A Good Grip on Crohn's Disease
Mar 05, 2021 Cassie Tomlin
It’s a gray Monday morning at the beach in Santa Monica, but Kate Bianco is conjuring up a fond, distant memory: a late night in a packed jazz club.
“The lights are dimmed, you’ve got a drink in your hand and everybody makes noise together when one of the musicians plays a cool riff,” she says. “Just a collective experience you’re sharing with strangers.”
Bianco, in a gingham-patterned face mask and a T-shirt printed with Shakespeare sporting an N95 mask, has a bad case of Zoom fatigue. The 24-year-old aspiring theater director is longing for the buzz of a live show.
In the year since the COVID-19 pandemic put Bianco’s career goals on hold, she’s struggled and stalled. But she’s also expanded her interests: This morning she rose at 5 o’clock to go rock climbing in the San Fernando Valley before breakfast. She’s taken up knitting, “gone through the whole bread-baking phase” and dusted off her bike from middle school, which she rides to and from one of her side jobs in retail.
Bianco can embrace new experiences, and cope with sadness and anxiety brought on by the pandemic, because her health is well-managed by a team of medical professionals just five minutes from her Santa Monica apartment.
Her doctors collaborate on her whole health— including treatment for Crohn’s disease—so she can focus on a pretty “normal” post-college, mid-pandemic life.
A TOUGH DIAGNOSIS
Bianco began suffering from severe stomach pains at age 10. For four years, she and her mom commuted an hour from her hometown of Visalia, in California’s Central Valley, for tests with specialists who tried to figure out what was wrong. Her parents first thought the pain was caused by anxiety—but her dad has ulcerative colitis, which eventually led doctors to suspect that Bianco, too, had a gastrointestinal condition.
In her freshman year of high school, she was finally diagnosed with Crohn’s, a chronic inflammatory bowel disease (IBD) that affects the digestive tract and can cause abdominal pain, diarrhea and weight loss, and increase the risk of colon cancer.
It was a rough year for Bianco: She’d had a hard transition to a big high school, barely ate because it hurt too much and her mom was diagnosed with breast cancer.
“I was super-skinny, I just had my wisdom teeth taken out so I was puffy, and I had an allergic reaction to a steroid and developed welts on my legs that looked like I’d been hit by a baseball bat,” she recalls.
After some trial and error with medications, her condition improved when she began receiving regular infusions of an immunosuppressant, which prevented inflammation and reduced her symptoms.
Eventually, with her health stabilized and her mom in recovery, Bianco was able to focus on a childhood passion and became more active in a local community arts program.
“In third grade, I drew the role of Dorothy in The Wizard of Oz out of a hat for a school play,” she says. “I remember running lines with my mom and being really committed to it and, from then on, I always knew this was what I wanted to pursue.”
Bianco moved to Los Angeles to study theater at Loyola Marymount University in 2015. As she chose a dorm and enrolled in classes and clubs, she also needed to find a new specialist and infusion center in Santa Monica, close to school.
"Dr. Wishingrad always had time for me—I was never in his office waiting for hours to have a five-minute discussion that I didn’t understand," Bianco says. "He cut through the BS, but was also so warm and welcoming."
Wishingrad says teenage and college-age patients with chronic conditions need clarity, honesty and compassion from their doctors.
"When you’re young and have a really tough chronic disease, you need to know you’re cared about and cared for," Wishingrad says. "We wanted to make sure Kate knew we were on her side and would do everything we could for her."
Bianco especially needed that support during her college years. She didn't have total control over her diet because her options were limited in the school cafeteria, and her hectic schedule made it hard to keep up with appointments. Steady care from Wishingrad and Serafini helped her better understand her condition and her body, she says.
After graduating from college in 2019, Bianco needed a primary care physician, and Serafini connected her with Stephanie Koven, MD, a colleague just down the hall at the Santa Monica Boulevard office. Being in such close proximity means Bianco’s care providers can always communicate with each other about test results, medication changes and colonoscopies.
“It’s so helpful to not have to relay the same information to five people in five different ways,” Bianco says. “They’re so well-connected, and they can all remind me of little things I forget.”
As Bianco’s primary care physician, Koven sees her role as “quarterback”—she can assess her patient’s questions and concerns in the context of her whole health. She recently referred Bianco to a sleep therapist for insomnia.
“I’m able to look at her health globally,” Koven says. “I can take a step back and see how the pieces of the puzzle fit together.”
When you’re young and have a really tough chronic disease, you need to know you’re cared about and cared for, we wanted to make sure Kate knew we were on her side and would do everything we could for her.”
-Marc Wishingrad, MD.
AN OPTIMISTIC MANTRA
Her Crohn’s is in remission, but since it is a chronic condition, Bianco will likely continue receiving infusions every six weeks for the foreseeable future. The process can take up to four hours and make her nauseous and groggy for at least a day, sometimes three.
But over the years she’s learned to monitor her body and balance her schedule and her habits—she knows she has to avoid tomatoes and most oil-based dishes, and she’s happy cooking healthful foods for herself and her roommates. She only rarely decides it’s worth it to eat two or three M&Ms or pasta with marinara and risk feeling awful later.
Before the pandemic, Bianco was coming off a rewarding internship at a professional theater company, where she got experience as an assistant director. She was preparing to work as an assistant lighting designer on a show in Orange County, but it was canceled when public gatherings shut down.
Like so many entertainment professionals and aficionados, Bianco wonders how many live venues and theaters will survive the pandemic, and how many careers—new and established—will suffer. But she stays active with the occasional virtual directing gig and Sunday night dinners on her close friends’ patio. And she regularly returns to advice she received from a mentor in college.
“He said, ‘Every day, take whatever you’re feeling and put it into your work,’ and I use that as my mantra both in directing and in life,” she says. “I wake up every day and I check in with myself, physically and mentally. I self-assess and learn.”
Kate Bianco’s medication, infliximab, was developed in part by Stephan Targan, MD, a globally respected IBD expert who is the director of the F. Widjaja Foundation Inflammatory Bowel and Immunobiology Research Institute at Cedars-Sinai and the Feintech Family Chair in Inflammatory Bowel Disease. Targan’s pioneering work changed the way doctors everywhere think about IBD: He discovered that it’s not just one disease but encompasses many subtypes based on various immune system responses and genetic variations. This revelation paved the way for more precise diagnosis and treatment tailored to each patient’s biological makeup.
Such groundbreaking research guides the work of internationally recognized specialists at the Cedars-Sinai Inflammatory Bowel Disease Center, where patients have access to the latest clinical trials into new treatments for Crohn’s disease, ulcerative colitis and other inflammatory bowel disorders. The center’s dedicated group of doctors, surgeons, nurses, researchers and dietitians are one of the reasons Cedars-Sinai is ranked as the No. 1 hospital in California for gastroenterology and gastrointestinal surgery for adults and children.
KATE BIANCO'S SANTA MONICA CARE TEAM
MARC WISHINGRAD, MD
Wishingrad is a board-certified gastroenterologist who has practiced in Santa Monica since 1995. He graduated from the UCLA Geffen School of Medicine, where he also completed his residency. He completed a fellowship at Stanford University Medical Center. Wishingrad hikes with his wife and daughters, and plays tennis at Memorial Park in Santa Monica, five minutes from his office.
Serafini graduated from California State University and has worked with Wishingrad since 2013. Prior to becoming a nurse practitioner, she worked as a nurse in hospital surgical and intensive care units. She enjoys exercising in her garage while her 10- and 12-year-old children play tennis or take virtual piano and guitar lessons.
STEPHANIE KOVEN, MD
Koven is a board-certified internal medicine physician who graduated from the UCLA Geffen School of Medicine. She completed her internship and residency in Internal Medicine at Cedars-Sinai. She has practiced at Cedars-Sinai since 2012; in 2018, she relocated her practice to Santa Monica to be closer to home. Koven runs on the beach early every morning, and enjoys spending time with her kids, ages 16, 14 and 11.