Life StoryAug/Sept 2008 Issue

College Students With Food Allergies

Diabetes and celiac disease. Two college roommates learn to adjust to life-changing medical conditions.

Trevor Wagener struggled through his economics midterm at Yale University in October 2007, nothing unusual for a freshman adjusting to his first semester in college. But his struggle wasn’t with the exam. It was with trying to read it. A few days earlier, his eyesight had started blurring. He also had no energy and was going to the bathroom every 30 minutes. Wagener knew something was wrong and the 18-year-old headed to Yale University Health Services to get checked out after the midterm. He assumed he would leave with a prescription for medication but instead he received a life-changing diagnosis. He had type 1 diabetes.

College Students With Food Allergies

“It was very, very sudden,” says the economics major from Chicago of the symptoms indicating diabetes. “I wasn’t expecting to hear that I have a chronic, incurable illness.”

While Wagener was coming to terms with this diagnosis, health issues were also plaguing his suitemate, Maximilian Goer, 18, a double major in applied math and economics from Switzerland.

Fatigue was affecting Goer’s academic performance and was making participation on Yale’s crew team more difficult. He wondered whether the extra workload of college was too much for him to handle.

“I wasn’t sure if it was just Yale or if it was something else,” Goer says. “Now I know it was something else.”
That “something else” was celiac disease, a hypersensitivity to the gluten in wheat, barley and rye. Goer’s diagnosis occurred when he was home during winter break, just two months after Wagener learned that he had diabetes.

Making Adjustments 
While other college freshmen can eat whatever they want and participate in a multitude of activities, the suitemates had to make immediate changes in their daily lives because of their diseases.

Wagener’s days now start with an injection of insulin in the stomach. He must do this every morning and before every meal. He also checks his blood sugar four times a day by pricking his finger and putting blood on a test strip. He dreads the blood checks and insulin injections.

“I’ve probably done it more than 1,000 times now, but injecting yourself in the stomach is not something you ever like,” Wagener says. “It’s just something you have to do and you stop thinking about it. But it still hurts. And it’s not fun.”

Wagener also must watch his diet. For example, he’s had to cut out sweets. That means that partaking in most desserts during study breaks at Yale, complete with chocolate fountains and cake, is no longer an option. He watches as his friends savor the foods he can’t eat. He chooses fruit, such as oranges, apples and mangos, to replace cake and cookies, but even natural sugars in fruit can elevate his blood sugar.

“In the end, you get used to it pretty quickly and it stops seeming like a burden and is more like something you have to factor in,” Wagener says.

He still goes out with friends, believing that adapting to the new diabetic lifestyle shouldn't signal an end to his social life. His friends actually help him deal with his disease, he says, noticing when he acts a bit confused (a result of low blood sugar). On some occasions, friends have told him to check his blood sugar and, sure enough, his glucose levels have been dangerously low.

To prepare for the possibility of blood sugar fluctuations, he always carries fruit in his book bag, along with his insulin pen (the injection device), needles, alcohol pads and a testing kit. Wagener says his companions’ alertness to his condition is crucial.

“By the time you notice that those things are off, you’re probably not in any shape to help yourself.”

Wagener’s suitemate Goer is among the friends who alert him when his blood sugar appears to drop. Wagener, in turn, tells his friend if he thinks something Goer is about to eat might contain gluten.
Living Gluten Free
Goer had experienced health problems for about four years before his diagnosis of celiac disease. He originally suspected that milk was the culprit so he avoided dairy products. He never ate much cereal or bread—but only because they were not foods he enjoyed.

About two years ago, chronic symptoms, including diarrhea, vomiting and constipation, worsened. Then, during his first semester at Yale, he began to eat a lot of bread and pasta in order to increase his carbohydrate intake for crew. 

“That’s when I started feeling sick every day,” Goer remembers.

Once Goer knew what was making him sick, he had to figure out how to navigate the gluten-free lifestyle while at college.

“When I learned the diagnosis, I wasn’t too worried about it,” says Goer, who was familiar with celiac disease. He had researched it after he was tested and he has a friend and a relative with the disease. He wasn’t concerned about missing the foods he no longer could eat because many gluten-containing foods aren’t his favorites. However, avoiding gluten completely turned out to be more difficult, as he soon realized that the protein was in unexpected items, such as soups and salad dressings.

“After about a week or two, I noticed how hard it actually is to stick to the diet,” Goer says. “But I knew I didn’t have a choice and that I’d have to adapt my taste. Then you kind of learn to live with it.”

Goer says he’s sometimes tempted to eat or drink something that contains gluten but he knows the consequences. He has to avoid common college practices, such as sharing a pizza and a beer  with suitemates. The lack of gluten-free options can also make it difficult when dining out at a restaurant. Often, menu selections are limited.

“I haven’t quite gotten used to that,” he says.

While the dining halls at Yale accommodate students with food allergies, Goer says they offer little variety for someone who is gluten free. He eats a lot of plain chicken, potatoes and rice. Plain rice has never been something he loves but he uses it to get his fill of carbohydrates in order to perform on the crew team. He also gets carbs from a supply of gluten-free crackers and protein bars that he keeps in his room.

Getting enough carbohydrates is one of Goer’s biggest challenges. When he first returned to Yale after his diagnosis, his energy was low and he lacked strength while participating in his sport. At 6 feet, 6 inches tall, he also was losing weight, dropping from 250 to 200 pounds in just a few months. It took him about three months after his diagnosis to adjust to the new lifestyle and to find ways to maintain his energy. Now he regularly consults with a sports nutritionist to help maintain both the gluten-free diet and his ideal weight.

“It just took a while to get used to all the different foods. But I feel healthy again, just like I did three or four years ago,” Goer says, noting that his energy has returned. His grades during the second semester of his freshman year improved a lot over those from the first semester when he was feeling sick all the time.

A New Lifestyle 
Wagener also experienced a drop in energy because of his disease. The drain diabetes put on Wagener’s energy meant that he had to limit his extracurricular activities at Yale. While still active on college counsel and in the political union and writing opinion pieces for Yale Daily News, he stopped regularly participating in intramural sports.

“Having diabetes meant that I had to scale a few things back because I just didn’t have the energy I had before,” Wagener says. “Even with treatment, diabetes can leave you feeling drained.”

Wagener, whose diet is now higher in meats and lower in carbohydrates,
believes it’s more challenging for his suitemate than it is for him to find
suitable meal choices.

“Options are more limited for someone with celiac disease,” he says. “For a diabetic, it’s definitely doable as long as you watch it.” He notes that the listing of nutrition facts on the food in the dining halls helps him determine which foods are safe for him.

Planning to Succeed
Goer and Wagener have figured out ways to manage their new diets and lifestyles at Yale. Their advice to college students who must navigate a special diet? Contact the dining halls to find out what is available and to arrange safe meal options. Goer also recommends talking to a nutritionist on campus to get additional information on which foods are safe to eat and where to find them.

“It’s a challenge to change your diet in college. Your options are limited, which makes it hard,” Goer says. “The nutritionist will know what’s available at your school.”

He also says students with special diets should be aware that they will need to shift their spending habits so more money is budgeted for food. For example, Goer says he orders gluten-free products online that just aren’t available on campus.

Wagener suggests talking to other students who are dealing with special diets, not only to find out what options they’ve discovered and how they navigate their diets, but also to get support from people with similar concerns. The two young men, who will be suitemates again for their sophomore year, continue to serve as reminders to each other that they’re not alone with their dietary issues.

Despite feeling so sick during freshman year’s economics midterm, Wagener scored well enough that he didn’t have

to retake the test. Now as he looks forward to his sophomore year, he’s armed with the knowledge that he can manage his disease.

“If you manage it well, diabetes is basically just an inconvenience, although a significant one,” Wagener says. “But it doesn’t have to be something that completely messes up your life.”

As for Goer, he enters his sophomore year with more confidence than he had as a freshman. He admits that the diagnosis of celiac disease “definitely made my transition into college a lot harder.” But having learned to make the gluten-free diet work, “I feel a lot more relaxed, a lot less pressure,” he says. LW

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