Christmas hurts! Why pelvic pain flares during the holidays.

Holiday Heart attacks

Ok, this blog is supposed to be about pelvic pain...why are we talking heart attacks? Work with me here, and we'll get to the pelvic pain in a minute.

There's a really disturbing thing that happens, specifically on Christmas day and New Years. It's not the weird red-clad man climbing into strangers homes, dropping off gifts, and stealing cookies. It's the rate of sudden cardiac death. More people die of heart attacks on Christmas day and New Years than any other day in the year. Seriously? Yes. And it's not just old people who have no one to celebrate with. It's across the board.

For many of us, Christmas is fun, and exciting. But it's also a little stressful, right? Having to plan gifts, parties, buy the right ugly sweater to impress what's-his-name from the office. We have to deal with crazy uncle Ed who always makes the most inappropriate remarks during dinner. There's also the many out there that don't like Christmas because of lack of social support, or the memory of the loss of a loved one. The stress of the holidays is problem #1. The food of the holidays is problem #2.

Problem #1: STRESS

There's these chemicals called catecholamines that are the way your body responds to stress. Ones you might have heard of are norephinephrine and epinephrine. These chemicals activate the sympathetic nervous system. They're made in your body naturally, and can also be created from some of the foods we eat. They're what make your heart race and give you the feeling of shortness of breath when something startles you. It's an activation of the fight-or-flight response. During the stress of the holidays, these chemicals tend to run amok. They're at high levels in your blood. Whether that's from uncle Ed embarrassing you in front of the new boyfriend, or the stress of getting the right gift for mom.

Those stress hormones aren't good for your blood pressure and heart rate. They give you the necessary jolt to run away from a bear, if you live in Alaska. But if you're in Cedar Rapids, Iowa, it's unlikely you're being chased by a bear. And raising your blood pressure and heart rate isn't good for long periods of time.

Problem #2: The FOOD

Taking in excess amounts of alcohol and certain foods puts you at increased risk of a heart attack due to an enzyme in the foods that prevents the breakdown of catecholamines. The levels of stress hormones rise when they're not broken down properly, leading to sustained rises in blood pressure and heart rate.

What the heck does all this have to do with Pelvic Pain??

When you're in acute pain, like from slicing your finger while cutting potatoes, your sympathetic nervous system gets activated. The fight or flight response gets you to quickly move the knife away and grab the bleeding finger to slow the blood loss. This is a good deal, because sympathetic activation lets your brain know that the pain signals are important. They make you move the knife instead of continuing to cut.

When you're in chronic pain, elevated sympathetic nervous system chemicals make it hard for your brain to decide if pain signals are important or not. On the side of caution, the elevated catecholamines lead the brain to think that pain signals are important, so they're processed more rapidly.

When your sympathetic nervous system is all amped up for long periods of time, you get increased processing of pain signals. In patients with fibromylagia, the higher the activation of the sympathetic nervous system, the higher the magnitude of pain.

Holidays = stress + foods that prevent catecholamine breakdown

Stress + high catecholamine levels = high sympathetic nervous system activation

High sympathetic nervous system = increased pain processing

You're not crazy if you feel like your pain is worse around the holidays. It really is!

Do I just suffer through the holiday season, then?

ADD PIC

No, ma'am, you need not suffer. There's some good techniques to lower the sympathetic nervous system. The sympathetic nervous system has an arch enemy called the parasympathetic nervous system. Its whole deal is to lower blood pressure, lower heart rate, and calm you down. It's at its best when you're chilling, like taking in rays on the beach. Now, most of us don't have a beach nearby. If you do, I'm jealous. For the rest of us land-lubbers, we can activate the parasympathetic nervous system a few other ways. Doing something super relaxing, like getting your nails done, or having a massage can work wonders.

Other options include deep breathing and meditation. Deep belly breathing will trigger your parasympathetic system. Deep breathing involves taking slow deep breaths through your nose, pretending they're going into your stomach instead of your chest. Hold the breath for a few seconds, and then release it slowly. Meditation is also very good at triggering the parasympathetic system. Meditation is getting your mind to clear. That sounds super hard, but it really isn't. There's a few apps that you can get on your phone that will help you learn how to meditate. "Headspace" is a good one for newbies. 

As Always

If you're having worsening pelvic pain during the holidays, I may be able to help with some of my techniques too. I'd love to see you for an exam and treatment at Nurture Womens Health. You can make an appointment to see me and we'll figure out how to lower your pain, and your risk of heart attack!

Rescources

https://www.ncbi.nlm.nih.gov/pubmed/22678655

https://www.ncbi.nlm.nih.gov/pubmed/26816852

https://www.ncbi.nlm.nih.gov/pubmed/25963185

https://www.ncbi.nlm.nih.gov/pubmed/25786044