Month: September 2015

Medications and Falls

Posted on by Michelle Fritsch, Pharm.D.

Did you know that taking some medications can increase your risk of falling?

Did you know not taking some medications can increase your risk of falling?

Did you know some medical conditions can increase your risk of falling?

Did you know not getting enough of some vitamins can increase your risk of falling?

Wow, fall risks are so complicated!

The Centers for Disease Control recently created and released a tool for healthcare providers and patients to help screen for and diminish fall risk. You can find it at http://www.cdc.gov/steadi/patient.html. I encourage you to use these tools to minimize your risks.

Some of the things addressed are clutter in your home that can trip you, the importance of exercise to stay strong, use/add grab bars, sturdy hand rails, wear shoes or nonslip slippers, improve lighting, and more.

In addition, have a medication expert review all of your medications to minimize the fall risk caused by drugs that you take.   This is an area where all of your healthcare team can work together to make sure your risks are minimized.

Some types of medication are more likely than others to make falls occur more easily. Then, if you take several of these medicines, your risk is even higher.

The vitamin associated with falls is vitamin D. If you have too little vitamin D your risk is higher. If your doctor has not checked your vitamin D level, request that be done at your next visit. Most adults have a deficiency.

If you would like a thorough fall risk assessment, please contact Meds MASH at www.medsmash.com.

Biblical Application

I have been struck lately by the words to a song sung by Jason Gray, “More Like Falling in Love”. If you have not heard it, I highly encourage you to check it out.

The lyrics say,

“More like falling in love

than something to believe in

more like losing myself

than pledging my allegiance.”

“It’s like I’m falling in love.”

I adore this description of meeting and giving it all to Christ.

If you’re going to fall, what’s better than falling in love? And what’s better than falling deeply in love with Christ?

Luke 10:27 ESV

And he answered, “You shall love the Lord your God with all your heart and with all your soul and with all your strength and with all your mind, and your neighbor as yourself.”

1 John 4:18 ESV

There is no fear in love, but perfect love casts out fear. For fear has to do with punishment, and whoever fears has not been perfected in love.

Psalm 85:10 ESV

Steadfast love and faithfulness meet; righteousness and peace kiss each other.

May you be enveloped with this wonderful love!

Blessings,

Michelle

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Know before you decide

Posted on by Michelle Fritsch, Pharm.D.

What is a tmedication-sliderhorough medication evaluation? Would you benefit from one? Don’t other people already
evaluate your medications on a regular basis? Do you worry about hurting someone’s feelings if there is a difference of opinion about your medication regimen?

You likely have several different healthcare providers – your primary care doctor, any nurse practitioners or physician assistants in that office, your specialist doctor(s), your local pharmacist, and maybe a chiropractor, physical therapist dietician, and others. Surely between all of them someone is providing you with a very thorough evaluation of your medications?

Do you take anything for a cold? Or a stomachache? Or to help you sleep? Or for pain?

Do you tell your healthcare providers about these things you take only once in awhile?

Do you take vitamins or supplements or herbal therapies that you select for yourself? Do you tell your healthcare providers about these?

Do you always take your medications at the same time every day? What do you do when you forget to take them? Do you take some of them only when you feel like you need them? Have you ever stopped taking a medication without telling your providers?

A thorough medication evaluation will cover all of these things. Our research has shown that in 98% of visits there is at least one thing that you didn’t know about your medication that you really should know.

As a clinical pharmacist, I am looking at all of your prescribed medications and other substances you take to assure none of these nine problems exist:

  • Each dose is not too high (You have more side effects than needed or even have toxicity.)
  • Each dose is not too low (You take it but it doesn’t work for you.)
  • All conditions that should be treated with a medication are being treated with the best medication(s) based on current medical studies.
  • Each medication you take is actually necessary. (Sometimes there are medications that have been on your list for a long time but no one remembers why.)
  • No medications interact with each other making your health worse. Also, your diet and supplements don’t interact with your other medications or each other.
  • You are able to obtain and take each prescribed medication. (Sometimes pills are too big, inhalers are hard to use, eye drops are hard to get into the eye, or medications are too expensive or not covered by insurance.)
  • None of your medications for one condition make another condition worse.
  • You are able to safely take all of your medications. Allergies and medication intolerances will be reviewed and clarified for your healthcare team.
  • You are taking each medication at the optimal time in relation to food, other medications, and potential side effects.

Clinical pharmacists have extensive training specific to all aspects of medications and how they work., more than any other health professional. Often, having a clinical pharmacist working with the rest of your providers will further assure that all of your medication use is necessary, safe, and effective.

For more information about a thorough medication assessment, contact www.medsmash.com.

Biblical Application

Just like medication intended for good can sometimes actually cause harm, are there elements of our spiritual lives that can be more harmful than good?

There are many interpretations of the content of the Bible. There are many preachers and teachers and blogs and radio programs and television programs and articles written.

Are they all true and accurate?

How do you determine what to believe and what to implement in your life?

Jesus, Paul, John, and others warned us about false teachers and the importance of discernment. Well, that sounds good, but how do you actually do it?

First, here is what the Bible says.

1 John 4:1 (MSG)

My dear friends, don’t believe everything you hear. Carefully weigh and examine what people tell you. Not everyone who talks about God comes from God. There are a lot of lying preachers loose in the world.

John 7:24 ESV

Do not judge by appearances, but judge with right judgment.

Proverbs 2:1-5 ESV

My son, if you receive my words and treasure up my commandments with you, making your ear attentive to wisdom and inclining your heart to understanding; yes, if you call out for insight and raise your voice for understanding, if you seek it like silver and search for it as for hidden treasures, then you will understand the fear of the Lord and find the knowledge of God.

Discernment might sound difficult or only for those with advanced theological training, but the Bible encourages us to pray about it. When you hear or read something that you’re not sure about, pray and ask God to guide you. Jesus says that the Holy Spirit is with us at all times.

Matthew 28:20 ESV

Teaching them to observe all that I have commanded you. And behold, I am with you always, to the end of the age.

Joshua 1:9 ESV

Have I not commanded you? Be strong and courageous. Do not be frightened, and do not be dismayed, for the Lord your God is with you wherever you go.

(And there are several more such verses throughout the Old and New Testament).

Let God lead you with discernment and love.

Blessings,

Michelle

Clots lead to TROUBLE

Posted on by Michelle Fritsch, Pharm.D.

Most strokes and heart attacks have something in common – CLclotOTS.

Normally blood whooshes right through veins and arteries with nothing blocking the way. The blood carries oxygen to all of the parts of the body to provide energy to keep everything functioning properly.

Sometimes a fatty diet and genes/family history and some medical conditions lead to fibrin (a protein in the blood) and fat lining the edges of the veins and arteries. Some of this can happen with no real danger.

Then other times, something occurs that takes that fat and fibrin and knocks out a chunk of artery lining or makes the surface rough. This allows platelets (a component of the blood) and fibrin to stick to the rough/injured area. As these continue to stick, the blood goes through a more and more narrow passage. Eventually, blood flow is completely blocked.

When this happens in the brain, a stroke results. When this happens in the arteries providing blood to the heart, a heart attack happens. When this happens in the legs, it is called deep vein thrombosis. When it happens in the lungs it is a pulmonary embolus.

What can you do to prevent these clots? There are several key things:

  • Stop smoking if you smoke
  • Exercise regularly
  • Lose weight if you are overweight
  • Avoid sitting for long periods of time (even if you travel, take breaks to move around)
  • After surgery or being sick in bed, get up and move as soon as possible and move frequently.
  • Lower high blood pressure
  • Eat a heart healthy diet

Take control of your future and make these positive changes so you can avoid clots.

For more information, contact www.medsmash.com.

Biblical Application

A clot often starts with some little thing going wrong. Either a tiny piece breaks off the fat lining of the artery or something roughs up the edge a bit. Then that small negative event grows and grows and grows until a major life-threatening event occurs.

How often does this happen in life and relationships?

Someone says something that hurts your feelings. It might be deliberate or a result of poor social skills or completely unintended. But, you take offense. Then, you start thinking about the words and you get more angry. Then you start recounting any other thing that person has ever done that could be interpreted negatively. Then you start watching this person and interpreting anything they say or do negatively. Maybe you even bring in other people to support your interpretation of the hurtful statement.

The next thing you know, that relationship stops receiving any sustaining positive input. It completely dies. Everyone walks away hurt.

Have you ever said or done something hurtful completely by accident? I recently was talking with a friend who plans to disown any relationships that didn’t reach out to support her when she lost a dear family member. I understand the hurt, especially at such a tender time. Did all of those people who didn’t reach out intend to hurt her? Or, was a mistake made? Did they not know how important that support could be? Did they not know how to support?

I’m not making excuses. I’m extending grace.

Ephesians 2:8-9 ESV

For by grace you have been saved through faith. And this is not your own doing; it is the gift of God, not a result of works, so that no one may boast.

Ephesians 4:32 ESV

Be kind to one another, tenderhearted, forgiving one another, as God in Christ forgave you.

James 1:19-20 ESV

Know this, my beloved brothers: let every person be quick to hear, slow to speak, slow to anger; for the anger of man does not produce the righteousness of God.

Let’s all try to keep our focus on love, forgiveness, and grace to bring out the best in each other.

Blessings,

Michelle

All Confused – Urinary Tract Infection

Posted on by Michelle Fritsch, Pharm.D.

thumb-confusion-clip-art-440303When we’re younger we learn the typical symptoms of a urinary tract infection (UTI). Burning, frequent urge to urinate, cloudy urine, pelvic pain, and sometimes fever usually accompany a UTI.

As we age, these symptoms can be quite different. Confusion is a common symptom. Yet confusion is such a nonspecific symptom, it is often misinterpreted. The person with the confusion or those around them may attribute the confusion to lack of sleep, stress, a cold, early dementia changes, or other things.

So, the point of this blog post is to help us all think of infection, and specifically UTI, when confusion occurs in someone over middle age.

Other symptoms of a UTI can include generally not feeling well (very nonspecific), more frequent urination, new-onset incontinence, and lower abdominal pain.

If a UTI extends beyond the urethra and bladder, the lower/mid back can also hurt. This can be an indication the kidneys are involved and could indicate a more severe infection. A fever does not always accompany a UTI as we age.

Any of these changes in wellbeing are worthy of a check up to include a urinalysis (check of a urine sample for bacteria).

There are several changes that occur with aging that increase risk for UTI in both women and men. For women, after menopause, atrophy of the vagina and changes in the urethra make it easier for bacteria to grow and move from one place to the other. Diabetes, incontinence, bladder prolapse (drop down), and use of a catheter also increase risk for UTI. In men, an enlarged prostate that causes any blockage of the urinary tract also increases risk.

Note, sometimes people can have bacteria in their urine and not have an infection. Your physician can determine if treatment of any bacteria that is found is warranted.

So please don’t ignore new onset confusion. Remember to check for a UTI if you experience these symptoms.

For more information, contact us at www.medsmash.com or call 410-472-5078.

Biblical Application

Confusion as a primary symptom of UTI makes me think of other aspects of life that aren’t as they initial appear.

How often does something happen in your life, and you make assumptions about the why, how, what of that event? You then start making plans and reacting based on those assumptions.

How often do we see only part of the picture and make wrong assumptions about the missing parts?

Have your assumptions ever been wrong?

Have you ever been embarrassed or even hurt someone because of those misguided assumptions?

These are the sorts of lessons we often learn the hard way.

Religion is much the same.  Some people looking in from the outside only see part of what God has in store for them.  One or two views of very human Christians not doing the right thing can give a skewed picture.  God’s grace is misunderstood.  Beliefs are created that aren’t founded in Biblical truth.

So how can we focus more on truth and test our assumptions before acting on them?

1 John 4:1 ESV

Beloved, do not believe every spirit, but test the spirits to see whether they are from God, for many false prophets have gone out into the world.

Proverbs 18:2 ESV

A fool takes no pleasure in understanding, but only in expressing his opinion.

Proverbs 25:8 ESV

Do not hastily bring into court, for what will you do in the end, when your neighbor puts you to shame?

Matthew 7:1 ESV

“Judge not, that you be not judged.

John 8:32 NLT

“And you will know the truth, and the truth will set you free.”

Give it all to God and ask him to first help you see the truth and then paint the accurate picture.

Blessings,

Michelle