Month: January 2016

Weight – Less of you might mean less in your medicine cabinet

Posted on by Michelle Fritsch, Pharm.D.

…or at

Medicine doses should be adjusted with weight loss
Medicine doses should be adjusted with weight loss

least lower doses.

Healthy weight loss can lead to decreased doses

Unhealthy weight loss can, too. Actually, sudden, unexpected, or drastic weight loss can be even more hazardous. If it is unplanned please talk with your doctor right away.

Fat loving (lipophilic) medicines distribute throughout all of the extra weight in our bodies. The medication finds places to travel and stay stored in all of these fatty areas. Once we lose fat, it takes a lower dose to get the same effect. If the dose is not changed with weight loss, the same dose you have taken for years can actually be toxic. Rather than being stored in the fat, the amount of medicine stays in your blood where it has more effect. I have seen several cases where someone was getting more confused, more sleepy, having more difficulty thinking with no change in their medicine regimen. Upon further analysis, we found they had lost several pounds over the past several months with no reduction in medicine dose. So talk with your doctor as you lose weight to double check doses of meds.

Medical conditions related to weight

There are also several medical conditions that are related to your weight, especially excess weight. For many people diabetes, high blood pressure, and high cholesterol are found when the person is overweight. They get worse with increased weight. If that person then loses weight, those medical conditions can get better. The need for medicines to control these conditions can go down as the body is better able to manage the blood sugar, blood pressure, and cholesterol on its own. This means the number and doses of medicines might also need to be decreased. Blood pressure medicine doses that are too high can lead to dizziness, especially with standing, and falls. Diabetes medicine doses that are too high can lead to low blood sugar, confusion, dizziness, sweating, or even passing out. Cholesterol medicine doses that are too high might increase risk of side effects like liver damage or muscle pain.

If you have diabetes, high blood pressure, or high cholesterol and have lost at least five pounds, ask your doctor if you could take fewer medicines or lower doses.

What are other benefits of weight loss?

Data has shown that a 5% weight loss can help prevent high blood pressure. It can also help control your blood pressure, your diabetes, and your cholesterol. So, if you weigh 200 pounds, this would be a 10 pound weight loss. This can be accomplished through diet and exercise. Fast weight loss fad diets are NOT the diets of choice. Eating healthy foods, vegetables, fruits, and low-fat options are the safest diet changes. Also, exercise does not mean running a marathon tomorrow. Increased movement several times each day can have a huge positive benefit.

I had one patient once who took this message to heart. He gradually changed his diet and started walking. None of his changes were extreme. Over time, he lost weight. We were able to remove EIGHT medicines from his regimen as his own body resumed control of his conditions. Not everyone will have results this dramatic, but small changes can have big positive impacts.

For more information about healthy weight loss and associated medicine reductions, please contact us at www.medsmash.com.

BIBLICAL APPLICATION

In line with these thoughts about the positive benefits of weight loss, consider the benefits of guilt loss! How much of your daily activity is influenced by guilt? Do ayou feel worthy, accepted, loved, precious, and good enough? Or, do doubts cast a shadow over you? Do feelings of guilt or shame impact your confidence and your attitude? Are you as positive and hopeful s you could be?

If you could shed guilt and shame, can you even imagine how much lighter your load would be? Think how much freer you would be to rejoice and praise and live the life you were meant to live!

Here are some of the thoughts in the Bible about guilt.

Romans 8:1 ESV

There is therefore now no condemnation for those who are in Christ Jesus.

Romans 3:23 ESV

For all have sinned and fall short of the glory of God,

Romans 5:1 ESV

Therefore, since we have been justified by faith, we have peace with God through our Lord Jesus Christ.

Rather than being burdened and weighed down by guilt, consider this offer from Jesus.

Matthew 11:28-30 ESV

Come to me, all who labor and are heavy laden, and I will give you rest. Take my yoke upon you, and learn from me, for I am gentle and lowly in heart, and you will find rest for your souls. For my yoke is easy, and my burden is light.”

The past is gone. You are forgiven! You do not need to carry around this guilt and shame. Shed it and see how good you can feel!

2 Corinthians 5:17 ESV

Therefore, if anyone is in Christ, he is a new creation. The old has passed away; behold, the new has come.

Ephesians 4:22-24 ESV

To put off your old self, which belongs to your former manner of life and is corrupt through deceitful desires, and to be renewed in the spirit of your minds, and to put on the new self, created after the likeness of God in true righteousness and holiness.

Blessings,

Michelle

Image Source:  National Center for Complementary and Integrative Health; National Institutes of Health; U.S. Department of Health and Human Services

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Flu or Cold – What do you take with high blood pressure?

Posted on by Michelle Fritsch, Pharm.D.

‘Tis the season of flu, cough, and colds. I’ll be surprised if you don’t know someone with one of these right now. There are many products lining the shelves of the pharmacies and grocery stores ready to treat your symptoms.

If you have high blood pressure or a heart condition

Does it matter which product you choose to treat your symptoms if you have high blood pressure, heart failure, have had a heart attack, or you have some other heart condition? Actually, it does. Most of the products used to treat your cold or flu contain two main ingredients: decongestant and antihistamine.

Decongestants decrease the swelling of the lining of your nose. When these swell, you feel stuffy and have trouble breathing through your nose. Taking one while you have a cold or flu can help you breath better and relieve that stuffed-up feeling. Decongestants can be found in tablets, capsules, nasal sprays, nose drops, and liquids. They are often found in combination with other medicines for fever, headache, cough, sore throat, and mucous.

Decongestants work by increasing your sympathetic system. This is the part of your system that kicks in to gear when you are angry or afraid. It is called the ‘fight or flight’ response. It also causes your heart to beat harder and faster.   Your veins and arteries get tighter. Your blood pressure goes up.

If you have high blood pressure or heart disease, this is not helpful. It puts you at risk of worse heart disease or even heart attack or stroke.

Antihistamines block histamine. This helps to dry up a runny nose, tearing of your eyes, sneezing, and itching in your nose and eyes. They are helpful with these symptoms for allergies or for colds/flu. They come in tablets, capsules, liquid, eye drops, and nasal spray. Some of the antihistamines (first generation) cause you to be sleepy and slow your thinking. The newer, second generation versions have fewer of these side effects, but they can still make you sleepy. Be very careful if you must drive while taking these.

Antihistamines should also be taken with caution with people in high blood pressure or heart disease.

The cold and flu medicines on the market for people with high blood pressure leave out the decongestant. They have the antihistamine and usually acetaminophen for fever. So, still be careful using these if you have high blood pressure. Check your blood pressure while you are taking them. Let your doctor know what you are taking for your cold and flu.

So, if most of the cough and cold and flu medicines on the market are not good for your heart or blood pressure, what should you do?

What can you do without taking cold and flu medicines?

For your fever, take acetaminophen. Medicines like ibuprofen (brand names Motrin, Advil) or naproxen (brand name Aleve) can raise your blood pressure and increase your risk of heart disease.

For your congestion, try a humidifier. Moist, warm or cool air can help break up the mucous and ease your swollen nasal passages.

Get plenty of rest so your body’s immune system can fight the virus. Drink plenty of fluid.

With or without a decongestant or antihistamine your cold or flu is likely to last about 5-7days.

Wash your hands, especially after being out in public. When you are in public or haven’t washed your hands recently, avoid touching your face (mouth, nose, eyes). And finally, please get your flu shot each year!

For more information about managing a cold or the flu with high blood pressure, please contact us at www.medsmash.com.

BIBLICAL APPLICATION

When you have high blood pressure or a heart condition, your treatment options for a cold or the flu are limited. To avoid letting your blood pressure get even higher, you need to carefully select a treatment that is best for you and your specific medical conditions.

Similarly, in your faith walk, what is best for you might not be best for someone else.

Paul mentioned this in at least two of his letters. After Christ came to reconcile us with God, the rules of the past changed. But, this was easier to accept for some people than for others. In particular, new believers found this transition to be confusing sometimes.

So Paul encouraged all believers to consider their friends and neighbors when making decisions. If something would cause confusion for someone else, then Paul encourages us to not do that thing.

Romans 14:13 ESV

Therefore let us not pass judgment on one another any longer, but rather decide never to put a stumbling block or hindrance in the way of a brother.

1 Corinthians 8:13 ESV

Therefore, if food makes my brother stumble, I will never eat meat, lest I make my brother stumble.

1 Corinthians 8:9 ESV

But take care that this right of yours does not somehow become a stumbling block to the weak.

These verses make even more sense in context, so I encourage you to read them within their chapter.

Remember those around you when making decisions. It is easy to get caught up in your own life and not even think about how your actions impact others. Even when you are making ‘good’ decisions, realize other people younger in their faith might not understand your freedoms and reasons for exercising those freedoms.

Blessings,

Michelle

Approach Your Doctor Visit Differently in 2016 – Win-Win

Posted on by Michelle Fritsch, Pharm.D.
Slide1
Prepare for your doctor visit

 

How do you prepare for a doctor visit? Have you ever experienced, or can you picture, the following scenario?

You have a health-related issue and want to see your doctor. You call to make the appointment. You wait and monitor the issue until the day of the appointment. You think about the appointment as you get ready and drive to the office. You think about the visit while in the waiting room. You briefly tell the assistant about the issue while you are being checked in with your weight, blood pressure, etc. You think more about the issue while waiting for your provider to enter the room. Then, your provider comes in and your mind goes blank.

Has this ever happened to you? Even if you remembered most of what you wanted to discuss, did you leave and realize you forgot to mention something important?

Doctor Visit Preparation

This happens all too often! Sometimes people feel rushed. Sometimes they get caught up in conversation with their doctor and don’t realize the time available for the appointment has slipped way. I have had patients bring up important information at the very end of appointments many times. It is so late that we can’t fully address the issue with the time remaining.

So, what can you do to avoid this situation?

Important steps

Here are some important steps to help you get the most from your healthcare visits.

  1. From the time the issue arises until your appointment, write down important details your doctor will want to know.
    1. When did it start?
    2. How did it start?
    3. What makes it worse?
    4. What makes it better?
    5. Use good descriptive words to describe your symptoms.
    6. How often does it occur?
    7. Have you had something like this happen before?
    8. What has changed that might be related to this issue?
    9. Keep a journal of how the issue impacts you daily.
    10. What outcome are you hoping to have from your visit?
  2. Prioritize the issues you want to discuss at the appointment.
  3. Limit your list to the top 3. You can bring others to mention if there is time, but most visits have time for only 1 major or up to 3 more minor issues.
  4. Bring two copies of your list to your appointment.
  5. Give the list to the assistant who checks you in. He/she can then give it to your provider to review before coming in to the room with you. This will save a lot of time in the first part of your appointment.
  6. When your provider comes in the room, you will each have a copy. This will take the pressure off of you to remember the details. It will also help guide your provider to quickly understand the issue(s) you want to talk about.
  7. You can now have a more relaxed conversation with your provider in the time that is available for your visit.

Your provider will truly appreciate this approach. Keep in mind, for some symptoms your provider only knows what you tell him/her. So, the more thorough you can be, the better your provider can make the correct diagnosis.

Consider your healthcare to be a partnership rather than a one-way interaction. You and your providers will feel better about your relationship.

For more information about preparing for doctor visits, contact us at www.medsmash.com.

BIBLICAL APPLICATION

Just as there are more successful ways to approach medical visits, there are some best practices for communicating with God.

Jeremiah 29:12-13 ESV

Then you will call upon me and come and pray to me, and I will hear you. You will seek me and find me, when you seek me with all your heart.

In all parts of the Bible there are tips, insights, and instructions for maintaining our awareness and dependence on our Lord and Savior to walk with us through any circumstance.

Mark 11:24 ESV

Therefore I tell you, whatever you ask in prayer, believe that you have received it, and it will be yours.

Philippians 4:6-7 ESV

Do not be anxious about anything, but in everything by prayer and supplication with thanksgiving let your requests be made known to God. And the peace of God, which surpasses all understanding, will guard your hearts and your minds in Christ Jesus.

James 5:16 ESV

Therefore, confess your sins to one another and pray for one another, that you may be healed. The prayer of a righteous person has great power as it is working.

John 15:7 ESV

If you abide in me, and my words abide in you, ask whatever you wish, and it will be done for you.

1 John 5:14-15 ESV

And this is the confidence that we have toward him, that if we ask anything according to his will he hears us. And if we know that he hears us in whatever we ask, we know that we have the requests that we have asked of him.

God is there with you, loving you, holding you at all times. He never leaves to take a break. He never gets distracted.

If you are feeling alone and not aware of His presence, you have your ‘shields’ up. Take them down. Go to Him in prayer and take down those defenses that are making you feel separated. God will love being able to communicate with you again. You will love that flood of security, grace, and unconditional love.

Blessings,

Michelle

P.S. Have you noticed that all of our instruction in prayer puts praise first? Then, bring your requests, hurts, and desires to God.

Are you meds making your memory better or worse?

Your Medications and Your Memory – making things better or worse?

Posted on by Michelle Fritsch, Pharm.D.
Are you meds making your memory better or worse?
Memory

Do you ever feel like your memory is slipping? Are you getting forgetful?

Prescription Medications and Memory

Which of your medicines is helping preserve your memory? There are several medical conditions that can make your memory worse. The medicines that treat those conditions then help preserve your memory. Some examples include medicines for heart disease, seizures, blood thinners, asthma inhalers, or emphysema and bronchitis inhalers. Oxygen is a common theme with many of these medications. If you have a medical condition that could decrease the oxygen getting to your brain, this could worsen your memory.

Which of your medicines is actually making your memory worse? Unfortunately, there are many medications that can do this. Any medication that can make you sleepy or slow your thinking can make it harder to remember things. Any medicine that impacts how your brain functions can alter clear thinking. This does not mean all of these medications should be avoided. It does mean to not assume you have dementia when you have foggy thinking while on these medications. There are many examples; some common ones are medications for pain, anxiety, and depression. Anticholinergic, or very drying, medicines cloud your thinking. Recently, statin medications for cholesterol have also been associated with memory impairment.

There are currently two classes of medicines approved for use in Alzheimer’s Disease. For many medical conditions, once diagnosed, you are prescribed a medication(s) to treat that condition. This is not as simple with the dementia medications. They do NOT cure or prevent dementia. They do NOT help all people with dementia. The best impact they have is to slow the progression of dementia, and again, not everyone who takes them will have this result. They have cholinergic side effects that include nausea and diarrhea. If they are stopped after they have been taken, there can be a rapid decline in the dementia. It is not known if the decline is to the point the person would have been if they had not taken the medicine, or if it is an even sharper decline. So there is much to discuss with your physician and healthcare team before deciding to take these medicines.

How about vitamins?

Vitamins are perfectly safe, right? The more the better, right? For many vitamins, taking more than you need is just a waste; your body gets rid of what it doesn’t need. But some other vitamins are not easily cleared, and too much can cause problems. Vitamin E is a vitamin that has been studied to see if it can help with memory. Although some studies have had mixed results, there is no evidence that vitamin E can prevent dementia. There is some data that suggests it might help slow the progression of Alzheimer’s disease. But, there have also been reports of increased risk of death with vitamin E. This is because it can interact with several medications, especially those that can cause bleeding such as medicines that prevent clots. It is also one of the vitamins that the body can’t easily expel, so it is possible to get too much.

Vitamin B12 is another that has been studied.  If your vitamin level is low, then vitamin B12 can help.  However, if your B12 level is normal  supplements will not help.

The best way to get vitamins is through your diet.

And what about herbal remedies, natural remedies, or supplements?

There have been some studies looking at gingko biloba. It does not appear to prevent Alzheimer’s or other forms of dementia. There is some data that suggests it might help stabilize dementia. In particular, some studies show that it can help stabilize mood. Healthy people who take gingko report feeling more alert. However, there are several medication interactions to consider before you take this. It can increase risk of bleeding and can impact blood sugar control if you have diabetes.

Other substances that will change your ability to think clearly are alcohol, marijuana, and illicit substances. They may not be prescribed (yet), but they can definitely impact how sharply you think. Include these when you talk with your physician and your pharmacist about your medicines.

Some medications can help preserve your memory, and some medications can make your memory worse. Vitamins, over-the-counter medicines, supplements, and herbal remedies all should be considered medications. Share all that you take with your primary care provider and your pharmacist. That will allow them to make sure there are no medicines or interactions that are negatively changing your memory.

For more information about your medications and your memory, please contact us at www.medsmash.com.

BIBLICAL APPLICATION

Just as medication can cloud our thinking and memory, what can cloud our spiritual life? Do you ever feel that you are just not fully connected with God? Does it ever feel like something is clouding the connection? Or do you find it’s easier to just ignore the connection?

In my life the most common culprits are:

  • To-do lists
  • Crazy schedules
  • Worries

Martha got caught up in similar tasks. She was fretting so much about hosting Jesus that she failed to experience Jesus.

Luke 10:38-42 ESV

Now as they went on their way, Jesus entered a village. And a woman named Martha welcomed him into her house. And she had a sister called Mary, who sat at the Lord’s feet and listened to his teaching. But Martha was distracted with much serving. And she went up to him and said, “Lord, do you not care that my sister has left me to serve alone? Tell her then to help me.” But the Lord answered her, “Martha, Martha, you are anxious and troubled about many things, but one thing is necessary. Mary has chosen the good portion, which will not be taken away from her.”

There are several verses that help us realign our thoughts and hearts.

Romans 12:2 ESV

Do not be conformed to this world, but be transformed by the renewal of your mind, that by testing you may discern what is the will of God, what is good and acceptable and perfect.

Matthew 11:28-30 ESV

Come to me, all who labor and are heavy laden, and I will give you rest. Take my yoke upon you, and learn from me, for I am gentle and lowly in heart, and you will find rest for your souls. For my yoke is easy, and my burden is light.

1 John 2:17 ESV

And the world is passing away along with its desires, but whoever does the will of God abides forever.

Philippians 3:13-14 ESV

Brothers, I do not consider that I have made it my own. But one thing I do: forgetting what lies behind and straining forward to what lies ahead, I press on toward the goal for the prize of the upward call of God in Christ Jesus.

To use a sports analogy, keep your eyes up and focused on the long game. Daily struggles become easier to navigate when your focus is on God. He will lead you step by step according to His plan for you.

For it is impossible to be in the presence of Jesus and not be changed.  

– Joanne Weaver

This might sound contrite, but truly give your day to Him, keep your focus on Him, and see what happens.

Blessings,

Michelle