On Cedric Mullins, Crohn’s Disease, and Inspiration

Cedric Mullins is even more amazing than we thought.

On February 2, Baltimore Orioles star center fielder Cedric Mullins revealed that he had Crohn’s Disease in an emotional video posted by MLB Players Media.

Honestly I don’t think the scope of Mullins’ accomplishment has been fully recognized. Crohn’s Disease isn’t just a nuisance. As someone with Crohn’s Disease myself, it’s hard to overstate just how remarkable Mullins’ accomplishment is. There seems to be a myth in the general population that Crohn’s Disease is similar to irritable bowel syndrome, an annoying but ultimately non-life threatening condition that causes gastrointestinal distress. The reality is that whilst the two present with initially similar symptoms, Crohn’s is a very different – and far more serious – medical condition that has no cure.

Crohn’s Disease is an autoimmune disease, meaning that the immune system attacks healthy structures in the human body instead of foreign invaders like bacteria or viruses. In Crohn’s Disease, the focal point of the immune system’s attack is typically in the intestine, but it can appear anywhere along the digestive tract from the lips to the anus. As the immune system attacks the digestive tract, the cells die, forms lesions and scar tissues, and eventually take on an appearance called “cobblestoning” because the damaged and dying tissue resembles a stone road.

Your insides turning into Ye Olde European streets isn’t good for digestion, and so the initial symptoms of Crohn’s Disease resemble a stomach flu: nausea, diarrhea, constipation that won’t go away, intense stomach pain. Unlike a stomach flu, however, Crohn’s doesn’t get better on its own. Diarrhea that lasts for weeks or more is extremely dangerous, leading to dehydration or worse. But Crohn’s is a progressive condition that won’t stay in one place; once the immune system has destroyed all the cells in one area of the intestine, it moves on. That’s worse than it sounds; Crohn’s-addled intestine is often useless intestine, unable to absorb nutrients from food or dietary supplements. Malnutrition is a major problem with Crohn’s Disease, and that leads to other conditions like lethargy, tiredness, chronic fatigue, headache, and even muscle wasting as the body looks desperately for other sources of food.

But Crohn’s won’t just make you tired and unable to absorb food. As the immune system eats away at the digestive tract, holes called fistulas and fissures form, leaking undigested food into the body and causing an infection called sepsis. In other areas, the immune system can have the opposite effect, building inflammation and scar tissue to the point where the intestine becomes sealed shut, forcing food and bowel movements back up through the mouth. Both are immediately life-threatening if not addressed by a doctor, and often surgery is required to remove the Crohn’s-damaged portion of intestine. The problem is that surgery isn’t a cure; most patients with Crohn’s will end up with worse symptoms then before within ten years of surgery. There’s also a significantly increased risk of developing cancer with Crohn’s Disease, a risk increased with each new surgery.

I had my first bowel obstruction the night before I was supposed to take the Illinois bar exam in 2012. At the time, I had been experiencing gastrointestinal symptoms for years, but doctors hadn’t yet figured out why, and were mostly concerned with my ever-dwindling weight. On this night, I was studying for the bar and eating carrot sticks, which my doctor had suggested not knowing my chronic malnutrition was from Crohn’s. Within a couple of hours, I had what I thought was food poisoning or a bad stomach flu, just like Mullins mentions in his video. As it turns out, raw carrot sticks are pretty much the worst thing you can eat with Crohn’s Disease, and what I thought was food poisoning was a bowel obstruction. When I arrived at the hospital emergency department in the early morning hours, I told the attending physician I needed to be discharged so I could go to the bar exam; she laughed sadly and told me that if I went to the bar exam, I wouldn’t live to come home.

There is no cure for Crohn’s Disease. Most moderate to severe cases can be capably managed with drugs called biologics, medicines like Humira and Remicade that suppress the immune system so it can’t attack your digestive tract. Often these drugs will be supplemented with steroids like prednisone during flares. The side effects of biologics are fairly extensive and not at all pleasant, but better than the alternative; “Humira Fatigue” is a documented condition.

It’s also important to note the number of dietary and lifestyle changes Crohn’s requires. Seeds, nuts, salads, beans, and raw fruits and vegetables are generally off-limits once you’ve been diagnosed with Crohn’s, as are hot dogs because of the casings. Shellfish are also typically ruled out fairly early after diagnosis. Non-steroidal anti-inflammatories are off-limits because they cause Crohn’s flares, so if you hurt yourself, say, banging into an outfield wall making a spectacular catch, you can’t take ibuprofen for that. You also can’t take cold medicine if you’re sick; that, too, can trigger a Crohn’s flare.

Since my first bowel obstruction in 2012 I’ve had several more, and more hospitalizations than I’d care to count. Crohn’s is a fickle disease; it can be silent for months or years and then suddenly roar to life, like a monster doing a jump scare in a horror movie. But even in the quiet times it’s always there, whether it be the weekly biologic injections or the chronic fatigue or the joint arthritis that is a common symptom of Crohn’s even in remission. My Crohn’s impacts my entire digestive tract; even the skin on my lips sloughs off when it’s active.

All of this is to say that Cedric Mullins‘ ability to not just play Major League Baseball but do so at an All-Star level is nothing short of extraordinary. Consider: he’s missing over a foot of his intestine from a condition that causes arthritis in his joints, chronic pain and weakness, and won’t even let him take most pain relievers when he’s sore from making catches like this:

Crohn’s has not spared Mullins from its ravages simply because he’s good at baseball. But Mullins is one of the best players in baseball despite having a condition that is utterly debilitating. I am in awe of his courage and his fortitude, because I know the kind of pain he must be in when he’s not sore from robbing home runs. What Mullins has done, putting up a historic season in the face of a disease that still kills thousands of people every year, is a testament to his work and his bravery.

Crohn’s is unpredictable, and it may end his career at any time – a dive that hits his intestine too hard, an uncomfortable swing, or even a bad meal could trigger a flare that doesn’t end. And here is Cedric Mullins, showing that he’s going to be the best he can be no matter how long that lasts. Mullins is more than an extraordinary baseball player. He’s an extraordinary man.

Photo by Randy Litzinger/Icon Sportswire Adapted by Doug Carlin (@Bdougals on Twitter)

Sheryl Ring

Sheryl Ring is a consumer rights and civil rights attorney practicing in the Chicago, Illinois area. This post is for informational purposes only and is not legal advice, and does not create any attorney-client relationship.

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