Here is what Joe Palumbo would like you to know about his year-long battle with an ulcerative colitis flare up: Not a ton.
Bowel habits, cramps and weight loss. It’s not exactly dinner time conversation.
“I wasn’t really in pain,” Palumbo said Saturday from Rangers spring training camp in Surprise, Ariz. “But all I can really tell you is it was kind of just urgency. I’ll leave it at that. I think you could use your imagination a little bit. But it wasn’t fun. I hope I never have to experience something like that again in my life. And I hope nobody else has to go through it, either.”
This is often the case for the 3 million or so Americans who deal with inflammatory bowel disease, which encompasses ulcerative colitis and Crohn’s Disease: You suffer in silence. Discussing the issue is often as embarrassing as the pain associated with it.
Palumbo, 26, is at least the third player in the Rangers organization to deal with IBD over the last five years. Reliever Jake Diekman, now with Oakland, and Kyle Gibson both suffered from debilitating flare-ups. Diekman detailed his battle with the disease he’s suffered with since age 11. It eventually led to surgery to remove his colon that cost him most of the 2017 season. Gibson was diagnosed in 2019, while with Minnesota, and struggled through medication and diet changes.
On Saturday, for the first time since the flare-up wrecked his 2020 season, Palumbo, 26, tried to put into words his own journey. The words did not come easily. He was first diagnosed in 2016, but medication had controlled it well. Then came 2020.
What started with some minor symptoms during spring training snowballed into fatigue and the “urgency.” On July 26, the first weekend of the delayed season, he pitched two impressive innings, then went out for a third and his velocity dropped significantly because of fatigue associated with ulcerative colitis. He pitched once more five days later, facing three batters. That constituted his season.
It only got worse.
On Aug. 10, he turned to his cousin, Jeremy Larkin, with whom he was living and said: “I think I’ve got to go to the hospital.”
“At the beginning of spring training last year, it was very manageable,” Palumbo said. “I was able to come to the field and do what I needed to do and pitch in games. It was a slow progression, but eventually, it got to the point where it was extremely serious and my quality of life was not the best.
“If I’m saying, ‘somebody take me to the hospital,’ obviously something is wrong,” he added. “But my symptoms were just out of control.”
He was there four nights. After he was released, he continued to lose weight, dropping a total of 30 pounds before he stabilized. Doctors eventually switched him from an oral medication to an injectable immunosuppressant to counterbalance the hyperactivity of his immune system, which can lead to the inflammation associated with IBD.
Slowly, he started to put on weight again. He began throwing. With help from Rangers dietician Stephanie Fernandes, he was able to restructure his diet and start putting on weight again. It’s not an easy task. Food that sits well with one ulcerative colitis patient doesn’t necessarily work for another.
“What we’ve learned is that everyone’s disease is individualized,” said Fernandes, who helped reshape Gibson’s diet. “And the conversations and experiences are all unique. It’s a matter of being able to pivot or knowing when not to pivot. People have the same disease, but different experiences.”
Palumbo was nearly 200 pounds when camp started last year. After falling as low as 165 at the height of his flare-up, he has returned to about 185.
“He was probably too heavy to start last year,” manager Chris Woodward said. “You can still be strong without putting on a ton of weight.”
The Rangers will also go slowly with him. Once considered a prime contender for a rotation spot, Woodward on Saturday indicated the plan for Palumbo is probably relief work for 2021.
“I don’t want to rule out starting, but I think that’s a progression,” Woodward said. “I don’t want to be irresponsible. He basically didn’t pitch last year. He’s a full go right now. He feels healthy. His arm feels good. He’s educated himself and come up with some ideas on how to change his lifestyle. Now, he can just focus on baseball.”
Which would be nice.
The ulcerative colitis flare up marked the fourth consecutive year his ascent to the majors has been sidetracked by a health issue. He seemed to be on the fast track going into 2017 but suffered a torn ulnar collateral ligament midway through the season and required Tommy John surgery. That took him out of the 2018 season. In 2019, he reached the big leagues for the first time, but dealt off and on with blister issues. Then came 2020.
“Honestly, I just want to be on the field,” Palumbo said. “I want to be on the mound. I want to pitch. I want to just show what I can do. Because I know I could do it. I know I have the stuff to pitch in the big leagues. It’s just all about me being healthy at this point.”
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