‘You’re not supposed to have to think to breathe’: Mandi Balaskovits’ life with eosinophilic esophagitis

Dairy is a trigger for Mandi Balaskovits’ eosinophilic esophagitis, which is a disease that causes buildup of white blood cells in the esophagus, causing it to narrow and make it hard to swallow. She was diagnosed with EoE when she was 16 years old.

Emily Blobaum

The whole ordeal lasted maybe five minutes.

Mandi Balaskovits was eating dinner with her family a week before moving into her residence hall at Iowa State.

All of a sudden, she felt her roast beef lodge in her throat. She couldn’t swallow. She couldn’t breathe.

Her eyes turned bloodshot and the color began to drain from her face.

“I’m going to die,” she thought as her parents called 911.

She wasn’t choking, so they couldn’t do the Heimlich maneuver. She wasn’t having an anaphylactic shock, so they couldn’t use an Epi-Pen.

All her parents and the paramedics could do was calm her down until the roast beef passed.  

The reason

Balaskovits started having throat problems when she was 14 years old. She had trouble swallowing, would get frequent stomach aches and would throw up.

Doctors diagnosed her with irritable bowel syndrome in middle school because she was showing symptoms of acid reflux, heartburn and chronic stomach aches.

It wasn’t getting better, so for nine months, she went to local gastroenterologists trying to find answers. She finally found one who recognized her symptoms as being something else and realized her irritable bowel syndrome was a misdiagnosis.

She was sent to a children’s specialist an hour away, where she was diagnosed with eosinophilic esophagitis, EoE, at age 16.

EoE is a chronic disease which causes a buildup of white blood cells that lead to constriction in the esophagus, making it difficult to swallow food.

According to the National Organization for Rare Disorders, the condition affects one in 1,000 children.

EoE has no known cure, but steroid medications have been known to control inflammation, so doctors put her on what Balaskovits called, “a ton of medicine,” which helped for more than three years.

A more permanent treatment

Balaskovits’ first semester of college was characterized by nausea, excruciating stomach aches, diarrhea, swallowing troubles and no appetite. The copious amounts of medicine weren’t enough to treat her symptoms anymore.

“All of my symptoms were as bad as they ever have been,” she said.

When she went back home for winter break, she was administered an endoscopy and her esophagus didn’t look good.

Her family debated whether she would return to school, Balaskovits said.

It was then, 3-and-a-half years later, that she turned to an elimination diet and stopped eating dairy after noticing eating ice cream often gave her stomach aches.  

Balaskovits remembers going out for ice cream with friends several times a week after getting her driver’s license in high school.

“When I couldn’t drive, I had ice cream sometimes as a treat, but my parents didn’t like to have it in the house, so then once I had that freedom, I seriously ate ice cream multiple times a week,” she said. “I think that’s what made it so much worse, because I was eating dairy so much more than I used to.”

It took a month for Balaskovits to notice an improvement, but after six months, she went back in for another endoscopy. The test results showed that her esophagus had mostly cleared.

In addition, she had her esophagus stretched from 14 millimeters to 16 millimeters twice in the span of two years in hopes of making it easier for her to swallow. However, she can’t get it stretched to the width of a normal esophagus — 20 millimeters — over fear that it would rip.

Chewing and swallowing

Now that Balaskovits knows what triggers her EoE, she feels she has a good handle on it.

She’s used to chewing her food for longer than average.

Food will occasionally get stuck in her throat if she swallows her food too fast, but she’s learned not to panic, and to instead close her eyes and take deep breaths through her nose until it moves along.

“It’s just a matter of if you can breathe, the food will eventually pass,” Balaskovits said.

She’s used to taking her medicine — which includes steroids, acid reducers and stomach inflammation reducers — 30 minutes before breakfast every day.

EoE is unlike an allergic reaction because a reaction from a trigger food doesn’t happen immediately, but rather over time.

“If I were to eat a slice of pizza, it wouldn’t kill me or anything. I could [eat pizza] if I really wanted to, but I won’t let myself have one treat because then I’ll want it all the time,” Balaskovits said.

In addition to avoiding dairy, Balaskovits can’t eat tree nuts, fish, legumes, bananas, melons and most vegetables but she has found foods that she can enjoy.

“Turkey sandwiches are my go-to,” she said. Sandwiches which consist of sliced turkey, spinach and onion, on Sara Lee whole grain white bread.

“As long as you are responsible enough to take all your meds and are disciplined enough to actually avoid the food that triggers it, [it’s manageable],” she said.

Balaskovits is one of the students featured at the Rare Disease Day event at 6 p.m. Wednesday in the Gallery Room of the Memorial Union. She looks forward to sharing her story and hopes to help erase fear of the word “disease.”

“I think there’s such a stigma around disease,” she said. “It’s just this big, bad word and there’s so many people that have diseases and you would never know that they’re completely normal.”