaker 1: Period of time, for about a year, and it did

366
00:20:42,520 --> 00:20:46,600
Speaker 1: prescribe me a regiment of medications that actually did work,

367
00:20:46,920 --> 00:20:51,439
Speaker 1: but only for that short time. Unfortunately, there was still

368
00:20:51,760 --> 00:20:56,440
Speaker 1: anxiety around urgency. There was still days where I would

369
00:20:56,440 --> 00:20:59,679
Speaker 1: feel fatigued. It wasn't remission, it was disease.

370
00:20:59,720 --> 00:20:59,880
Speaker 5: Man.

371
00:21:00,400 --> 00:21:03,280
Speaker 1: So it was about as normal as it could have been.

372
00:21:03,680 --> 00:21:05,760
Speaker 1: I was able to go to school and do what

373
00:21:05,800 --> 00:21:08,520
Speaker 1: I had to do for my classes. I was able to,

374
00:21:08,680 --> 00:21:11,080
Speaker 1: you know, spend some time with friends, but there was

375
00:21:11,080 --> 00:21:14,440
Speaker 1: still that that anxiety part of it, the possibility and

376
00:21:14,600 --> 00:21:16,120
Speaker 1: kind of those thoughts in the back of my head

377
00:21:16,119 --> 00:21:19,159
Speaker 1: and Frankly, symptoms would arise when I would least expect it,

378
00:21:19,200 --> 00:21:23,080
Speaker 1: so manageable, but yeah, still not what it was prior

379
00:21:23,119 --> 00:21:24,240
Speaker 1: to the diagnosis.

380
00:21:24,840 --> 00:21:27,960
Speaker 4: Were you in denial initially when things came back full

381
00:21:28,040 --> 00:21:32,520
Speaker 4: force that first huge flare after a year of having

382
00:21:32,600 --> 00:21:35,879
Speaker 4: had things settle down, were you hoping it was just

383
00:21:35,920 --> 00:21:37,080
Speaker 4: like a temporary blip.

384
00:21:38,080 --> 00:21:38,320
Speaker 2: Yeah?

385
00:21:38,520 --> 00:21:40,359
Speaker 1: I could have compared it to the mindset I had

386
00:21:40,400 --> 00:21:43,840
Speaker 1: when I first had symptoms. I was just like, I'm

387
00:21:43,880 --> 00:21:45,800
Speaker 1: just gonna be feeling like this today, or I'm just

388
00:21:45,800 --> 00:21:47,480
Speaker 1: gonna be feeling like this this week. And then the

389
00:21:47,520 --> 00:21:50,320
Speaker 1: week turned into two weeks and it was like, no,

390
00:21:50,760 --> 00:21:52,160
Speaker 1: it's here we go again.

391
00:21:53,080 --> 00:21:54,080
Speaker 4: And then what happened?

392
00:21:54,760 --> 00:21:58,680
Speaker 1: Then I flared, So all of the symptoms came back

393
00:21:59,080 --> 00:22:03,040
Speaker 1: full force, the fatigue, the blood, the pain. They had

394
00:22:03,320 --> 00:22:06,280
Speaker 1: tried in other kind of regiment of medications. They had

395
00:22:06,320 --> 00:22:10,520
Speaker 1: tried to increase hostages, and nothing worked this time. So

396
00:22:10,680 --> 00:22:11,640
Speaker 1: it got to the point.

397
00:22:11,440 --> 00:22:15,600
Speaker 8: Where I was I was hospitalized for a good portion

398
00:22:15,680 --> 00:22:19,440
Speaker 8: of time and actually had to take a semester off

399
00:22:19,480 --> 00:22:22,200
Speaker 8: of school because I was missing so much of it.

400
00:22:22,800 --> 00:22:27,560
Speaker 4: That's so much, Jose, Yeah, you must have just felt

401
00:22:28,160 --> 00:22:33,720
Speaker 4: so overwhelmed with having to just fight through every day.

402
00:22:34,680 --> 00:22:37,840
Speaker 1: Yeah, it was difficult because at the worst I was

403
00:22:38,160 --> 00:22:41,600
Speaker 1: just long term admitted to the hospital and my condition

404
00:22:41,800 --> 00:22:47,680
Speaker 1: was continuously dropping. None of the treatment was working. I

405
00:22:47,760 --> 00:22:52,119
Speaker 1: had dropped down to round one hundred pounds.

406
00:22:53,880 --> 00:22:56,359
Speaker 2: So we went into a lot of problems. He was

407
00:22:57,000 --> 00:23:00,840
Speaker 2: not keeping food down. They had to put a food

408
00:23:01,119 --> 00:23:05,800
Speaker 2: tube in him, which in itself was very, very scary

409
00:23:05,880 --> 00:23:09,159
Speaker 2: and difficult to make a decision, but there's no other choice.

410
00:23:09,960 --> 00:23:13,640
Speaker 2: So I pretty much lived in the hospital with him

411
00:23:13,640 --> 00:23:16,800
Speaker 2: for a whole month, and that was very hard.

412
00:23:17,520 --> 00:23:20,080
Speaker 1: It was quite a battle, and yeah, I was pretty

413
00:23:20,119 --> 00:23:24,680
Speaker 1: much experiencing everything you could possibly experience associated with with colitis.

414
00:23:24,720 --> 00:23:29,880
Speaker 4: At that point, after everything you had been through too,

415
00:23:30,040 --> 00:23:33,000
Speaker 4: and he had been through, that just must have been

416
00:23:33,160 --> 00:23:34,880
Speaker 4: like how much more can you two take?

417
00:23:35,800 --> 00:23:39,080
Speaker 2: It was very hard, but you can't give up, right,

418
00:23:39,160 --> 00:23:41,399
Speaker 2: You have to keep going. There has to be some

419
00:23:41,600 --> 00:23:43,600
Speaker 2: kind of bright light at the end of all of this.

420
00:23:44,320 --> 00:23:46,160
Speaker 4: It must have been like a nightmare that you felt

421
00:23:46,160 --> 00:23:47,560
Speaker 4: you couldn't wake up from.

422
00:23:48,280 --> 00:23:50,800
Speaker 2: It was you don't want anyone to have to go

423
00:23:50,920 --> 00:23:53,280
Speaker 2: through that with a child. And like I said, the

424
00:23:53,280 --> 00:23:56,520
Speaker 2: weight loss was scaring me and I felt like I

425
00:23:56,600 --> 00:24:01,520
Speaker 2: was losing him.

426
00:23:59,600 --> 00:24:03,080
Speaker 1: Or you freight for sure, because I was again at

427
00:24:03,080 --> 00:24:05,560
Speaker 1: one hundred pounds with that, with everything going on, like

428
00:24:06,119 --> 00:24:08,240
Speaker 1: it came back to that question of what now, like

429
00:24:08,280 --> 00:24:09,880
Speaker 1: what could potentially happen here?

430
00:24:10,600 --> 00:24:12,480
Speaker 4: I say, how long were you in the hospital?

431
00:24:13,040 --> 00:24:15,679
Speaker 5: It was in and out a couple of months.

432
00:24:16,160 --> 00:24:18,399
Speaker 1: And then the doctors came to me and they were like,

433
00:24:18,720 --> 00:24:21,440
Speaker 1: to be Frank, there's two options here. There's this due

434
00:24:21,520 --> 00:24:25,000
Speaker 1: form of medication that's out that we can see if

435
00:24:25,000 --> 00:24:29,320
Speaker 1: that works after a couple of infusions or their surgery.

436
00:24:29,960 --> 00:24:33,359
Speaker 4: And by surgery, it means to take a huge chunk

437
00:24:33,400 --> 00:24:35,040
Speaker 4: of your intestines.

438
00:24:35,000 --> 00:24:38,160
Speaker 5: The entire large intestine, the entire large intestine out.

439
00:24:38,520 --> 00:24:41,520
Speaker 1: So again at nineteen, me and my mom were sitting there,

440
00:24:41,600 --> 00:24:44,040
Speaker 1: you know, having to make the decision, and you know,

441
00:24:44,080 --> 00:24:46,560
Speaker 1: we're like, let's shot the medication because we're not going

442
00:24:46,600 --> 00:24:49,520
Speaker 1: to opt into such a major surgery.

443
00:24:49,880 --> 00:24:52,280
Speaker 5: So we did, and that didn't work.

444
00:24:52,920 --> 00:24:56,359
Speaker 4: I'm sure your mother is trying to be your biggest

445
00:24:56,400 --> 00:25:00,800
Speaker 4: support system at that point, but we're are you ever

446
00:25:01,440 --> 00:25:05,480
Speaker 4: worried about her? Did you then kind of make that

447
00:25:06,119 --> 00:25:10,840
Speaker 4: the guilt of being sick when you see how it

448
00:25:10,960 --> 00:25:15,840
Speaker 4: impacts someone else is sometimes overwhelming.

449
00:25:16,440 --> 00:25:17,399
Speaker 5: Yeah, one hundred percent.

450
00:25:17,520 --> 00:25:19,280
Speaker 1: I mean, she took time off of work, could the

451
00:25:19,359 --> 00:25:21,280
Speaker 1: nights at a stay in the hospital. She was there

452
00:25:21,320 --> 00:25:23,120
Speaker 1: with me, even if she had a sleep on a chair.

453
00:25:23,720 --> 00:25:27,000
Speaker 1: She was there throughout that entire time. And even to

454
00:25:27,040 --> 00:25:29,320
Speaker 1: this day sometimes I think about it because you know,

455
00:25:29,400 --> 00:25:32,600
Speaker 1: my mom was always a very strong woman, but after

456
00:25:32,640 --> 00:25:36,000
Speaker 1: this diagnosis, she became very anxious. So I always think

457
00:25:36,040 --> 00:25:37,879
Speaker 1: back to myself, like, I wonder, was it because of

458
00:25:37,880 --> 00:25:39,560
Speaker 1: my diagnosis that she got that way?

459
00:25:39,800 --> 00:25:41,640
Speaker 5: So, yeah, it definitely took a toll.

460
00:25:42,480 --> 00:25:45,400
Speaker 4: What did her being there for you mean to you?

461
00:25:45,960 --> 00:25:48,440
Speaker 1: It meant the world because growing up I was raised

462
00:25:48,440 --> 00:25:50,480
Speaker 1: by my grandparents because my mother had me very young,

463
00:25:51,040 --> 00:25:53,679
Speaker 1: so she was as present as she could be. But

464
00:25:53,800 --> 00:25:55,919
Speaker 1: it wasn't until I moved in with her when I

465
00:25:55,960 --> 00:25:59,840
Speaker 1: started high school that we really started to build a relationship.

466
00:26:00,320 --> 00:26:04,160
Speaker 1: But it was during this period where I couldn't thank

467
00:26:04,200 --> 00:26:07,400
Speaker 1: her and appreciate her enough for just her being there

468
00:26:07,440 --> 00:26:10,359
Speaker 1: at the time where I frankly needed somebody the most

469
00:26:10,400 --> 00:26:11,160
Speaker 1: and she was there.

470
00:26:12,040 --> 00:26:15,760
Speaker 4: Desperate to avoid major surgery and the risk of irreparable

471
00:26:15,840 --> 00:26:19,520
Speaker 4: damage to his intestines, Jose began a series of infusions

472
00:26:19,560 --> 00:26:23,160
Speaker 4: to reduce the kalitis symptoms and hopefully improve his quality

473
00:26:23,160 --> 00:26:23,679
Speaker 4: of life.

474
00:26:24,520 --> 00:26:27,119
Speaker 1: I believe it was either two or three rounds of

475
00:26:27,160 --> 00:26:30,760
Speaker 1: infusion over a period of a few weeks and nothing improved.

476
00:26:31,800 --> 00:26:33,800
Speaker 5: So now now we had to do the surgery.

477
00:26:35,119 --> 00:26:38,280
Speaker 4: Surgery is not even a choice, it's a necessity to

478
00:26:38,320 --> 00:26:43,280
Speaker 4: save your life. Yeah, all right, walk me through the surgery.

479
00:26:44,600 --> 00:26:44,840
Speaker 5: Yeah.

480
00:26:44,880 --> 00:26:48,480
Speaker 1: So the first surgery was a total collectomy, so again

481
00:26:48,600 --> 00:26:52,520
Speaker 1: removal of the entire large intestine. I'd been told going in,

482
00:26:52,560 --> 00:26:56,040
Speaker 1: you're going to have an ostemebag for a time, possibly forever,

483
00:26:56,119 --> 00:26:58,080
Speaker 1: but at least the idea was for it to be

484
00:26:58,080 --> 00:27:00,560
Speaker 1: for a time to collect.

485
00:27:00,640 --> 00:27:02,399
Speaker 4: To me, was the first and what would be a

486
00:27:02,560 --> 00:27:07,240
Speaker 4: three part surgery sequence, creating an external bag to collect

487
00:27:07,320 --> 00:27:11,679
Speaker 4: bodily waste. Doctor Bosworth took over Jose's care after his

488
00:27:11,720 --> 00:27:15,480
Speaker 4: first surgery, and from the beginning they established a relationship

489
00:27:15,480 --> 00:27:18,600
Speaker 4: built on trust, the basis of what would become a

490
00:27:18,640 --> 00:27:19,840
Speaker 4: lifelong partnership.

491
00:27:23,160 --> 00:27:28,560
Speaker 3: Most patients when they have the jpouch surgery beforehand are

492
00:27:28,680 --> 00:27:32,480
Speaker 3: apprehensive and really fearful that they're going to be left

493
00:27:32,520 --> 00:27:36,280
Speaker 3: with a permanent bag. And having completed his surgeries, that

494
00:27:36,400 --> 00:27:38,280
Speaker 3: was one of the things that he was concerned about,

495
00:27:38,359 --> 00:27:40,520
Speaker 3: am I going to have to have another surgery and

496
00:27:40,560 --> 00:27:43,840
Speaker 3: then be left forever having a bag outside? And how

497
00:27:43,880 --> 00:27:46,000
Speaker 3: is that going to impact his life?

498
00:27:49,119 --> 00:27:52,880
Speaker 1: I remember just feeling relief because doctor Bosworth, even at

499
00:27:52,920 --> 00:27:56,119
Speaker 1: that time, was extremely well regarded in the space.

500
00:27:56,720 --> 00:27:59,560
Speaker 4: Do you remember meeting jose and his mother for the

501
00:27:59,560 --> 00:28:00,600
Speaker 4: first time.

502
00:28:00,800 --> 00:28:03,720
Speaker 3: Very well, Now he comes to appointments without his mother

503
00:28:03,800 --> 00:28:07,000
Speaker 3: from president, but the very beginning she was right there

504
00:28:07,080 --> 00:28:10,520
Speaker 3: by his side every step of the way. And when

505
00:28:10,600 --> 00:28:13,959
Speaker 3: we first met, we talked through what his course beforehand

506
00:28:14,080 --> 00:28:17,360
Speaker 3: had been, and what the decision to actually undergo surgery

507
00:28:17,520 --> 00:28:20,359
Speaker 3: was and what that meant for somebody who was eighteen,

508
00:28:20,440 --> 00:28:23,520
Speaker 3: nineteen twenty years old, and how I was going to

509
00:28:23,520 --> 00:28:27,160
Speaker 3: help both of them together go forward and what that

510
00:28:27,240 --> 00:28:30,080
Speaker 3: meant for them as they continued on with him having

511
00:28:30,160 --> 00:28:31,240
Speaker 3: the EJ Pouch.

512
00:28:31,720 --> 00:28:35,479
Speaker 1: The confidence in which that he spoke, and even his

513
00:28:35,800 --> 00:28:39,880
Speaker 1: rapport and bedsign manner like, he was just very comforting.

514
00:28:39,880 --> 00:28:43,000
Speaker 1: It was almost like talking to a friend if he will,

515
00:28:43,040 --> 00:28:44,800
Speaker 1: didn't feel like I was talking to a doctor.

516
00:28:44,920 --> 00:28:47,520
Speaker 5: He was just very approachable.

517
00:28:48,400 --> 00:28:51,480
Speaker 3: One of the things that I think is really important

518
00:28:51,520 --> 00:28:55,720
Speaker 3: in working with patients and their families and a goal

519
00:28:56,360 --> 00:28:59,200
Speaker 3: is that patients with chronic diseases are going to have

520
00:28:59,280 --> 00:29:02,800
Speaker 3: chronic disease, but it shouldn't be who they are, and

521
00:29:02,840 --> 00:29:06,000
Speaker 3: it shouldn't control their lives. And being able to help

522
00:29:06,080 --> 00:29:11,680
Speaker 3: to restore some degree of control, some individuality, and some

523
00:29:11,880 --> 00:29:14,720
Speaker 3: ability to function. Knowing that you have this but it's

524
00:29:14,800 --> 00:29:18,760
Speaker 3: not dictating what you're doing is a challenge and working

525
00:29:18,840 --> 00:29:23,120
Speaker 3: with both Jose and his mom together to get past

526
00:29:23,320 --> 00:29:26,320
Speaker 3: some of the anxieties of the therapies that he'd had in

527
00:29:26,360 --> 00:29:29,600
Speaker 3: the past, what the future might hold, treat any flares

528
00:29:29,640 --> 00:29:32,520
Speaker 3: that might occur, but also give them hope. And I

529
00:29:32,560 --> 00:29:35,800
Speaker 3: think that hope is such an important concept when you're

530
00:29:35,840 --> 00:29:37,640
Speaker 3: talking about a chronic disease.

531
00:29:41,240 --> 00:29:44,840
Speaker 4: The first surgery to remove Jose's large intestine was a success,

532
00:29:45,280 --> 00:29:48,440
Speaker 4: but the doctor still needed to perform a few additional

533
00:29:48,440 --> 00:29:51,480
Speaker 4: procedures to ensure he was set up for long term

534
00:29:51,520 --> 00:29:52,840
Speaker 4: recovery and comfort.

535
00:29:54,840 --> 00:29:58,400
Speaker 1: I had pretty much every post surgical complication you could

536
00:29:58,440 --> 00:30:01,920
Speaker 1: possibly have to because of the health state I was in.

537
00:30:02,320 --> 00:30:05,120
Speaker 1: They started to slowly introduce foods and I was regularly

538
00:30:05,120 --> 00:30:07,680
Speaker 1: having blockages with the ostomy, so they actually had to

539
00:30:07,680 --> 00:30:11,520
Speaker 1: do another minor surgery not too long after the major

540
00:30:11,560 --> 00:30:15,480
Speaker 1: one to increase the size of the ostom to allow

541
00:30:15,520 --> 00:30:17,440
Speaker 1: things to kind of like pass through better.

542
00:30:17,960 --> 00:30:22,120
Speaker 3: Fairly shortly after surgery, he came in and was having

543
00:30:22,200 --> 00:30:26,920
Speaker 3: some bleeding. And when you're patient with ulcerocalitis who was

544
00:30:27,000 --> 00:30:30,480
Speaker 3: diagnosed because you were bleeding, it evokes so much.

545
00:30:31,000 --> 00:30:31,680
Speaker 5: And I'm going to.

546
00:30:31,760 --> 00:30:33,360
Speaker 3: Say it, even though it wasn't formally, I know it's

547
00:30:33,360 --> 00:30:36,200
Speaker 3: post traumatic stress disorder, right. You really have that PTSD

548
00:30:36,280 --> 00:30:38,479
Speaker 3: reaction when you see something that reminds you of a

549
00:30:38,520 --> 00:30:41,240
Speaker 3: place when you were so sick and there was nothing

550
00:30:41,280 --> 00:30:45,520
Speaker 3: that was happening. There's a lot of both anxiety that

551
00:30:45,600 --> 00:30:48,760
Speaker 3: occurs and real fear of what's to come.

552
00:30:48,920 --> 00:30:49,720
Speaker 5: Because if you've now.

553
00:30:49,720 --> 00:30:51,840
Speaker 3: Already had surgery, what's the next step. How could I

554
00:30:51,880 --> 00:30:54,680
Speaker 3: have more surgery? My colon's gone, but yet I'm still bleeding.

555
00:30:54,720 --> 00:30:57,720
Speaker 3: And so we did a pouchsibly we looked in fact,

556
00:30:57,720 --> 00:30:59,240
Speaker 3: his pouch did not have any inflammation.

557
00:31:00,200 --> 00:31:02,920
Speaker 4: The next step for Jose was surgery to remove the

558
00:31:03,000 --> 00:31:06,640
Speaker 4: rectum and create a J pouch, preparing him for a

559
00:31:06,680 --> 00:31:10,040
Speaker 4: third procedure that would eliminate the need for an external

560
00:31:10,120 --> 00:31:12,200
Speaker 4: bag for his digestive system to function.

561
00:31:13,000 --> 00:31:14,760
Speaker 5: That third surgery was success.

562
00:31:15,080 --> 00:31:18,240
Speaker 1: They were able to reverse the ostomy and the jpouch

563
00:31:18,440 --> 00:31:21,880
Speaker 1: surgery and that three part sequence had been completed. But

564
00:31:21,960 --> 00:31:24,160
Speaker 1: it was just such a relief to know that the

565
00:31:24,200 --> 00:31:26,720
Speaker 1: ostemy had been reversed and now there could be a

566
00:31:26,760 --> 00:31:30,040
Speaker 1: potential way forward for me to move on with my life. Frankly,

567
00:31:30,640 --> 00:31:34,320
Speaker 1: it just made me appreciate everything so much more, even food,

568
00:31:34,840 --> 00:31:37,720
Speaker 1: because you know, going through this recovery period of eating

569
00:31:37,880 --> 00:31:41,719
Speaker 1: plan things or liquid diets and whatnot. Literally, just the

570
00:31:41,760 --> 00:31:44,720
Speaker 1: little things I learned to appreciate in value more.

571
00:31:45,280 --> 00:31:47,720
Speaker 5: Yeah, it just completely shifted my perspective.

572
00:31:48,200 --> 00:31:51,360
Speaker 4: Wow, that is such a lovely way to look at things,

573
00:31:51,440 --> 00:31:55,600
Speaker 4: after everything you've been through, pulling the positives from it.

574
00:31:57,600 --> 00:32:02,720
Speaker 4: After enduring numerous complications and finally undergoing the successful three

575
00:32:02,840 --> 00:32:07,000
Speaker 4: part surgery, Jose's treatment has now shifted to symptom maintenance.

576
00:32:07,520 --> 00:32:11,240
Speaker 4: This consists of regular checkups to monitor his inflammation and

577
00:32:11,440 --> 00:32:16,160
Speaker 4: ensure everything remains under control. Having navigated the terrifying road

578
00:32:16,200 --> 00:32:19,040
Speaker 4: to relief, he is now determined to be an example

579
00:32:19,080 --> 00:32:22,520
Speaker 4: to others living with IBD. He currently works at the

580
00:32:22,560 --> 00:32:26,280
Speaker 4: Crones and Colitis Foundation, having started there as an intern

581
00:32:26,440 --> 00:32:27,440
Speaker 4: and worked his way up.

582
00:32:29,040 --> 00:32:32,320
Speaker 1: There's a camp program for children that have closes, these

583
00:32:32,320 --> 00:32:35,800
Speaker 1: and ultrative colitis that the Foundation runs. So I did

584
00:32:35,800 --> 00:32:41,040
Speaker 1: that and that changed my life again, just going to

585
00:32:41,240 --> 00:32:45,200
Speaker 1: a camp and seeing these kids who were the youngest

586
00:32:45,280 --> 00:32:50,320
Speaker 1: were six seven, oldest being you know, seventeen, and these

587
00:32:50,400 --> 00:32:53,360
Speaker 1: kids dealing with what I just went through, and it's

588
00:32:53,400 --> 00:32:55,560
Speaker 1: just like geez, some of these kids have ostomies that

589
00:32:55,560 --> 00:32:56,880
Speaker 1: are not going to be reversed.

590
00:32:56,960 --> 00:32:59,440
Speaker 5: Some of these kids are on medications that they're never going.

591
00:32:59,320 --> 00:33:02,000
Speaker 1: To get off of, and just to see them enjoy

592
00:33:02,520 --> 00:33:04,840
Speaker 1: that week of camp as if they were normal kids.

593
00:33:05,280 --> 00:33:06,840
Speaker 1: But it's just kids being kids at the end of

594
00:33:06,880 --> 00:33:10,440
Speaker 1: the day, and the kids are always so grateful to

595
00:33:10,480 --> 00:33:13,239
Speaker 1: the counselors there, but you know, amongst us, counselors were

596
00:33:13,280 --> 00:33:15,080
Speaker 1: always like the kids don't know the effect they have

597
00:33:15,160 --> 00:33:17,800
Speaker 1: on us. Again, you just see life in a different way,

598
00:33:17,840 --> 00:33:20,040
Speaker 1: like if these kids are doing it, then why can't

599
00:33:20,040 --> 00:33:21,800
Speaker 1: I am? Sure they look at us in reverse like,

600
00:33:21,840 --> 00:33:24,320
Speaker 1: oh they're older, they're living with what I have, they're successful,

601
00:33:24,320 --> 00:33:25,920
Speaker 1: then I can do it too. So it was just

602
00:33:26,000 --> 00:33:28,840
Speaker 1: such a powerful experience. I volunteered as a counselor for

603
00:33:28,960 --> 00:33:31,160
Speaker 1: ten years.

604
00:33:32,920 --> 00:33:37,920
Speaker 4: You must be so proud of how he's blossomed in

605
00:33:37,960 --> 00:33:38,800
Speaker 4: spite of all of this.

606
00:33:39,840 --> 00:33:42,880
Speaker 2: Yeah, he's so strong. I don't even think I would

607
00:33:42,880 --> 00:33:45,120
Speaker 2: be able to do what he did. I don't think

608
00:33:45,200 --> 00:33:49,720
Speaker 2: I would have the strength and the positiveness that he has.

609
00:33:49,920 --> 00:33:52,800
Speaker 2: He wanted to share with the kids, he wanted to

610
00:33:52,840 --> 00:33:55,960
Speaker 2: see them. He went for years just trying to see

611
00:33:55,960 --> 00:33:59,040
Speaker 2: how they progressed and trying to share his story and

612
00:33:59,080 --> 00:34:02,200
Speaker 2: tell them that they're going to be okay. And he's

613
00:34:02,240 --> 00:34:03,400
Speaker 2: a really strong person.

614
00:34:04,120 --> 00:34:09,640
Speaker 4: So if your health struggles depleted you after getting diagnosed,

615
00:34:09,880 --> 00:34:13,920
Speaker 4: involving yourself and that community was what replenished.

616
00:34:13,280 --> 00:34:16,280
Speaker 5: You one hundred percent. It gave me a community.

617
00:34:16,920 --> 00:34:18,840
Speaker 1: It gave me friends that I still have to this

618
00:34:18,960 --> 00:34:23,320
Speaker 1: day that again could just really understand everything because they're going.

619
00:34:23,120 --> 00:34:25,600
Speaker 5: Through it themselves or have been through it themselves.

620
00:34:26,120 --> 00:34:28,160
Speaker 1: I've been with the cons and Clients Foundation as a

621
00:34:28,200 --> 00:34:30,640
Speaker 1: full time employee for the better part of the last

622
00:34:30,680 --> 00:34:33,880
Speaker 1: eight years now, which I'm again just extremely extremely grateful

623
00:34:33,920 --> 00:34:36,520
Speaker 1: for so so many pieces, Like I look back on

624
00:34:36,560 --> 00:34:38,480
Speaker 1: it and it was one of the worst things that

625
00:34:38,520 --> 00:34:40,239
Speaker 1: have ever happened to me, ended up being such a

626
00:34:40,239 --> 00:34:43,759
Speaker 1: blessing because it's created the career that I have that

627
00:34:43,880 --> 00:34:47,239
Speaker 1: allows me to support myself and live the life that

628
00:34:47,239 --> 00:34:49,120
Speaker 1: I want to live and help my family however I

629
00:34:49,160 --> 00:34:51,840
Speaker 1: can help them and be there, so like, I honestly

630
00:34:51,840 --> 00:34:53,879
Speaker 1: don't know what my life would look like today if

631
00:34:53,880 --> 00:34:57,680
Speaker 1: it wasn't for all of those experiences occurring the way

632
00:34:57,719 --> 00:34:58,680
Speaker 1: they happened.

633
00:34:59,480 --> 00:35:03,560
Speaker 3: His ability to give hope, his ability to counsel and

634
00:35:03,719 --> 00:35:07,200
Speaker 3: celebrate the wins for other patients, being able to look

635
00:35:07,239 --> 00:35:10,640
Speaker 3: back and reflect and one what he's doing. It's just incredible,

636
00:35:10,760 --> 00:35:13,280
Speaker 3: and I'm so proud of the work that he's doing,

637
00:35:13,680 --> 00:35:15,640
Speaker 3: and he knows he's making an impact, and I know

638
00:35:15,680 --> 00:35:18,560
Speaker 3: he's making a real impact both in other patients and

639
00:35:19,200 --> 00:35:20,040
Speaker 3: for himself too.

640
00:35:20,960 --> 00:35:24,879
Speaker 4: In what ways do you think watching him box did

641
00:35:24,920 --> 00:35:25,279
Speaker 4: help you?

642
00:35:26,120 --> 00:35:30,440
Speaker 2: That's a tough question. I guess the boxing, I'm worried

643
00:35:30,440 --> 00:35:33,279
Speaker 2: that he's going to get hurt. You're right, but you

644
00:35:33,280 --> 00:35:37,040
Speaker 2: can stop it. But with the disease, you can't stop it.

645
00:35:37,200 --> 00:35:39,520
Speaker 2: You can't run away from it. You just have to

646
00:35:39,760 --> 00:35:43,239
Speaker 2: cope with it and be strong and just go on

647
00:35:43,400 --> 00:35:44,239
Speaker 2: with it.

648
00:35:45,200 --> 00:35:48,440
Speaker 4: What do you want people listening to take from your story?

649
00:35:48,840 --> 00:35:51,760
Speaker 5: Always have faith and hope.

650
00:35:52,239 --> 00:35:54,600
Speaker 1: This is going to sound super cliche, but an attitude

651
00:35:54,600 --> 00:35:57,279
Speaker 1: of gratitude goes a really long way to really be

652
00:35:57,320 --> 00:35:59,920
Speaker 1: grateful for what you have and even if you're a

653
00:36:00,239 --> 00:36:04,600
Speaker 1: bad situation, do the best you can to learn and

654
00:36:04,800 --> 00:36:07,680
Speaker 1: look for help and resources and support, like never be

655
00:36:07,760 --> 00:36:10,279
Speaker 1: too proud to do that, and just do what you

656
00:36:10,320 --> 00:36:12,799
Speaker 1: can and just never give up hope there could be

657
00:36:12,840 --> 00:36:14,680
Speaker 1: a way where you could change your situation.

658
00:36:17,320 --> 00:36:20,200
Speaker 4: You can find out more about both Crones and Colidis

659
00:36:20,239 --> 00:36:24,839
Speaker 4: at the Crones and Colidis Foundation website at Cronescalidisfoundation dot org,

660
00:36:25,239 --> 00:36:28,440
Speaker 4: where you might also come across some of Jose's work.

661
00:36:33,320 --> 00:36:34,640
Speaker 5: My name is Jose Tares.

662
00:36:34,760 --> 00:36:38,120
Speaker 1: It took me about a year to get my proper

663
00:36:38,120 --> 00:36:42,800
Speaker 1: diagnosis of all sort of colitis and three surgeries later

664
00:36:43,000 --> 00:36:46,520
Speaker 1: in over a decade. Now I'm fortunate enough to have

665
00:36:46,600 --> 00:36:48,760
Speaker 1: no symptoms and be living a normal life.

666
00:36:50,840 --> 00:36:54,480
Speaker 4: On next week's episode of Symptomatic, Kelly Dubois is suddenly

667
00:36:54,520 --> 00:36:59,280
Speaker 4: confronted with severe heartburn, rapid weight gain, and appealing scalp,

668
00:36:59,680 --> 00:37:03,120
Speaker 4: leading her on a confusing path that even led to

669
00:37:03,200 --> 00:37:04,000
Speaker 4: brain surgery.

670
00:37:04,960 --> 00:37:07,839
Speaker 9: I looked up and I saw my neurosurgeon, and he's

671
00:37:07,880 --> 00:37:10,279
Speaker 9: asking me the questions like you see on TV when

672
00:37:10,280 --> 00:37:13,640
Speaker 9: you know something really bad happen? Do you know your name?

673
00:37:14,360 --> 00:37:16,880
Speaker 9: Do you know what year it is? And do you

674
00:37:16,960 --> 00:37:21,680
Speaker 9: know who's the president? And I've struggled to speak.

675
00:37:21,880 --> 00:37:25,040
Speaker 4: But when brain surgery leaves her with irreparable damage and

676
00:37:25,080 --> 00:37:28,759
Speaker 4: without much relief, she becomes desperate for answers to what

677
00:37:29,040 --> 00:37:35,759
Speaker 4: really is going on. As always, we would love to

678
00:37:35,800 --> 00:37:38,520
Speaker 4: hear from you. Send us your thoughts on this episode

679
00:37:38,680 --> 00:37:41,879
Speaker 4: or share a medical mystery of your own at Symptomatic

680
00:37:42,320 --> 00:37:47,080
Speaker 4: at iHeartMedia dot com and please rate and review Symptomatic

681
00:37:47,120 --> 00:37:50,279
Speaker 4: wherever you get your podcasts. We'll see you next time.

682
00:37:50,520 --> 00:37:54,960
Speaker 4: Until then, be well. Symptomatic is a production of Ruby

683
00:37:55,040 --> 00:37:58,360
Speaker 4: Studio from iHeartMedia. Our show is hosted by me Lauren

684
00:37:58,360 --> 00:38:03,160
Speaker 4: Bret Pacheco. Execroducers are Matt Romano and myself. Our EP

685
00:38:03,320 --> 00:38:07,440
Speaker 4: of post production is James Foster. Our supervising producer is

686
00:38:07,480 --> 00:38:11,640
Speaker 4: crra Kaiser. Our writers are John Erwin and Diana Davis,

687
00:38:12,000 --> 00:38:21,000
Speaker 4: and our editor is CR Spreen. I'm Cindy Lauper with

688
00:38:21,080 --> 00:38:24,520
Speaker 4: fellow Concentics Advocate chef Michelle Bernstein.

689
00:38:24,800 --> 00:38:28,719
Speaker 6: We'll share our experiences with plaque sariases with soriatic arthritis,

690
00:38:28,719 --> 00:38:31,600
Speaker 6: and doctor Panico will talk about the possible.

691
00:38:31,120 --> 00:38:33,000
Speaker 5: Connection Cocentic sec you can you.

692
00:38:33,000 --> 00:38:35,319
Speaker 7: MAB is prescribed for adults with moderate to severe plack

693
00:38:35,400 --> 00:38:38,040
Speaker 7: sorias as three hundred milligram dose and adults with active

694
00:38:38,080 --> 00:38:40,920
Speaker 7: soriatic arthritis one hundred and fifty milligram dose. Don't use

695
00:38:40,960 --> 00:38:43,719
Speaker 7: if you're allergic to cocentics. Before starting, get checked for TB,

696
00:38:44,000 --> 00:38:47,000
Speaker 7: serious allergic reactions, severe skin reactions that look like ecima,

697
00:38:47,000 --> 00:38:49,520
Speaker 7: and an increased risk of infections. Some fatal have occurred.

698
00:38:49,600 --> 00:38:51,799
Speaker 7: It may lower your ability to fight infections, so tell

699
00:38:51,840 --> 00:38:55,799
Speaker 7: your doctor if you have an infection or symptoms like fevers, sweats, chills, muscle, eggs,

700
00:38:55,880 --> 00:38:57,719
Speaker 7: or cough, How do to vaccine or plan to or

701
00:38:57,760 --> 00:39:01,200
Speaker 7: if IBD symptoms Developer Warson learn more at one eight

702
00:39:01,239 --> 00:39:04,320
Speaker 7: four four Conthentics, orcocentics dot com, slash chef Michelle