Month: November 2016

Thanksgiving – Gratitude keeping you Healthy

Posted on by Michelle Fritsch, Pharm.D.
thanksgiving-14-grab
A grateful attitude can improve your outlook and your health!

Gratitude, grateful, thankful, thanksgiving, appreciation

What do these words mean to you? What role do they play in your everyday life?

Wow, I am amazed how much information is available on this important link between gratitude and health. Just search for these two terms and see what all you will find.

What is gratitude?

This is being aware of all of the good things in your life. And it is being thankful for those things. Have you considered being grateful for:

  • A safe place to sleep
  • Food to eat
  • Clothes to cover yourself
  • Having a friend to call
  • Your job – current or past
  • A beautiful day

This simple awareness of and being thankful for these ‘little’ things can boost your health.

Note, it doesn’t have to be the biggest house or the softest bed or the tastiest food or the latest fashion clothing to be grateful. Gratitude focuses on what you have – all of the good things – rather than what you don’t have.

Expressing gratitude can:

  • Boost your spirits and sense of well-being
  • Boost your immune system making you less likely to get sick
  • Decrease your chances of heart disease
  • Improve your performance (grades, work productivity, concentration)
  • Bust your stress

There are many ways you can make gratitude part of your life. Here are a few recommended in a Harvard Mental Health newsletter:

  • Write a thank-you note
  • Go up and thank someone
  • Keep a gratitude journal
  • Pray
  • Meditate
  • Keep a list of your thanks = count your blessings

See your day and your health improve by focusing on the positive.

Even therapy for mood disorders and approaches to negative thinking know this truth. I am quoting this from Rick Warren, “When you change the way you think, it changes the way you feel. And when you change the way you feel, it changes the way you act.”

On this Independence Day weekend, as a country, we have much reason for gratitude!

For more information on gratitude and health, contact us at www.medsmash.com.

BIBLICAL APPLICATION

We have so many reasons to be grateful!

Have you ever been in a ‘funk’ having a bad day and then remembered to be grateful? I have done this so many times. When all looks dark and gloomy, make yourself think about all of the things that are good and right.

1 Thessalonians 5:18 ESV

Give thanks in all circumstances; for this is the will of God in Christ Jesus for you.

I’ll quickly admit I don’t always think to do this. I stay in that dark place far too long. Later, once I’m out I realize I had the ‘magic potion’ to leave that darkness behind. It was given to us by Christ when he died to erase our sins. It was given to us by God who maintained His love and focus on the good in the Jews through centuries of missteps (just as we live a series of missteps).

Lamentations 3:23 ESV

They are new every morning; great is your faithfulness.

I don’t even know where to begin selecting Bible verses to draw us closer to the benefits of gratitude. There are so many!!!

Psalm 118:24 ESV

This is the day that the Lord has made; let us rejoice and be glad in it.

Colossians 3:17 ESV

And whatever you do, in word or deed, do everything in the name of the Lord Jesus, giving thanks to God the Father through him.

Psalm 136:1 ESV

Give thanks to the Lord, for he is good, for his steadfast love endures forever.

Ephesians 1:16 ESV

I do not cease to give thanks for you, remembering you in my prayers,

James 1:17 ESV

Every good gift and every perfect gift is from above, coming down from the Father of lights with whom there is no variation or shadow due to change.

I feel energized, positive, and excited just reading these verses full of hope and promise! I am thankful for each person who takes the time to read this. May you be blessed by these assurances from God!

I pray you can stay focused on the many good things in your life this week and that can keep you out of the dark, gloomy places.

Blessings,

Michelle

 

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Medication Choices for ‘Everyday’ Pain

Posted on by Michelle Fritsch, Pharm.D.
otc-pain-meds
Everyday pain meds are important to discuss with your doctor and pharmacist.

Do you ever have pain when you wake up?   Do you have pain when you sit too long? Does your back bother you on a long car ride? Do you get a headache when the weather changes? Do your muscles hurt the next day when you overdo it?

What do you do about this ‘everyday’ sort of pain? 

You have many choices. Walk in to any pharmacy, grocery store, or super store and you will find several shelves of options. You will find brand name pain medications next to generic, or store, versions of the same medication.

Which ones do you pick? Do you have a ‘stand by’ favorite or do you like to keep switching to try something new? I have had many clients with either of these philosophies.

Here are a few things I want you to know about these options so you can make an informed decision.

Nonsteroidal anti-inflammatory drugs (NSAIDs)

NSAIDs are medications such as ibuprofen (brand names Motrin and Advil), naproxen (brand name Aleve), and aspirin (brand names Bayer, Excedrin, Bufferin). These can relieve pain, fever, and inflammation. The over-the-counter doses are lower than the prescription doses.

There are three big risks associated with these that I want you to know about:

  1. They can be hard on your kidneys. Be sure your doctor and your pharmacist know that you take these, how much you take, and which ones you take. They will monitor your kidney function and likely ask you to stop taking them if your kidneys show signs of injury.
  2. They can be hard on your stomach. Your risk of stomach ulcer goes up when you take these. ALWAYS take them with FOOD. If you develop stomach pain, more indigestion, reflux, or burning, tell you doctor.
  3. They can raise your blood pressure. This in turn can increase the stress on your heart. If you have high blood pressure or a heart condition, talk with your doctor and pharmacist BEFORE choosing to take an NSAID.

Another important tip is to make sure your doctor and your pharmacist know you are taking any NSAID and how much. There are many of these available by prescription. I have seen many people who are taking a prescription and an over-the-counter NSAID at the same time. They had no idea because the names are different. So, share all of your medications – prescribed and self-selected – with your healthcare team. Too much NSAID makes the three risks stated above worse.

Acetaminophen

Acetaminophen (brand name Tylenol) is similar to the NSAIDs without the anti-inflammatory part. Acetaminophen can relieve pain and fever. Studies have found it is just as effective as NSAIDs for relieving pain not associated with inflammation.

There are two primary risks with acetaminophen:

  1. Too much can hurt your liver. The current guideline is to take no more than 3 grams (3,000 mg) per day.
    1. Drinking alcohol can make the damage to your liver even worse.
    2. If you already have liver problems, talk with your doctor and pharmacist BEFORE taking acetaminophen.
  2. It can increase the blood thinning effects of warfarin.
    1. If you are on a blood thinner, talk with your doctor and pharmacist about taking acetaminophen.

Note, acetaminophen can be found in many combination products. Please look for it in your headache, cold, flu, sinus, and prescription pain medications. The TOTAL amount for the entire day should be 3,000 mg or less.

Some other options

Sometimes there are simple things you can do that will relieve the pain without the use of medication. Here are just a few:

  • Stretching – for sore muscles and back pain
  • Icing – for sprained or strained muscles
  • Applying heat – for back pain
  • Drinking plenty of water – for headache
  • Closing the eyes and covering with warm compress – for headache
  • Exercising – even a stroll can help with some muscle and back pain and relieve tension related headaches

Your physical therapist is a wealth of information about stretches and exercises to relieve many types of pain. In many states, you can call and make an appointment with your physical therapist without a referral.

For more information about pain treatment options, contact us at Meds MASH at www.medsmash.com/contact.

BIBLICAL APPLICATION

What are the spiritual pains you have experienced or are experiencing now? Life brings plenty of pain and turmoil and struggle. NSAIDs and acetaminophen won’t do much for this type of pain. So what are your options?

Jesus, his disciples, and Paul provide us with a lot of instruction and comfort to guide us through these life pains.

2 Corinthians 4:8-10 ESV

We are afflicted in every way, but not crushed; perplexed, but not driven to despair; persecuted, but not forsaken; struck down, but not destroyed; always carrying in the body the death of Jesus, so that the life of Jesus may also be manifested in our bodies.

1 Peter 5:10 ESV

And after you have suffered a little while, the God of all grace, who has called you to his eternal glory in Christ, will himself restore, confirm, strengthen, and establish you.

If you’ve experienced painful experiences in your life, you are certainly not alone. We are guaranteed hardships. Our choice is how we deal with them. Most importantly, it’s how much we lean on God through them that matters.

Romans 8:18 ESV

For I consider that the sufferings of this present time are not worth comparing with the glory that is to be revealed to us.

Romans 5:3-4 ESV

More than that, we rejoice in our sufferings, knowing that suffering produces endurance, and endurance produces character, and character produces hope,

I think the following is a very comforting verse to memorize and lean on in difficult circumstances.

John 16:33 ESV

“I have said these things to you, that in me you may have peace. In the world you will have tribulation. But take heart; I have overcome the world.”

Blessings,

Michelle

Feeling Stress – Find Health in Hope and Looking Outside Yourself

Posted on by Michelle Fritsch, Pharm.D.
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This 3-step recipe can help you find hope and peace in the stress.

The media, social media, and even people on the street are expressing a lot of stress and insecurity. Change is difficult – even more so for some people than others. Uncertainty is also difficult to handle. Put the two together, as the United States did this week with a new election, and people react. No matter the outcome of this election, change and uncertainty were inevitable. Any new leader brings new ideas and ways of handling political situations, and each leader is elected with the hope of a brighter future. In the months before the election our fears are played upon to help steer us toward one candidate or the other. And once the election is finished, one set of fears, or the other, becomes the new reality.

So now what?

I heard a lot of people this week talking about heavy drinking, protesting, sleeping to avoid dealing with their thoughts, self medicating with anti-anxiety agents or drugs, having anxiety episodes, and feeling rage. At the end of any of these options, it is highly unlikely that person will actually feel better. These are destructive choices that won’t actually resolve anything.

Simple recipe

There are other alternatives that will both help overcome the stress AND help you to feel better.

  1. Focus on your source of hope.
  2. Focus on all of the good things in your life.
  3. Do something kind for someone else.

This simple three-ingredient recipe is a key to contentment and happiness.

Healthier options

Getting outside of yourself is good for your health – both physically and emotionally. Find even the smallest of ways to do something good for someone else. Get together with friends to work on projects together. Help someone celebrate a milestone. Take flowers to someone who is down. Walk around your house and remember the occasion that led to each picture, each memento, and each special possession. Talk on the phone with someone dear to you, and let them know how much they have done for you in life. And to top it all off, spend quiet time with God and your faith.

I’ve written before how impressed I am by the amount of science supporting this simple recipe. It can decrease anxiety, depression, hurt feelings, concern for the future, and stress. It can lower your blood pressure, lower your anxiety, and improve your outlook on life.

It might sound overly simple or pious, but it really works!

For more information about stress management to improve your health, contact us at Meds MASH at www.medsmash.com/contact.

BIBLICAL APPLICATION

I can’t imagine life without my ROCK SOLID source of HOPE.

I have been blessed to know about this unwavering hope throughout my life.

I see the angst in the world right now and wonder how many people have never even heard about my source of hope. How many have heard only the ‘media version’ and never the truth? How scary would all of this unrest be without such hope?

Then I know of friends who attend church each Sunday and have for all/most of their lives. But attending church doesn’t equal having that deep-seated hope. Having Christ solidly in your life is a decision – a life altering decision that opens this whole world of peace and hope.

Having a source of hope gets you through all situations. Having an eternal perspective puts everything else in perspective.

Just as the Israelites were reassured, I HOPE we can be as well.

Deuteronomy 31:6 ESV

“Be strong and courageous. Do not fear or be in dread of them, for it is the Lord your God who goes with you. He will not leave you or forsake you.”

I mentioned a recipe for health. Here is a three-part recipe that has seen me through many difficult situations.

Romans 12:12 ESV

Rejoice in hope, be patient in tribulation, be constant in prayer.

Uncertainty will always be part of our world until Christ returns. These times of upheaval can draw us closer and closer to our one true source of hope.

Proverbs 23:18 ESV

Surely there is a future, and your hope will not be cut off.       

There is nothing happening that God can’t see us through.

Blessings.

Michelle

 

 

The Dominoes of Medication – Avoid the Tipping Point

Posted on by Michelle Fritsch, Pharm.D.
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Follow these steps to prevent sudden confusion in the hospital like a series of falling dominoes.

Growing up I played countless games of Dominoes with my grandparents. And of course, the other fun thing to do with Dominoes is line them up and watch them fall is some funky pattern.

Hospitalization and memory or behavior changes

Many times in my career I have seen people experience a sudden decline in their health, often around a hospitalization. The general theme that I see far too often resembles falling dominoes and goes something like this:

  • Someone has a reason to go to the hospital
  • A medication is given that makes the person confused
  • An assumption is make this person has some form of dementia
  • That diagnosis is added to the record
  • With the confusion, behaviors change (crying out, pulling at IV’s, getting out of bed)
    • By the way, this is very alarming for the family and friends
  • More medications are added to control the behaviors
  • The person now truly looks like someone with advanced dementia
    • Unable to safely walk
    • Unable to clearly think and answer questions
    • Unable to care for him/herself
  • The person cannot return home and to the independent life led before the hospitalization
  • The person is sent on to rehabilitation or assisted living or skilled nursing care
  • The diagnoses and the medication go with them and are continued for the rest of life

In this scenario there might have been some early cognitive decline (early signs of some sort of dementia). The move to the unfamiliar environment with the scurry of activity and then the altered schedule can ‘unmask’ that early dementia and make it seem suddenly incredibly worse. Add an infection or painful condition, and this is even worse still. It could also be a sign of delirium (a short term confused state). That DOES NOT mean this confused state is the way this person will stay. Some of the best actions at this point are to dim the lights, quiet the person’s room, keep someone dear close by to assure the person that all is ok. This quieter reassuring environment can help reduce the confusion and behavior changes.

Elective procedures

Another all-to-familiar scenario is similar:

  • A person has an elective procedure
  • Part of the sedation and anesthesia for the procedure makes the person confused and disoriented
  • Any cries out or uncoordinated behaviors are interpreted as pain
  • More pain medication is given
  • When the person goes to rehabilitation or back home to recover, a schedule pain regimen is included
  • Rather than moving and doing all of the exercises that will enable rapid and full recovery, the person is too sedated from the pain medication and sleeps
  • The lack of post procedure stretching, movement, and exercises prescribed by physical therapy limit the range of motion and full recovery from the procedure
  • For the rest of life the person has limited use of the limb/joint due to lack of use right after the procedure

How can you better navigate these scenarios?

If there have been any signs of memory changes, know that you might see this sudden confusion.  Also, it seems the more critical the admission the higher the risk of delirium. (So, accidents, being in critical care, being placed on a ventilator, and such carry the higher risk).

Talk with the healthcare team about taking the following steps:

  • Dim the lights
  • Have a private room/space that stays as quiet as possible
  • Keep someone reassuring nearby
  • Keep glasses and hearing aids on to help with orientation
  • Have a clock and date information visible
  • Assure there is no infection (can cause confusion and behavior changes)
  • The healthcare team can make sure no medications are being used that can alter thinking.
  • If there is a sudden change in your loved one, stay calm. Delirium goes away with time and with these calming steps.
  • Ask for the minimum amount of pain medication to be given to limit the associated confusion and sedation.

The goal is to take care of the problem that led to the hospitalization without delirium or other confusion. Let those dominoes say standing.

For more information about delirium and steps you can take to prevent or resolve it, contact us at www.medsmash.com/contact.

BIBLICAL APPLICATION

How confusing can God be to people who have never heard about Him? I was at a conference yesterday where a speaker quipped in reference to Jesus, ‘and who knows what this guy does.’ He was trying to be funny. It was a medical type of conference, not a religious conference. But it struck me as a sentiment that is likely true for a lot of people.

1 Corinthians 14:33a ESV

For God is not a God of confusion but of peace.

David and other Psalm writers struggled to understand.

Psalm 119:169 ESV

Let my cry come before you, O Lord; give me understanding according to your word!

Psalm 119:34 ESV

Give me understanding, that I may keep your law and observe it with my whole heart.

What would you say to someone who finds the whole concept of God confusing?

Romans 3:21-24 MSG

But in our time something new has been added. What Moses and the prophets witnessed to all those years has happened. The God-setting-things-right that we read about has become Jesus-setting-things-right for us. And not only for us, but for everyone who believes in him. For there is no difference between us and them in this. Since we’ve compiled this long and sorry record as sinners (both us and them) and proved that we are utterly incapable of living the glorious lives God wills for us, God did it for us. Out of sheer generosity he put us in right standing with himself. A pure gift. He got us out of the mess we’re in and restored us to where he always wanted us to be. And he did it by means of Jesus Christ.

In these confusing times, may the message, hope, and peace of Jesus Christ bring clarity and comfort.

Hebrews 13:8 ESV

Jesus Christ is the same yesterday and today and forever.

Blessings,

Michelle

Healing Our Wounds – Skin and Relationships

Posted on by Michelle Fritsch, Pharm.D.
scar-tissue
Healing skin wounds is a complex process. The same is true for relationship wounds.

Civility, caring for other people, conflict management, self-control, integrity are constructive traits.  I am disappointed and dismayed by the negativity in society right now.  As we near our national election there is blame, ridicule, slander, questionable integrity, and division.  Candidates and regular people on the streets are tearing each other apart.  These wounds can be hard to heal.  Consider what love, patience, and goodwill could do to aid healing in our society right now.

Healing skin wounds

Do you have any scars?  The body’s primary defense mechanism and largest organ is the skin.  Any breach in the skin’s integrity can allow bacteria and infection into the body, alter the body’s ability to regulate temperature and water storage, and it usually hurts.  The skin is a very sensitive organ.

Any cut, tear, wound results in an influx of parts of the immune system to start healing the wound.

If the wound is small enough, the skin on either side of the cut can rejoin, sometimes without even a scar.

If the wound is larger, the gap is too big to allow the two sides of the skin to reattach.  In that case, granulation tissue forms to fill the gap.  New small blood vessels grow in to the area, fibrin ‘scaffolding forms’ and cells build in around the fibrin.  Then, more small blood vessels are formed, more fibrin ‘scaffolding’ forms, and more cell fill in the area.  This continues until the whole space is filled with granulation tissue.  This appears as a scar.  The space where the wound left a gap that was filled with granulation tissue is noticeable.  That skin will not be or look the same.  Granulation tissue contains fewer cells and blood vessels compared to normal skin.

Healing relationship wounds

This scar tissue is only 60-85% as strong as normal tissue.  So although the body heals itself, it is not like the wound never happened.  That is so true of our emotional scars as well.  It’s too easy to let words fly when we’re angry.  In a rage, your objective might be to win and tear the other person down.  This might feel ‘good’ in the moment.  But what happens later?  What about the guilt and shame?  What about the damage done to the relationship?  Some things can’t be completely undone.  But much healing CAN be done, and a 60-85% healed relationship is better than no relationship at all.

For more information about how the body heals itself or the health impacts of negativity, contact us at http://www.medsmash.com/contact.

Biblical Application:

It can distressing to see so much negativity all over the media.  It seems to be adding to the negativity in the workplace, the community, the church, and the home.  I encourage us to take a deep breath and focus on our one stable source of hope and joy.

Our interpersonal differences can lead to cuts and wounds in families and groups.  If those cuts can be identified and resolved quickly through skilled communication and love, they can often heal without so much as a scar.

But, when they are left unaddressed or allowed to get worse and worse, the healing process can be messy and less effective than it would have been if handled quickly.  This is not to say that healing is impossible.  Just as the human body is amazing in its resilience, with mediation, healing, communication, and forgiveness, relationships can heal and grow.  They may not look the same, changes may occur, but reconnection and resumed integrity can be achieved.
Psalm 147:3
He heals the brokenhearted and binds up their wounds.
1 Peter 2:24
He himself bore our sins in his body on the tree, that we might die to sin and live to righteousness. By his wounds you have been healed.

May your wounds, your relationships, your faith be strong.

Blessings,

Michelle Fritsch

yourhealthandsoul

Image showing granulation tissue filling a woundDo you have any scars?  The body’s primary defense mechanism and largest organ is the skin.  Any breach in the skin’s integrity can allow bacteria and infection into the body, alter the body’s ability to regulate temperature and water storage, and it usually hurts.  The skin is a very sensitive organ.

Any cut, tear, wound results in an influx of parts of the immune system to start healing the wound.

If the wound is small enough, the skin on either side of the cut can rejoin, sometimes without even a scar.

If the wound is larger, the gap is too big to allow the two sides of the skin to reattach.  In that case, granulation tissue forms to fill the gap.  New small blood vessels grow in to the area, fibrin ‘scaffolding forms’ and cells build in around the fibrin.  Then, more small blood vessels are formed, more fibrin…

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