craps table shaped like a digestive tract with dice and chips

Roll Of The Dice

About four years ago, I was at the craps table in Atlantic City. What a hot streak! Everyone kept cheering. I made several points. There was an All Tall Small bet that was extremely unlikely. You have to hit all the numbers on the table before rolling a seven. If you do so a small bet pays an astronomical sum. I made it. Everyone celebrated wildly.

The other players at the table came over to congratulate me. Some of them were on a bachelor party. Before my roll, no one was winning. It helped make the evening memorable. They shook my hand and thanked me. It felt great.

Other times, at the craps table, it can feel like death. You keep losing incessantly. You may even wonder if you will be able to afford the bus ride home. Everyone around you starts to annoy you. You want some way, any way, to make it stop.

How Crohn's disease compares to gambling

Why do I bring this up? Well, because Crohn’s disease, in many ways, is like gambling. It all comes down to streaks. To patterns. To good days and bad days. It’s just as unpredictable. Just as dependent on pure chance.

I’m not just making a facile comparison. There is so much riding on the line when you have this condition. Will the colonoscopy report be okay? Does it seem smart to go in for elective surgery?

Should you try a biologic medicine and risk the side effects? Crohn’s disease, in so many ways, is a gamble, an existential wager, a risk that requires luck.

Calculating odds and trusting instints

Then, too, the two keys to having any success at the casino are: 1) comprehending the mathematical odds 2) trusting your instincts. For example, there are certain bets in craps that have very low odds. Avoiding those is critical. At the same time, just as important as grasping the math is gaining enough experience to trust your instincts.

I believe it is similar to Crohn’s disease. You need to know what gives you the highest mathematical chance of success. For example, don’t just trust your doctor. Look up remission rates for various drugs. Before agreeing to a procedure, study the risks involved.

Get to know your body and follow intuition

At the same time, after you have some experience with your own pattern of symptoms, let intuition guide you. Don’t be afraid to personalize your treatment, make unconventional choices (such as trying alternative therapies), or to even suggest to your doctor a certain class of drugs that have worked in the past.

IBD is similar to a game of craps. We are always at risk, the stakes are quite high, and we depend on luck. To improve our health outcomes, it is best to employ mathematical analysis.

That said, at other times, this has to be balanced with trusting the instincts we’ve honed over time, or, put differently, taking a creative approach to treatment.

Thanks for reading. I hope this analogy was helpful. Feel free to provide feedback in the comments or to share your own insights.

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