“What Is The Weight of Iron?” by Alisson Aviles, 16

It was a normal morning by all accounts, it was just past 8 am. I hadn’t done anything except eat breakfast but my heart pounded like I'd just done the mile at school. I had gone up those stairs hundreds of times. ButI remember everything about it because something felt off, first came the dizziness then the static that clouded my vision. I couldn't even see the step in front of me then everything went black. When I finally opened my eyes I was face down on my tile floor. The metallic sting of my blood lingered in my nose. How long had I been laying like this? I wondered as I reached up to wipe the blood coming from my nose. I had fallen down 8 steps. My hands trembled as I tried again to wipe my nose and just stop the bleeding and that's when reality sunk in: my body had betrayed me again. It wouldn't be the first time and it most certainly wouldn't be the last.

I was thirteen that first time I blacked out walking up those stairs but my story starts much earlier.

I have suffered from Iron deficiency Anemia since I was six years old. But the signs all started long before the doctors gave it a name. My constant dizziness, fatigue, shortness of breath, unexplainable bruises and stomach pain that just wouldn't go away. Yet for years I was ignored and dismissed. “Shes growing up” “Kids get tired, it's normal”. “Of course she's tired” the doctor's voices would all echo to me and my mother. But when the chest pains began I was taken more seriously. Something deeper in me wasn't right. That's when all the tests started. I learned that my body couldn't make enough hemoglobin because it lacked iron. My blood, the very thing that kept me alive, was starving. And with that, all of my childhood changed. While some kids grew up in jungle gyms and kickball courts. I grew up in hospitals. My playground was the phlebotomy lab where they drew my blood. Every nurse knew my name. I even stopped fearing the needles by the time I turned seven, I just started dreading what came after. The results that would tell me whether I had to be poked further or if I just barely scraped the minimum and got to go home. I didn't even look down at my arm anymore, so much so I never noticed when the butterfly needle went away until during one of this year's tests I looked down to see a bigger needle in me. I couldn't feel the vein in my right arm anyways.

While Iron deficiency anemia may not sound terrifying to some, living with it shaped my entire life. I had to navigate a world that wasn't built for someone whose body could give out at any given moment. During gym class while the other kids raced across fields I stood by on the side holding onto the metal pole trying to stay upright and make my vision stop spinning. At recess nosebleeds were common. The blood came down my face while I quietly dabbed them with a tissue pretending I couldn't see the looks my classmates gave me. And in the summer when the sun would come out and free most kids from school and stress, it turned mine into a dizzy blur of headaches and even blurrier vision. Heat was my enemy and with every wave of it I had to spend more time inside, more time isolated in a sterile hospital.

After I fell down the stairs doctors realized my iron level had dropped even further so they tried bringing them up. They placed me back on the iron pills that I had for years as a kid but they barely made a difference. Due to my levels never increasing enough I was eventually hospitalized and put on a more aggressive treatment plan that included iron injections during every blood draw. Those worked, sort of while my levels stabilized to a solid number they will

likely never reach the healthy range. Most women need more irondue to menstruation, yet my body couldn't even meet the baseline for men. My average? A 9.5 at every physical. The same number that is well below a healthy range. And the hardest part? No one can see it. Invisible illness has a cruel way of making you feel like you have to prove your pain. Others don't look at me and immediately recognize something is wrong. I don't wear a cast or use a cane. I'm not hooked to a machine or wrapped in bandages. You're presumed to be just fine. Lazy, maybe. Moody. Going through a phase. They don't see when you collapse onto your bed after school, not because of drama or an exam but because the walk down the hallway left you winded. They don't see you lying awake at night not out of teenage angst but because your heart races and your body aches and it just wont give into sleep.

But living with a chronic condition has taught me more than I had ever expected. It forces me to be so in tune with my body in ways most kids almost never are. I can recognize the subtitles shifts in my body when my iron is dropping before a lab report can even confirm it. The tests always go one way or another anyways. I’ve switched doctors countless times, whether it's due to our insurance changing or relocating, it always stays the same. I stay the same. I've learned how to advocate for myself when I'm not even taken seriously and learned to calm a new doctor or intern when they read my blood results that send them into a quiet panic. That is what a chronic illness is. No dramatic episode, just a lifetime of learning how to adapt to a body that doesn't always cooperate.

Now at sixteen, things have changed. I still take Iron. I still get monitored regularly. But I’ve built routines that more than support my health. I’ve found ways to balance school,friendships. I can even play soccer now despite the unpredictable rhythm of my body. And while some days I feel like I'm thirteen again crumpled up, laying on the floor, breathless and bleeding, most days feel like progress.

Still one thing that continues to frustrate me is how little awareness there is around iron deficiency anemia. This condition I face isn't rare. It's the most common nutritional disorder in the world. More than 30% of the world population is anemic. Most of them due to iron deficiency. In the United States alone around 10 million people are iron deficient and 5 million have iron deficiency anemia and despite these numbers it receives less attention than other chronic conditions. There's a lack of awareness, empathy and representation especially for young people struggling with it silently being told they are “just lazy” especially teenagers. Because when someone thinks of a chronic illness they picture the hospital visits and the machines and a dramatic diagnosis or visible disability. But chronic can just mean quiet. It can mean having to get up every day pretending that you're fine because it's easier than explaining to others why you're not. It can mean sitting in class trying to concentrate while your vision flicks and your heart races from just getting up from your chair too fast.

Iron deficiency anemia may have shaped many aspects of my life and story but it does not define who I am nor should it define the millions of others dealing with it either. It is just part of my story , not the headline. We deserve to be seen, heard and supported. This isn't just about me, it's about the thousands of quiet stories out there just like mine that don't get the voice they need. And this is the first step to them listening. I used to think that the strength to get above this was to push through without letting anyone know I was struggling. But now I know real strength is in being honest and loud. In listening to your body. In demanding those answers. To embrace the normal many have to face no matter how different that might be. We do not have to prove our pain.