bitterpill – Citronnade

no, I did not eat too many sweets • Type one diabetes • bitterpill

TW: mention of blood, needles, mental health, abuse, death

DISCLAIMER: I’m not a professional health adviser, thus the posts should not be used for a diagnosis. Every person that has been interviewed for this project shares their own personal stories. If you have any worries concerning your own health, you should consult with a doctor.

In the year of my AS studies in May 2018, just after I got back from a school trip to Italy, I was sitting with some friends at a coffee shop. I had a bad cold. My throat was sore, and my voice was not more than a cracked whisper. Still, I left my room and couch potato self behind to enjoy the sunny day with my friends.

After a while, one of my peers from school, that I have briefly met before, asked me about the ‘Walkman’ that is attached to my hip – he meant my insulin pump. “I have diabetes.”, I told him. His puzzled look confirmed my assumption that he had absolutely no clue what diabetes was. Maybe it was quite mean of me to crack a joke with my faint, whisper voice as I said, “I can’t photosynthesise properly.” but I would have never thought that he would believe me. Don’t get me wrong, biology isn’t everyone’s cup of tea, but it was at that moment, I realised that he wasn’t the one to blame for the lack of understanding society has towards diabetes mellitus as a whole.

I have always been open with sharing my story, but I can’t count how often I had to explain to people that I did not get diabetes by eating too many sweets. The truth is, diabetics need sugar as much as everyone else does to live.

It started in third grade, nine-year-old me on a hospital bed, surrounded by her loving parents that cried into each other’s arms. Nine-year-old me had no clue what exactly was happening. I have never seen my mum and dad that sad before. “Am I dying?“ was the first thing that crossed my mind. The answer: yes and no. I would have died, but I got the diagnosis in time—diabetes mellitus type one. Sounds quite nasty, doesn’t it?

Diabetes comes from the Ancient Greek word for “passing through” and refers to a large amount of urine. Mellitus deprives from the Latin meaning “as sweet as honey”. In other words, diabetes mellitus combined means sweet urine. This actually describes one of the key symptoms of this disease. In the past, doctors tasted their patient’s urine to test if they have diabetes. Now that most definitely sounds nasty. If the urine was sweet, it would have been a death sentence for that person back then. Many different therapy methods were used to treat people with diabetes but one thing was still missing and it’s a hormone called insulin.

Insulin is produced in your pancreas and acts as a key to open up the muscle cells to guide the carbohydrates from your food through in order to make energy. Without insulin, the carbohydrates remain in your blood, and that is toxic for your body which will eventually lead to death. Diabetes is a game of balancing. The glucose levels should not reach hyperglycaemia (high blood sugar) or hypoglycaemia (low blood sugar). For diabetics, insulin needs to be injected externally by needle or, in my case, with an insulin pump.

The insulin pump does look a bit like a Walkman. I can regulate the doses of insulin, and it even calculates the necessary amount from the total of carbohydrates I eat. Insulin is in that little cartilage and is pumped through a tube into my body.

The hormone that is used nowadays was discovered in the 1930s. Before that, insulin from the pancreas of pigs was used as it is pretty similar to a human’s insulin. However, the early version of insulin was often contaminated and not a long-term solution. It is safe to say that I feel lucky in an unlucky fate to live in our modern world of technology and medical treatments.

I spent the summer of 2010 drinking my body weight in water while losing a lot of weight. I was a chubby child, and losing weight wasn’t really my top priority as I loved ice cream and chocolate way too much. But, this was not the reason for my health problems.

The people in school used the disease as another reason to make me feel worthless. Even the parents of my “friends” made comments that still make me tear up. I was not invited to any birthday parties because I would, as those parents pointed out, “ruin the mood by not eating cake”. Children and adults mentally abused me. Nothing excuses this, and there is no way I’m leaving this out in my story. It is not my fault that I got type one diabetes, and it is crucial to raise awareness and talk about the lack of understanding.

Diabetes is also known as “sugar disease” – is that the reason people believe that eating too many sweets causes it? Or is it because the differences between type one diabetes and type two diabetes are unclear?

When the doctor explained to me in a “child-friendly” way what diabetes was, he mentioned, “It’s what your grandmother has, but different.” My grandparents have type two diabetes, and although it affects your diet and insulin production, it is not the same as type one. First of all, it is more common, and mostly older people and individuals that lack physical activity and have a bad diet are at risk. The cause of diabetes type two is insulin resistance. The body does not normally respond to the essential hormone, and the pancreas tries to act against that by producing more insulin. The glucose levels in the blood remain high, and treatment is needed.

No one really knows how and why I got diabetes type one. Often, it is inherited, but no family member has type one diabetes. It remains a mystery to me and doctors as well.

“I kind of look like a cyborg.” is my introduction to my different treatment gadgets. From tubes to transmitters, modern technology makes the monitoring of glucose levels more accessible. I don’t have to prick my finger as often as I used to as a child. My fingertips were full of scars because I had to measure a droplet of blood before every meal. Nowadays, a transmitter, a smartphone and the Freestyle Libre App go hand in hand. The result: continuous checking.

I have to watch this graph regularly to ensure that my glucose levels remain in the green range. You know now that carbohydrates raise the blood sugar levels but did you know that stress, mental health and the hormone adrenaline decrease insulin’s effect?

I used to be scared that my life would depend on computers. Computers make mistakes. I would face the consequences of these mistakes. But over time, my body would alarm me if there is something wrong; although the phone screen would say otherwise. That’s rarely the case. When my blood sugar is low, my body starts to shiver, and I can’t concentrate anymore. I feel hot and cold at the same time, and I crave food much more. It’s not a feeling of hunger but a desire to just grab the next carbohydrate-rich food and stuff it in my mouth. I can kind of relate to the cheesy vampire shows where the vampires smell blood and go all crazy – that’s me just with food at that moment. It’s a mechanism that doesn’t require your thinking.

One of the many things I have learned is that diabetes is a part of me, but it doesn’t define who I am. Despite my health issue, I was able to travel, study and continue to live life to its fullest. Luckily, people do not respond as poorly to my diabetes as I was used to as a child, and many show great interest. I have recently seen people with diabetes on TikTok, showing how the transmitter is injected correctly and also explain the myths behind the disease. It is essential to continue to raise awareness, and I don’t want another child to be in a similar situation and be attacked for something they are not responsible for.

SOURCES

https://www.canr.msu.edu/news/how_diabetes_got_its_name

https://www.cdc.gov/diabetes/basics/type2.html

There aren't many sources as I wrote this article from my own knowledge and history. If there is anything that you don't agree with, please let me know.

when plants can’t keep it in their pants • Oral Allergy Syndrome

TW: mental health

DISCLAIMER I’m not a professional health adviser, thus the posts should not be used for a diagnosis. Every person that has been interviewed for this project shares their own personal stories. If you have any worries concerning your own health, you should consult with a doctor

Puffy and itchy eyes, a running nose and sneezing – many people are affected by pollen, especially, as the weather gets warmer and dryer. However, sometimes the body confuses a protein that is found in food with a pollen protein, causing an allergic reaction. This condition is known as Oral Allergy Syndrome – this is Annie’s bitterpill.

Oral Allergy Syndrome is known to develop on top of an environmental allergy, such as hay fever.

“I remember being told nearly half of those that have experienced hay fever will have this syndrome, but however, for most, it will never fully develop or only appear with one or two foods.”

When did you get the diagnosis?

“I don’t remember exactly at what age I developed it but I remember when I was around 12, I ate a banana, and it felt as if something was stuck in my throat and I remember already experiencing that before but ignoring it as I was young and didn’t know better. I remember telling my mum and she just telling me to wash it down with water. From then on, I remember reacting to more and more foods like this, but when bringing it up to my mum, I was told I was just being picky and imagining it. My mum didn’t believe me until one time I think I ate strawberries and it got so bad I was wheezing. Then she took me to the doctors about it, and they just said I likely have this reaction and there is nothing I could do about it. I was told it was because of my hay fever, and the best thing I could do was to avoid the food.”

Mostly raw fruits, vegetables, nuts and soya cause the body to response this way. The structure of their proteins is very similar to the ones of pollen. When the raw food comes into contact with the mouth, an allergic reaction occurs – also known as s cross-reactivity.

“However, once cooked or if bought canned, the food is usually then safe to eat. In my personal experience, I react to every possible food there is to react.”

When the food is cooked, the proteins start to ‘denature’ due to the heat, meaning that their bonds break apart. This process makes it safer to eat for people with oral allergy syndrome.

“Accidental reactions happen so often that at this point, I have stopped trying new foods as I really hate the feeling I get.”

The symptoms vary depending on the type of allergy. Annie is allergic to alder pollen, birch pollen, grass pollen, mugwort pollen and ragweed pollen. Due to these allergies, she has to be careful with the following foods:

“It always feels as if there is something stuck at the back of your throat and that no matter how much water I drink, it doesn’t go away.”

How does it influence your everyday life?

“It influences me a lot, and it’s personally awful for me. I cannot just go to any restaurant and eat anything I want. I often can’t eat “healthy” foods like salads and starters and always seem as unhealthy or picky like a child. I’m always limited to the foods I can eat at a restaurant and when I go there, and they ask if I have any allergies I have learned to keep my mouth shut and say no because otherwise they will not serve me anything as they take the job very seriously which is good for those with a serious food allergy, but for me, it just stops me from eating anything. Majority of the staff don’t know anything about this allergy, so they are lost. I have to take an antihistamine every day as well as always carry a stronger medicine like Benedryl with me at all times in case of a reaction.”

It is difficult to avoid foods that could trigger this kind of allergic reaction. Especially with already prepared food, it is challenging to distinguish if the ingredients could affect your body or not.

“I guess when I was growing up, I would always avoid fruit and veg and therefore seemed as if I was picky and unhealthy. I often would eat foods I knew caused an allergic reaction just because I wanted to fit in, and often that was the only food available for me.”

As the freedom of an essential process like eating is limited, constant worry and the strict diet takes a toll on mental wellbeing.

“According to my allergist later in life, she thinks I most likely was also experiencing panic attacks which would explain the tight pain chests I would feel when I ate the food.”

Although Oral Allergy Syndrome is normally not life-threatening, people with this condition have to change their diet drastically to avoid the uncomfortable consequences.

A cure for this condition has not been found yet. Like people suffering from environmental allergies, oral allergy syndrome requires consistency and monitoring.

“The only solution is to avoid the foods and that is extremely hard when I am allergic to so many. I did see a dietitian who suggested me ways I could still maintain a healthy diet but honestly it is so hard to follow that I definitely need to see someone again soon.”

Special thanks to Annie for sharing her story!

let’s talk about endometriosis

TW: mention of menstruation, infertility, pain needle

Rania suffers from endometriosis, a painful disorder affecting female reproductive health. In the following interview, she talks about her life with this bitterpill.

” 1 in 10 women are said to be affected by endometriosis, and I wouldn’t be surprised if more women in my family have it, but were socialised to undermine their own pain.”

Pain is your body’s response, signalling that there is a problem. It is one of the most uncomfortable feelings a living being can experience, and it is even more frustrating if the cause is not found.

Menstruation is a significant part of a woman’s life. It indicates fertility and growth. Although it might cause cramps, an imbalance of hormones and overall discomfort, it should not be associated with immense pain.

“I first got my period when I was nine years old and started noticing problems in terms of abnormal amounts of pain and irregularities when I was 11 years old. Unfortunately, endometriosis is often misdiagnosed or largely dismissed by healthcare professionals and can only formally be diagnosed through surgery. So seven years later, when I was eighteen years old, I had a diagnostic laparoscopy.”

Endometriosis affects the female reproductive system – more specifically the “endometrium” which is the tissue lining the uterus. It is typically shed during the menstrual cycle.

The endometrium of people suffering from the disorder grows outside of the uterus, so during menstruation, the tissue layer is unable to leave the body.

A laparoscope is used during the diagnostic laparoscopy. Organs in the abdomen are examined using this instrument.

“The swelling and blockage of the endometriosis not only leads to cramping and discomfort during and outside of the menstrual cycle. It can also cause painful sex, intestinal issues, frequent bleeding, infertility, and cancer.”, says Rania.

It took many years for Rania to get the diagnosis. What goes through the mind now that the reason for the pain is determined?

“Honestly, it was both a relief and extremely disorienting to receive a diagnosis. Part of me was glad I finally had a name for all the pain that I was experiencing, but I had a lot of information dumped on me all at once, and it was overwhelming. I also learned about how hard it is to treat endometriosis, and it scared me to learn about my increased risks of infertility and cancer. After all of that settled, I realised I was kind of angry it took this long for me to be diagnosed.“

Women with endometriosis do not only face problems during their period. Consequences resulting from the disorder affect their everyday life fundamentally.

“It takes a toll on me every day. It’s rare that I wake up not in pain, and it affects what I eat, how often I can exercise, and even what kind of menstrual products I can use. It has also made vaginal penetration extremely painful for me.”

What kind of treatments do you go through to help you control endometriosis?

“There are new medications to treat endo, but most treatments are not covered by standard insurance. I have tried conventional medication and birth control, but the minor pain relief wasn’t worth the cost and side effects. To treat it, now I use CBD products, lidocaine, acupuncture, pelvic floor therapy, and massages. I have pain medication for severe flare-ups, but I try to avoid taking too much because it can cause a dependence.

Everything I do to treat my endometriosis only minimises my pain to an extent, I still deal with my pain on a daily basis despite the various treatments.”

Rania uses a variety treatments, such as acupuncture.

“The best way I deal with my endo is to just take it one day at a time. I also lean on my support system, like my family and friends when I’m going through hard times. That’s all that I can do for now.”

Endometriosis changes your plans for the future. What are your main concerns and hopes thinking about the next years?

“My greatest fears for the future are that I might not be able to have children, and I may have to live with this pain forever. I try not to think about those things too much.

I stay up to date on any new treatments and medications for chronic pain and endo. I hope that there will be a cure for it in my lifetime. For now, laparoscopies are an option for me to remove endometrium and scar tissue, but having this procedure too many times is both costly and dangerous for your reproductive system.”

“Discussing women’s reproductive health is still pretty taboo in current society, and my pain often gets dismissed or minimized as “regular period pain” which is pretty offensive to me.”

Endometriosis is a common disorder. Women from around the world unknowingly suffer from the condition. It is hiding behind the fact that many experience cramps during their period, therefore raising awareness is essential to understand the body’s cry for help.

I used the following link to read about endometriosis: https://www.womenshealth.gov/a-z-topics/endometriosis 
However, most of the information was gathered during the interview with Rania.

A special thank you to Rania for taking her time to share her story.

The issue on the table • Eating Disroder

TW: eating disorder (anorexia), depression, mental health

DISCLAIMER I’m not a professional health adviser, thus the posts should not be used for a diagnosis. Every person that has been interviewed for this project shares their own personal stories. If you have any worries concerning your own health, you should consult with a doctor

The issue is quite literally on the table. Eating disorders are severe and should not be a topic of debate. This is the story about Mara’s bitterpill.

Drawing by Mara (@mara_ic2002) “You would not look your 5 year old self in the eyes and tell her the things you yourself now, would you?”

“Eating disorders are not so much about how one looks. They are about the spirals one goes through every time they catch a glimpse of themselves in the mirror and can’t hold back tears because they cannot see how they can ever look good enough.”

Growing up in a world of expectations has always pressured young people’s minds—every Barbie or princess movie – toy commercial – a trend on social media. The perfect body image sticks and shapes our society.

Beauty standards seem to be set, although beauty hasn’t been defined. Body acceptance decreases and the individual value plays a less critical role. Many have experienced this first hand, just like Mara.

“I was 13, I was in Paris with my mother, and I looked in
the mirror one morning, and I thought to myself: ‘Hmm I could lose a bit of the fat that I have on my legs’. Before that, I was obsessed with googling the height and weight of girls I saw on Disney channel. I was both shorter and heavier than them. As soon as I got home, I started to starve myself and to try hundreds of different diets.”

There are several types of eating disorders – the most commonly known are anorexia, bulimia, and binge eating disorder. Life of the people affected revolves around constant worries about what and how much they eat. It also has a significant impact on the emotional state.

“I still know how many calories are in a slice of bread. Or in an apple. Or in exactly 45 grams of porridge. Or in half a biscuit. I starved myself for a week to the point where I texted my best friend that I am close to passing out. She told me to eat which I did.“

Weight measuring, avoiding interaction with other people, dizziness, uncontrollable cravings – are just a few of many consequences.

Crying when you receive a slice of toast with a bit of cheese instead of just plain toast- so having to eat 20 calories more- is not just a phase.”

How has your everyday life changed from that point onwards?

“I remember getting to school early and taking photos of my legs, searching for a thigh gap to appear somewhere- and to have proof that my legs seem bigger at night not because I suddenly got fat, just because the body gets bloated. I also remember not getting my period for two months which to me was very scary, given that I had quite regular periods. I was always hungry, always thinking about what I want to eat next.”

The imagination of a child’s life full of love, success and happiness often overshadows reality and it is harder for parents to notice if something is wrong.

” ‘But you always eat when you are eating with us’- would my family say, because, indeed, those were what I considered ‘cheat days’. Only I would hate myself with such burning passion that once I was done eating, I would get home and run on the spot for an hour to “make up” for the food. I tried to go vegan to get rid of all the calorie dense foods I was eating. I would binge-watch “what I eat in a day to lose weight” videos; I would watch anorexia recovery videos, I would watch raw vegan recipe videos. Anything that would ensure I would end up as thin as the girls on my phone. The worst part is that I was being encouraged because come on, who does not want to look like a supermodel?”

Photoshop, as well as face – and body -enhancing filters on social media act as motivation to continue to follow the socially constructed standards. The most challenging part is to find a way to accept yourself. It is easier said than done, especially since media continues to flood our minds with images of people that appear to look perfect.

How have you found a way to moved forward?

“Gaining weight was my biggest fear. And it happened. And frankly, nobody ever seemed put off by it. And if they did well… they can f*ck off. I did put on weight. And it seemed like it would not stop, and I was still so hungry all the time. And it is important to keep going because I can promise you that one day you will wake up and you will no longer feel the need to demolish the fridge. Because your body will finally feel safe. But it won’t happen in a week, a month or even a year. The longer you have hurt it for, the longer it will need time to recover. And so do you.”

2020 has changed our way of thinking dramatically. More people raise awareness about this issue and support body positivity on social media. Nowadays, uniqueness is more recognised and praised. However…

“I believe that while this statement starts to appear more and more online and offline, it has not been internalised. I find myself being rude to my body a lot still, and even though I do believe that everyone should be at least accepting of the exact way they look, I still have a hard time finding that acceptance for myself. And I think most of us do. And that does not make me or you or anyone else a “fraud”. We have heard for so long that we are not good enough which is much easier to believe than to believe this new trend of ‘actually, you are good enough’.

And hopefully sooner rather than later, with our kids, this will be more than a trend. It will be the reality.”

Introduction – “bitterpill”

Everyone has to swallow a bitter pill at some point in life. It might not be visible to others and might taste more bitter, but accepting and embracing this distasteful situation is essential for growth.

“Growth is the only evidence of life.”
JOHN HENRY NEWMAN

The concept of this project is to raise awareness about all sorts of health-related “bitterpills” that people encountered and continue to live with.

THANK YOU! 
 ... to everyone that took part in this project and shared their stories. 

Feel free to share your opinions on the project at any time! I'm thankful for every feedback.