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Megan Howard started drawing as she sat in unbearable pain in a Chicago hospital room, awaiting a skin graft to treat an ulcer on her leg.

The lines on the paper looked like nerves, eventually forming a vague image of a face that was screaming—an artistic, visual expression of her physical pain.

“When I saw it, it reminded me of the famous painting of ‘The Scream’ by Edvard Munch, and I thought that was appropriate with the way I was feeling,” she said.

Megan Howard created “Screaming in Pain,” a Prismacolor marker drawing to visually express the pain of living with her chronic illness – Behcet’s Disease.

The 30-year-old woman living in Mayfair on the Northwest Side said she uses art as an outlet to help her deal with the pain of living with Behcet’s disease, a rare disease.

She entered that piece of artwork—created two years ago during her hospital stay—into this year’s Rare Artist Contest, sponsored by the EveryLife Foundation for Rare Diseases, to raise awareness of Behcet’s disease and hopefully lead to more research and treatment.

Her “Screaming in Pain,” a Prismacolor marker drawing, has the most votes on Facebook to date. The entry that gets the most online votes by Tuesday wins a $500 gift card and a travel stipend to go to Washington, D.C., where the winning artwork will be displayed during Rare Disease Week in late February.

Behcet’s disease causes the immune system to become confused and attack the body; it is more common in the Middle East and Japan than in the U.S., with symptoms ranging from mild to severe to even life-threatening, said Dr. Calvin Brown Jr., professor of medicine in the division of rheumatology at Northwestern University’s Feinberg School of Medicine.

When the immune system attacks the body, it can be extremely fatiguing, like when you catch a cold, he said. “You know how crummy you can feel. People with Behcet’s have to live with that every day,” said Brown, who does not treat Howard.

The disease is not contagious, but it can inflame the blood vessels, lead to blood clots and cause problems in the central nervous system, he said.

There is no cure for Behcet’s disease, which tends to develop in young people in their 20s and 30s, and the exact cause is unknown, but it is believed that genetics and the environment can be factors, according to the National Institute of Arthritis and Musculoskeletal and Skin Diseases.

Diagnosing Behcet’s disease can be difficult because no specific test confirms it and symptoms may not occur at the same time, Brown said.

Among Howard’s symptoms: mouth ulcers explained away in the past as canker sores, skin lesions, headaches, joint pain and digestive problems.

She said a doctor referred her to a dermatologist who told her it appeared to be Behcet’s disease and sent her to the Cleveland Clinic, where she was diagnosed and began treatment in 2004, when she was a college freshman studying graphic design.

An immunosuppressant drug worked for a few years until the symptoms returned with a vengeance in 2009 as she was working on her master’s degree in art therapy, she said.

“My mouth ulcers were very deep. I couldn’t even smile without it being so painful that I’d cry. I just felt so tired and burnt out,” Howard said.

She went from walking around on campus at Adler University downtown to requiring a wheelchair because she was so fatigued. She was in and out of the hospital. She stopped being able to eat regularly and couldn’t keep food down. She now uses a feeding tube.

Some medication has helped suppress the symptoms, she said, but the disease is not fully under control.

For her, art is welcome distraction. Her media ranges from drawing with markers to painting with watercolors to glass torching for jewelry.

“When I am in a lot of pain and I don’t want to take a pain pill, or I already have and it’s not working, sitting there and drawing and focusing on what my hand is doing on the paper takes my mind away from the pain,” Howard said.

When she has energy, she uses a torch to melt glass for an art piece or ventures outdoors for inspiration.

“My good day today could turn into my really bad day tomorrow if I push myself too far. So a good day is maybe getting a little sunshine and being able to see a little nature, [get] some rest and maybe work on some art and maybe [get] some rest again,” Howard said.

She often grabs her journal next to her bed when she’s not feeling well enough to get up.

Although the disease has taken away some independence as she relies on a caretaker, she still tries to stay positive.

“When you’ve lost the ability to do certain things that we take for granted every day, you look at those things differently,” Howard said. “Everything I am able to do today, I’m just really thankful for and try to take advantage of and make the most out of life.”