By Anil Kesavan, MD
I first met Tyler Jankiewicz and his mother, Ann, in August 2013, when he was 15 years old. Tyler had been referred to Rush’s pediatric gastroenterology program seven months earlier and was diagnosed with Crohn’s disease, a chronic autoimmune disease that causes inflammation throughout the intestinal tract. People with Crohn’s experience a variety of symptoms (abdominal pain, diarrhea, vomiting, blood in the stool), as well as weight loss, inflammation in the eyes and skin, fevers and joint pain.
Tyler first started having symptoms in December 2012, and his condition had progressed dramatically. He couldn’t eat and rapidly lost 40 pounds. By the spring of 2013, his weight was down to 115, and he didn’t have the strength or stamina to play volleyball on his high school team. He was anemic, and his condition was worsening.
My colleagues and I believe it’s essential to get to the root of our patients’ problem — not take a Band-Aid approach and only treat the symptoms. We want our patients to feel better because we’ve effectively addressed the underlying cause.
Tyler had severe disease in both his small and large intestine, so our treatment goal was twofold: first, stop and reverse all inflammation, and second, prevent it from coming back. Our team put together a treatment plan that used nutritional therapy, which included short-term placement of a nasogastric feeding tube (one that goes through the nose into the stomach), and a combination of oral and injectable medications.
It is important to us to always be empathetic about our patients’ conditions. We want them to know that we have an understanding of what they’re going through, and that we are here to help them. Every patient we see is unique, so every care plan is unique. We strive to educate parents on the medical options that are available for their child, and then work with them to figure out a treatment option that works best for that family.
I say for the family — not just for the child — because in every pediatric specialty, parents play a crucial role in both the treatment process and the child’s overall health and well-being. Parents know their child the best; I trust their opinions and rely on them to tell me what’s going on with their child. If a child is going to get better, the parents must be partners with the clinical team.
That has definitely been true of Tyler’s parents — and of Tyler himself. They were all very motivated and worked really hard to get him healthy, even though at times it was extremely difficult.
Tyler’s treatment course was long and required many medication changes before we were able to achieve remission. Tyler has been completely asymptomatic since October 2014; he has gained more than 50 pounds from his lowest weight. It took him awhile to regain his strength, but he is now able to play volleyball, basketball and football again.
He was also able to graduate high school on time, which is truly amazing considering how sick he was. It is a blessing to see the tremendous progress he has made from when I first met him to now.
He started college in August and I look forward to seeing where his future takes him. My goal is to keep him in remission so he can focus on the important things in life, growing up and achieving his dreams. That’s the hope I have for all of my patients.
Anil Kesavan, MD, is a pediatric gastroenterologist at Rush University Medical Center.