Author: Michelle Fritsch, Pharm.D.

Learn How YOU Can Be a Life Saving Hero – Cape Optional!

Posted on by Michelle Fritsch, Pharm.D.
Be a hero to prevent opioid overdose deaths
Be a super hero and save a life! Save opioid overdose deaths.

We need a hero! People are dying at alarming rates. Who is your favorite superhero? Have you ever dreamed of being a superhero? Can you picture yourself as a hero? [I’m curious, in your vision, are you wearing a superhero cape? What color?]

The need for a hero

The rate of overdose and overdose deaths is rising rapidly. It is hard to even fathom this epidemic. In particular, overdose rates with opiates are skyrocketing. Opiates are pain medications such as oxycodone, Percocet®, Oxycontin®, hydrocodone, Vicodin®, methadone, Fentanyl®, and more. An illegal opiate that is readily available is heroin. Now there are batches of heroin that are ‘cut’ with other drugs such as fentanyl and carfentanyl (used to sedate elephants). These mixtures are getting more and more dangerous.

The way these drugs are fatal are that they stop the breathing process. At low doses, for the treatment of pain, most people take prescription opiates and are fine. As the pain lessens, the use of the opiate should lesson. However, for some people the brain starts to beg for more and more. As the brain gets huge amounts of excitement through neurotransmitters such as dopamine, the rest of the body says, ‘Whoa, that is way too much!’ The body stops making its own supply of these neurotransmitters and it shuts down the receptors that move them along. So, it takes bigger and bigger doses to get the same effect. And, if someone suddenly stops taking the drug, withdrawal starts. This is a terrible feeling with nausea, vomiting, chills, agitation, anxiety, muscle aches, yawning, and more.

Not everyone who takes an opiate for their pain will ever feel this rush of excitement and have their brain demand more. One of the many problems right now, is there is no way to know who will get this rush of excitement that can lead to addiction and who won’t. People with a risk for addiction some in every age, gender, size, race, financial pattern, level of education, and geographic area.

There are many available statistics. Here are some from the Centers for Disease Control (CDC):

  • In 2014, almost 2 million Americans abused or were dependent on prescription opioids.
  • As many as 1 in 4 people who receive prescription opioids long term for noncancer pain in primary care settings struggles with addiction.
  • Every day, over 1,000 people are treated in emergency departments for misusing prescription opioids.

How you can be a hero

To be a hero, you just need to carry and know –

  • When
  • Why
  • How

to give Narcan® to someone who has overdosed on an opiate.

Naloxone is a medication that can block the receptors to opiates. When given, it puts the person is immediate withdrawal. If someone has overdosed and is either sound asleep and can’t be woken or has stopped breathing, naloxone can block those receptors and wake them up. If the overdose very recently occurred, it can help breathing start again. Naloxone can save the life of someone who has overdosed!

Outside of a healthcare setting, there are two products regular people are likely to use to save a life.

If you suspect an overdose, try to wake the person. When they don’t respond to shaking and talking to them, try rubbing their breastbone with your knuckles. If no response, TREAT!

  • Narcan® is a nasal spray
    • Put index and middle finger on either side of the nozzle
    • Put the nozzle in the nose
    • Push the plunger
  • Evzio® is an injection that goes into the thigh
    • The device tell you what to do
    • Remove the red cap
    • Put the device against the thigh
    • Push the button
    • Hold until the 5 second countdown is complete

The sudden withdrawal from the medication might cause the person to vomit or two be very surprised and angry. It does not feel good to be in sudden withdrawal.

It DOES feel good to be alive!

Call 911 to continue the person’s care and to help them into rehabilitation.

Note, depending on the opiate dose that was taken, after 2-3 minutes the person might need another dose if they go back to sleep. This is SUCH a brief description. Call us to talk about this in more detail at 410-472-5078, or e-mail me at michelle@medsmash.com, or contact us at www.medsmash.com/contact.

BIBLICAL APPLICATION

What is our role in this sad, alarming epidemic? Why is this happening? What are so many people struggling with addiction?

Are addicts bad people? Are they being punished? Are they ‘those people’? Before the addiction, were they different from you and your family?

I know many have these opinions about ‘them’.

I challenge you to respond with compassion and love for all people. Until a discovery is made of the ‘addiction gene’ or addiction identifier, each and every person prescribed an opiate beyond the time or dose needed for their pain or experimenting with an opiate could find him/herself instantly struggling with addiction.

I know some of you will disagree with the following, and I would love to hear from you.

I wonder how much of the current opiate addiction overdose epidemic is a sign of our stressed out time and how much is a challenge for us to demonstrate the length we will go to be compassionate and care for each other.

Ephesians 4:32 ESV

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

Galatians 6:2 ESV

Bear one another’s burdens, and so fulfill the law of Christ.

Matthew 7:12 ESV

“So whatever you wish that others would do to you, do also to them, for this is the Law and the Prophets.

Zechariah 7:8-10 ESV

And the word of the Lord came to Zechariah, saying, “Thus says the Lord of hosts, Render true judgments, show kindness and mercy to one another, do not oppress the widow, the fatherless, the sojourner, or the poor, and let none of you devise evil against another in your heart.”

I encourage you to rise to the occasion to show compassion, learn more, and save lives. You can contact me at michelle@medsmash.com

Blessings,

Michelle

Advertisement
Kindness improves your health!

Kindness, Care of Others, and Your Health

Posted on by Michelle Fritsch, Pharm.D.
Kindness improves your health!
Choose kindness to improve your health

When was the last time you did something for someone else? When is the last time you were kind? When did you do something for someone else expecting nothing in return? Kindness is so good for your health!

This is not just my idea. Kindness and thinking of others rather than always thinking about yourself is promoted by most of the world’s religions. All of the major religions encourage treating other people the way we want to be treated. If we would find something hurtful, then we shouldn’t do that thing to other people.

In my mind, if all of the major religions of the world agree to this basic principle, then it might truly be good for you!

Kindness is a choice

Good, beautiful things happen all around you every day.

Discouraging, annoying, negative things happen all around you every day.

Which do you notice more?

Is your first, natural reaction a kind one – or – a negative one?

We might tell ourselves that events are happening TO us, but the reality is, we get to choose our reaction. Our response is in our own control.

Maybe you haven’t always exercised that control, but you can choose kindness over a more negative response.

When we focus on other people, we both benefit!

Kindness and health

As I’ve researched this I have been amazed at all of the studies, literature, and measurements of the health benefits of kindness. Noticing, caring for, and being kind to other people has a positive benefit throughout our whole body.

Kindness is good for your mental and your physical health!

Here are just a few of the changes that YOU will experience when you are kind:

  • More relaxed
  • Less focused on your own pain, mood, worries
  • More positive outlook
  • Feel better about yourself
  • Decreased loneliness and helplessness
  • Sense of feeling connected

Kindness has also been shown to:

  • Help with weight control
  • Lower your blood pressure
  • Decrease your acid reflux in your stomach
  • Boost your immune system
  • Help you sleep better
  • Decrease your pain

Truly, there is so much to gain! When you are kind, the whole world feels like a brighter place.

I have seen medication use decrease, overall health increase, and people love their life so much more when they decided to practice kindness.

For more information, a list of references, or just to chat about this topic, please contact me at michelle@medsmash.com; 410-472-5078; or www.medsmash.com/contact.

BIBLICAL APPLICATION

Kindness is at the heart of the Golden Rule. When Jesus was asked which commandment was the greatest, here was his response:

Matthew 22:37-39 NIV

Jesus replied: “‘Love the Lord your God with all your heart and with all your soul and with all your mind.’  This is the first and greatest commandment.  And the second is like it: ‘Love your neighbor as yourself.’

If you are loving your neighbor as yourself, then you are good, kind, helpful, understanding, forgiving, and loving.

We all long to be loved. We all like when kindness is shared with us.

I propose we were designed to express and experience kindness as a key element of our lives.

Ephesians 4:32 ESV

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

Proverbs 11:17 ESV

A man who is kind benefits himself, but a cruel man hurts himself.

Kindness is one of the fruits of the spirit.

Galatians 5:22-23 NLT

But the Holy Spirit produces this kind of fruit in our lives: love, joy, peace, patience, kindness, goodness, faithfulness, gentleness, and self-control. There is no law against these things!

I encourage each of us to practice kindness. When tempted to have an angry, frustrated, or negative response, stop and consider the choice of kindness.

Blessings,

Michelle

2% have great med regimens

Are you part of the 2% with a perfect medication regimen? I hope so!

Posted on by Michelle Fritsch, Pharm.D.
2% have great med regimens
Are you in the 2% with a perfect med regimen or part of the 98% with room for improvement?

After thousands of patients and over 20 years of collecting data, I consistently find that 2% of the patients I see don’t need any medication change.   I hope you are in this esteemed 2%. It means your medication regimen is safe, effective, dosed correctly, and working just as expected for you. You have no unmet health needs. You are doing the things you want to do in your life with no limitations posed by medicine.

A full 2% understand their medications and take them correctly.

How do you know if you’re part of the other 98%?

A medication use specialist reviewing your health plan might uncover any of these things:

  • Your medication is causing a side effect that is impacting your day
  • There is another medication that could have the same benefit without the disruptive side effect
  • Your dose is too low to completely do what it is intended to do
  • Your dose is too high for what you need
  • Your kidneys or liver have changed, so your dose needs to change
  • A medication for one purpose is making another medical condition worse
  • You have a problem that could be treated and no treatment has been started
  • You are not taking the medication that has been prescribed and have not told your healthcare team (doctor)
  • The medication is so expensive you are having to make decisions about what to purchase each month
  • Your medication is not covered by your insurance; another safe and effective option is covered
  • You take your medicine at a time of day that will limit its effect
  • You take your medicine with other medicine or food that will change its effect
  • Your medication is making your dizzy or otherwise increasing your chance for falls
  • Your memory is changing because of your medication
  • The time of day you take your medication is limiting its effectiveness
  • You don’t remember which medication is for which indication
  • You have your medications confused
  • You pick and choose each day which medication to take (when maybe it only works if taken regularly)
  • You are taking a medicine that you no longer need
  • Medications, supplements, vitamins, over-the-counter items, and other things you take aren’t known by your healthcare team, are causing issues or are making you better such that you no longer need some of your prescriptions

What if you’re part of the 98%?

That’s why I do what I do!

The key elements of a Meds MASH health review:

  • Talk about your health goals and hopes
  • Review your health records
  • Review all of your medications exactly as you use them
  • Assess all of your supplements, herbals, over-the-counter medicines, vitamins, and the things you take just once in awhile
  • Evaluate your falls risk (helpful even if you are an athlete)
  • Evaluate your heart disease risk
  • Evaluate your memory
  • Assess your depression, anxiety, stress levels
  • Prepare you to get the most out of all healthcare visits with your doctor, therapist, or other providers
  • With your permission, share our findings and recommendations with your doctor and healthcare team
  • If you prefer, coach you to share our findings and recommendations with your doctor and healthcare team
  • Help your doctor with prioritizing items and medication titration (very gradually, carefully monitoring changes)

Contacting Meds MASH

A full 98% of people have room for improvement or education with their medications. Nearly ¾ need an actual medication or dose change. Even after I have worked with people for years, about ½ of the time, there is more work to be done. I never make changes all at once. Your health is too important.  Any changes, agreed to by you and your doctor, are made one at a time while we carefully monitor your response.

If you want to know if you are in the 98%, contact Meds MASH today at www.medsmash.com/contact or by calling 410-472-5078 or e-mailing michelle@medsmash.com.

BIBLICAL APPLICATION

This health blog was about the fact that most people have some room for improvement in their medication use.

Isn’t the same true in our life? I know I have a lot of room for improvement!

The sermon at my church today was about patience. I will readily admit that is not my strong suit. God has taught me a lot on this subject throughout my life so far. Like most of you, events have happened that absolutely stopped me in my tracks. All of my plans were out the window. The future was completely unclear. These are the times when we choose to shut down, take over our own planning, or give it all to God’s plan.

Solomon was the king blessed with great wisdom.  He was well aware of the value of waiting on God’s plan.

Proverbs 16:9 ESV

The heart of man plans his way, but the Lord establishes his steps.

Proverbs 19:21 ESV

Many are the plans in the mind of a man, but it is the purpose of the Lord that will stand.

As hard as we try to control these things ourselves, we can’t create, accumulate, or lead to the magnificent degree possible through Christ.

You are loved! God wants to guide you through your life according to HIS plan.

Throughout the Bible we have examples of God’s plan going beyond what we can even fathom. Even in terrible times, when people find themselves in dire situations, God has repeatedly demonstrated how He can turn things around.

Jeremiah 29:11-14 ESV

For I know the plans I have for you, declares the Lord, plans for welfare and not for evil, to give you a future and a hope. 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. I will be found by you, declares the Lord, and I will restore your fortunes and gather you from all the nations and all the places where I have driven you, declares the Lord, and I will bring you back to the place from which I sent you into exile.

Jesus addressed our tendency to stress out, worry, and try to assume control.

Matthew 6:25-34 ESV

“Therefore I tell you, do not be anxious about your life, what you will eat or what you will drink, nor about your body, what you will put on. Is not life more than food, and the body more than clothing? Look at the birds of the air: they neither sow nor reap nor gather into barns, and yet your heavenly Father feeds them. Are you not of more value than they? And which of you by being anxious can add a single hour to his span of life? And why are you anxious about clothing? Consider the lilies of the field, how they grow: they neither toil nor spin, yet I tell you, even Solomon in all his glory was not arrayed like one of these. …

Ephesians 2:10 ESV

For we are his workmanship, created in Christ Jesus for good works, which God prepared beforehand, that we should walk in them.

How can you improve your life by turning it over more fully to God? He loves you! He has great plans for you! How can you be 100% committed to God and his plan in your life?

Blessings,

Michelle

 

When the simple is complex

When Something so SIMPLE is NOT so simple – Tylenol®

Posted on by Michelle Fritsch, Pharm.D.
When the simple is complex
When simple pain meds aren’t so simple

How often have you reached for simple acetaminophen (brand name Tylenol®) in your life? It is the go-to remedy for so many symptoms. It will reduce a fever, help with a headache, and help with general aches and pains.

Note, acetaminophen is the generic name. The generic version works just the same as the brand Tylenol® version. It is sometimes abbreviated APAP. So, Tylenol® = acetaminophen = APAP.

#1 treatment of osteoarthritis

Do you have arthritis? I know I do. Most of us (about 90%) have osteoarthritis. This is a condition where the cartilage coating our joints has worn away. There is now pain where bone is rubbing against bone. Your main symptoms are usually pain when you use the joint, stiffness, weakness (from your tendency to use it less), and crackling sounds.

I know I can no longer sneak up on my teenagers when I climb the stairs. My gravely sound in my knees is easy to hear.

The American College of Rheumatology, the main group of specialist doctors who treat arthritis, recommends acetaminophen for osteoarthritis.

Safer than NSAIDs (ibuprofen = Motrin®, Advil®; naproxen = Aleve®, Naprosyn®)

Nonsteroidal anti-inflammatory drugs (NSAIDs) are commonly used for pain. They treat pain in a way just like acetaminophen, and they also help with inflammation.

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.

Risks of acetaminophen – not so simple

Acetaminophen is safe, but not completely safe. It has some risks. The biggest risk is when we take too much. And taking too much, is VERY EASY to do.

Sometimes people don’t realize that Tylenol® and acetaminophen are the same thing. When in pain, they take both thinking they are different medicines.

Many opioid pain medicines contain acetaminophen (APAP). Here are some examples:

  • Percocet® (oxycodone and APAP)
  • Roxicet® (oxycodone and APAP)
  • Endocet® (oxycodone and APAP)
  • Norco® (hydrocodone and APAP)
  • Vicodin® (hydrocodone and APAP)
  • Lortab® (hydrocodone and APAP)
  • Lorcet® (hydrocodone and APAP)
  • Tylenol #3® (codeine and APAP)
  • Tylenol #4® (codeine and APAP)

Many cough/cold/flu medicines also contain APAP. Some examples are:

  • Contac Cold & Flu
  • Theraflu
  • Alka Selzer plus Cold
  • Vicks Sinex
  • Comtrex

Too much acetaminophen in a day can damage your liver. The most that should be taken in a day is 4,000 mg (8 Extra Strength 500mg tablets). A group of experts is supporting a change so people use 3,000 mg or less. This will decrease the chance of people taking too much if their combination medicines have some ‘hidden’ acetaminophen.

The other important factor is alcohol. It is best to not drink alcohol when taking acetaminophen. Both make the liver work hard. Each can damage the liver when the liver is overworked. It can hurt your kidneys, too. If drinking while taking acetaminophen, please not every day and not beyond 1-2 drinks.

For more information about best use of acetaminophen, contact us at www.medsmash.com/contact, 410-472-5078, or michelle@medsmash.com. We can assess all of your medication regimen to screen for hidden acetaminophen.

BIBLICAL APPLICATION

Oh my, isn’t this also true of our Christian walk? The rules are ‘simple’ – Love the Lord your God and your neighbor as yourself.

Love, love, love!

It is good for you, it is good for others, it’s so simple!

I can give a list of the people I have hurt, offended, taken for granted, or overlooked in the last day or two.   I get distracted, frustrated, caught up in work, or frazzled. There is no excuse. My intention is to spend each day expressing God’s love. And, each day, I fall short of my well-intentioned goal.

Paul describes his own struggle with this in Romans Chapter 7.

Romans 7:14-25 NIV (underline emphasis mine)

We know that the law is spiritual; but I am unspiritual, sold as a slave to sin. I do not understand what I do. For what I want to do I do not do, but what I hate I do. And if I do what I do not want to do, I agree that the law is good. As it is, it is no longer I myself who do it, but it is sin living in me.  For I know that good itself does not dwell in me, that is, in my sinful nature.[c] For I have the desire to do what is good, but I cannot carry it out. For I do not do the good I want to do, but the evil I do not want to do—this I keep on doing. Now if I do what I do not want to do, it is no longer I who do it, but it is sin living in me that does it.

So I find this law at work: Although I want to do good, evil is right there with me. For in my inner being I delight in God’s law;  but I see another law at work in me, waging war against the law of my mind and making me a prisoner of the law of sin at work within me.  What a wretched man I am! Who will rescue me from this body that is subject to death?  Thanks be to God, who delivers me through Jesus Christ our Lord!

So then, I myself in my mind am a slave to God’s law, but in my sinful nature[d] a slave to the law of sin.

Why can’t we follow this simple rule of love?

Living in love means turning away from fear and selfishness*. We are so hardwired to think of ourselves first and foremost. It is a true choice (sometimes a very difficult choice) to put other people first. True love as demonstrated by Jesus is not selfish.

1 Corinthians 13:4-7 NIV

Love is patient, love is kind. It does not envy, it does not boast, it is not proud.  It does not dishonor others, it is not self-seeking, it is not easily angered, it keeps no record of wrongs.  Love does not delight in evil but rejoices with the truth.  It always protects, always trusts, always hopes, always perseveres.

Can you imagine our world if we all lived in perfect love, as we were designed to live? Can you imagine each person you see treating you with love and respect? Can you imagine a world without conflict?

It is coming!

Blessings,

Michelle

* This is a reminder of a book I have been recommending that addresses this conflict between fear/selfishness and love. The God-Shaped Brain by Timothy R. Jennings, MD.

Redwood forest serenity

Serenity- Exploring this component of your health

Posted on by Michelle Fritsch, Pharm.D.
Redwood forest serenity
Finding time for quiet serenity is key to good health.

Where do you find serenity? Webster defines

serenity as, ‘the state of being calm, peaceful, and untroubled’.

I have just returned from a trip of celebration with my Mom (70), me (50), and my daughters aged 18 and 16. We have been planning this trip for over a year. One of my favorite aspects was the serene places we found. While in the Redwood Forest it was awe inspiring and silent. Even though there were other people in the forest, somehow we couldn’t hear them if we weren’t beside them. To be in the midst of those giant trees and surrounded by giant ferns, it was so calm, awe-inspiring, and yes, serene.

The Redwoods were protected from excess logging by conservation efforts including the formation of the Redwood National Park in 1968. Then President Nixon dedicated a grove in the park to Lady Bird Johnson. Here is a quote on a plaque in that grove that struck me:

‘One of my most unforgettable memories of the past years is walking through the Redwoods last November – seeing the lovely shafts of light filtering through the trees so far above, feeling the majesty and silence of that forest, and watching a salmon rise in one of those swift streams – all our problems seemed to fall into perspective and I think every one of us walked out more serene and happier.’ Lady Bird Johnson, July 30, 1969

The part that grabbed my attention was, ‘all our problems seemed to fall into perspective…’

When was the last time you felt truly serene? How often do you slow down and allow yourself to just truly relax? What are the places or activities that bring you to that place of serenity?

Serenity and health

When you are calm, peaceful, and untroubled your whole body benefits. Your blood vessels relax, your blood pressure lowers, you breath more deeply, and your think more clearly. Your immune system is more active and you sleep more deeply.

I have been fascinated by the book, ‘The God-Shaped Brain’ by Dr. Timothy R. Jennings who is a psychiatrist and psycho-pharmacologist. He makes a compelling case that directly relates to serenity and health. He describes which part of your brain is working for you to think, reason, and plan. There is also a part that allows you to experience empathy, compassion, and love. When you are serene, these parts of your brain are fully operating.

When you are stressed, other parts of your brain take over. They put you in ‘fight or flight’ mode so that you are fully alert and ready to tackle the source of the stress. You were designed to have this stress alarm triggered only in rare truly life-threatening situations. However, in today’s society, so many of us are under constant stress. This system starts taking over our brain on a regular basis. As this stress system takes charge of your brain, your ability to think clearly, calmly, and to genuinely relate to others declines.

You have the power to give your stress signals a rest. As you do, and the more you do, the better your brain will function. You will be able to think through problems, plan, and prioritize. You will feel more connected to your own feelings, be able to manage them, and relate more to other people.

One of the best parts is that you will be free to think less about your own needs and more about the needs of others. That has been explored in previous blogs and will be explored again. There is a mountain of evidence that this is very good for your health!

The Role of Medications

There are many medications available to you that in some way target your mood, your anxiety, your depression, your anger, your emotions, and/or your reactions. These have a role. They cannot produce serenity. They cannot remove your stresses or your responses to them. They can help you cope. They are most effective when combined with therapy that can help you decrease the control of your stress response in your brain and let your thinking and loving parts of your brain resume control.

When medications are used, they should be used with great care and at the best doses. Your best medication and dose depend on several factors:

  • your kidneys and how they function
  • your liver and how it functions
  • side effects you might experience
  • your allergies
  • interactions with your other medications and your other medical conditions
  • evidence (studies that have been done to demonstrate what works best in a situation like yours)

The Role of Meds MASH

At Meds MASH a medication-use expert who is specialized in people over age 60 will help you and your doctor make sure the best, safest, most effective medication is used and only for the time period necessary. Meds MASH specialists can also help you find the counseling component you need to go with your medications.

Contact us today at 410-472-5078 or www.medsmash.com/contact or e-mail me at michelle@medsmash.com.

BIBLICAL APPLICATION

With each moment of our lives we have one basic decision to make. Will you make a choice for yourself or a choice for others? Jesus tells us our basic guiding principles are:

Luke 10:27 NIV

He answered, “‘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, ‘Love your neighbor as yourself.’”

I mentioned the book I have been reading, ‘The God-Shaped Brain’. Dr. Jennings focused the book on how our brain functions when we are living according to God’s plan of love vs when we are not.

We get further and further from God’s plan the more we focus on ourself. Pride, envy, harbored resentment, anger, judgmental attitudes, and lust are just a few of the ways we turn our focus to ourself and our own needs.

Galatians 5:19-21 ESV

Now the works of the flesh are evident: sexual immorality, impurity, sensuality, idolatry, sorcery, enmity, strife, jealousy, fits of anger, rivalries, dissensions, divisions, envy, drunkenness, orgies, and things like these. I warn you, as I warned you before, that those who do such things will not inherit the kingdom of God.

1 Timothy 6:4 ESV

He is puffed up with conceit and understands nothing. He has an unhealthy craving for controversy and for quarrels about words, which produce envy, dissension, slander, evil suspicions,

1 Corinthians 3:3 ESV

For you are still of the flesh. For while there is jealousy and strife among you, are you not of the flesh and behaving only in a human way?

God’s plan is rooted in love and turns our focus outward. It also promotes the ‘best’ function of our brain, reduced stress, lower blood pressure, enhanced immune system function, and overall joy.

1 Corinthians 13:4 ESV

Love is patient and kind; love does not envy or boast; it is not arrogant

Galatians 5:22-23 NIV

But the fruit of the Spirit is love, joy, peace, forbearance, kindness, goodness, faithfulness, gentleness and self-control. Against such things there is no law.

It sounds so simple, but it is so hard to pursue and maintain. It is a daily, moment-by-moment decision to love and keep the focus turned outward. God is with you each of those moments ready to guide you and enable you to make those positive decisions.

Blessings,

Michelle

Safe meds and independence!

Independence – Live the Retirement of your Dreams

Posted on by Michelle Fritsch, Pharm.D.
Safe meds and independence!
Maintain your independence through safe medication use.

Happy Independence Day! On this day of immense gratitude for all who have served to preserve our freedom, I am also thinking about your freedom. My passion professionally is to help people live out their retirement dreams in good health avoiding physical limitations. It sounds so basic. No one thinks medication-related issues will apply to him or her – until they do.

I have talked with hundreds of people who found themselves suddenly limited. It happened ‘out of the blue’ in many instances. In others, it was a gradual approach that was more visible in hindsight.

Pay attention to maintain your independence

In many cases people noted a change but didn’t pay much attention to it. Often a medication had been changed, and their energy level or their clear thinking changed. Maybe they got dizzier or couldn’t exert themselves as much. These little changes led to new symptoms that led to more new medications. This can be a slow, barely noticeable cycle that leads to trouble.

Ask the right questions to maintain your independence

Before any new medication is started, fully understand why it is necessary, what other options were considered, and what you should expect. Read the information that comes with the prescription. Look at the common side effects and pay attention to whether you experience those. If they last more than a couple of days or they make you decrease your activity levels, call your doctor. Talk with your pharmacist.

Take active steps to maintain your independence

Always go to your medical visits prepared. Take a list of every medicine you take – including vitamins, supplements, over-the-counter medicine, and any other substance. Even include the ones you only take once in awhile.

Take two copies of any items you want to discuss. Give one to the medical assistant who takes you to the exam room. Ask that assistant to give it to your doctor. Keep the other copy for yourself. Take a pen or pencil to take notes for each item on your list.

Think about any new symptoms and how you could best describe those. Include any details such as what makes it better or worse, what you have already tried, and when you first noticed the symptoms. These details help your doctor discover the cause more quickly.

Medication is nearly always involved in someone’s loss of independence. So often that is completely avoidable. Don’t let it happen to you. Let us thoroughly review your medication regimen today. We can help you avoid the common pitfalls that lead to lost independence.

You can reach us at www.medsmash.com/contact, 410-472-5078, or michelle@medsmash.com.

BIBLICAL APPLICATION

This blog has been about maintaining your independence. It is about leading your life to the fullest with no avoidable decline in function.

On the flip side, we live our best life when we live in full dependence. Dependence on God, that is.

John 15:5 MSG

“I am the Vine, you are the branches. When you’re joined with me and I with you, the relation intimate and organic, the harvest is sure to be abundant. Separated, you can’t produce a thing.

Paul lived in complete dependence on God. He lived only to serve and do what was asked of him, even when he knew extreme hardship, flogging, and prison were waiting for him.

Galatians 2:20 ESV

I have been crucified with Christ. It is no longer I who live, but Christ who lives in me. And the life I now live in the flesh I live by faith in the Son of God, who loved me and gave himself for me.

2 Corinthians 1:8-9 ESV

For we do not want you to be ignorant, brothers, of the affliction we experienced in Asia. For we were so utterly burdened beyond our strength that we despaired of life itself. Indeed, we felt that we had received the sentence of death. But that was to make us rely not on ourselves but on God who raises the dead.

2 Corinthians 12:9-10 ESV

But he said to me, “My grace is sufficient for you, for my power is made perfect in weakness.” Therefore I will boast all the more gladly of my weaknesses, so that the power of Christ may rest upon me. For the sake of Christ, then, I am content with weaknesses, insults, hardships, persecutions, and calamities. For when I am weak, then I am strong.

I am praying you stay healthy, living independently in this lifetime so that you can do all God has called you to do. I am also praying you live in full dependence on the One who can guide your life through the amazing adventures He has planned just for you.

Blessings,

Michelle

 

Full bucket to avoid tired tears

Tired to the Point of Tears – Remember Self-Care

Posted on by Michelle Fritsch, Pharm.D.
Full bucket to avoid tired tears
Avoid tired tears by keeping your bucket full

Have you ever been tired to the point of tears? You feel the tears coming and you don’t even know why. You just need to cry. What a sinking feeling.

It happens all too easily when we get stretched a bit too far (or a lot too far).

Things that bring us to tears

From what is probably a much long list, here are the things I can think of that can bring us to tears when we are stretched too far:

  • Anger
  • Fear
  • Guilt
  • Regret
  • Exhaustion
  • Limitations
  • Frustration
  • Sadness
  • Chronic pain
  • Complex disease state
  • Chemo that seems like it just won’t end

Can you relate to any of these?

When we are faced with obstacles we don’t know how to get around or just too much of the same obstacle over and over, it’s easy to reach your tipping point. This is your tear tipping point.

Bucket analogy

I have a bucket analogy to share with you.   Consider you have a bucket of energy, satisfaction, love, confidence, and all things good. Each difficult situation, difficult barrier, unkind word, negative situation sloshes water out of your bucket.

When you get tired to the point of tears, your bucket is empty. That bucket dries up while you’re busy doing all of the things that drain the water. It often dries up before you even know your supply is low. Then, the tears start to flow.

Keeping Water in your Bucket

So how do you keep water in your bucket? You can pick your favorite way; the one that brings you the most joy and peace. Here are some options patients and friends have told me about:

  • Quiet, alone time to meditate or pray
  • Walks or quiet sitting in nature
  • Time with friends who life your spirits
  • Time with family who fill you with love
  • Exercise (endorphins are great bucket fillers)
  • Dancing
  • Singing
  • Reading
  • Concerts

I’m sure that list could go on and on.   The key is to fit these things (your best things) into your schedule on a regular basis. Fit them in before your bucket runs dry.

Story

This blog was inspired when I heard of a woman who is always upbeat and joyful. Her first child was stillborn. Her second died at a few days of age. Her third was killed in a car accident in his first year of college. Her fourth was permanently injured in war.  She certainly has reason to be tired to the point of tears.  And yet she is upbeat and full of hope and joy. She certainly knows the secret to keeping her bucket full.

For more information about how to keep your bucket full, please contact us at Meds MASH at 410-472-5078 or www.medsmash.com/contact. We look forward to talking with you!

BIBLICAL APPLICATION

Do you find yourself always caring for others and not considering your own needs? So many people do. Most of us find ourselves in a caregiver role at some point in our life. For some, this is always true as they transition from the care of children to grandchildren to aging family members.

At some point, your ability to care drains. This happens when you haven’t paid attention to your bucket. Your bucket is dry.

Consider Jesus. Jesus is God in human form. So, he knows everything! He knows exactly how humans are made to function. He made us! And when he was in human form, he made his own bucket refilling a high priority.

Here are some of the passages where Jesus went off alone to pray.

Mark 1:35 ESV

And rising very early in the morning, while it was still dark, he departed and went out to a desolate place, and there he prayed.

Matthew 14:23 ESV

And after he had dismissed the crowds, he went up on the mountain by himself to pray. When evening came, he was there alone,

Luke 6:12 ESV

In these days he went out to the mountain to pray, and all night he continued in prayer to God.

If Jesus always made it a priority to stop and be alone and pray, then our need for that is at least as great! Since we are so far from perfect, I propose our need is even greater.

In addition to the many times in scripture that Jesus stopped to pray, there are many other passages that prompt us to pray when we are in need.

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.

I hope and pray this blog helps you recognize your need for self-care and for prayer. You can only do so much without taking the time to keep your bucket full. If you keep your bucket full, and you are in regular communion with God, there is no limit to what He can do through you!

Blessings,

Michelle

 

No more isolation

Isolation Avoidance – You Never Need to be Alone

Posted on by Michelle Fritsch, Pharm.D.
No more isolation
Isolation is very bad for your health. It can be avoided.

Isolation is a growing issue in our society.   Isolation is being chronically alone with no support.

Many cultures function as a family unit, and as family members advance in age, they are incorporated into the daily life of younger generations. Senior living, assisted living, and nursing homes are not options in those cultures.

For other families, members spread out to various parts of the country or even to other countries. Members no long live in the same community where they can care for each other. Or, members might live close together but have busy schedules that hamper time together. Then, there are instances when there are no family members to provide care. Perhaps friends have their own needs and are unable to be supportive.

Risks of Isolation

Isolation is sometimes a gradual situation, as it gets hard to get out and about. Other times, an injury or medical event rushes someone from an active lifestyle to a homebound situation.

Unfortunately, I have seen too many examples lately of medication changes that led to sudden isolation. These medication changes cause dizziness, sedation, nausea, diarrhea, incontinence, or some other side effect that made it hard to leave the house. Often people don’t recognize the link to the medication change. Many people try to ‘live with it’ and consider it a new normal.

Isolation is not good for your health. It is not good for your physical, mental, emotional, or spiritual health. Through many studies and experiences of people of all ages, the negative effects of isolation are many! Some of the most common are:

  • Depression
  • Anxiety
  • Alcoholism
  • Increased blood pressure (due to more stress hormone production)
  • Higher reaction/perception of stress
  • Heart disease
  • Decline in thought processes
  • Alzheimer’s disease
  • Changes in sleep patterns
  • Increased suicide rates

Isolation remedies

A concept considered in these blogs before is that we all need to be needed. Isolated people suffer from sensory deprivation, lack of social interaction, and that important concept of being needed. Total lack of interaction can actually play with your mind leading to loss of time perception and even hallucinations.

So, how do we help people avoid this isolation?

There are a number of different kinds of living communities for adults over 55. These include independent living, assisted living, dementia care, and more skilled care. All aspects of care are integrated into one community with a wide range of activities to engage all interests. These are designed to avoid isolation. If you are living alone and feeling isolated, consider the many senior living options in your area. [We can help you find a professional to show you the local options and help you through the process.]

If you don’t think your budget will allow a community option, or if you really don’t want to leave your home, there is another low-budget, high-reward option. You are not the only person feeling isolated. You have two primary responses.

Be resentful and hopeless ==> takes you down a negative, unhealthy path

Reach out to others ==> you and those you reach will both win!

There are SO MANY people feeling isolated. And, as our population ages and the culture continues to change, the numbers are rapidly growing. Finding someone else in a similar situation can be a solution for both. Calling to check on each other, remind each other to take medication, and just share life can be so healing.

I have been marveling at a member of our church. She had an accident riding a horse and is now paralyzed. She has very limited use of one hand, just enough to operate a special wheelchair. She can’t type, drive, dress herself, or fix her hair. So many in her situation would experience the symptoms listed above. She went from living life fully functional to loss of most functions in one incident. (Now, I’m sure she has had some very low moments.) Overall, she is hopeful and finding new ways to live a full, fulfilled life. One of the things she is pursuing is training as a ‘Stephens Minister’. This will put her in the first line to help other members of the church during a time of distress. The main pastors can’t always get there immediately, so the Stephens Ministers can be first responders. I’m sure she will encounter hurdles that she will need to overcome, but she is putting herself out there to continue to be needed and avoid the deep depression and isolation that could so easily consume her.

So, if you can make a phone call, answer a phone call, type a message, let someone in the door to visit, there are some important, exciting ways you can be fulfilled, needed, and avoid isolation.

We would love to help you figure this out. If you are feeling isolated and aren’t sure what to do, please contact us at www.medsmash.com or 410-472-5078 or michelle@medsmash.com. Together we will help you avoid isolation in ways that inspire and fulfill you.

BIBLICAL APPLICATION

We are designed to be members of a community. Jesus surrounded himself with his disciples and many others. He regularly visited close friends, like Mary, Martha, and Lazarus. In Acts, the new church lived, worshiped, studied, and shared all things together.

There are even several verses in the Bible that emphasize these principles.

Hebrews 10:24-25 ESV

And let us consider how to stir up one another to love and good works, not neglecting to meet together, as is the habit of some, but encouraging one another, and all the more as you see the Day drawing near.

Ecclesiastes 4:9-12 ESV

Two are better than one, because they have a good reward for their toil. For if they fall, one will lift up his fellow. But woe to him who is alone when he falls and has not another to lift him up! Again, if two lie together, they keep warm, but how can one keep warm alone? And though a man might prevail against one who is alone, two will withstand him—a threefold cord is not quickly broken.

As members of the church, I encourage each of us to especially aware of those in our community who might become isolated. It is amazing how much assistance you can provide with simple visits, phone calls, text messages, e-mails, or any outreach. Let those people know they are not forgotten. Help them find those opportunities to still reach out to others and find purpose in helping others avoid isolation.

Galatians 6:2 ESV

Bear one another’s burdens, and so fulfill the law of Christ.

1 Corinthians 12:14 ESV

For the body does not consist of one member but of many.

I will be praying for God to show me where I can be helpful others, especially those who are isolated. The negative impact of that is so great! And the remedy is so attainable. I pray the whole church finds those opportunities to reach out and keep all connected in the love and fellowship of community.

Blessings,
Michelle

 

Clean up the garbage in your life with healthy choices

Garbage in can turn you to rubble – change your choices

Posted on by Michelle Fritsch, Pharm.D.
Clean up the garbage in your life with healthy choices
Garbage in your life leads to negative consequences.

You’ve heard, ‘garbage in – garbage out’. Wow, that holds true with our health, too. I want to focus on three particular types of garbage in our lives.

  1. Garbage food

I admit I am not the most healthy eater. But, I do try to make good choices most of the time. I have eaten enough healthy food to notice the impact of unhealthy food.

The other day I was at a meeting in an unfamiliar part of town. Time was tight as I left that meeting and went to teach a class. So, I opted for the fast food restaurant that I could see a couple of blocks down the road rather than search for some other quick food source. When I was growing up, and even earlier in our marriage, it was not uncommon to eat at this fast food chain. I had not eaten there now in a few years. I had a small burger and onion rings. It looked good, tasted, great, and went down easily. Then, within an hour, I felt queasy, bloated, and tired. I was surprised at how different I felt.

There is extensive evidence that our food choices impact our risks for diabetes, heart disease, high cholesterol, and maybe even dementia. Your brain, your veins and arteries, your heart, your kidneys, your liver, your eyes, your skin, your hair, your nails, and more parts of your body are impacted by what you eat.

If you have not seen it, I encourage you to watch the documentary, Super Size Me. I found it very eye opening about the dangers of frequent fast food.

Eating your largest portions with colorful fruits and vegetables, joined by a fist size piece of lean protein (e.g. meat such as lean chicken or fish), and some grains is ideal. You can find more detailed guidelines at Choose My Plate.

  1. Garbage media

What you see and what you hear have a big impact on what you think. Media plays a big part in our lives! Music, television, video games, and social media are huge general areas of so much content. The choices we make about our media help shape how we think, how we view the world, our ability to concentrate, or attention span, and our mood.

If you’re interested in the science linking music and our thoughts and actions, see this interesting article by a known expert on the subject, Dr. Bernard Luskin.

Media that promotes negativity, hate, and crime promotes such thoughts and activities. Pornography changes thinking, desires, and satisfaction. There is even an addiction associated with social media.

On the other hand, spending time with uplifting people, positive music, and other positive media can really brighten your day!

  1. Garbage relationships

Who in your life lets you know how valuable, appreciated, and loved you are? Keep those relationships!

If you have people in your life who feed you negative, demeaning, or other messages that kill your sense of self-worth and confidence, move away from those relationships. Surround yourself with the positive images of your immense value and lovability.

The messages you receive can impact how you see yourself. Stay around those who are the positive influences in your life.

Choose to replace your garbage with treasure

This is just a brief exploration of how garbage in can damage you. I encourage you to consider how you can replace the garbage. Consider the diet changes that will make you feel better, more energetic, less bloated, and give you more clear thinking. Consider how what you watch and hear could be more positive and uplifting. Consider how you could spend more time with people who lift you up.

To better understand how positive input will enhance your health, contact us at Meds MASH at 410-472-5078 or www.medsmash.com/contact.

BIBLICAL APPLICATION

Just like our physical and emotional health negatively respond to ‘garbage’, so does our spiritual health.

What are the sources of ‘garbage’ when it comes to our spiritual health?

False teachers

We are repeatedly warned in the Bible about people who will look legitimate but actually be teaching false information.

2 Timothy 3:5 ESV

Having the appearance of godliness, but denying its power. Avoid such people.

We are warned about times coming that will tempt us to turn away from God’s truth.

2 Timothy 4:3-4 ESV

For the time is coming when people will not endure sound teaching, but having itching ears they will accumulate for themselves teachers to suit their own passions, and will turn away from listening to the truth and wander off into myths.

Colossians 2:8 ESV

See to it that no one takes you captive by philosophy and empty deceit, according to human tradition, according to the elemental spirits of the world, and not according to Christ.

Temptations

We are surrounded by strong temptations. As we saw above, media and other social messages teach a message much different than God’s truth.

Galatians 5:16 ESV

But I say, walk by the Spirit, and you will not gratify the desires of the flesh.

1 Corinthians 15:33 ESV

Do not be deceived: “Bad company ruins good morals.”

Negativity in our society

2 Corinthians 12:20 ESV

For I fear that perhaps when I come I may find you not as I wish, and that you may find me not as you wish—that perhaps there may be quarreling, jealousy, anger, hostility, slander, gossip, conceit, and disorder.

Titus 3:10 ESV

As for a person who stirs up division, after warning him once and then twice, have nothing more to do with him,

So to avoid the ‘garbage’ that is all around you, follow God’s plan. In the midst of it all, keep this in mind.

Philippians 4:8 ESV

Finally, brothers, whatever is true, whatever is honorable, whatever is just, whatever is pure, whatever is lovely, whatever is commendable, if there is any excellence, if there is anything worthy of praise, think about these things.

Blessings,

Michelle

Numbers: Do you know the importance of each of your numbers?

Posted on by Michelle Fritsch, Pharm.D.
Slide1
Know how your numbers are key to your health.

What are the key numbers in your life? I just turned 50. That is a number that seems like a real turning point. I like a viewpoint a friend shared with me: the first half-century is training and preparation for the better half!

Also, my daughter is graduating from high school. So, in her world the key numbers are GPA, SAT, ACT, and college fees.

Other numbers we keep close to us are phone numbers, bank balances, addresses, and birthdays.

Numbers and Health

Now I want to make sure you are aware of key numbers for your health. There is a reason for those labs at your annual physical. And there are goals for those numbers. When you see your lab results you will see your number and a range that contains all of the normal numbers. Ideally, your number falls in this range. If your numbers are little bit outside this ‘normal range’ for a little while, just talk with your doctor. If your numbers stay outside the range, your doctor will probably take action with medication, exercise changes, diet changes, or other plans.

Blood pressure – If you are under age 65, normal is less than 140/90. If you are over 65, some experts agree it’s ok for your systolic blood pressure (top number) to get as high as 150. Your blood pressure is one indicator of how hard your heart has to work. There are several medications that can be used to lower your blood pressure and protect your heart from having to work too hard. I am often asked about how low is too low for your blood pressure. That is not really determined by a number. It is found through symptoms. If you get really dizzy when you stand up, turn around, or try to walk faster, talk with your doctor. A little bit of this is expected with the medicines that are protecting your heart. If it is causing you to fall or keeping you from doing your normal activities, then let your healthcare team know.

Pulse – This is usually between 60 and 90 beats per minute. You can quickly check your own by touching the center of your neck and letting your fingertips slide to the soft area just to the side. Your carotid artery is there, and you can count the beats for 15 seconds then multiple by 4. The more you exercise, the more efficient your heart gets. So, really fit people tend to be at the bottom of this range. This should be measured when you are really at rest. If you are worried, in pain, stressed out, or in a conversation your heart rate will be higher. So, when this is measured, think quiet thoughts and don’t talk. If it gets and stays high, your doctor will order some more tests to check why. The same is true if your heart rate is slower than 60 beats per minute. Tests will be ordered to see what your heart is doing to cause the slow rate.

Cholesterol – We all have cholesterol, or fats, in our blood. This is normal. But there are healthy amounts and unhealthy amounts. These are the key numbers. For most people, your low density lipoproteins (LDL) number should ideally be under 100 mg/dL. If you have a strong history of heart disease, your doctor might have you try to reach an even lower goal. This is your ‘bad cholesterol’. Your high density lipoproteins (HDL) is your ‘good cholesterol’. Ideally you want this number to be over 40 mg/dL. Another cholesterol number is your triglycerides. This tends to go up if you have diabetes that isn’t well controlled. This number should be less than 150 mg/dL. Diet, exercise, and medications are all key in keeping these numbers in the goal range if you have high cholesterol (also called hyperlipidemia).

Blood sugar – Speaking of diabetes, this is a very important number for people with diabetes. It is important whether you have type 1 (requires insulin) or type 2 diabetes (can be treated with medicines you take by mouth, by inhalation, or by injection). Your blood sugar changes throughout the day. It is usually lowest before a meal and highest after. When you have not eaten for at least 8 hours, your blood sugar should be less than 100 mg/dL. (This is a ‘fasting blood glucose’.) Your healthcare team might ask you to measure your blood sugar at home. There are several types of monitors to do this. They might want you to check sometimes before you eat, sometimes after you eat, sometimes before bed, and sometimes when you first wake up. This will give them the best look at what your blood sugar does throughout the day.

Glycosylated hemoglobin (A1c) – This is another way to see what your blood sugar does over a period of time – about 3 months. It is a reflection of your average blood sugar over those months. People who do not have diabetes have an A1c under 6%. Current guidelines encourage a goal of less than 6.5% for people with diabetes. However, if someone is at risk for their blood sugar being too low your doctor might increase this goal closer to 7%. When people with diabetes also have other medical conditions, sometimes ‘tight control’ to under 6.5% is not possible or safe. Talk with your healthcare team for your specific goal and why that is the goal for you.

Body Mass Index (BMI) – This measurement is a reflection of your height, your weight, and your gender. It helps to define what is a healthy weight for you. The goal BMI is between 18.5 and 24.9. If your BMI is 25 to 29.9 you are overweight. If it is over 30 then you are obese. Your healthcare team will help you with a plan to get to a healthy weight and stay in that healthy range.

Blood Urea Nitrogen and Serum Creatinine (BUN and SCr) – These are important measures of your kidneys. They determine if your kidneys are clearing extra fluid, medications, and toxins from your body as they should. They can also tell your doctor if you are dehydrated from not drinking enough. As a pharmacist, I always look at these numbers when deciding if a medication is safe and at the right dose. When your kidneys are not working as they should, then it is hard to get some medications back out of the body. Another interesting numbers – Our kidneys start to very gradually slow down when we are in our late 30’s or early 40’s. This happens to everyone. So, with each birthday in our 50’s and beyond, these are important numbers to assess.

Aspartate aminotransferase and alanine aminotransferase (AST and ALT) – These are measures of how your liver is working. Many medications are metabolized (broken down) in the liver. If these numbers are very high, then the liver is not able to do its job to break down the medication. These are numbers I always look at when evaluating someone’s medication regimen. It helps determine what medicines should be avoided and what doses are best for you based on your liver.

Number of Medications – Sometimes several medications are needed to treat all of your medical conditions. Sometimes they are not. The more medications someone takes, the more risk of medications interacting and causing problems rather than helping them. There is no ‘magic number’, but most experts agree that taking more than 4 medications regularly means you need to have an expert very carefully evaluate your regimen. This is to double check that your medication regimen is providing optimal good with minimal risk.

An Evaluation of YOUR Numbers

Are you curious about your numbers? At Meds MASH we specialize in these evaluations, especially in anyone over age 60. Do you want to better understand your particular numbers? Do want to know that your medicines are providing optimal good and minimal risk? Call us today! We have found that over 50% of our clients need a medication adjustment once an expert evaluation is done. These adjustments come from your own doctor with our collaboration.

You can call for your appointment at 410-472-5078 or e-mail at michelle@medsmash.com or through our website www.medsmash.com/contact.

BIBLICAL APPLICATION

Have you read the entire Bible? I am on my second journey through the whole book. In the past I have read my favorite parts, read parts pertaining to Bible studies I was in, or read parts that others have recommended. After years of this focused reading, I thought I knew the Bible fairly well. But, here I am reading it all and learning so many new things!

I was recently working my way through the book of Numbers. I have to admit, I don’t find this to be the most exciting book. It can be downright hard to get through. But, I was hit by a new insight.

In Numbers God directed Moses through the exact, meticulous details of building the temple and the Ark of the Covenant.

  • He provided exact measurement for each aspect of the temple.
  • He described elements of the temple in extreme detail.
  • He gave exact specifications for each furnishing.
  • Each bowl and utensil was described in detail.
  • The role of each person in service to the temple was directed.
  • The clothing of each priest was designed to the last thread.

It hit me how incredibly precise is our God. Not any detail was left with precise design. God is perfect in every way.

Then, I thought about how sloppy I am in my communication with God. I pray, read my Bible, focus when I find the time. I squeeze God into the nooks and crannies of my day. Some days are much better than others. Even now as I am reading through the Bible in a year, I find myself rushing rather than deeply meditating on what I read.

Sloppy is NOT what God wants from me. He is more important than ANYTHING else in my life. My to-do lists, dirty house, and work schedule are not the priorities per God’s plan. They are the distractions. They are Satan’s best weapon to keep me away from a deep, life-sustaining life with my Creator.

How about you? Is your relationship with God truly all-in? What are your distractions?

Paul knew we would all face these distractions and temptations.

1 Corinthians 10:13 ESV

No temptation has overtaken you that is not common to man. God is faithful, and he will not let you be tempted beyond your ability, but with the temptation he will also provide the way of escape, that you may be able to endure it.

Paul also knew we wouldn’t do it just because anyone said so. Rather we are encouraged to stay focused on God to find and lead the life of peace and joy that is ours if we choose this path.

1 Corinthians 7:35 ESV

I say this for your own benefit, not to lay any restraint upon you, but to promote good order and to secure your undivided devotion to the Lord.

I pray we can all keep striving to keep God at the center as in the words of David:

Psalm 19:14 ESV

Let the words of my mouth and the meditation of my heart be acceptable in your sight, O Lord, my rock and my redeemer.

Blessings to you my sloppy but trying to be better friends!

Michelle