“April is National Humor Month! Celebrated from April 1^st to the 30^th, National Humor Month was first set up in 1976 by Larry Wilde. Wilde is a well-known author and humorist who, according to the National Humor Month website, created National Humor Month in order to “heighten public awareness on how the joy and therapeutic value of laughter can improve health, boost morale, increase communication skills and enrich the quality of one’s life.”

Humor is a wonderful thing and while it varies from person to person the idea of it, finding something that amuses you and allowing yourself to enjoy it, doesn’t change. Indulging in laughter is a great way to enjoy things in life that make you happy and take a break from all the stress out there. Not to mention laughter has many awesome benefits to you, like helping your health. In fact, the use of humor and laughter in a therapeutic sense is also starting to become more widespread. Larry Wilde wrote about this on his website, he said that “[t]he idea of laughing and the use of humor as a tool to lift ailing spirits is growing. Scientific research now indicates that the curative power of laughter and its ability to relieve debilitating stress and burnout may indeed be one of the great medical discoveries of our times.” It has been found that laughter can cause positive, healing reactions in the body, such as; it can reduce stress and pain, strengthen the immune system, help your heart, and help relax and recharge the body.”

Bellevue University – Freeman Lozier Library (Freeman/Lozier Library)

EVER FEELING RUN DOWN?

Try laughing more. Some researchers think laughter just might be the best medicine, helping you feel better and putting that spring back in your step. “I believe that if people can get more laughter in their lives, they are a lot better off,” says Steve Wilson, MA, CSP, a psychologist and laugh therapist. “They might be healthier too.”

Recommended Related to Mind, Body, Spirit How to Get the Life You Want By Kristyn Kusek Lewis’s point of view she says:   You’ve been putting it off forever — that secret dream to start a business, write a book, run a marathon…. Whatever your desire, ignoring it means denying who you really are. And don’t you deserve better? Here, your no-excuses, no-regrets guide to answering the voice in your head that says, “I want more.” Ask yourself: Are you ready to finally tackle the burden or bad habit that’s been dragging you down? You’re many things—maybe a wife and mom, prized employee,… Read the How to Get the Life You Want article > > Yet researchers aren’t sure if it’s actually the act of laughing that makes people feel better. A good sense of humor, a positive attitude, and the support of friends and family might play a role, too.

“The definitive research into the potential health benefits of laughter just hasn’t been done yet,” says Robert R. Provine, professor of psychology and neuroscience at the University of Maryland, Baltimore County and author of Laughter: A Scientific Investigation. But while we don’t know for sure that laughter helps people feel better, it certainly isn’t hurting. Continue reading below…

Laughter Therapy: What Happens When We Laugh? We change physiologically when we laugh. We stretch muscles throughout our face and body, our pulse and blood pressure go up, and we breathe faster, sending more oxygen to our tissues. People who believe in the benefits of laughter say it can be like a mild workout — and may offer some of the same advantages as a workout. “The effects of laughter and exercise are very similar,” says Wilson. “Combining laughter and movement, like waving your arms, is a great way to boost your heart rate.”

One pioneer in laughter research, William Fry, claimed it took ten minutes on a rowing machine for his heart rate to reach the level it would after just one minute of hearty laughter. And laughter appears to burn calories, too.

Maciej Buchowski, a researcher from Vanderbilt University, conducted a small study in which he measured the amount of calories expended in laughing. It turned out that 10-15 minutes of laughter burned 50 calories. While the results are intriguing, don’t be too hasty in ditching that treadmill. One piece of chocolate has about 50 calories; at the rate of 50 calories per hour, losing one pound would require about 12 hours of concentrated laughter!

Laughter’s Effects on the Body In the last few decades, researchers have studied laughter’s effects on the body and turned up some potentially interesting information on how it affects us:

• Blood flow – Researchers at the University of Maryland studied the effects on blood vessels when people were shown either comedies or dramas. After the screening, the blood vessels of the group who watched the comedy behaved normally — expanding and contracting easily. But the blood vessels in people who watched the drama tended to tense up, restricting blood flow.
• Immune response – Increased stress is associated with decreased immune system response, says Provine. Some studies have shown that the ability to use humor may raise the level of infection-fighting antibodies in the body and boost the levels of immune cells, as well.
• Blood sugar levels – One study of 19 people with diabetes looked at the effects of laughter on blood sugar levels. After eating, the group attended a tedious lecture. On the next day, the group ate the same meal and then watched a comedy. After the comedy, the group had lower blood sugar levels than they did after the lecture.
• Relaxation and sleep – The focus on the benefits of laughter really began with Norman Cousin’s memoir, Anatomy of an Illness. Cousins, who was diagnosed with ankylosing spondylitis, a painful spine condition, found that a diet of comedies, like Marx Brothers films and episodes of Candid Camera, helped him feel better. He said that ten minutes of laughter allowed him two hours of pain-free sleep.
• Humor is infectious – The sound of roaring laughter is far more contagious than any cough, sniffle, or sneeze. When laughter is shared, it binds people together and increases happiness and intimacy. Laughter also triggers healthy physical changes in the body. Humor and laughter strengthen your immune system, boost your energy, diminish pain, and protect you from the damaging effects of stress. Best of all, this priceless medicine is fun, free, and easy to use.  Laughter is strong medicine for mind and body.
• Laughter – is a powerful antidote to stress, pain, and conflict. Nothing works faster or more dependably to bring your mind and body back into balance than a good laugh. Humor lightens your burdens, inspires hopes, connects you to others, and keeps you grounded, focused, and alert.  With so much power to heal and renew, the ability to laugh easily and frequently is a tremendous resource for surmounting problems, enhancing your relationships, and supporting both physical and emotional health.
• Laughter – is good for your health.
• Laughter – relaxes the whole body. A good, hearty laugh relieves physical tension and stress, leaving your muscles relaxed for up to 45 minutes after.
• Laughter boosts the immune system – Laughter decreases stress hormones and increases immune cells and infection-fighting antibodies, thus improving your resistance to disease.
• Laughter triggers the release of endorphins, the body’s natural feel-good chemicals.  Endorphins promote an overall sense of well-being and can even temporarily relieve pain.
• Laughter protects the heart – Laughter improves the function of blood vessels and increases blood flow, which can help protect you against a heart attack and other cardiovascular problems.

REFERENCES: 1.) Melinda Smith, M.A., and Jeanne Segal, Ph.D. Last updated: April 2014.  HELPGUIDE.ORG 2)  By R. Morgan Griffin   WebMD Feature  Reviewed by Michael W. Smith, MD

“Infertility can feel like being dealt a bad hand, where the odds seem stacked against you and the path to building a family is uncertain #ALLinFertility honors the resilience of those facing these challenges while spotlighting the need for inclusivity, understanding, and action.  

Much like a deck of cards, family building holds countless possibilities. Each person’s journey is uniquely their own. There’s no single “right” way to create a family—there are many paths, each with its own set of challenges and rewards. Whether you experience going through fertility treatments, adoption, donor conception, fostering, or living child-free not by choice, we honor every path taken and every story you shared.

Infertility affects people from all backgrounds, identities, and communities. #ALLinFertility ensures that diverse voices and experiences are represented, advocating for equal access to family building care, regardless of ethnicity, gender, sexuality, or socioeconomic status.”

national infertility awareness week (About NIAW | Niaw Resolve)

If you and your partner are struggling to have a baby, you’re not alone. In the United States, 10% to 15% of couples are infertile. Infertility is defined as not being able to get pregnant despite having frequent, unprotected sex for at least a year for most couples.

Infertility may result from an issue with either you or your partner, or a combination of factors that prevent pregnancy. Fortunately, there are many safe and effective therapies that significantly improve your chances of getting pregnant.

The main symptom of infertility is not getting pregnant. There may be no other obvious symptoms. Sometimes, women with infertility may have irregular or absent menstrual periods. In some cases, men with infertility may have some signs of hormonal problems, such as changes in hair growth or sexual function.

Most couples will eventually conceive, with or without treatment.

Risk Factors to being prone to this diagnose:

Age. Women’s fertility gradually declines with age, especially in the mid-30s, and it drops rapidly after age 37.

Tobacco use. Smoking tobacco or marijuana by either partner may reduce the likelihood of pregnancy.

Alcohol use. For women, there’s no safe level of alcohol use during conception or pregnancy. Alcohol use may contribute to infertility. With men it can decrease sperm count.

Being overweight. Among American women, an inactive lifestyle and being overweight may increase the risk of infertility. Sperm count for men can be affected by low sperm count.

Being underweight. Women at risk of fertility problems include those with eating disorders, such as anorexia or bulimia.

Exercise issues. A lack of exercise contributes to obesity, which increases the risk of infertility. Less often, ovulation problems may be associated with frequent strenuous, intense exercise in women who are not overweight.

When to take a trip to the doctor:

You probably don’t need to see your health care provider about infertility unless you have been trying regularly to get pregnant for at least one year. Women should talk with a care provider, the earlier the better, but if you haven’t yet go if you are:

• age 35 or older and have been trying to conceive for six months or longer
• over age 40
• having irregular or absent periods or very painful periods
• with known fertility problems
• diagnosed with endometriosis or pelvic inflammatory disease
• have had multiple miscarriages
• have undergone treatment for cancer
• have a history of endometriosis
• have a history of fallopian tube damage or blockage
• have a history of cancer and its treatment
• history of pelvic adhesions

Men should talk to a health care provider if they have:

• A low sperm count or other problems with sperm
• A history of testicular, prostate or sexual problems
• Undergone treatment for cancer
• Small testicles or swelling in the scrotum
• Others in your family with infertility problems

Know for many infertility can be treated with medicine, surgery, intrauterine insemination, or assisted reproductive technology.  So go to the doctor if you are having problems and they can give you direction.

Have a Happy Easter Weekend!

Rabbits are clean and for the most part there are very few health risks involved with sharing our lives with them. However, some people may experience problems and it is always wise to know what signs to look out for and steps to take to try and prevent any problems occurring. It should be stressed that health problems from people contracting things from rabbits are rare, and owners should not lose sleep over them!

“NewYork-Presbyterian cares for one of the world’s largest populations of patients with movement disorders, through the Center for Parkinson’s Disease and Other Movement Disorders at NewYork-Presbyterian/Columbia University Irving Medical Center and the Parkinson’s Disease and Movement Disorders Institute at NewYork-Presbyterian/Weill Cornell Medical Center.

Our neurologists are experts at diagnosing and treating all types of movement disorders, from the most common to the rarest. Our neurosurgeons are exceptionally skilled and among the most experienced in the country offering treatments such as deep brain stimulation and high-intensity focused ultrasound (HIFU) for Parkinson’s disease and other select movement disorders.

Our multidisciplinary team also includes neuropsychologists, nurses, genetic counselors, registered dietitians, and physical, occupational, and speech/swallowing therapists, along with other specialists who collaborate to ensure that each patient receives the most effective care available.”

New York Presbyterian Hospital (Movement Disorders | NewYork-Presbyterian)

Parkinson’s disease is the second most common progressive, neurodegenerative disease after Alzheimer disease. Parkinson’s disease is named after James Parkinson, a 19^th century general practitioner in London.

Parkinson’s disease is characterised by pathologic intra-neuronal α–synuclein-positive Lewy bodies and neuronal cell loss. Classically this process has been described as involving the dopaminergic cells of the substantia nigra pars compacta, later becoming more widespread in the CNS as the disease progresses. However, recently there has been a growing awareness that the disease process may involve more caudal portion of the CNS and the peripheral nervous system prior to the clinical onset of the disease.¹ Parkinson’s disease affects movement, muscle control, balance, and numerous other functions.

TREATMENTS:

MEDS: The combination of levodopa and carbidopa (Brand names Sinemet, Parcopa, Duopa^® (as a combination product containing Carbidopa, Levodopa=Rytary^® (as a combination product containing Carbidopa, Levodopa).

Levodopa and carbidopa are used to treat the symptoms of Parkinson’s disease and Parkinson’s-like symptoms that may develop after encephalitis (swelling of the brain) or injury to the nervous system caused by carbon monoxide poisoning or manganese poisoning. Parkinson’s symptoms, including tremors (shaking), stiffness, and slowness of movement, are caused by a lack of dopamine, a natural substance usually found in the brain. Levodopa is in a class of medications called central nervous system agents. It works by being converted to dopamine in the brain. Carbidopa is in a class of medications called decarboxylase inhibitors. It works by preventing levodopa from being broken down before it reaches the brain. This allows for a lower dose of levodopa, which causes less nausea and vomiting.

Medications are commonly used to increase the levels of dopamine in the brain of patients with Parkinson’s disease in an attempt to slow down the progression of the disease. Dopaminergic agents remain the principal treatments for patient with Parkinson’s disease, such as Levodopa and Dopaminergic agonist. In many patients, however, a combination of relatively resistant motor symptoms, motor complications such as dyskinesias or non-motor symptoms such as dysautonomia may lead to substantial disability in spite of dopaminergic therapy. In recent days, there has been an increasing interest in agents targeting non-motor symptoms, such as dementia and sleepiness.

As patients with Parkinson’s disease live longer and acquire additional comorbidities, addressing these non-motor symptoms has become increasingly important. Among anti-depressants, Amitriptiline and SSRI are commonly used, while Rivastigmine became the first FDA approved medication for the treatment of dementia associated with PD.

SURGERY:   Surgery for Parkinson’s disease has come a long way since it was first developed more than 50 years ago. The newest version of this surgery, deep brain stimulation (DBS), was developed in the 1990s and is now a standard treatment. Worldwide, about 30,000 people have had deep brain stimulation.

Lifestyle modifications have been shown to be effective for controlling motor symptoms in the early stages of Parkinson’s disease. The surgical treatment options available for Parkinson’s patients with severe motor symptoms are pallidotomy, thalamotomy and Deep Brain Stimulation (DBS).

The novel approaches for treatment of Parkinson’s disease that are currently under investigation include neuroprotective therapy, foetal cell transplantation, and gene therapy.

What is Deep Brain Stimulation (DBS) as a treatment?

DBS was introduced two decades ago and has gained widespread popularity as a surgical treatment for medically refractory Parkinson’s disease. DBS is a reversible procedure that has advantage over surgical lesioning (pallidotomy) and unilateral brain stimulation. DBS is comparable in efficacy to unilateral surgical lesioning⁷ while bilateral subthalamic nucleus stimulation is superior to pallidotomy. DBS is FDA approved for the treatment of medically refractory Parkinson’s disease and ET. DBS has proven its efficacy in the treatment of cardinal motor features of Parkinson’s disease such as bradykinesia, tremor and rigidity and it is unresponsive for non-motor symptoms such as cognition, speech, gait disturbance, mood and behaviour. Long-term studies have demonstrated that many of these effects last for long as long as levodopa responsiveness in maintained

During deep brain stimulation surgery, electrodes are inserted into the targeted brain region using MRI and neurophysiological mapping to ensure that they are implanted in the right place. A device called an impulse generator or IPG (similar to a pacemaker) is implanted under the collarbone to provide an electrical impulse to a part of the brain involved in motor function. Those who undergo the surgery are given a controller, which allows them to check the battery and to turn the device on or off. An IPG battery lasts for about three to five years and is relatively easy to replace under local anesthesia.

Is DBS Right for Me?

Although DBS is certainly the most important therapeutic advancement since the development of levodopa, it is not for every person with Parkinson’s. It is most effective – sometimes, dramatically so – for individuals who experience disabling tremors, wearing-off spells and medication-induced dyskinesias.

Deep brain stimulation is not a cure for Parkinson’s, and it does not slow disease progression. Like all brain surgery, deep brain stimulation surgery carries a small risk of infection, stroke, or bleeding. A small number of people with Parkinson’s have experienced cognitive decline after this surgery. That said, for many people, it can dramatically relieve some symptoms and improve quality of life. Studies show benefits lasting at least five years.

Gamma Knife radiosurgery

 Gamma Knife radiosurgery is a painless procedure that uses hundreds of highly focused radiation beams to target deep brain regions to create precise functional lesions within the brain, with no surgical incision. Gamma Knife may be a treatment option for patients with Parkinson’s tremor who are high risk for surgery due to medical conditions or advanced age.

As the nation’s leading provider of Gamma Knife procedures, UPMC has treated more than 12,000 patients with tumors, vascular malformations, pain, and other functional problems.

It is very important that a person with Parkinson’s who is thinking of treatment from meds to surgery to possiby Gamma Knife radiosurgery be well informed about the procedures and realistic in his or her expectations. This means there’s no standard treatment for the disease – the treatment for each person with Parkinson’s is based on his or her symptoms.

Advanced treatments

MRI-guided focused ultrasound (MRgFUS) is a minimally invasive treatment that has helped some people with Parkinson’s disease manage tremors. Ultrasound is guided by an MRI to the area in the brain where the tremors start. The ultrasound waves are at a very high temperature and burn areas that are contributing to the tremors.

Remember Parkinson’s disease can’t be cured, but medications can help control the symptoms, often dramatically. In some more advanced cases, surgery may be advised.

Your health care provider may also recommend lifestyle changes, especially ongoing aerobic exercise.

In some cases, physical therapy that focuses on balance and stretching is important.

A speech-language pathologist may help improve speech problems.

There is always support groups for Parkinson’s Disease for patients diagnosed with it and the family involved also!

“Every six minutes there is a new diagnosis of PD, which means that in April alone nearly 7,200 people in this country will learn they have PD. These people need to know that they are not alone, and that APDA is here for them,” states Leslie A. Chambers, President and CEO, APDA.

The American Parkinson Disease Association (APDA) is a nationwide grassroots network dedicated to fighting Parkinson’s disease (PD) and works tirelessly to assist the more than one million people with PD in the United States live life to the fullest in the face of this chronic, neurological disorder. Founded in 1961, APDA has raised and invested more than $252 million to provide outstanding patient services and educational programs, elevate public awareness about the disease, and support research designed to unlock the mysteries of PD and end this disease.”

American Parkinson Disease Foundation

(https://www.apdaparkinson.org/article/american-parkinson-disease-association-to-celebrate-the-power-of-a-supportive-community-during-parkinsons-disease-awareness-month/)

What are the signs and symptoms (s/s) of this disease?

The early signs and symptoms of Parkinson’s disease that are often overlooked by both patients and doctors because the symptoms are subtle and the progression of the disease is typically slow. S/S of parkinson’s disease are:

Parkinson’s disease does not affect everyone the same way. In some people the disease progresses quickly, in others it does not. Although some people become severely disabled, others experience only minor motor disruptions. Tremor is the major symptom for some patients, while for others tremor is only a minor complaint and different symptoms are more troublesome.

The Motor function symptoms associated with Parkinson’s Disease:

• The tremors associated with Parkinson’s disease has a characteristic appearance. Typically, the tremor takes the form of a rhythmic back-and-forth motion of the thumb and forefinger at three beats per second. This is sometimes called “pill rolling.” Tremor usually begins in a hand, although sometimes a foot or the jaw is affected first. It is most obvious when the hand is at rest or when a person is under stress. In three out of four patients, the tremor may affect only one part or side of the body, especially during the early stages of the disease. Later it may become more general. Tremor is rarely disabling and it usually disappears during sleep or improves with intentional movement.
• Rigidity, or a resistance to movement, affects most parkinsonian patients. A major principle of body movement is that all muscles have an opposing muscle. Movement is possible not just because one muscle becomes more active, but because the opposing muscle relaxes. In Parkinson’s disease, rigidity comes about when, in response to signals from the brain, the delicate balance of opposing muscles is disturbed. The muscles remain constantly tensed and contracted so that the person aches or feels stiff or weak. The rigidity becomes obvious when another person tries to move the patient’s arm, which will move only in ratchet-like or short, jerky movements known as “cogwheel” rigidity.
• Bradykinesia, or the slowing down and loss of spontaneous and automatic movement, is particularly frustrating because it is unpredictable. One moment the patient can move easily. The next moment he or she may need help. This may well be the most disabling and distressing symptom of the disease because the patient cannot rapidly perform routine movements. Activities once performed quickly and easily — such as washing or dressing — may take several hours.
• Postural instability, or impaired balance and coordination, causes patients to develop a forward or backward lean and to fall easily. When bumped from the front or when starting to walk, patients with a backward lean have a tendency to step backwards, which is known as retropulsion. Postural instability can cause patients to have a stooped posture in which the head is bowed and the shoulders are drooped.

The Non-Motor function symptoms that are often associated with Parkinson’s Disease include:

-Cognitive impairment –Dementia –Psychosis –Depression –Fatigue -Sleep disturbances -Constipation -Sexual dysfunction -Vision disturbances.

As the disease progresses, walking may be affected. Patients may halt in mid-stride and “freeze” in place, possibly even toppling over.  Patients may walk with a series of quick, small steps as if hurrying forward to keep balance. This is known as festination.

A detailed overview of the Unified Parkinson’s Disease Rating Scale that is used by doctors to follow the course of disease progression and evaluate the extent of impairment and disability.

Abstract

The Movement Disorder Society Task Force for Rating Scales for Parkinson’s Disease prepared a critique of the Unified Parkinson’s Disease Rating Scale (UPDRS). Strengths of the UPDRS include its wide utilization, its application across the clinical spectrum of PD, its nearly comprehensive coverage of motor symptoms, and its clinimetric properties, including reliability and validity. Weaknesses include several ambiguities in the written text, inadequate instructions for raters, some metric flaws, and the absence of screening questions on several important non-motor aspects of PD. The Task Force recommends that the MDS sponsor the development of a new version of the UPDRS and encourage efforts to establish its clinimetric properties, especially addressing the need to define a Minimal Clinically Relevant Difference and a Minimal Clinically Relevant Incremental Difference, as well as testing its correlation with the current UPDRS. If developed, the new scale should be culturally unbiased and be tested in different racial, gender, and age-groups. Future goals should include the definition of UPDRS scores with confidence intervals that correlate with clinically pertinent designations, “minimal,” “mild,” “moderate,” and “severe” PD. Whereas the presence of non-motor components of PD can be identified with screening questions, a new version of the UPDRS should include an official appendix that includes other, more detailed, and optionally used scales to determine severity of these impairments.

How Parkinson’s disease is diagnosed:

There isn’t a specific test to diagnose Parkinson’s disease;  it is based on factors such as signs/symptoms, patient history, physical examination, and a thorough neurological evaluation.

A doctor trained in nervous system conditions (neurologist) will diagnose Parkinson’s disease based on your medical history, a review of your signs and symptoms, and a neurological and physical examination.

Your doctor may suggest a specific single-photon emission computerized tomography (SPECT) scan called a dopamine transporter (DAT) scan. Although this can help support the suspicion that you have Parkinson’s disease, it is your symptoms and neurological examination that ultimately determine the correct diagnosis. Most people do not require a DAT scan.

Furthermore, making the diagnosis is even more difficult since there are currently no blood or lab tests available to diagnose the disease. Your health care provider may order lab tests, such as blood tests, to rule out other conditions that may be causing your symptoms.  Some tests, such as a CT Scan (computed tomography) or MRI (magnetic resonance imaging) and PET Scans may be used to rule out other disorders that cause similar symptoms. Imaging tests aren’t particularly helpful for diagnosing Parkinson’s disease.  Given these circumstances, a doctor may need to observe the patient over time to recognize signs of tremor and rigidity, and pair them with other characteristic symptoms.

The doctor will also compile a comprehensive history of the patient’s symptoms, activity, medications, other medical problems, and exposures to toxic chemicals. This will likely be followed up with a rigorous physical exam with concentration on the functions of the brain and nervous system. Tests are conducted on the patient’s reflexes, coordination, muscle strength, and mental function. Making a precise diagnosis is essential for prescribing the correct treatment regimen. The treatment decisions made early in the illness can have profound implications on the long-term success of treatment.

Recommended Related to Parkinson’s

Questions to Ask Your Doctor About Parkinson’s Disease:

Since you’ve recently been diagnosed with Parkinson’s disease, ask your doctor these questions at your next visit.   1.What stage is my illness in now?

2. How quickly do you think my disease will progress?

3. How will Parkinson’s disease affect my work?

4. What physical changes can I expect?

5. Will I be able to keep up the activities, hobbies, and sports I do now?

6. What treatments do you suggest now?

7.Will that change as the disease progresses?

8. What are the side effects of medication?…

Because the diagnosis is based on the doctor’s exam of the patient, it is very important that the doctor be experienced in evaluating and diagnosing patients with Parkinson’s disease. If Parkinson’s disease is suspected, you should see a specialist, preferably a movement disorders trained neurologist.