NORTH PROVIDENCE -- Alicia Vanasse began a new life three years ago.

It’s “180 degrees different,” she says. In many ways, Alicia’s life resembles that of other college students and she is thankful for its very ordinariness.

Alicia attends Rhode Island College full-time. She is an honor student, vice president of the senior class and president of the Communications Club. She has a job as an intern in the college’s public relations office. She has friends. She dates. She owns a car, a midnight blue convertible Sebring that she loves in the way people do when they are young and the car means freedom.

Her new life feels “normal,” or as close to normal as Alicia, 24, dreamed it could be.

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Journal photo / Bob Breidenbach

Alicia Vanasse talks about living with Tourettte's

When Alicia was 13, she began exhibiting symptoms of what she and her parents would learn was Tourette syndrome, a neurological disorder characterized by involuntary facial and body movements and utterances, called tics.

Because the condition is relatively rare, and its symptoms difficult to mask, people with Tourette’s often experience misunderstanding, even cruelty, when they “tic” in public.

Alicia has been teased, rejected and mocked. Shopkeepers and restaurant owners have thrown her out of their businesses, thinking she was acting up. She’s been removed from classrooms. She has been asked to leave movie theaters. She has lost friends.

“When she was younger, she would look at me and say, ‘Mom, what’s wrong with me? Why can’t I be normal?’ ” said her mother, Donna Vanasse. “Those are her famous words. Those are words that break the heart.”

THE FIRST SIGN came in 1996, when Alicia started hiccupping uncontrollably. A few weeks later, she had trouble running and hitting the ball during a softball game. Then she began making odd, high-pitched noises, which sounded like a bird or a sharp whistle. Her facial muscles, eyes, shoulders, neck and arms twitched and jerked.

“We never knew when it was going to happen,” said Donna Vanasse, a guidance counselor at North Providence High School. “When it happened in school, they’d call me, because they didn’t know what to do.”

It took doctors 18 months to diagnose her, but by then her parents had figured it out. Alicia’s father, Michael Vanasse, is a technologist at Miriam Hospital who conducts brain wave tests on patients. He had seen Tourette’s before and recognized the signs.

Most researchers think Tourette’s is a genetic disorder, although environmental factors can trigger it. Symptoms usually appear in childhood, between the ages of 7 and 10. In Alicia’s case, doctors at the Yale New Haven Hospital told the Vanasses they believe an undiagnosed strep infection may have traveled to Alicia’s brain stem, possibly contributing to the condition.

Alicia had been diagnosed with dyslexia when she was younger, and had been given medication used to treat attention deficit disorder. Doctors do not know why, but a high percentage of Tourette syndrome patients are prone to learning disabilities such as ADD.

There is no cure, but the condition is not usually degenerative. People with Tourette’s have average intelligence ranges and life spans. About 200,000 Americans have Tourette’s, according to the National Institute of Neurological Disorders and Stroke, and as many as 1 in 100 may exhibit subtle signs of the disorder, such as coughing repeatedly or involuntarily twitching their eyes.

Alicia’s case was considered severe. Unlike most people with Tourette’s, Alicia experienced tics in her sleep, which prevented her, and her family, from getting a good night’s rest. They had to awaken her at night if her tics flared up, so she did not fall out of bed or hit her head against a wall.

At times, the tics were so violent Alicia could not dress or feed herself. Her parents and younger sister, Ashley, now 20, helped her during severe episodes, which can be triggered by stress, exhaustion and other factors, such as flashing lights or certain foods.

“I can remember when I was about 14, my sister had to help me,” Alicia said. “I was so frustrated. I was thinking, ‘My little sister has to tie my shoes. This is not what I want.’ ”

At Birchwood Middle School in North Providence, teachers and students did not know what to make of Alicia’s condition. She says she endured teasing from classmates and struggled in school.

But her symptoms improved slightly after she entered North Providence High School, enabling Alicia to hold a pen and use a computer for schoolwork.

After high school, as she tried to take courses at the Community College of Rhode Island, Alicia’s condition worsened. Her body had built up resistance to the drugs she was taking, and her tics intensified. Potassium levels in her body plunged, requiring multiple hospitalizations.

Alicia could barely keep up with one course a semester. Most days, she could not drive. Drugs she was on caused her weight to balloon. By nature an outgoing person, Alicia became withdrawn and shy. She avoided going out and spent most of her spare time with her family, including several aunts, who gave her another safe place to be besides her home.

ABOUT THREE years ago, Alicia began a new regimen of drugs through the Yale New Haven Hospital, and her condition rapidly improved, with severe episodes occurring less frequently.

Around the same time, she transferred to RIC. At first it was hard to find her niche, and the classes were tough. Alicia became involved in some campus events, but she became discouraged and considered dropping out.

Her mother reached out to RIC spokeswoman Jane Fusco, who Alicia had met through a campus group, the American Democracy Project. Fusco persuaded Alicia to stay in school.

Fusco recommended Alicia for an internship with U.S. Sen. Jack Reed’s office last spring, an experience that built up Alicia’s confidence.

“I’d never been in an environment like that before,” Alicia said. “I’d never had a job. No one ever took the time with me before.”

Alicia now works for Fusco as an intern in the college’s public relations office.

Although Fusco had never met anyone with Tourette’s, she had a knack for knowing how to help Alicia, and has gone out of her way to ensure that Alicia feels comfortable at RIC.

She helped Alicia draft a letter to professors. It outlines accommodations she needs, and asks if she can address the class, so students are not caught off guard when she experiences tics in class. Fusco explained Alicia’s condition to others in the public relations office before she started the job. Fusco makes sure the sofa in her office is available to Alicia on her “bad days,” when she needs to relax.

Even with medicine and accommodations, Alicia experiences tics every day, and continues to have severe episodes every few weeks.

She needs to avoid direct sunlight, camera flashes, fire drills, and other sudden light flashes and noises, which can trigger an intense episode of tics. Her body jerks repeatedly and she makes noises as if she is gasping for breath. When this happens, Fusco and friends at RIC help calm her, seating her in a darkened room. They make sure she gets home afterward.

“Alicia doesn’t need our pity. She needs understanding,” Fusco said. “The most important thing is, in this office, she feels at home.”

Alicia worries about when she will eventually have to leave RIC.

“I’ve always been ‘that girl with Tourette’s,’ ” she said. “But here I’ve been given the chance to just be Alicia. People have been willing to work with me, to help me. I haven’t found that anywhere else.”

Alicia is grateful for the days she is able to dress and feed herself, drive to RIC, work, attend classes and see her friends.

“My worst day now was my best day then,” Alicia said. “It is a different life.”

STILL, MANAGING Tourette’s requires a lot of work.

Alicia gets up early — 5:30 a.m. most days — in order to get ready for the day.

It takes her about an hour to get out of bed. Often she feels grumpy and not well-rested.

She experiences a lot of tics in the morning, as the medicine from the previous day has worn off. Because the drugs are powerful, she must watch her weight in an effort to keep the dosage as low as possible. If she gains weight, the doctors have to increase the dosage, something they try to avoid because of the potential damage to Alicia’s liver.

Alicia practices deep breathing, similar to yoga, to help reduce stress. Then she has breakfast with her sister, Ashley, and chats with her parents before they run out the door for work. She loves the smell of coffee, but can’t have any. No caffeine, no chocolate, no citric acid, nothing with red dye or preservatives. Those foods exacerbate the tics.

Then, she takes a half-dozen pills. Within 30 minutes, the vocalizations and the neck and arm twitches decrease.

“Sometimes I hear people [on campus] complain about this or that. But I have to do a lot just in order to be here, to get dressed, to go to my classes,” Alicia said. “I feel very lucky.”

Alicia plans to go into public relations and event planning after she graduates in May. She also wants to advocate for children with disabilities, and hopes to start a softball team for them.

These days, three or four weeks can go by without a “bad day,” although stressful events like holidays usually trigger a spate of tics.

Alicia knows the medication could stop working one day, and the bad days could become more frequent. “But I don’t worry about that,” she says. “I just focus on what I am able to do today.”

Given the chance, Alicia says she would not go back in time and choose not to have Tourette’s.

“The one thing Tourette’s has taught me is perception. You feel right away how people respond to you, how they treat you,” Alicia said. “Tourette’s has made me more disciplined. It’s taught me resilience and drive. I wouldn’t be where I am today without Tourette’s.”

Her goals are typical, she says.

“I just want to live a life like everybody else — that’s it,” Alicia said. “I want to have a job, a family, a home.”

jjordan@projo.com