1. COPING WITH CHRONICILLNESSGabriela Cherascu M.D.Adult and Geriatric Psychiatrist Medical Director Mental Health Unit Mercy Hospital, Iowa City, IA

2. CHRONIC ILLNESS: What is it? To accept it or deny it?ACCEPTANCE is essential.Acceptance does not mean resignation. 3. ATTITUDE: Attitude is a little thing that makes a bigdifference. ~Winston Churchill If you dont like something change it; if you cantchange it, change the way you think aboutit. ~Mary Engelbreit To be upset over what you dont have is to waste 4. MORE ON ATTITUDE: I cant change the direction of the wind, but I can adjust my sails to always reach my destination., Jimmy Dean I am convinced that life is 10% what happens to me and 90% of how I react to it. And so it is with you... we are in charge of our Attitudes. , Charles R. Swindoll 5. WHAT CAN HELP? Find ways to feel more in control (learn, plan) Take control ( be active participant in yourtreatment plan) Problem solve Communicate with other people Build a support network ( friends, support group) Ask for help 6. LEARN ABOUT YOUR ILLNESS: Learn as much as you can about your illness(read books, articles, blogs, go to support groups) Work with your providers, ask questions Learn your warning signs of illness Learn what works for you Learn how to take your treatment Help your partner/family learn about your illness Keep track of your symptoms and treatments 7. PLAN AND FOLLOW YOUR PLAN. - keep your appointments - take your treatment as prescribed - attend support group 8. SUPPORT GROUP: Join a support group - it will allow you to share your experience and learn from others. The people who have the same problem understand best what you are going through. 9. CROHN & COLITIS FOUNDATIONOF AMERICA (CCFA): Good resource Support In many languages Special part for kids and teens (camp) 10. My IBD (myibd.org) The Foundation for Clinical Research in Inflamatory Bowel Disease 11. GASTROKIDS web site 12. STRESS: Stress does not cause IBD, but can worsen it 13. STRESS REDUCTION: Exercise Relaxation techniques different types Meditation live in the present Develop and use other coping skills (humor,music, prayer, journaling, breathing techniques,yoga, etc.) Volunteer Socialize Faith and spirituality 14. SMALL ADVICE: Know where the restrooms are, situate yourselfclose to them Have extra garments on hand Car kit with toilet paper and a change of clothes Medical Alert Restroom Access Pass (My IBDweb site) Bring the list of symptoms, of questions and themedications you take to your appointments 15. DO I HAVE DEPRESSION? 1/3 of people with chronic illness have depression Symptoms of depression:- feeling sad/blue/down in the dumps- poor sleep or oversleeping- decreased concentration- low energy- decreased or increased appetite- guilt- thoughts of suicide- hopelessness- crying spells out of the blue 16. TREATMENT OF DEPRESSION: Improves overall medical condition Increases quality of life Increases adherence to the treatment plan of thechronic illness Options of treatment: medication and/orpsychotherapy (individual and groupcounseling), exercise, meditation 17. DO I HAVE ANXIETY? Many people with chronic illness have anxiety Symptoms of anxiety:- excessive fear/worry, feeling keyed up or on edge, easily fatigued, mind going blank, irritability, muscle tension disturbed sleep- attacks of panic with palpitations, sweating, shaking, shortness of breath, chest discomfort, lightheadedness, numbness 18. TREATMENT OF ANXIETY: Improves overall medical condition Increases quality of life Increases adherence to the treatment plan of thechronic illness Options of treatment: medication and/orpsychotherapy, deep breathing, relaxation,meditation, exercise 19. SMOKING: DONT SMOKE, WILL MAKE YOUR CROHNS DISEASE WORSE best recognized risk factor 20. SMOKING: HOW TO QUIT: - decide if you want to quit smoking or not - it can be hard to quit smoking, but it is doable (the more you try, the more chances you have to succeed) - find a motivation - tell somebody and reward yourself - consider tapering - nicotine replacement - should you use medication? 21. FOR KIDS: Ask questions Talk with your parents and doctors Dont give in to peer pressure to drink ( interactswith your medication), smoke ( worsens yourillness), or do drugs Educate your peers ( most are ignorant or lackknowledge about your illness) 22. FOR PARENTS: Your attitude counts a lot. Help your children understand what happens and how they can best help themselves (empower them). 23. BOOKS: Coping with Crohns Disease, by Amy Trachter and Henry Wodnicki Check Your Pride at the Door: Learning to Live with IBD, by Darryl Helems IBD: A Guide to Patients and Their Families, by Stanley H. Stein and Richard P. Rood 24. MORE BOOKS: Dont Die of Embarrassment; Life after Colostomy and Other Adventures by Barbara Barrie It Takes More Than Guts: Life Changing Discoveries About Surviving and Overcoming IBD and Chronic Illness, by Phillip Van Hooser 25. ARTICLE: Coping with Chronic Illness Clinical Center NIH 26. THANK YOU!