The Healing Power of Laughter

“Always laugh when you can, it is cheap medicine” -Lord Byron

I woke up tired again today. For me, waking up tired is one of the hardest feelings in the world. When this is combined with steroids, stress, and an inability to meet my responsibilities the days feel incredibly long. Yesterday, I yelled at my partner for cutting potatoes for French Fries into rectangles as opposed to using the cheese grater to make round potato chip like French Fries. Of course, this yelling resulted in my second crying meltdown of the day.

They say that people with Crohn’s ought to avoid stress. But, when the Crohn’s is resulting in decreased economic earning power, the difficulties of meeting basic life functions i.e. being awake long enough to do things like dishes, laundry, and showering, and there is the added guilt of not being physically able to spend time with a dying parent the emotional devastation gets to be a bit much. When daily pain is thrown in, and our diets become so restricted that even a simple meal becomes a challenge of extraordinary proportions it can be incredibly hard to focus on the big picture, hold onto to hope, or hell even smile at the insane. But, laughter truly is the best medicine and in these moments finding something to laugh at can make all of the difference.

Yesterday, my thing to laugh at was the need to be institutionalized. I felt as if my grip on reality was slipping, my emotions were a yo-yo of anger, frustration, grief, and fear which led to more than one moment of me crying while my partner kept telling me it was going to be okay, and while I knew that it was going to be okay in the moment I did not feel like it was going to be okay.

In response to a desperate plea for help my sister unknowingly made me laugh so hard I cried. After texting her that I was losing my grip on reality and that I felt as if I needed to be admitted to a psychiatric facility she replied with “well start with finding out if you can wean a little? And then get a referral to an institution.” For some reason, I just started laughing- perhaps there was nothing else I could do? But, in laughing, I finally had a little bit of relief from the emotional agony I had been walking through.

The Power of Laughter

Laughter has a myriad of benefits. Among these benefits are: stress reduction, immune system boosts, decreased physical pain, and improved mood.

Stress Reduction

High levels of stress are linked to decreased health. When we experience stress our hearts race, our breathing becomes faster, and our muscles prepare for action. During the time of stress, our adrenal glands release both adrenaline and cortisol which have negative impacts on our health. In fact, high stress has been linked to cardiovascular problems, headaches, stroke, body aches, and harmful behavior such as overeating and alcohol and drug abuse. But, when we laugh our bodies have increased oxygenation and our brain releases endorphins and neurotransmitters. The increased oxygenation can decrease the risks of cardiovascular problems as well as reducing the other negative impacts of stress on the body. Laughter also decreases the presence of stress hormones which lower immune response and lead to harmful behaviors.

Immune System Boost and Pain Relief

Endorphins are the bodies plain relievers. Like opiates, Endorphins attach to our brain receptors which can reduce pain as well as improve our overall mood. Not only does laughter result in decreased physical pain, but it also has been linked to immune systems boosts. Stress results in a chemical reaction in the body which lowers our immune response. In contrast, laughter releases neuropeptides which can fight stress and illness. Laughter also increases the efficiency of T-cells which gives a person an additional immune boost. Finally, the decrease of stress hormones that comes with laughter has its own immune-boosting effect.

Mood Enhancement

With the increase in endorphins that it provides laughing has a natural mood-boosting effect. We also can’t be angry or anxious when we are laughing. The Mayo Clinic says that laughter can also lessen depression and anxiety which will lead to us feeling happier. Laughter also helps us to shift our thinking from negative to positive. Through laughter, we can gain perspective on the situations and gain psychological distance from the depression, anger, or anxiety. With this psychological distance comes balance and a better ability to think positively about the situation at hand.

Health Benefits of Laughter by Jenny

How to Find Humor

For those of us living in hopeless or defeating circumstances, it can be challenging to find something to laugh at. Finding ways to find humor in the absurd can help to increase the presence of laughter in our lives. But, even if we are not in a place where we can laugh at the situation, we can find others ways to obtain the health benefits of laughter

  1.  Watch a comedy special or a funny movie. Netflix and Hulu both offer a range of options for comedy. If I don’t have time for an entire comedy special or movie, youtube has countless funny videos that can make me laugh in under five minutes. Start with a search for your favorite comedian, or terms such as “funny.”
  2. Spend time with funny people. My brother is one of those people who have zero ability to self-filter which leads to him saying the things everyone is thinking, but no one says. As such, whenever I spend time with him, I find myself laughing more than not. When I need a mood boost, Luke is always someone I can count on.
  3.  Fake it! Some Yoga gurus have already caught onto the healing power of laughter and in some practices fake laughter and breath work go hand in hand. Even though we might feel a bit ridiculous faking our laughter, eventually the mood boost of faking it and the absurdity of it will lead to real laughter.

The Devil’s Medication- Prednisone and IBD

“Sometimes I say the medication is even tougher than the illness” -Sanya Richards-Ross

I wrote a text to my sister this morning, “while I was showering I determined Crohn’s has turned me into a tired rage-filled hormonal chipmunk with acne.” For us IBD patients, this sentence is all too familiar. One of the more effective medications for IBD, just happens to be Prednisone. Prednisone, the stuff nightmares are made of. When Prednisone is combined with other medications and treatment it can sometimes make us feel like the disease itself is better than the treatment for it.

Throughout the decades I have had Crohn’s, I have been on many expensive “miracle” medications which have all promised to relieve the suffering that I experience. Sadly, for me, the majority of these have failed me. The fact that, for me, these medications have not worked has threatened my in general low-key and often accepting personality. For example, whenever I see an Entyvio commercial I find myself arguing with the tv. “Junk!” I proclaim, all Entyvio did for me is allow fistulas and abscess to form. Of course, my general anger at the TV, is probably due in part to the copious amounts of Prednisone I am currently taking while I, “wait and see” if Stelera (the newest, latest, and greatest “miracle” medication) works. This is not to say that biologics are all bad. In fact, I am so grateful for TNF inhibitors. I often wonder if these had been available to me when I first experienced Crohn’s symptoms, if I would have ever had to have my large intestine removed in the first place. But, like other contemplative processes, the “what ifs” can drive one crazy and in general I am grateful for and have never regretted having a proctocolectomy.

Prednisone

I both love and hate prednisone. In the middle of a flare, under-weight, in pain, and unable to function in daily life, I am always so grateful for the relief that Prednisone provides. In fact, of all of the miracle medications, I have ever been on the only one which has consistently given me relief has been Prednisone. But, with this relief comes a sacrifice and toll on both my body and mind. As I said to my sister, on Prednisone, I become a rage-filled hormonal chipmunk with little sleep, mood swings, and the development of other medical problems which come with their own treatments. For example, at seventeen I was diagnosed with Osteopenia which is a precursor to Osteoporosis.

Dealing with Prednisone Side-Effects

I am the first to admit that I am not always the most graceful at managing the side-effects which come with Prednisone. Recently, I was angry with my partner for an inordinate amount of time for no other reason than I was just angry and he happens to live with me. But, I do the absolute best I can, to not let Prednisone rule my life.

Support

While support alone will not take away the horribleness that can be Prednisone, it can make it easier. Helping my partner to understand how it feels to be on Prednisone and the associated rage/mood swings allow him to be more empathetic as opposed to angry that I am being such a, well for lack of better word, bitch. In addition to my partner, I use my girlfriends and family for comic relief and to check my rationality. It helps immensely that my best friend has also experienced the joys of Prednisone and she helps me to laugh about it often.

Food

One of the more infuriating Prednisone side-effects is a feeling of constant hunger. For those of us who have IBD, food is the enemy and being constantly hungry is not necessarily helpful. Furthermore, the weight gain associated with Prednisone hits hard and fast which can be not so beneficial for those of us who struggle with self-esteem as it is. To combat the constant hungry, I tend to keep foods I know are “safe” but also relatively healthy on hand. Yogurt, crackers, and smoothies become God sends for me. An added benefit of yogurt or other dairy products is the calcium which can help to mitigate the bone density issues related to Prednisone use. In addition to increasing calcium, some experts recommend the limiting of salt as water retention is one of Prednisone’s side-effects.

Self-Talk and Positive Thinking

Ideally, one can develop a way of talking back to the mood swings and other side-effects. When I find myself laying in bed crying because all I want is a turkey sandwich with both lettuce and pickles and know that eating it would cause a bowel obstruction it helps to tell myself that a.) this won’t be forever, b.) I can still have a turkey sandwich just no lettuce and no pickles, but, I can have bacon!, c.) I’m crying because I am on the devil’s medication not because I have real genuine feelings about the sandwich. (Although, I do have real feelings about the turkey sandwich just not ones that would typically result in sobbing, but that is a post for another day…). Reminding myself that this too shall pass and that someday I will taper off this medication and be back to my regular self-does help me to keep it all in perspective.

In the midst of joint pain, or weight gain, or rage it can be so difficult to remain stable and focused. But, for me, those side-effects, in general, outweigh the alternatives and I know that Prednisone is just a temporary situation to hold me over until the some-day that I will be able to taper. With that being said, I feel as if it would be irresponsible of me to release this into the universe without saying this: follow the directions of your doctors. No matter how bad the side-effects are, going off of Prednisone without a taper (especially if you like me have been on it for months or years) can have serious consequences. For more information about the importance of using a taper read “Prednisone Withdrawal: Why Taper Down Slowly” from the Mayo Clinic.

Additional Reading

  1. Prednisone Frequently Asked Questions
  2. IBD Medication Guide- Corticosteroids 
  3. Fact Sheet- Corticosteroids 
  4. Crohn’s and Colitis Foundation- Corticosteroids 

If you have any great tips for managing Prednisone side-effects I would love to hear from you in the comments!

Splenda Might Cause Crohn’s Disease Inflammation

“Splenda might have pro-inflammatory implications only if consumers have susceptibility to CD, potentially aggravating the severity of symptoms and flare-ups, which would be in agreement with observations reported by IBD patients” –Alex Rodrigues-Palacios and colleagues

It is no secret that people with IBD manage complex and shifting diets depending on their personal symptoms and disease state. But, new evidence suggests that all patient’s who suffer from Crohn’s disease might want to consider avoiding Splenda. A recent press release from Case Western Reserve, says that a recent study by researchers found that “the artificial sweetener sucralose, known by the brand name Splenda, worsens gut inflammation in mice with Crohn’s disease, but had no substantive effect on those without the condition.” In other words, the mice with Crohn’s had worse inflammation after the consumption of Splenda while the mice without Crohn’s had no significant inflammatory changes.

Why Might Splenda Increase Inflammation?

The research found two reasons for the link between Splenda and increased inflammation in the mice with Crohn’s.

  1. Splenda created increased growth of E. Coli which lead to increased bacterial penetration in them mice with Crohn’s disease.
  2. Splenda increased myeloperoxidase (an enzyme in white blood cells which kills microorganisms) activities in the mice with Crohn’s Disease.

What these two reasons together mean is that the E. Coli increased the myeloperoxidase activities as the mice’s bodies attempted to fight off the invasion. The pro-inflammatory disposition of people with Crohn’s disease resulted in the increased myeloperoxidase activity which resulted in inflammation and symptoms. As the study’s lead author Alex Rodrigues-Palacios, DVM, MSc, DVSc, Ph.D. notes “this study demonstrates that the sweetener induces changes in gut bacteria and gut wall immune cell reactivity, which could result in inflammation or disease flare-ups in susceptible people.”

Alternatives to Splenda

For patients with IBD natural sweeteners might be a safer alternative than Splenda. Healthline points out that Stevia, Erythritol, Xylitol, and Yacon Syrup are alternatives to Splenda and sugar. But, Erythritol, Xylitol, and Yacon Syrup can all cause digestive problems. Therefore, for patients with Crohn’s disease, colitis, and other gastrointestinal disorders the best bet might be Stevia or natural sweeteners such as honey, maple syrup, molasses, and coconut sugar.

The Study

You can Click on the link to access the full text of the study, The Artificial Sweetener Splenda Promotes Gut Proteobacteria, Dysbiosis, and Myeloperoxidase Reactivity in Crohn’s Disease–Like Ileitis

Further Reading