Taming the Wild Card

[carolm]

I'm asking a lot here, but I have decided that my next mission is to get a proactive plan to manage my gut when stressful things happen. Here's what led me to this latest brainstorm:

Thursday I was driving to Kansas City for an Autism workshop. While in the Flint Hills (Kansas is not all flat) I had my first hydroplane experience on I-70 and it scared me on a whole new level. I managed to get the skidding stopped and get the car straight once it reached the shoulder and I remember looking at the ridges they form into the asphalt on the shoulders and thinking maybe I could get traction there. Frankly I was just lucky. The rain was torrential and visibility was nil. . It was for sure a reminder that life can change in a flash. It was just luck that the car and I were not in pieces. It was a horrid drive (pouring rain and some lightening) during the following 2 hours to KC

You can imagine what followed. I had to stop after about 45 minutes for a bathroom break. I did my deep breathing exercises as I drove. By the time I reached KC I went to my daughter's apartment to drop off my stuff. I decided to sit down and relax (I was full of tension in my back and shoulders) and then my gut went wacky. Although they were Normans, they were coming every 20 minutes, and I was nauseated. I started with Imodium to slow down the motility, and a meclizine. Eventually it was obvious that this was going to persist-- and I was going to miss the start of the workshop I went there for. Soon I had to add an anti-spasmodic and a Zofran. I spent the rest of the afternoon laying down when I wasn't in the bathroom. I was better in about 3-4 hours.

Tex has said, and I have quoted him a few times, 'Stress is the wild card". Well, I want to figure out how to tame this wild card. I hate to take Imodium since it gives me C but there are times it has proved immensely helpful. Do I take a couple for insurance when something stressful happens? The other meds I have are too sedating to take unless I am going to be somewhere I can lay down. I've been learning more and trying to practice more 'mindfulness meditation'. I think it has promise as one tool.

What do you do to head off your sensitive gut overreacting to a situation?

Carol

[Heady]

Glad you are ok!
Just an odd question... Did you have cruise control on??? Cause that's a no no in rain like that!
I have yet to experience the unpleasant effects of stress on MC. Still a raw newbie! Lol

[carolm]

No, I absolutely did not have the cruise on. I know better than that. And I was going 15 mph below speed limit in a new car with traction control and front wheel drive. If you live in north central Kansas you will encounter everything but hurricanes. It's not unusual to drive on tricky stuff-- ice, snow, slush, gravel roads (like driving on marbles) and you get pretty good at it-- but I'd rather drive on ice than drive in the conditions I did Thursday. Cruise control is a no-no on everything but dry pavement.

This just happened to be the episode that set off my gut, but it could have been any external stressor that is out of the ordinary. I seem to be okay with the usual daily work stressors, but I hate to have one thing wreak havoc on my entire weekend. I'm fairly sure I'm not the only one who experiences a gut 'over- reaction' when the adrenaline hits. I'm interested in what others have done or are doing.

thanks,
Carol

[ldubois7]

Carol,

It seems that the only two choices would be meditation/relaxation, or drugs. I have been lucky in that I have not had a major stress event yet (of course, I'm not fully in remission yet) I was wondering the same as you, to be ahead of a reaction, what can I do? I like to be preventive.

Suggestions are appreciated.

[Sheila]

Very scary experience when your car hydroplanes repeatedly. In Florida we get torrential downpours frequently in the summer and I had an experience similar to yours. Within a month I bought a larger, heavier car hoping to avoid a repeat experience. When the repeated hydro planing happened I was still taking budesinide. Other than exhaustion and a headache at the end of the drive from Hell, I didn't have a flare.

I've been off budesinide for a couple of months and during a stressful time, I thought I was very calm, not allowing the stress to rule my life. Still got WD. Your question is certainly interesting but I very much doubt one can instantly control our bodies reaction to a frighteningly stressful event. How can you shut off that release of adrenalin? It would take phenomenal mind-body control. I think if a person practices mindful meditation on a regular basis it might be possible to reduce ongoing stress.

It's an interesting question, Carol. Hopefully you will get some good feedback.

Sheila W

[carolm]

Linda, since the onset of my LC I've dealt with my dad being hospitalized 3 times in 2 weeks for heart issues, then his sudden death a few months after that. Then last year my husband had 4 hospitalizations all related to atrial fib-- 1 was an intrusive surgery and 1 was an ablation. Those had to be in Kansas City, which is 4 hours from us. He had complications after the first surgery and we went from what was supposed to be 4 days in ICU to 8 days in ICU. The day he was dismissed I drove us through slush and ice as a snow storm hit KC. We were doing 30 mph where the speed limit was typically 70mph. Good times!! We knew we'd be out of the icy stuff in about 60 miles or we wouldn't have left.

These were obviously stressful times. I stuck rigidly to my safest foods, ate small portions, drank more water and chicken broth, and did my best to stay rested. When my dad passed I was still on Entocort. But last year I was not. I was (and still am) on Amitriptyline and it was very helpful. I've managed over time periods like these. So can I take what I've learned and apply it to the unexpected event? Not as easily it seems.

Thanks Sheila for your thoughts. I think you hit the nail on the head- how do you turn off that shot of adrenalin? Or can I find a way to lessen the impact?

[nerdhume]

carol,
so glad you are ok. I know what you mean about the Imodium, sometimes it causes C which is worse IMO.
I have tried really hard to let go of things and stress less. I know it's part of the problem.

[Polly]

Hi Carol!

That is the million dollar question. I agree that mindfulness meditation helps but is more for the longer term stress reduction. You are going to laugh, but I have found that "self-talk" helps me during the immediate crisis. Really! I just start talking out loud to myself, like "OK now, we are NOT going to let this situation get to my gut". I tell myself to breathe slowly and deeply, slow down my heart rate, etc. I even raise my voice at myself and become adamant. I try to bring myself into the present - by mentioning those sights/sounds/smells/feelings, etc. that I am experiencing at that moment in my environment. I guess this is really a form of "emergency" mindfulness. HAHAHAHA - I guess you now know that I am certifiably CRAZY.

Also, if you are in a situation where you can do vigorous activity/exercise right after the stress, it helps to burn up the adrenaline faster.

Love,

Polly

P.S. So glad that all turned out OK - what a scare!!!!

[ldubois7]

That's good to know, Polly. I know you said that you exercised throughout your recovery period (as did Leah), and both of you seem to be moving forward, with minimal setbacks.

So, Carol....you needed to pull over to the side of the road and drop and do 50! But, seriously, it's good to know that exercise will burn up adrenaline quickly! Thanks! :)

[tex]

I'm going to offer some thoughts on this topic (I'm strictly thinking out loud here — some of this is proven by research, but some is not). Anyway, FWIW, here are my thoughts:

Because we have proven our uniqueness by developing an autoimmune type disease that was once considered to be rare, it's clear that we do not have an immune system that meets the definition of "normal". Though we might not be reactive, most of us still have an elevated anti-gliadin antibody level (because it takes several years for significantly elevated gluten antibodies to decay back to normal levels, even if we are never re-exposed to any gluten within that time frame (which is unlikely). The fact is, we are very likely to be exposed to tiny doses of gluten on a somewhat regular basis. The exposures are not sufficient to trigger a relapse, but they are sufficient to keep our antibody level above the normal range (which means that our immune system will tend to remain at a higher level of sensitivity than would be the case if our antibody levels were normal).

This almost surely implies that the vitamin D receptors (VDRs) are much more likely to be activated by any stressful event (than they would be if the immune system were not already in a heightened state of alertness/readiness). And as we already know, people why are prone to the development of autoimmune type issues have a problem switching off the VDRs, once they are activated.

So I'll pose a question: In such a situation (immediately following an extremely stressful event), is it possible that massive doses of vitamin D might switch the immune system back to neutral, (by deactivating the VDRs), and thereby terminating the high-stress state? As far as I'm aware, no one has ever tried that.

But here's another thought to consider. When one of our paleo ancestors barely escaped being caught (and eaten) by a short-faced bear, for example, she or he surely had the same type of adrenaline rush that we would have when we narrowly escape a car crash on the highway. So the question is, "Why were they able to recover so quickly and go back to their normal routine?"

Of course, the obvious answer is that we don't actually know that they were able to escape the same fate (diarrhea). After all, in a truly life-threatening situation, the enteric nervous system completely shuts down the digestive system. That means zero motility. With no motility, any food in the digestive system begins to rot. Whether or not that becomes a serious problem depends on how long it is shut down, but IMO, barely escaping a major predator probably caused our paleo ancestors to have at least one subsequent episode of D, where their digestive system was purged. And after that, everything probably returned to business as usual.

So maybe it can't be avoided (at least not an initial episode).

Tex

[Polly]

Tex,

Good thought about the vitamin D. I think massive doses of D have been used for infectious processes, which are certainly stressful. I'll try to find some references.

I think one reason our paleo ancestors had less problem with stress than we do is because, in order to deal with their stress (being eaten by a bear), when the adrenaline rush kicked in, they had to either fight or flee i.e. the old "fight or flight" response kicked in. The adrenalin was necessary to prepare the body to either fight or run but then was metabolized quickly as a result of those actions. The problem is......our modern day stressors are very different - money worries, job issues, etc. - they do not require a fight or flight response any more, but the adrenalin rush still occurs. That's why exercise can help the body get rid of the adrenalin..

Love,

Polly

[tex]

That's why exercise can help the body get rid of the adrenalin.

That certainly makes sense to me. The original arrangement was valid because an all-out, energy-intense response was almost always essential. And as you point out, such a response seldom occurs today, so our unresolved chemistry relentlessly gnaws on all our organs.

Love,
Tex

[carolm]

Polly, I think you are on to something. Certainly self-talk has been recognized as an effective tool in psychotherapy ever since Albert Ellis introduced Rational Emotive Therapy . His self-talk wasn't out loud but it made us aware that we are always talking to ourselves, and it's what we tell ourselves that brings on our emotional responses (both good and bad).

Getting adamant might be one way to use up some adrenalin when I'm in a position where I can't exercise it away. In a car by myself, I could lecture and yell all I want. Certainly if there had been someone with me we would have discussed what happened and that probably would have been some kind of release. Although it might not prevent the whole gut episode maybe it would lessen the intensity. Who knows?. Or maybe that type of release combined with a couple of Imodium could derail the gut purge.

It probably was not at all helpful that I had to continue to drive in that kind of weather for another 2 hours. My muscles were knotted by the time I reached my destination. In the car there wasn't a chance to relax, I always had to be vigilant. There were a couple of times it was so dark that my car switched the dashboard lights and navigation screen to night time mode! I might have had a different outcome if 10 minutes after I hydroplaned, the rain stopped and the skies cleared so that I didn't have to be constantly on guard.

Tex, that would be something if Vit D would be helpful at times like that. It did occur to me that maybe what I did was the only thing that could be done and that when 'stuff happens' I may just have to cancel life for 4 hours and take the meds and wait for it all to subside. Now that you mention it I do recall reading that the digestive system would purge itself as part of fight or flight. I'm going to have to come up with some powerful tools to overcome thousands of years of innate survival traits.

Thank you all for weighing-in.

I guess the good news is I'm doing well enough that I'm down to this kind of fine tuning.

Carol

[maestraz]

Hi Carol,
Driving is often a high-anxiety situation for me even without rainstorms, living here in the I-95 corridor. Like Polly, I have gotten quite proficient at self-talk, and I find that it sometimes works, sometimes not. I also find yoga breathing to help. I frequently take alprazolam/Xanax before situations I know will be stressful (even driving--fortunately for me, Xanax takes the edge off but does not make me drowsy at all). I always take Immodium before a trip. I'm not crazy about how it makes me feel, but it gives me a bit of security that helps alleviate stress.

Managing the stress is such a challenge. Interestingly, since I upped my vitamin D, I feel like I have had a lesser degree of stress in certain situations.

[carolm]

thanks Suze-- I'm seeing some trends.... Increased Vit D, Imodium as insurance... maybe I should take extra Amitriptyline the night before I travel. I've been doing so well I hadn't been relying on extra Amitriptyline, but maybe when travel is involved I should try it.

I may get a plan in order yet.

c.