Category: Health x Body

You can’t turn on the television without seeing a Viagra commercial. You know the ones: An older man and a woman who is noticeably younger end up in the bedroom after a date, all thanks to Viagra. Or maybe you recognize the commercials for Cialis: two older adults holding hands…while sitting in separate bathtubs. Every time one of those commercials comes on, I wonder when we’ll see a commercial for female Viagra.
I’m still waiting on the commercial, but it turns out that the future is now: Female Viagra is a real thing. Well, kind of.
Surprised? Me too. I had no idea that a female libido enhancer had been on the market, let alone for almost three years. But does it work? Here’s what I found out.

What is “female Viagra”?

Viagra is the trade name of the drug sildenafil citrate, which treats erectile dysfunction by increasing blood flow to the penis so that a man can get and maintain an erection during sex.
Recently, Addyi (the brand name of the drug flibanserin), has been nicknamed “female Viagra,” because it’s the first-ever pharmaceutical treatment for women’s sexual dysfunction.
[pullquote align=”center”]“The days of marginalizing women’s sexual dysfunction are numbered.”[/pullquote]
But as it turns out, Addyi has little in common with Viagra. While Viagra treats a physical problem by stimulating blood flow, Addyi treats women’s sexual dysfunction by actually altering your brain chemistry.
According to a clinical review of flibanserin, women’s sexual desire is affected by many things: hormonal changes, psychological factors like stress, and comorbidity of other medical conditions, to name a few. (But we already knew that…)
Originally, flibanserin was created to increase serotonin levels in patients with major depressive disorder, but during clinical trials, female patients reported increased libido as a side effect. Based on further clinical trials specifically testing the drug’s effect on women’s libido, flibanserin was approved by the FDA in 2015 under the trade name Addyi to treat women’s sexual dysfunction.
Addyi, which is created and manufactured by Sprout Pharmaceuticals, is now marketed and prescribed for pre-menopausal women who suffer from hypoactive sexual dysfunction disorder (HSDD). HSDD is classified as a chronic lack of interest in sex, and it affects as many as one in 10 women.
Sexual desire isn’t just governed by hormones or stress levels; our libido is also impacted by the neurotransmitters dopamine and norepinephrine, which increase sexual desire, and serotonin, which inhibits desire. It’s not yet fully understood, but when your brain transmits too much serotonin, your libido can drastically drop.
Addyi works as a serotonin modulator to increase the flow of dopamine and norepinephrine while reducing serotonin levels to increase libido and sexual desire in women.

Sildenafil, aka Lady Era

There’s another drug on the market that you may come across if you google “ladies Viagra,” “female Viagra,” or a similar search term, and this one actually is female Viagra.
It’s called Lady Era, and it’s the trade name of the women’s version of sildenafil. Sildenafil treats women’s sexual dysfunction in a way that’s similar to what Viagra does for men: It increases blood flow to the genital area. In men, this results in an erection, and in women, sildenafil may help increase lubrication and sensation during sex.
Before you buy Lady Era, though, you should know that it’s not FDA approved. Addyi is the only drug currently approved by the FDA to treat female sexual dysfunction.

Does Addyi work?

“In the face of scientific evidence, the days of marginalizing women’s sexual dysfunction are numbered,” Cindy Eckert, CEO of Sprout Pharmaceuticals and founder of The Pink Ceiling, tells HealthyWay. “Addyi will be a key factor to leveling the playing field by cutting through that unscientific societal narrative to a data-driven discussion.”
But exactly what does the science say?
According to preliminary drug trials (which were annoyingly named after flowers, because you know, we’re women) that were conducted in 2012, Addyi increased the number of satisfying sexual events (SSE) participants had and decreased their distress caused by sexual dysfunction.
[related article_ids=1002508]
But when you break down those numbers, the little pink pill may not be the cure-all for women’s sexual dysfunction it claims to be. A more recent 2016 study found that while, technically, women do report more SSEs per month while taking Addyi, the number of SSEs participants experienced only increased by an average of 1.5 times per month—while also increasing associated side effects like dizziness, nausea, and fatigue.

Side Effects of Flibanserin

Since flibanserin was initially created as a drug for major depressive disorder, it’s not surprising that women taking flibanserin for sexual dysfunction experience many of the side effects associated with selective serotonin reuptake inhibitors (SSRIs). Those include dizziness, nausea, somnolence (excessive sleepiness), fatigue, and dry mouth.
But women taking flibanserin can also experience more serious side effects, most notably hypotension and syncope, especially if flibanserin is combined with alcohol or some antifungal medications. In fact, Addyi comes with a black label that warns women to avoid all contact with alcohol while taking the drug. For a drug that is supposed to be taken every day, that’s a pretty tough pill to swallow (excuse the pun).
Because Addyi has only been FDA approved for three years, perhaps the biggest risk of taking flibanserin daily is that the long-term side effects on your brain and body aren’t yet known. But research is promising that Addyi, while incompatible with alcohol, may be safe to take in combination with other serotonin modulators.

Why Addyi Is Important (Despite Efficacy Rates)

HSDD is now grouped under Female Sexual Interest/Arousal Disorder (FSIAD) in the Diagnostic and Statistical Manual of Mental Disorders (DSM) that mental health professionals use to help diagnose patients. And that’s a big deal for a couple of reasons.
[pullquote align=”center”]“Ultimately, Addyi is giving women the same access to medication that men have had for decades to treat their sexual dysfunctions.”[/pullquote]
Even though HSDD and subsequently FSIAD were introduced in the DSM three decades ago, little progress has been made toward actually treating the condition. That’s why a drug like Addyi is so important, says Eckert.
“Addyi is a groundbreaking first. For the millions of premenopausal women who have distressing low sexual desire, finally there is an FDA-approved treatment option,” says Eckert. “Addyi has opened the doors to a conversation on what’s happening for women in the bedroom biologically that, until now, has been loaded with myth and misconception. Ultimately, Addyi is giving women the same access to medication that men have had for decades to treat their sexual dysfunctions.”
And despite concerns over efficacy, Eckert says that the number of satisfying sexual events women have while taking Addyi is an average, and that the number of satisfying sexual events many women who responded positively to Addyi was much higher. “Many responders had four to six more [satisfying sexual] events,” Eckert asserts. “Regardless of that nuance, and this I want to say empathically, it’s HER CALL. For a woman who is struggling with the life impact of HSDD, just one more event can be profoundly meaningful. Women all over the country have shared their stories with me, and it’s their inspiration that fuels me to keep fighting for Addyi to be accessible to any woman who needs it.”
Eckert is right; the pink pill may not be right for every woman struggling with sexual dysfunction. But Addyi has not only started a conversation about women’s sexual health that should have begun decades ago, but it has also given women a choice when it comes to their own sexual desire (or lack thereof). And that is something every woman can get behind.
[related article_ids=17847]

There was no name for orthorexia when Lisa Fogarty started showing the signs of the eating disorder as a young tween. “I gave up eating foods with sugar when I was 12,” Fogarty recalls. “I lost a little weight and got positive attention for it, so I kept going. I remember loving how it felt to not feel full, so I gradually restricted more and more until I was skipping meals and labeling a lot of foods, including carbs and veggies like sweet potatoes, as bad.”
Most of us associate some foods with being inherently “bad” for our bodies—after all, no one is eating a platter of brownies expecting it to make us healthier. But people with orthorexia don’t just categorize some food as “bad” and some as “good”: They’re preoccupied with the differentiation, and they eschew the “bad” and only eat the “good.” Put more simply, people with orthorexia are obsessed with healthy eating—to the point of what doctors call disordered eating (which commonly includes having an eating disorder).
After dire warnings about the childhood obesity crisis in the aughts, Americans have slowly but surely come around to the idea that a nutritious diet is crucial to our overall health. Spend more than a few minutes on any social media site, and you’re bound to run into a slew of posts about eating healthy: Raw food. Clean eating. Farm-to-table. Whole30. Non-GMO.
Surely those people are just trying to make good choices for their bodies, right? Well, most of them are!
But what happens when you go from eating healthy so you can sustain your body and mind to allowing healthy eating to become an obsession? How do you go from a diet that’s designed to keep your heart muscles happy and your mind sharp to a therapist’s office and a diagnosis of orthorexia?

What is orthorexia?

In 1997, a name appeared for the restricted diet that’s followed Fogarty and thousands like her into adulthood. That’s when Steven Bratman, MD, a physician from Fort Collins, Colorado, wrote an article in Yoga Journal that changed the face of the eating disorder discussion in America and around the world. It’s believed to be the very first time the term “orthorexia” was written down.  
Titled “Health Food Junkie,” the article centered around Bratman’s premise that healthy eating can be good for you, but it can also become an unhealthy obsession.
“Many of the most unbalanced people I have ever met are those who have devoted themselves to healthy eating,” Bratman wrote at the time. “In fact, I believe some of them have actually contracted a novel eating disorder for which I have coined the name ‘orthorexia nervosa.’ The term uses ‘ortho,’ meaning straight, correct, and true, to modify ‘anorexia nervosa.’ Orthorexia nervosa refers to a pathological fixation on eating proper food.”
How does someone end up, as Bratman described in 1997, “dominated by efforts to resist temptation, self-condemnation for lapses, self-praise for success at complying with the chosen regime, and feelings of superiority over others less pure in their dietary habits”?
The experts say orthorexia has direct ties to other eating disorders (such as anorexia, bulimia, or binge eating disorder) and the risk factors inherent in them all.

Signs of Orthorexia

Of course, just because you love kale smoothies and could live the rest of your life without ever eating an Oreo doesn’t mean you’re orthorexic. Some people have better dietary habits than others, and just about every medical practitioner out there will tell you to eat a nutritious diet as often as possible.
“Orthorexia is defined as an ‘unhealthy obsession’ with healthy eating, a term which literally means ‘fixation on righteous eating,’” says licensed marriage and family therapist Ashley Moser, site director at the Renfrew Center, an eating disorder treatment facility in Charlotte, North Carolina.  
Here’s how Moser says you can tell if you (or a loved one) might be crossing the line into an obsession with healthy eating:

• Compulsively checking of ingredient lists and nutrition labels
• Refusal to eat foods labeled as “unhealthy” or processed
• Showing high levels of distress when “healthy” foods are unavailable
• Variety of foods eaten becomes fewer and fewer
• Increased social isolation and eating alone

Typically folks who battle orthorexia have similar risk factors to those who battle other eating disorders, says Lauren Smolar, director of programs at the National Eating Disorders Association (NEDA). She divides those risk factors into three categories: Social pressures, psychological risk factors, and/or biological predispositions.
For example, someone with a family member who has (or had) an eating disorder might have a biological predisposition to disordered eating, whereas someone who struggles with weight stigma or teasing and bullying might have social pressures that increase their risk of an eating disorder, including orthorexia.
From a psychological standpoint, issues such as body image dissatisfaction and a personal history of an anxiety disorder can up one’s risk for an eating disorder such as orthorexia.
What’s more, there are typically what doctors call comorbidities that come along with orthorexia. That means that you can have two (or more) conditions at the same time. With orthorexia, that typically involves other eating disorders as well as an anxiety disorder and/or obsessive–compulsive disorder (OCD), Smolar says. OCD in particular is often found in folks with orthorexia, but because orthorexia isn’t an “official” diagnosis, there is little research on why the two crop up together so frequently.

Diagnosing Orthorexia: How does it work?

If you look at the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (more commonly known as the DSM-5), you won’t find orthorexia nervosa listed.
The DSM-5 is the diagnosing manual used by the American Psychiatric Association, which declined to add orthorexia as its own diagnosis in its most recent edition.
So does that mean orthorexia doesn’t exist as anything more than a word thrown out by Bratman once upon a time?
Not at all, says Thom Dunn, PhD, a professor of psychological sciences at the University of Northern Colorado who has committed much of his time to researching orthorexia.
Although orthorexia isn’t in the DSM, neither was binge-eating disorder before 2013, “although it was widely acknowledged that it existed before then,” Dunn tells HealthyWay.
Researchers like Dunn have found conclusive evidence that orthorexia is real, and professionals in the eating disorder field—such as the folks at NEDA—do recognize orthorexia as something that can not only occur with other disordered eating conditions but is a separate condition in and of itself.
[pullquote align=”center”]“The irony is that people are being unhealthy in their pursuit of being strictly healthy.”
—Thom Dunn, PhD[/pullquote]
What sets orthorexia apart from other eating disorders is an obsession with being “healthy” that takes someone to the point of actually being the exact opposite.
“For some people, their desire to be healthy becomes all consuming and it starts to affect their ability to live their lives,” Dunn explains. “For some, they get malnourished. The irony is that people are being unhealthy in their pursuit of being strictly healthy.”
So, if orthorexia isn’t an “official” diagnosis, how can someone be diagnosed with it?
Often, patients aren’t—at least not where health insurance companies are concerned.
“Most often these people get an anorexia diagnosis since they are underweight,” Dunn says. That can be enough to trigger a health insurance company to start paying for treatment. If not, practitioners like Dunn may diagnose someone with “other specified feeding or eating disorder” (OSFED), which is in the DSM.
For Fogarty, that’s exactly what had to happen. Now 40, she spent her twenties and thirties drifting in and out of therapy for anorexia; it was at age 34 that a therapist and nutritionist both told her that she had “orthorexic tendencies” and began treating her for her food-related obsessions in addition to her tendency to starve herself.
She works with a nutritionist now to help develop the skills she needs to vary her diet. “The biggest obstacle I have is overcoming the fear of new foods or foods that I still associate as bad,” Fogarty says, “like taco shells or white pasta. The recent campaign against carbs really screwed with my head a bit, I admit.”

Orthorexia Treatment and Recovery

For those who have extreme orthorexia that has caused them to become malnourished, hospitalization may be required. After all, Moser says, while it’s sometimes referred to online as the “good eating disorder,” there’s nothing positive about restricting your food intake to the point of getting sick.
And someone with orthorexia can get very sick. “Some of the risks include medical complications from malnutrition, which affects every organ system in the body,” Moser points out.
It’s a fact Fogarty knows all too well. When she was 21, she was slated to enter a hospital and be force-fed food, which is what first prompted her to seek treatment.
Fogarty has been trying to make treatment work for nearly 20 years. That’s because there is no quick cure for an eating disorder. Often recovery begins with treatment—be it hospitalization or intensive, outpatient therapy—and turns into living in recovery.

Living With Orthorexia

It’s partly because of the near constant and often contradictory headlines about what different foods will do to our bodies (butter’s healthy—no, it’s not—wait, yes, it is!) that orthorexia recovery can be so difficult.
While an alcoholic may be able to steer clear of bars and ask their friends to throw booze-free bashes, we can’t ignore all the news or stay away from the grocery store and its human-sized displays touting the purported benefits of the latest health craze.
[pullquote align=”center”]“It is important to provide education on balanced eating and approach food with a more neutral stance of ‘all foods fit.’”
—Ashley Moser, LMFT[/pullquote]
That’s why orthorexia treatment focuses not just on therapy but on forming a healthier relationship with food.
“It is important to provide education on balanced eating and approach food with a more neutral stance of ‘all foods fit,’” says Moser. “It’s helpful to remember these messages when faced with societal pressure to eat healthy.”
If you’re struggling to develop a food plan without falling back on old habits, set up an appointment with a nutritionist. They can help you map out meals that are healthy—both in the sense of giving your body the nutrition it needs and in the sense of stretching beyond orthorexic tendencies. You may also want to start a food journal, which you can review and/or share with your nutritionist on a regular basis to ensure you’re actually meeting your nutrition goals rather than denying yourself.
You can also work with a nutritionist to set goals that test the bounds of what you’ve come to consider as “safe” and “okay” foods. For example, Fogarty has been challenged by her nutritionist to eat dessert at least once or twice a week with her family.
“That’s hard,” she admits. “But my nutritionist is trying to make me understand that the things I think will happen, like losing control or gaining 10 pounds overnight, won’t happen when you just let go of some of these fears. It’s an ongoing process and it takes therapy and nutritional counseling.”
Not sure where to begin? That’s okay. Call the NEDA support line at 800-931-2237 or look into their online chat options to talk to someone on their team.

Going to therapy can be tough.
That’s an understatement. There’s a great deal of stigma surrounding therapy and mental health issues, accessing a therapist can be expensive, and sometimes your therapist doesn’t really gel with you.
Not to mention that it’s often difficult to talk about your experiences, thoughts, and fears.
I’ve seen therapists off and on from the age of 13. My first therapist was more harmful than helpful, and she barely helped me with my post-traumatic stress disorder symptoms at all. I was afraid of approaching a second therapist because my first experience was so unhelpful.
I’m glad that I eventually tried therapy again, because my second experience helped me a great deal. My new therapist used two kinds of therapy—cognitive behavioral and eye movement desensitization and reprocessing (EMDR)—which meant her approach was totally different from the first therapist. This approach helped me a great deal.
[pullquote align=”center”]If you discover that one type of therapy doesn’t seem to be helping you, don’t be put off therapy altogether.[/pullquote]
It’s important to realize that different therapists will have different approaches to therapy. In part, this is because they each have their own areas of interest and expertise. It’s also because there are a number of types of therapy out there. Many psychotherapists are trained in more than one kind of therapy, and some may use a blend of different methods to treat you. Some types of therapy might work for you, and others won’t. It’s a matter of finding something that suits you.
If you discover that one type of therapy doesn’t seem to be helping you, don’t be put off therapy altogether. Consider seeing another therapist or pursuing another kind of therapy; it might just pleasantly surprise you.

What types of therapy are there?

There are numerous types of therapy, and while we can’t cover them all here, we can discuss some of the most common types of therapy.

Client-Centered Therapy (CCT)

Also known as person-centered therapy, client-centered therapy is a widely used form of therapy that was first conceptualized in the 1940s. The idea behind CCT is to constantly remember that the client is a person and that we have the power to heal ourselves—we just need a little support. The therapy focuses on the client; the therapist is there primarily to listen and empathize. While the therapist can give a little guidance, they encourage the client to make their own decisions and work through their own feelings.

Cognitive Behavioral Therapy (CBT)

Another fairly common type of therapy, cognitive behavioral therapy focuses on changing your thought patterns to help you develop healthier patterns of behavior.
“Cognitive behavioral therapy revolves around the principle that our feelings result from our thoughts and that therefore the best way to improve how you feel is to work on changing your thoughts,” says Raffi Bilek. Bilek is a licensed clinical social work counselor and director of the Baltimore Therapy Center, as well as the director of the Montgomery County Abuse Intervention Program in Maryland. “This kind of therapy is usually practical, concrete, and directed.”
Olivia Djouadi, a licensed psychotherapist and counselor, often uses the image of a triangle to help her clients navigate certain experiences. The three points of the triangle represent thoughts, feelings, and behavior, all of which she examines when helping a client work through an experience.

Dialectical Behavior Therapy (DBT)

Dialectical behavior therapy (DBT) includes helping the client change their behavior by developing new skills. These skills could include mindfulness, positive social skills, regulating your emotions, and tolerating distressing situations.
If you’re prone to self-destructive behavior, or if you struggle with regulating your emotions, this could be a great form of therapy for you. Although DBT was originally used to treat people with borderline personality disorder, substance abuse issues, and/or suicidal thoughts, it’s also effective for a range of other mental health issues. Studies suggest that DBT can be helpful in eating disorder treatment, particularly for binge-eating disorder and bulimia.

Eye Movement and Desensitization Reprocessing Therapy (EMDR)

According to the EMDR International Association (EMDRIA), this type of therapy is helpful in processing trauma. If the memory of a trauma is greatly upsetting to you, EMDR can help you process the experience. This form of therapy can also be used to treat a range of other mood and personality disorders.
An EMDR session might seem different from most types of talk therapy. In my case, my therapist would tap one knee and then the other while I had to imagine and recall the details of traumatic experiences. While this was hard, it ultimately helped.
EMDRIA notes that the movement of the eyes during EMDR is like what happens when we dream. Our eyes move back and forth, which is why the dreaming phase of sleeping is called rapid eye movement or REM. We know that dreaming is important for storing and processing information, and it is thought that EMDR elicits a similar process.

Mindfulness-Based Cognitive Therapy

Mindfulness-based cognitive therapy (MBCT) can blend mindfulness practices with CBT. “Mindfulness broadly refers to the practice of being aware of your feelings, thoughts, and sensations in the present moment,” Bilek says. “This kind of therapy is aimed at helping you develop the skill of mindfulness, which can help you gain more control over your experience and thereby better achieve your goals.” Mindfulness-based therapy can also include using meditation and breathing exercises as tools.
“It slows down the thinking patterns and can help people focus on the situation they have been through and start to accept what has happened,” Djouadi says. “Before discussing any trauma, I connect a client with a safe object, which may be a good memory or their phone. Some clients might not have ever had a safe feeling so I slowly introduce what one may be,” she explains. This exercise helps to ground them and help them feel safe.
Studies have found that mindfulness-based therapy is effective in treating depression as well as bipolar disorder and anxiety disorders.

Play Therapy

Talking about your feelings and past experiences isn’t always easy, so expressive forms of therapy like play therapy can be useful. Djouadi says that play therapy, while often used with children, can also be used to treat adults. “I use play therapy when clients struggle with dissociation, as it begins to heal the developmental areas that were affected by early trauma,” she says.

Which type of therapy is right for me?

As you can see, there are so many types of therapy out there that it can be hard to choose one. The important thing to remember is that there are many different approaches to therapy, and you can seek another therapist or a different kind of therapy if one doesn’t work for you.
[pullquote align=”center”]“The best therapy to go with is the one that resonates with you the most.”
—Raffi Bilek, LCSW[/pullquote]
The type of therapy that’s used to treat you will depend on your own needs; particular types of therapy are more suited to certain types of mental illnesses or emotional struggles.
“Research seems to indicate that the best therapy to go with is the one that resonates with you the most,” Bilek says. “Studies have shown that all therapeutic modalities are more or less equally effective, so long a there is a plausible theory behind it. This means that if you really like the idea of CBT, then that will work well for you, and if mindfulness is your thing, that can work well for you too,” he says. Experimenting with different types of therapy could be helpful.
You should always ensure that your therapist has a license to practice therapy. If you’re looking for a therapist who practices a specific type of therapy, ask what types of therapy they practice and what their relevant training is.
Bilek points out that it’s more crucial to make sure that you’re comfortable with your therapist than to look for a specific kind of therapy. “Far more important than the kind of therapy is the relationship you have with the therapist. So your best bet is to pick a therapist, meet with them, and see how you like them. If you don’t, try someone else,” he says. “You shouldn’t shop around forever between all the therapists in town, but you should feel free to try a couple until you find one you feel comfortable with.”
Opening up about your innermost feelings and life experiences can feel overwhelming, but fortunately there are many types of therapy available—and qualified therapists who are willing to help.

Tick bite symptoms are about as maddening as it can get. Sometimes they show up. Sometimes they decide to hide like an ostrich with its head in the sand.
And yet, everywhere you turn, there are warnings that getting bitten by a pesky tick can put you at risk for some serious diseases, including Lyme, the most rampant tick-borne disease of them all.
If you’ve been bitten by a tick or you’re wondering if one of those wily arachnids snacked on your skin, you’re probably searching for a rash that looks like a bullseye somewhere on your body. So what happens if you find one? And, for that matter, what happens if you don’t?

Tick Bite Symptoms: The Bullseye

The bullseye rash has become synonymous with tick bite symptoms ever since Yale University researchers first discovered Lyme disease and deer ticks—the critters spreading the infection—way back in the 1970s. The first cases of Lyme disease cropped up in and around Lyme, Connecticut (hence the name), where 51 residents were diagnosed with juvenile arthritis or arthritis of unknown cause. The more research scientists did, the more sure they were that the problem was the bite of the deer tick, or Ixodes scapularis.
Fast forward some 40 years, and the Centers for Disease Control (CDC) estimates 329,000 cases of Lyme disease now occur annually in the United States. The species of tick that makes people sick has spread from Connecticut to 14 states in the Northeast and upper Midwest, and they typically come out to bite people during the late spring, summer, and early fall (from about April to October).
As the tiny disease-carrying creatures have spread, the tick bite symptoms that doctors tell patients to look for have changed rather drastically too.  
The bullseye that was once known as a classic sign that someone has been bitten by a tick and was at high risk of contracting Lyme is no longer a given, says Bruce Robinson, MD, a clinical professor of dermatology at Lenox Hill Hospital in New York City and the creator of JAS, Just Amazing Skincare, a plant-based skincare collection.
“It can look like an ordinary mosquito bite,” Robinson says of a tick bite. “It can look like any version of a bite from a filled-in circle of red to a bullseye.”
In fact, Robinson finds that many patients show up thinking they have a “new mole,” only to find out that the new spot on the body is actually a tick bite.
Even more confounding? Different bodies react differently to tick bites, says David Claborn, doctor of public health and director of the master of public health program at Missouri State University. Your tick bite symptoms might include itching. Your friend’s tick bite symptoms might involve pain. But each of you could have been bitten by the same little critter!
“Much depends on the body’s reaction to the bite,” Claborn explains. “Allergic reactions can cause a great deal of discomfort—or worse. If the person has pulled the tick off, the tick’s mouthparts may have been left in the bite site and these can fester up.”

Why Tick Bites Are So Dangerous

Being bitten by a tick is unpleasant. It can itch. It can cause pain, and for some people, diseases and other conditions can set in.
For example, Claborn says, if the tick is feeding near the spinal cord or base of the brain, a type of paralysis called tick paralysis can occur. This usually resolves quickly after the tick is removed or drops off. Another condition linked to tick bites causes an allergy to red meat, Claborn says, although the full explanation for how this allergy develops is not yet known.
There’s also ehrlichiosis (a bacterial disease fairly common in parts of the U.S.), Rocky Mountain spotted fever, tularemia (a bacterial disease often associated with hunting rabbits that is actually transmitted by ticks) and diseases common to the Midwest caused by the Bourbon virus and the Heartland virus.
[pullquote align=”center”]“For some people, Lyme disease can go away on its own within several weeks, but for others, if not treated, Lyme disease can spread to the central nervous system, muscle and joints, eyes and heart.”
—Jack Cornwell, MD[/pullquote]
Finally, there’s  Lyme disease, the most common tick-borne illness in the U.S. Every year, approximately 30,000 cases of Lyme disease are reported to the CDC by state health departments and the District of Columbia, but the CDC estimates there are substantially more cases that go undiagnosed and thus unreported.
It’s Lyme disease that gets the most attention in part because it’s most prevalent but also because it has devastating effects for some people who don’t get treatment or aren’t treated in a timely manner.
“For some people, Lyme disease can go away on its own within several weeks,” explains Jack Cornwell, MD, medical director at CareWell Urgent Care, “but for others, if not treated, Lyme disease can spread to the central nervous system, muscle and joints, eyes and heart.”
“Everyone’s body reacts differently, and symptoms may vary in severity,” Cornwell continues, “but since Lyme disease can affect multiple systems, it’s important to see a doctor right away if you suspect it.”

When will tick bite symptoms show up?

What tick bite symptoms should you be looking for, and when should you be looking?
Unlike a bee that stings and flies off quickly or even a mosquito that lands, snacks, and flies away within seconds, ticks stick around on your body. An adult female tick can actually stay for as long as 7 to 10 days without being noticed, although nymphs (young ticks) or larvae (very young ticks) tend to feed off a subject for less than four days according to Robinson.
[related article_ids=1001374]
Some more good news here: In most cases, to transmit Lyme disease, a deer tick has to be attached to its host for 36 to 48 hours, Robinson says. Grabbing a tweezer and pulling that sucker off before it hits that point means you can usually stop potential infection before it sets in, although it’s still good to check in with your doctor as your estimate of how long the tick was attached may be off.
Gross? Yes.
But if you don’t notice a tick using you as a snack, don’t beat yourself up too hard. It happens, and it’s extremely common—hence the CDC’s warning that estimates of Lyme disease are on the low side. Ticks are tiny, even smaller than your pencil eraser, so you may or may not notice one on your body. And they like to move into warm, moist spots on the body, such as the crack of your butt or the fold between your leg and labia (or penis).
And even when they drop off, the signs that a tick has bitten you may not be immediate. Rashes may appear anywhere from 3 to 40 days after a bite, Robinson warns.
Even then, the rash only occurs in about 70 to 80 percent of the population. When it does, it will typically (but not always!) look like a bullseye or target that expands gradually over a period of days, spanning a diameter of 12 inches (30 cm) or more across.
You may also experience fever, chills, headache, fatigue, muscle and joint aches, and swollen lymph nodes. Any or all of these symptoms of a tick bite are reason to head to your doctor ASAP.
If Lyme isn’t caught early, it can progress to additional symptoms, including:

• Severe headaches and neck stiffness
• Additional rashes on other areas of the body
• Arthritis with severe joint pain and swelling, particularly the knees and other large joints.
• Facial palsy (loss of muscle tone or droop on one or both sides of the face)
• Intermittent pain in tendons, muscles, joints, and bones
• Heart palpitations or an irregular heartbeat (known as Lyme carditis)
• Episodes of dizziness or shortness of breath
• Inflammation of the brain and spinal cord
• Nerve pain
• Shooting pains, numbness, or tingling in the hands or feet
• Problems with short-term memory

Tick Bite Testing

Once you show up in the doctor’s office, they’ll examine your rash or bite mark—if you have one—and run some blood tests.
Unfortunately, even if you are tested for Lyme, as many as 60 percent of cases are missed by diagnostic testing, says Jo Ellis, director of education with Bay Area Lyme Foundation. And that’s even when doctors use the blood tests that are what Ellis calls the “gold standard” for diagnosing Lyme.
“As a result of the difficulty in diagnosing and treating Lyme disease, at least 500,000 Americans, and possibly up to one million, suffer from its debilitating later-stage symptoms,” Ellis says.
So what does that mean for you if you’ve been bitten by a tick? If you continue to experience any of the symptoms mentioned above, follow up with your doctor immediately. Sometimes performing the test at a later date may result in a positive.
Some doctors have now taken to treating patients prophylactically—aka without a confirmed diagnosis—if it can be confirmed that they were bitten by a tick (an attached tick or a bullseye rash are major indicators). But that means calling your doctor very quickly after a suspected tick bite, Cornwell notes.
[pullquote align=”center”]Many doctors’ offices and urgent care centers have the ability to send ticks out for testing for Lyme, which can help a doctor make the diagnosis even if a blood test is negative.[/pullquote]
“The window for taking prophylactic doxycycline, the medicine that decreases the likelihood that you develop Lyme disease, closes between 48 and 72 hours after infection,” he warns.
If you found the tick attached to your body and you were able to remove it with a pair of tweezers, you can stick it in a Ziploc baggie and bring it along to your doctor’s office for testing, although it’s not required.
“There is no way to know for sure if a tick is carrying Lyme disease or not unless the tick is tested,” Cornwell explains. Many doctors’ offices and urgent care centers have the ability to send ticks out for testing for Lyme, which can help a doctor make the diagnosis even if a blood test is negative.
This only works if the entire tick is intact, however, so Cornwell is quick to warn patients to pull gently with their tweezers so they can ensure they get the entire tick off the skin.
If the tick comes out in pieces, however, don’t stress yourself, especially if you’re not showing any symptoms!
“Plenty of laboratories offer to test ticks to determine whether they’re carrying any diseases. But that’s generally not worth your money,” Robinson notes, explaining that the tests can be $50 or more at some labs. “Even if the tick is infected with something, it doesn’t mean that it was able to transmit that infection, and if your tick comes back positive for Lyme disease or another infection, you probably won’t be treated unless you yourself start having symptoms.”

Don’t anger the tick!

Notice that the experts suggest grabbing a set of tweezers to remove a tick? No matter what you’ve seen on Pinterest or what your best friend swears her grandpa used to do to remove a tick, tweezers are the only doctor-recommended removal method for ticks.
“Common folk wisdom strategies for getting that tick to detach include holding a lit match toward it, smothering it with petroleum jelly or nail polish, and dabbing the spot with acetone or bleach,” Robinson says, but he’s quick to note that “all are questionable ideas!”
“With the lit-match strategy, you may just end up burning yourself, and while you might kill the tick, that won’t necessarily cause the tick to detach,” he warns. “ A dead tick is not going to come off any more easily than a live tick. As for the other methods above, even if they do work—and it’s not clear that they will—they may take long enough to allow a tick to pass on an infection.”
So grab the tweezers and grasp the tick as close to the surface of your skin as possible (this way you get the head as well as the body). Then firmly but steadily pull the tick directly backward from the bite site without twisting or jerking, Robinson suggests.
If there are still bits of the tick in the bite, use the tweezers to remove them as well. After everything’s gone, grab the rubbing alcohol and a cotton swab or a washcloth with soap and water, and clean the area to prevent additional infection of the wound.  

Don’t panic.

Although the number of Lyme cases in the U.S. has been trending upward and tick bites are not to be ignored, simply being bitten by a tick does not mean you will get sick.
“Only 2 percent of tick bites result in Lyme disease,” Cornwell says, “So while it’s important to be proactive, not every bite will result in an infection.”

Let me just make a few things clear right out of the gate. Accidents happen. It’s hard to remember to take a daily birth control pill, much less remember to take it at the same time each day. Condoms can break. You may have miscalculated your fertile time if you’re practicing natural family planning.
There are about a thousand different reasons you might need emergency contraception, and there are approximately zero reasons you should feel bad about purchasing it.
Even though some forms of emergency contraception have been available without a prescription for over a decade, misinformation about emergency contraception abounds. So, with the help of emergency contraception experts, we’re here to help set the record straight.
Here are the emergency contraception facts every woman (and frankly, every man) needs to know.

How Emergency Contraception Works

Emergency contraception can help prevent unintended pregnancy in a couple of different ways.
One of the most popular forms of emergency contraception is the morning after pill, which delivers a large dose of hormones designed to delay or prevent ovulation from happening. If you don’t ovulate, there’s no egg to be fertilized, meaning you can’t get pregnant.
Another method of preventing pregnancy through emergency contraception is through a copper IUD. Essentially, copper is toxic to sperm. So, when sperm try to swim toward their goal, the copper in your cervical mucus from the IUD kills the sperm.

How Emergency Contraception Works With Your Menstrual Cycle

Here’s a quick refresher on the menstrual cycle:
“Most women have a menstrual cycle that lasts around 28 days from the start of one period to the start of the next (a few are longer and some are shorter in length),” explains Melissa Grant, chief operating officer of carafem Health. “On average, most fertile women ovulate around day 14 of this cycle, meaning they release one egg cell during this time, and it survives about one day. If a fertile man’s sperm comes into contact with a woman’s reproductive tract (through the vagina, cervix, and uterus to the fallopian tubes) the sperm cells can live in her body for up to five days. This means even if a woman does not have sex on the day she ovulates, it is still possible for sperm and egg to join in conception if live sperm are still in her reproductive tract on the day she ovulates.”
This window of opportunity for pregnancy to occur is why Adeeti Gupta, MD, the founder of Walk In GYN Care, cautions women that while emergency contraception pills do work to prevent pregnancy, it’s hard for most women to accurately pinpoint their exact ovulation date to know whether or not they may become pregnant. “The menstrual cycle is helpful [in preventing pregnancy] only if your cycles are regular like clock work,” says Gupta. “However, this should not be used a gauge to decide when and whether or not you need to take emergency contraception.”
So, to recap: If you have unprotected sex around the time that you normally ovulate, you are at risk of becoming pregnant, even if it wasn’t on the exact day of ovulation.

When to Use Emergency Contraception

Luckily, there’s no guesswork involved in knowing when you should take emergency contraception.
“Emergency contraception can be used any time there is unprotected intercourse, unless you are already on birth control pills or have an IUD,” Gupta explains.
According to both Grant and Gupta, you can take emergency contraception at any time during your menstrual cycle and any time that you’re worried you might become pregnant after sex.
Even though most kinds of emergency contraception, like Plan B, are typically effective within 72 hours of intercourse (and others are effective for longer periods), both Grant and Gupta urge women to act quickly after unprotected sex to prevent an unintended pregnancy, and they say the claims that emergency contraception is as effective on day one as it is on day five isn’t completely true.
“It is variable. The efficacy also depends on the woman’s menstrual cycle, so it’s hard to predict,” Gupta says.
Still, research shows that all forms of emergency contraception should be taken as soon as possible after unprotected sex in order to be most effective.
And, if you were worried, this means that emergency contraception is not the same as having an abortion. I repeat: emergency contraception is NOT an abortion.
And if you’ve heard differently or are still unsure, take it from the expert:
“An abortion ends an established pregnancy,” explains Grant. “Emergency contraception pills work to prevent ovulation and have no effect on an ongoing pregnancy.”

Purchasing Emergency Contraception: A Guide

Now that you know the key facts about emergency contraception, here’s what you need to know about the most popular forms of emergency contraception available and how to purchase them.

The Morning After Pill

The “morning after pill” is a term that describes a couple different forms of emergency contraception pills. This type of emergency contraception contains hormones that help prevent ovulation.

Levonorgestrel

Levonorgestrel is a type of progestin, one of the hormones that affects your menstrual cycle and pregnancy.
Most levonorgestrel emergency contraception options, like Plan B One Step (one of the most popular name-brand types of levonorgestrel emergency contraception), are single-dose options that are most effective when they are taken as soon after intercourse as possible.
Levonorgestrel Effectiveness
When taken within 72 hours, levonorgestrel is 89 percent effective in preventing pregnancy. However, efficacy rates decline the longer you wait to take the pill; by day five, you’re five times more likely to become pregnant.
You should know that some research has shown that the morning after pill is slightly less effective in women with higher BMIs. In fact, one study showed that in women with high BMIs, pregnancy was three times more likely to occur despite using emergency contraception; if you have a BMI greater than 25, it’s recommended that you do not take levonorgestrel. If you have a high BMI, don’t despair: The two other methods of emergency birth control are shown to be more effective overall, even if you have a higher BMI.
Levonorgestrel Side Effects
Because levonorgestrel is a large dose of hormones, it’s normal to experience nausea or even vomiting as a side effect. If you do vomit after taking the morning after pill, Gupta advises following up with a second dose. Other common side effects are similar to how you feel during PMS: bloating, fatigue, breast tenderness, and cramping have all been reported.
Where to Buy Plan B One Step
Plan B (and generic forms of it) can be found in the family planning aisle of most drugstores, so anyone age 17 or older can purchase it without asking the pharmacist or having a prescription. That means your partner, your best friend, or a stranger on the street could purchase the morning after pill for you, no questions asked. You can also buy the morning after pill online through most retail pharmacies, but be aware that shipping times vary, and you may not receive the pill within 72 hours when it is likely to be most effective.

ella (Ulipristal Acetate)

Ulipristal acetate, known on the market as ella, is another type of morning after pill. Ulipristal acetate is a progesterone receptor modulator. Gupta explains that ella also works to delay ovulation, “but works through a different mechanism of action. It goes into the cells and blocks the progesterone receptor to prevent progesterone surges and hopefully ovulation.”
Ella Effectiveness
One of the best things about ella is that it can also be taken up to five days after intercourse, but unlike levonorgestrel-only pills, has even rates of efficacy as time goes on.
In addition, ella has been shown to be more effective in women with higher BMIs, but not failsafe. In one study of over 2000 women, a total of 1.9 percent became pregnant after using ulipristal acetate, but among obese women in the study, the rate of pregnancy while using this form of emergency contraception jumped to 8.3 percent.
Ella Side Effects
Side effects of ella are similar to the side effects of other morning after pills on the market. You may experience symptoms similar to those during PMS, but they should subside after a couple of days.
Where to Buy ella
Ella is currently only available with a prescription, but that usually doesn’t require a visit to your doctor. Usually, your physician can simply call the prescription in to your pharmacy, and in some states, you can even get the prescription straight from the pharmacist. With a prescription, ella can be ordered online and shipped to most states.

Copper IUD

A copper IUD is the most effective form of emergency contraception at 99 percent efficacy up to 120 hours of insertion, regardless of BMI. Plus, unlike the morning after pill, a copper IUD can continue to act as birth control, preventing pregnancy for five to ten years or until you decide to have the device removed.
It only takes about five minutes to insert a copper IUD, and the experience is about as uncomfortable as having a pap smear or colposcopy. A speculum is inserted into the vagina, and then your doctor will use a special tool to place the IUD into your uterus.
Copper is toxic to sperm, so they prevent fertilization of an egg from taking place. Even if you ovulate, the IUD prevents implantation by impairing sperm motility.

How much does emergency contraception cost?

The Affordable Care Act requires insurers to cover FDA-approved contraception methods (thanks, Obama!). That includes emergency contraception, but there are restrictions, so your insurance may or may not cover the cost of emergency contraception. The best way to find out if your insurance covers emergency contraception is to call them directly.
If you go with the morning after pill, like Plan B, which can be purchased at any pharmacy, you’ll likely be paying out of pocket, though insurance may cover some of the cost. Generic brands of levonorgestrel-only emergency contraception have the same rates of efficacy, but are generally a little bit cheaper. You can also save money by visiting the Plan B website directly, as they usually offer online coupons that can be redeemed in stores. Since ella requires a prescription, insurance is more likely to cover all or a portion of the $50 cost.
The best bet for insurance-covered emergency contraception is the IUD, since it requires an in-office doctor’s visit. Without insurance, an IUD can be pretty expensive (think between $500 and $1,000), but insurance brings that cost down considerably.
If you need emergency contraception, but money is tight, you do have options. Visit your local health department or Planned Parenthood to find out about your options for receiving free or low-cost emergency contraception.

I found out I am pregnant after I took emergency contraception. Will it hurt the baby?

Sometimes women find they’re pregnant despite taking emergency contraception. This might be because ovulation had already occured when you took emergency contraception, or the emergency contraception may have been taken incorrectly.
Copper IUDs are 99 percent effective at preventing pregnancy, but while it is extremely rare, pregnancy can occur if the IUD malfunctions or was inserted incorrectly. Even more rare are adverse outcomes if you do become pregnant with an IUD. That said, studies have shown that the risk of ectopic pregnancy and miscarriage are much higher in women who become pregnant with an IUD in place.
That’s not the case with other forms of emergency contraception, though. If you find out you’re pregnant after taking emergency contraception, research has shown that the morning after pill likely has little effect on fetal development.
In fact, a 2009 study of over 600 women in China found that there were no statistical increases in the risk of miscarriage or other adverse pregnancy outcomes when women were exposed to levonorgestrel-only emergency contraception after becoming pregnant.
This may be because most OTC emergency contraception contain high levels of common hormones similar to pregnancy hormones like progesterone. So how can progesterone both promote and prevent pregnancy?
“Yes, progesterone is one of the hormones that surges during pregnancy,” Gupta says. “However, if we give that hormone from external sources [like emergency contraception] then it works through a mechanism called feedback suppression and suppresses ovulation.”
Basically, progestin is a synthetic hormone used in emergency contraception that mimics progesterone but is manufactured to act on the bodies progesterone receptors in a desired way, which is the feedback suppression Gupta mentioned. Grant further explains, “One effect of the type of progestin in emergency contraceptive pills is to inhibit ovulation (stop the release of an egg cell). The most commonly available emergency contraception pill in the United States contains the progestin levonorgestrel.”

Frequently Asked Questions About Emergency Contraception

You asked, we asked the experts, they answered.

Does emergency contraception prevent STDs?

“No, emergency contraception does not prevent STDs,” says Grant. If you have unprotected sex, it’s always a good idea to get tested, just in case.

Is it safe to use emergency contraception more than once?

“Yes, emergency contraception is very safe, and can be used as needed,” says Grant. Unless you throw up immediately after taking the morning after pill, there’s no need to follow up with a second dose. Any time you have unprotected sex and are concerned about pregnancy, you may take emergency contraception.

Can you use emergency contraception as regular birth control?

“No, not at all,” says Gupta. “I do not recommend this method on a routine basis because it can cause irregular periods and high chance of unwanted pregnancy.”

Are you sure that emergency contraception isn’t the same as the abortion pill?

“Yes! They have completely different compositions,” Gupta explains. “Ella is similar in chemical composition but it’s used differently and at a different dose for abortion.”

Will emergency contraception affect my menstrual cycle?

Maybe. “Emergency contraception can sometimes delay the cycle and cause unpredictable bleeding in the subsequent cycles,” says Gupta.

Does emergency contraception hurt?

“No,” says Gupta. “You may get some cramps, but it shouldn’t hurt too much.” See the side effects above so you know what to expect!

Is it safe to use emergency contraception if I recently started hormonal birth control?

“Yes, if your hormonal birth control is not yet effective and there is a risk of ovulation, emergency contraception pills can be a good way to further reduce the risk of an unintended pregnancy,” Grant explains.

If you take two morning after pills is it twice as effective?

Sorry, but nope. Plus, according to Grant, “The effectiveness of taking more than one EC pill has not been widely studied. Current recommendations are to follow the package directions.”

My period started right after I had unprotected sex. Do I still need emergency contraception?

“Some women bleed in the middle of a menstrual cycle and others may ovulate even during a period,” Grant explains. “If you have had unprotected sex and want greater protection from pregnancy, you can take emergency contraception pills at any time during your cycle.”

I feel HORRIBLE after taking emergency contraception. When should I call my doctor?

You shouldn’t feel bad after taking emergency contraception. If you do, Gupta says, “Call or go the nearest GYN office/ER right away. Your doctor needs to rule out pregnancy, ectopic pregnancy, or anything else that may be serious.”

Does emergency contraception affect fertility?

According to Grant, “Emergency contraception pills only prevent ovulation at the time you take them. They do not offer long-term protection against pregnancy, and they do not impact future fertility.”

Should I feel bad about using emergency contraception?

“The choice about when and whether to become pregnant or have children is one that is best decided by the people involved,” Grant says. “Having children when you feel ready is something to feel good about!”

When Heather Sliwinski is out in public, people don’t see her as sick. The Crohn’s disease symptoms and side effects that can make living with the chronic condition debilitating at times are largely invisible.
“I’ve been sitting on the bus before on a bad day—in pain and sick—and told by a stranger that I shouldn’t be sitting, that I should give up my seat to someone else who needs it because I’m a younger, seemingly healthy individual,” the PR professional from San Francisco says. “What they couldn’t see is that I was in pain, sick, and terrified that I may have an accident. Who wants to tell a stranger that they have diarrhea to justify taking up a seat on the bus?”
An estimated 1.6 million Americans are walking around with some type of inflammatory bowel diseases (IBD), a classification that includes both Crohn’s and colitis. These diseases are typically diagnosed before someone hits their thirties, and they’re chronic. There is no cure for Crohn’s.
And yet, myths about Crohn’s disease, its symptoms, and what will happen to those diagnosed run rampant. Here’s what the experts say is really going on in the gastrointestinal tract of people like Sliwinski and what to do if you think you might be experiencing symptoms of Crohn’s disease.

What is Crohn’s disease?

Before you can consider whether or not you have Crohn’s disease, you need to know what Crohn’s disease is, right?
Ramona Rajapakse, MD, a gastroenterologist and director of the Inflammatory Bowel Disease Center (IBD) at Stony Brook Medicine, describes Crohn’s as an inflammatory condition of the gastrointestinal (GI) tract, the system of organs that stretches from the mouth all the way to the anus.
Although sometimes confused with colitis, which refers to an inflammation of the inner lining of the colon, Crohn’s disease is its own separate condition. Setting it apart from colitis are a number of factors, including the fact that Crohn’s can affect all layers of the bowel wall and can appear anywhere along the GI tract. What’s more, Crohn’s disease can do something doctors call “skip,” meaning there may be sections of the bowel affected by Crohn’s with perfectly healthy, normal tissue in between them.

What causes Crohn’s disease?

Despite the large numbers of Crohn’s sufferers in America, the cause of the disease still stumps doctors, says Meenakshi Bewtra, MD, a gastroenterologist and assistant professor of medicine at the Hospital of the University of Pennsylvania.
“We really don’t understand what causes Crohn’s disease (CD), but we currently believe it is an interplay between some unidentified environmental factor, a dysregulated immune system, a change in the gut microbiome, and some genetic factors,” Bewtra says. “Unfortunately, we haven’t figured out what any one of these are, let alone what combination causes CD.  So I try and also make sure that [patients know they] did nothing to cause this—either to themselves or to their children. They are not responsible for this.”
The one and only risk factor that doctors can point to is heredity: There’s a higher incidence of Crohn’s for people who have a family member with the disease. And yet, even having a parent, grandparent, or sibling with the disease is no guarantee that you’ll end up with a Crohn’s diagnosis, nor does everyone with Crohn’s have a family history to report to their doctor.
People with Crohn’s disease often ask Bewtra if the disease can be passed on to their children, and to that she says absolutely not.
“While there does seem to be some genetics at play, I caution against not having children if that is something a patient wants simply because they fear passing on CD,” she says. “There are plenty of children with CD who do not have parents with CD, and there are plenty of parents with CD who do not have children with CD.”

What are the Crohn’s disease symptoms to look for?

Crohn’s disease can be silent for a long time before someone, or their doctors, make the connection and reach a diagnosis. This is in part because symptoms vary from patient to patient, Rajapakse says.
When Amanda Semenoff was finally diagnosed with Crohn’s disease more than a decade ago, she realized the symptoms had been present and slowly creeping up for a long time.
“Diagnosis took more than two years, and my symptoms were pretty extreme by the time they figured it out,” the mediator from New Westminster, British Columbia, tells HealthyWay. In that time, Semenoff had lost more than 100 pounds and found herself too weak to climb stairs without lying down about halfway up to rebuild her strength.
Even now, she has fuzzy memories of those two years due to a perpetual brain fog, coupled with stomach ulcers, bleeding rectal fissures, and near constant vomiting.
For Sliwinski, the path to diagnosis was even longer and likewise fraught with complications.
“The onset of my symptoms was in 2010. I was managing, and I had been told by my primary care physician that I had irritable bowel syndrome (IBS), so I was used to having multiple bowel movements a day,” she recalls. “But it got to the point where I couldn’t finish a meal without having to run to the bathroom.”
A year after the onset of symptoms, she landed in the hospital with high fever, extreme abdominal pain, and diarrhea. When she noticed blood in her stool, Sliwinski says she knew there was something more than IBS going on. Still, it wasn’t until 2013 that she finally got the answer: Crohn’s disease.
While the effects of Crohn’s do vary from person to person, the Crohn’s & Colitis Foundation suggests keeping an eye out for the following Crohn’s symptoms:

• Persistent diarrhea
• Rectal bleeding
• Urgent need to move bowels
• Abdominal cramps and pain
• Sensation of incomplete evacuation (of your bowels)
• Constipation (can lead to bowel obstruction)
• Fever
• Loss of appetite
• Weight loss
• Fatigue
• Night sweats
• Loss of normal menstrual cycle

Although it’s typically diagnosed in one’s twenties or thirties, Crohn’s can show up in younger kids as well, and failure to grow is a major indicator, says Ashkan Farhadi, MD, a gastroenterologist at MemorialCare Orange Coast Medical Center and director of MemorialCare Medical Group’s Digestive Disease Project in Fountain Valley, California.

How is Crohn’s disease diagnosed?

Crohn’s can take months or even years to diagnose in part because it manifests itself differently from patient to patient. But it’s also a complex condition to diagnose, Farhadi says.
Crohn’s disease is diagnosed based on a series of tests. First, Farhadi says, there are clinical findings—basically examination by a doctor and review of your medical history. Next a potential Crohn’s patient will undergo imaging, be it CT scan or MRI. Typically an endoscopy—a procedure in which the digestive tract is viewed via a miniscule camera inserted into the tract (or sometimes swallowed by a patient)—will be done to give doctors a look at what’s going on in the GI tract. Finally, biopsies may be taken, and the tissues will be reviewed to determine if there’s inflammation or other issues.
In addition to the GI tract itself, a doctor may look at other parts of the body. That’s because Crohn’s disease is what Bewtra calls a full-body disease. “There are other parts of the body such as the eyes, liver, bones, etc. that can also be affected, sometimes even if the patient feels otherwise well,” she notes.

What happens if you’re diagnosed with Crohn’s disease?

A Crohn’s diagnosis is a major step to feeling better, but just how quickly you will get there depends on the severity of the disease.
Typically the first step is medication, Farhadi says. Short-acting steroids may be used in order to get the inflammation of the GI tract to calm down, offering relief from pain. Other medications prescribed, called immuno-modulators, may be focused on getting the body’s immune system in check.
“It’s an autoimmune disease; the immune system is acting against its own GI tract,” Farhadi explains.
For some patients, diet and other lifestyle changes will be necessary to help the gut heal. Those changes could be temporary or long-term.
Surgery is typically kept as a last resort, but it’s also on the table for some patients with Crohn’s disease. Sometimes that means taking out an inflamed section of the GI tract, Farhadi says. Other times it means going in to perform a stricturoplasty, a procedure that removes scar tissue in the intestinal tract that has built up due to chronic inflammation. Removing that tissue can help waste flow more smoothly through the bowels and reduce a patient’s pain.
The most common surgery for Crohn’s disease is the treatment of a fistula, a tunnel created when inflammation works its way through the walls of the intestines.  
For Semenoff, treatment was long and extreme.
“It took three years for me to get to functioning at all,” she recalls. “Hospitalizations, procedures, all kinds of crazy medications and weird diets, journaling, massage therapy, supplements, and many doctors. Some of it worked, but in some spaces it isn’t as obvious. My Crohn’s is now mostly in remission and controlled by avoiding my trigger foods, some fasting, and basic self-care.”
Remission is exactly what doctors shoot for when they treat people with Crohn’s disease. “We don’t cure it,” Rajapaske says. “We control it.”
It’s a disease that waxes and wanes, she adds. Weeks, months, or even years with no pain or intestinal issues can be followed by what’s called a flare-up, a sudden reactivation of symptoms. Sometimes patients can go for lengthy periods of times living medicine-free or eating what they want, but they’ll need to return to their doctor for treatment if Crohn’s rears its ugly head again.
[pullquote align=”center”]“Despite all of this—and it is scary and overwhelming—our primary goal in IBD care is to make sure that the patient can live the life they want to live.”
—Meenakshi Bewtra[/pullquote]
“When someone is in a flare … they can have terrible abdominal pain—it’s hard to describe how it feels, but it is relentless,” Bewtra says. “Sometimes it feels better temporarily after going to the bathroom, but it always comes back. They can go to the bathroom every hour—even though sometimes they only pass a little mucus or maybe some blood. They are fatigued and may even have a low grade fever. They cannot participate in normal activities—they simply do not feel well enough.”
It’s a fact that Slewinski knows all too well, but she’s found power in taking charge of her own health. Being diagnosed with Crohn’s has given her the tools she needed to go the next step and find the treatments that work for her body.
“I still have bad days here and there, but the good days greatly outweigh the bad. I can’t guarantee these therapies will work for everyone, in whole or in part, but I’ve learned to become the CEO of my own health, so to speak, and that has helped me figure out a mix of treatments that work for me,” she says. “So eight years into my IBD, I’m managing with diet and lifestyle changes, as well as keeping my anxiety in check, since we know the gut/brain connection is strong. I’m always looking at other alternative therapies that could improve my quality of life.”

How can you get help with Crohn’s disease?

Diagnosis of Crohn’s disease is typically made by a gastroenterologist, so if you think you have Crohn’s disease symptoms, it’s best to talk to your general practitioner about a referral.
Bewtra not only treats the disease but also battles Crohn’s herself, and she encourages her patients to be open and honest with their doctors.
“Despite all of this—and it is scary and overwhelming—our primary goal in IBD care is to make sure that the patient can live the life they want to live,” she says. “I really try to emphasize that there may be times of greater challenge, times when goals may need to be put on hold, but every physician I know tries to emphasize that our goal is that they live the life they want, be it volunteering in a [developing] country, working in a hospital, teaching preschool, running a business, etc.”
If you are diagnosed, the road ahead doesn’t have to be walked alone. The Crohn’s & Colitis Foundation offers online support groups as well as information on how to find in-person groups in your area. The foundation also runs a program called Team Challenge, a fundraising effort to not only help provide services to people with Crohn’s disease but also to fund research.
“The program has become more than just a fundraising and advocacy effort for me, but an extended family for a shoulder to lean on when times get tough,” Slewinski says. “I’m sure anyone else who has found the organization would say the same thing.”