Relationships are messy. Couples fight, break up, and make up. One minute you're in the honeymoon stage and the next you're hit with the dreaded "we need to talk". Things are never black and white and confusion comes with the territory. My relationship with remission is no different.
I’ve had my eyes set on remission since the day I was diagnosed with Crohn’s disease, and so far it hasn’t been an easy pursuit. One could argue that remission is very good at playing hard to get. I've never been the type of girl to wait eagerly for a guy to text me back, but when it comes to remission I feel like I'm pathetically waiting for a text that will never come. After months of struggling through a severe flare, I thought that remission was simply out of my league.
By definition, remission is a temporary recovery. During this time, a person experiences little to no symptoms of their disease. Crohn's remission occurs when inflammation subsides and the digestive tract heals. The main goal is to achieve and maintain remission for as long as possible; but for many, this is easier said than done. People with Crohn's and other autoimmune conditions may experience remission for a few days or a few years, and no two cases are alike.
There are several different types of remission. Clinical remission is the improvement or resolution of symptoms. Biochemical remission occurs when inflammatory markers found in blood and stool samples fall within the normal range. Histologic remission is achieved when biopsies taken during an endoscopy show no signs of active inflammation or disease. The specific terminology used to describe the different levels of remission are often used interchangeably in the medical community, only adding to the confusion.
After my diagnosis, I spent a lot of time searching through online forums to learn more about remission. I wanted someone to give me a clear cut answer of what it is and when I would likely reach it. I read countless conversations centered around this one question. It seemed like everyone was searching for answers, too. But the more I learned, the more vague and unclear the term became.
I always thought that the day my doctor told me I was in remission would be like getting engaged. I would be totally shocked and cry tears of joy. Afterward, I'd call up my family and friends and proclaim that I'm free of my disease. I'd flaunt my health as proudly as if I were showing off a diamond on my left hand. I'd bombard social media with the news and people would come out of the woodwork to congratulate me. I thought that once my disease went into remission, I would live happily ever after.
At my last appointment, I was told I'm in clinical remission. My blood work wasn’t perfect and I was still experiencing mild Crohn’s symptoms, but my doctor felt it was time to Define The Relationship. Once that perfunctory task was out of the way, the appointment proceeded as usual. Remission didn't put a ring on it and I was clearly underwhelmed. Instead of leaving with feelings of excitement, I walked out of the office more puzzled than ever.
All of my previous notions of what remission was supposed to look like were completely shattered. I realized that remission was an incredibly subjective term. There wasn’t any one test that could determine the absence of my disease, and it was ultimately something that I had to define for myself. I also had to come to grips with my new normal. So many of my decisions going forward would revolve around my disease, and achieving remission was not going to change that.
Eventually I will undergo more extensive tests to determine if I still have signs of active Crohn's disease. Although I strive to celebrate tiny victories every day, achieving remission is bittersweet. There's always the fear looming overhead that my disease could rear its ugly head when I least expect it.
I still don’t totally understand what remission means for me. Even if my physical body eventually shows no signs of Crohn’s disease and I’m in a true state of remission, my life will never go back to the way it was before. And that’s OK. I’ll continue to work on my relationship with remission and pray that one day we can go steady.