Author: Michelle Fritsch, Pharm.D.

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

Michelle Fritsch, Pharm.D.'s avataryourhealthandsoul

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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Medicare Open Enrollment – comparing your options

Posted on by Michelle Fritsch, Pharm.D.
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October 15 to December 7 is your window to select a Medicare plan. Let us help.

Medicare Open Enrollment for your 2017 plan is from October 15 to December 7, 2016.   Before you make a selection, here are some resources to help you compare your options.

Medicare provides a tool where you can compare options before you make a decision. You can find it at this link.

The information you need is:

  • Your Medicare number
  • If you have a Medigap or Medicare supplement plan, the name and type of the plan
  • Your zip code
  • A list of your medicines prescribed by each of your doctors
  • The name and location of your preferred pharmacy

You can search through options using your specific information or you can do a general search. I highly recommend you perform a search with your specific information at least once before you make final decisions. That will give you the best look at your anticipated likely costs.

The tool will walk you through step by step.

  1. It starts with your zip code and information from your Medicare card.
  2. Enter your current Medicare coverage type. Include whether you get extra help paying for your medication costs.
  3. Enter your prescribed medicines. Include the strength, whether you get your medicine every month or every 3 months, and whether you get your medicines from a local pharmacy or a mail order pharmacy.
    1. Be sure to include all of your medicines
    2. If your doctor has talked about maybe starting new medicine, include these, too. This will make sure the plan you choose will cover all of these medicines.
  4. Select your pharmacy. Note, if your pharmacy doesn’t show up at first, expand the number of miles from your home so that your pharmacy will be on the list.
  5. You can then choose whether you want to compare medication only Medicare D plans, Medicare Health Plans with drug coverage, and Medicare Health Plans without drug coverage.
    1. If you aren’t sure, select all three options
    2. If you know which you want to compare, select just that option
  6. A list of all options will appear on the next page. They appear in order of cost with the lowest annual cost option appearing first after Original Medicare. You have the option to select different sort options.
  7. Select three plans that you want to directly compare.
    1. The three options will be displayed side by side.
    2. You can compare three at a time as many times as you want.
    3. All costs for the year include deductibles, co-pays, gap payments, and other fees will be displayed.
    4. Look at your total annual cost
    5. Look at the deductible which is money you will pay at the first part of the year
    6. Look at the projected money you will pay in the coverage gap

To look at your options with Medigap plans, you can go to this link. This one will let you compare types of Medigap plans and their costs.

NOTE – A friend, and expert in the field, clarified that Medicare Advantage plans can be purchased at any time. Her comment: “Medicare Supplement policies do not have an annual open enrollment, but changes can be made based on your health after your original open enrollment or a special enrollment period.”

If you have any questions about how to use these tools or how to compare your options, please contact us at www.medsmash.com/contact.

BIBLICAL APPLICATION

For Medicare plan decisions, comparisons are good. They are key to making the best decision.

In the rest of your life, comparisons can be hazardous. How often do you compare yourself to someone else? You might not even realize you’re doing it.

Do you ever have negative thoughts about yourself when you see something you admire in someone else?

Do you ever feel extra good about yourself when you can do something that someone else can’t do?

In what sneaky ways can ENVY enter your thoughts?

I’ve read a couple of really good blogs about this from pastors recently. I know I’m guilty of comparison without ever intending for it to happen. I fall into a thought process of envy or comparison then catch myself and feel so ashamed.

Apparently I’m not alone. There are many Bible verses about the problems with envy.

Galatians 5:26 ESV

Let us not become conceited, provoking one another, envying one another.

1 Peter 2:1 ESV

So put away all malice and all deceit and hypocrisy and envy and all slander.

Instructions in the Bible can be very clear. It is clear ENVY is to be avoided. And if it’s mentioned this many times, it must be common.

Titus 3:3 ESV

For we ourselves were once foolish, disobedient, led astray, slaves to various passions and pleasures, passing our days in malice and envy, hated by others and hating one another.

James 3:16 ESV

For where jealousy and selfish ambition exist, there will be disorder and every vile practice.

The antidote to envy is to lay it all before the Lord. God has a very special, very specific plan just for you. Your gifts, your strengths, your weaknesses, your opportunities, your looks, your dreams are very UNIQUELY yours.

It doesn’t matter how other people are blessed. There are other blessings that are all for you!

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.

This could be the week to turn your eyes from what everyone else has. Instead, look at what God has in store just for you. Ask, He’d be happy to show you all the good things you have and what is still coming you way!!

Blessings,

Michelle

Medicare Open Enrollment – Which plan type for you?

Posted on by Michelle Fritsch, Pharm.D.
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October 15 to December 7 is your window to select a Medicare plan. Let us help.

I find Medicare and Medicare Open Enrollment to be very confusing. Do you? Let’s spend the next two weeks trying to better understand your options and guide you through the Open Enrollment process. I highly encourage you to delay your final decisions until we walk through this process and you compare your options.

The first big decision is which TYPE of insurance coverage is best for you.

Main TYPES of insurance coverage options over age 65

Original Medicare – When you turn 65 and meet eligibility criteria (use this link), you can have Medicare Part A, Medicare Part B, and Medicare Part D. Medicare has a list of items they do and do not cover at this link. Medicare covers part of the expenses, and you pay the rest through your copay and deductible.

  • Part A covers hospital, long term care, home care, hospice, lab tests, and surgery.
  • Part B covers doctor visits, other healthcare provider visits, outpatient care, durable medical equipment, some prevention, and home health care.
  • Part D covers medicines.

Medigap – This is a supplemental insurance to go with your Medicare Part A and Medicare Part B. Medigap will cover some of the copayments, coinsurance, and deductible expenses not covered by original Medicare. You purchase a Medigap policy through a private insurance company. You will pay a monthly premium for this co-insurance.

Medicare SELECT – Medicare SELECT is a managed care version of Medigap. It is the health maintenance organization (HMO) of Medigap plans. These plans contract with specific provider groups for a lower fee. So, they are typically less expensive. Be sure your provider or a provider with whom you are comfortable is participating before you select this type of plan.

Medicare Advantage – This is also known as ‘Medicare Part C’. Medicare Advantage plans are private insurance plans that you can select IN PLACE OF Medicare. They have similar coverage to Original Medicare and can have additional benefits as well. These have a wide range of prices.

A Medicare Medical Savings Account Plan is a high deductible Medicare Advantage Plan with a bank account. The plan puts money from Medicare into the account, and you use that money to pay for Medicare-covered expenses. This limits your out-of-pocket expenses to meet your deductible.

NOTE: you cannot have both a Medigap and a Medicare Advantage plan. You can have one or the other.

Other – You might have insurance through your former employer, insurance through special programs, Tricare, Veteran’s benefits, Indian Health Service plans, or other unique plans.

Medicare resources to help you

The Medicare website has a list of eight questions to consider when you are thinking about changing plans. You can find them at this link.

Next week we will talk about the tool(s) available to you to help you compare your plan options. These will let you predict your costs over the next year. You can compare several aspects of the types of plans you want to consider. I encourage you to compare your options before making your final decision. I’ll walk you through it step by step.

For more information about your Medicare options, contact us at www.medsmash.com/contact. If we can’t answer, we have some colleagues who are experts in the field.

BIBLICAL APPLICATION

Medicare is not the only area of life where there can be a lot of confusing messages. I have teens.   I know just a few of their areas of confusing message are:

  • What to wear
  • How to act

Many of my recent pharmacy students are working their way through messages about:

  • What job to choose
  • How much of their income to spend on houses, cars, vacations
  • When to start a family; or whether to start a family

Many of my peers are sorting through messages about:

  • Helping children with college and career decisions
  • How much independence to allow teen children
  • Preparing for empty nest and soon retirement

My patients are working through message about:

  • Living at home vs. a senior living community
  • Options to move in with children when assistance is needed
  • Activities that enhance quality of life and keep them active

And we know there are countless people struggling with even more life-altering decisions surrounded my many confusing messages.

So, where does the truth reside?

John 14:6 NIV

Jesus answered, “I am the way and the truth and the life. No one comes to the Father except through me.

Psalm 145:18 ESV

The Lord is near to all who call on him, to all who call on him in truth.

Not to sound too pious, God is with you always. Whether you ‘feel’ His presence or not, He’s there…with you…always! When the messages from the many sources are confusing, you can just ask.

Matthew 7:7-8 ESV

“Ask, and it will be given to you; seek, and you will find; knock, and it will be opened to you.  For everyone who asks receives, and the one who seeks finds, and to the one who knocks it will be opened.

When the messages are all confusing, ASK!

Blessings,

Michelle

Emergencies and Medications – Are You Prepared?

Posted on by Michelle Fritsch, Pharm.D.
ready-emergency-supply-list
Remember medications and medical equipment in emergencies.

Hurricane Matthew has wreaked havoc on the Caribbean and now part of the southeastern US. Millions of people evacuated while millions more ‘weathered out’ the storm in shelters and secure buildings. In all of those scenarios, daily life was drastically altered.

When you take chronic medications, they are a part of your daily routine. When that routine is upset, medications can be missed. Or, in the excitement, they can be taken more than once.

In emergencies, you might forget to grab them as you evacuate. Or, the emergency can take place right as you are taking your last dose. Then what?

Preparing for Emergencies

The Federal Emergency Management Agency (FEMA) has a program called Ready. You can find it at www.ready.gov. One of the many valuable resources is a list of items to include in an Emergency Supply Kit. You can get the full list here. The items that I want to emphasize are:

  • Prescription medications – at least 3 days; more depending on the emergency
    • Include inhalers, eye drops, and patches
    • Include the medications you only take when you need them
    • Include any ‘just in case’ medications such as an epinephrine injectable or migraine therapy injectable if one has been prescribed for you
    • Supplies such as syringes for insulin
  • Glasses
    • Take your glasses even if you usually wear contacts
    • Take the supplies for your contacts
    • Take your reading glasses if you just wear those as needed
  • Feminine supplies
  • Urinary incontinence supplies
  • Ambulation devices – such as a cane
  • Sturdy shoes – you might be in a situation where you are not walking on an even surface
  • Hand sanitizer
  • Warm, dry change of clothes and a blanket (in a water proof bag if in wet conditions)
  • Written list of:
    • medications
    • allergies, including what happens if you take that medication or eat that food
    • medical conditions

The available lists provide step-by-step guidance on what and how to prepare for emergencies. There is another good one available through the Centers for Disease Control found here. Note, if you live in an area where natural events such as hurricanes, tornadoes, blizzards, or wildfires are not uncommon, it will help to pack these emergency kits before the danger season. You will save yourself tremendous time and stress.

Prescription Medications

I have one more important fact about your prescriptions and associated medical supplies to share. When the threat of the emergency is known ahead of time, and you are nearly out of medication, make getting your refills a priority. You will not be alone trying to get more medication. Your pharmacist and their staff will appreciate the advanced notice. You will save yourself a lot of time and frustration waiting in long lines to get medication when you need to be doing so many other things to prepare. In the high-risk seasons, be extra vigilant about dwindling medication supplies.

I do want to share that I hear heroic stories of pharmacists, physicians, nurses, and others assuring their patients have what they need in the worst of circumstances. I am grateful for such dedication!

For more information about emergency preparedness, contact us at www.medsmash.com/contact.

BIBLICAL APPLICATION

I have had two songs going through my head this week as I’ve prayed for the people in the path of Hurricane Matthew. One is ‘Eye of the Storm’ by Ryan Stevenson. You can find a link here. The other is a song that is frequently sung by the Maryland State Boychoir, ‘The Storm is Crossing Over’. One of the moms posted this recording.

It’s interesting how often STORMS are found in the Bible. In nature they can be ferocious and devastating. And wow, isn’t the same true of the storms that brew up inside of us?

Remember in Matthew (and in Mark 4) when Jesus was taking a nap in the boat?

Matthew 8:23-27 ESV

And when he got into the boat, his disciples followed him. And behold, there arose a great storm on the sea, so that the boat was being swamped by the waves; but he was asleep. And they went and woke him, saying, “Save us, Lord; we are perishing.” And he said to them, “Why are you afraid, O you of little faith?” Then he rose and rebuked the winds and the sea, and there was a great calm. And the men marveled, saying, “What sort of man is this, that even winds and sea obey him?”

Do you often feel weak and helpless in these storms? There’s no doubt we will face them. Again, you find reference to them all through the Bible. So, how do we prepare for them, survive them, and move on from them?

2 Corinthians 12:9 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.

Besides Hurricane Matthew, one of the ‘storms’ weighing heavy on my mind right now is all of the war, turmoil, and conflict in the world. A dear friend is active duty as of this weekend and will be deployed this week. He has a loving wife and young children. And we all know he is not alone in this situation. I am holding in prayer those deployed, those in all layers of leadership, and those on the ‘other side’ who don’t want to be doing this and are caught in an ugly situation.

Psalm 46:10 ESV

“Be still, and know that I am God. I will be exalted among the nations, I will be exalted in the earth!”

Nahum 1:7 ESV

The Lord is good, a stronghold in the day of trouble; he knows those who take refuge in him.

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.”

Praise be to God, our strength in the storm.

Blessings,

Michelle

Image source: http://www.ready.gov    

 

 

 

 

Quality of Life – your attitude and health

Posted on by Michelle Fritsch, Pharm.D.
Slide1
Your quality of life is shaped by your attitude, and that also impact your health.

Your quality of life is different than just living. If you are breathing and your heart is beating, then you are alive. Within that life there can be a HUGE range in your quality of life. Quality of life is your overall well-being or satisfaction. How is yours?

Being satisfied with your life encompasses many different factors. There is no one ‘right recipe’ for gloriously high quality of life. Your quality of life will likely change throughout your life with your changing circumstances. But, some people maintain a relatively good quality of life in spite of their circumstances. It is interesting that the factors some people would rate as important don’t actually lead to high quality of life scores.

  • For instance, many people would propose more money would increase their quality of life. Yet there are many miserable people who have a lot of money.
  • Many people would propose that better health is the key to quality of life. Yet there are sick/disabled/injured people with a wonderful quality of life and super healthy people who are miserable.
  • Some would list having many friends around as the key to quality of life. But there are some people who are at parties all of the time surrounded by friends who are miserable. There are others who lead very quiet lives with few friends who are very happy and content.

So what is the key to a magnificent quality of life? 

Your attitude

I have been very interested in the large range of responses people give when asked about their life satisfaction. I am not the only one interested in this. I have read many articles from all sorts of authors on the subject of health and attitude. If you are interested, to get started, just search for the terms ‘attitude and health’. I think you will be surprised by all that you find.

Will there be dark days when things are not going right? Will you lose loved ones? Can your life slip out of your control on more than one occasion? YES!

You then make a choice as to how you respond.   Your attitude matters.

Great example

Your physical health, mental health, emotional health, and spiritual health are all wrapped up in how you live your life. There will be many things that happen ‘to you’. But you alone decide how you respond. Here is a story I’ve read in many places that captures this truth:

A 92-year-old, petite, well-poised and proud lady, who is fully dressed each morning by eight o’clock, with her hair fashionably coifed and makeup perfectly applied, even though she is legally blind, moved to a nursing home today. Her husband of 70 years recently passed away, making the move necessary.

After many hours of waiting patiently in the lobby of the nursing home, she smiled sweetly when told her room was ready. As she maneuvered her walker to the elevator, I provided a visual description of her tiny room, including the eyelet sheets that had been hung on her window. “I love it,” she stated with the enthusiasm of an eight-year-old having just been presented with a new puppy.

“Mrs. Jones, you haven’t seen the room …. just wait.”

“That doesn’t have anything to do with it,” she replied. “Happiness is something you decide on ahead of time. Whether I like my room or not doesn’t depend on how the furniture is arranged, it’s how I arrange my mind. I already decided to love it. It’s a decision I make every morning when I wake up. I have a choice; I can spend the day in bed recounting the difficulty I have with the parts of my body that no longer work, or get out of bed and be thankful for the ones that do. Each day is a gift, and as long as my eyes open I’ll focus on the new day and all the happy memories I’ve stored away, just for this time in my life.”

She went on to explain, “Old age is like a bank account, you withdraw from what you’ve put in. So, my advice to you would be to deposit a lot of happiness in the bank account of memories. Thank you for your part in filling my Memory bank. I am still depositing.”

And with a smile, she said: “Remember the five simple rules to be happy:

  1. Free your heart from hatred.
  2. Free your mind from worries.
  3. Live simply.
  4. Give more.
  5. Expect less.

(Copied from this source.)

If you would like to know more about how your attitude impacts your quality of life and your health, please contact us at www.medsmash.com/contact.

BIBLICAL APPLICATION

How is your attitude? How easily do you become bitter, frustrated, angry, and discontented? Wow, doesn’t that happen so easily!!!!

The devotions that come to my e-mail every day from Pastor Rick Warren have been focused on envy for several days. What a nasty, cruel, pervasive worm is ENVY.

Doesn’t that negatively impact your day?

Paul outlines to Timothy many facets of living a God-centered life. And he repeatedly makes reference to the fulfillment, joy, and quality of life that comes with that kind of living.

1 Timothy 6:6-7 ESV

But godliness with contentment is great gain, for we brought nothing into the world, and we cannot take anything out of the world.

Paul tells Timothy about all of the pitfalls in this world. He even talks about how things will get worse the closer we get to the coming of Christ. So, finding contentment in the midst of so much negativity is not easy. It is a choice and an active pursuit. A pursuit that is well worth the effort.

1 Timothy 6:11-12 MSG

But you, Timothy, man of God: Run for your life from all this. Pursue a righteous life—a life of wonder, faith, love, steadiness, courtesy. Run hard and fast in the faith. Seize the eternal life, the life you were called to, the life you so fervently embraced in the presence of so many witnesses.

The following kind of advice from Paul makes me feel more at ease. I like the visual I get and the response from other people when this is put into action.

Ephesians 4:31-32 MSG

Make a clean break with all cutting, backbiting, profane talk. Be gentle with one another, sensitive. Forgive one another as quickly and thoroughly as God in Christ forgave you.

Now that you are on your road to a fabulous quality of life and true contentment no matter what is going on around you, here is some encouragement from Paul.

Ephesians 4:1-3 MSG

In light of all this, here’s what I want you to do. While I’m locked up here, a prisoner for the Master, I want you to get out there and walk—better yet, run!—on the road God called you to travel. I don’t want any of you sitting around on your hands. I don’t want anyone strolling off, down some path that goes nowhere. And mark that you do this with humility and discipline—not in fits and starts, but steadily, pouring yourselves out for each other in acts of love, alert at noticing differences and quick at mending fences.

Blessings,

Michelle

 

 

 

Preventing Falls – New Tools and Resources

Posted on by Michelle Fritsch, Pharm.D.
fallenman
There are new tools to help you avoid falls.

Now that it is fall, let’s talk about falls. September 22 (or the first official day of fall each year) is national Falls Prevention Awareness Day. This year we have some new resources to learn about and to celebrate.

Every year very unintended falls, those slips that come out of nowhere, lead to deaths, fractures, hospitalizations, and need for assistive devices. In addition, fear of another fall leads to changes in day-to-day activities. One ‘little oops’ can take someone from doing all they want to do to needing assistance and having restrictions. No one wants that.

Falls Risk Factors

Besides snow, ice, and rickety steps there are so many things that can increase your risk for falling. Below are a few.

Medications

  • Those that make you sleepy
  • Those that relax you or change your mood
  • Those that make your blood pressure drop too low or too suddenly
  • Those that make your blood sugar dip too low
  • Many pain medicines
  • Any medicine that makes your mouth and eyes really dry
  • Most of the over-the-counter sleep aids

Medical conditions

  • Heart disease
  • Stroke
  • Anything that makes your legs hurt
  • Pain in general
  • Obesity
  • Incontinence

In your home

  • Rugs
  • Cords
  • Pets that get under your feet
  • Steps

Other

  • Vision problems or glasses that don’t fit or aren’t the right prescription
  • Hearing problems
  • Using a cane, crutches, or walker in the wrong way

Wow, and this is just a partial list!

New Falls Prevention Resources

That is why I am so excited to tell you about some new resources from the Centers for Disease Control (CDC). They released last summer the Stopping Elderly Accidents, Deaths & Injuries (STEADI) toolkit. The toolkit can be found here: http://www.cdc.gov/steadi/patient.html. You can find a checklist for your home. This will help you identify and fix any risks you might not have known about. There is a checklist to complete before you go to the doctor. It will help your doctor determine how much fall risk you have. The specific resources in the toolkit I encourage you to pull up are:

  • Stay Independent questionnaire
  • What Can You do to Prevent Falls brochure
  • Check for Safety home assessment guide

The STEADI toolkit has now been joined by a new toolkit that focuses more on the role of medications, medical conditions, and your physical function. This toolkit is the result of a collaboration between the American Society of Consultant Pharmacists and the National Council on Aging. This ASCP/NCOA resource was announced on National Falls Prevention Day. It will be first unveiled in a webinar for pharmacists on October 18. You can learn more at the ASCP website.

Also, on the 2016 National Falls Prevention Day, the CDC has released new statistics about the realities of falls in the US. You can learn more here.

Let us provide a comprehensive assessment of your falls risks today! Your preventative steps today can keep you active in the future. You can contact us at www.medsmash.com/contact.

BIBLICAL APPLICATION

Falling, especially after age 50 can change the course of the rest of your life. No wonder so much effort is put into preventing these falls.

What about falling away from what we’re called to do as Christians? Have you ever done something so terrible you feel like life will never be the same? Have you gotten caught up in activities that you later realize are not what God would want you to do? How far away did you fall?

How did you feel when you realized you had fallen away?

It’s often a big life event that reminds us that we fell away from God. Sometimes it’s an illness or birth of a child or death of a loved one. Sometimes it’s loss of a job or the end of a marriage.

How do you know if you have fallen too far? Could you fall so far that there is no return to God?

Ephesians 2:1-6 MSG

It wasn’t so long ago that you were mired in that old stagnant life of sin. You let the world, which doesn’t know the first thing about living, tell you how to live. You filled your lungs with polluted unbelief, and then exhaled disobedience. We all did it, all of us doing what we felt like doing, when we felt like doing it, all of us in the same boat. It’s a wonder God didn’t lose his temper and do away with the whole lot of us. Instead, immense in mercy and with an incredible love, he embraced us. He took our sin-dead lives and made us alive in Christ. He did all this on his own, with no help from us! Then he picked us up and set us down in highest heaven in company with Jesus, our Messiah.

Amazing news! You are saved through amazing grace! There is absolutely nothing you can do that can separate you from God.

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 2:8-9 ESV

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

Romans 8:38-39 ESV

For I am sure that neither death nor life, nor angels nor rulers, nor things present nor things to come, nor powers, 39 nor height nor depth, nor anything else in all creation, will be able to separate us from the love of God in Christ Jesus our Lord.

So, you can fall and hurt your body in a way that can’t always be fixed. But, if you decide to come back, you CAN NOT fall so far away from God that you can’t return. We are so blessed! God is so good!

Blessings,

Michelle

Image source: National Library of Medicine, National Institutes of Health, United States Department of Health and Human Services

Senior Service Providers – a huge network of resources

Posted on by Michelle Fritsch, Pharm.D.
occupational_therapist
There are many types of senior service providers for you to research in your area.

Our population is aging! And there is a rapidly growing network of Senior Service Providers to help promote healthy, safe aging. I was first introduced to this ever expanding network about a year and a half ago.

So I want to introduce you to the many resources available to you, to your aging loved ones, and to anyone you know who is anxious to stay as healthy as possible.

I don’t think it would be possible to make a list like this complete. So know if you have a specific need not listed, search for what you need. I’m fairly certain someone has thought of that need and designed a solution. At the end of this blog I’ll point you toward a think-tank of even more innovative solutions being pursued.

Senior Service Providers to seek in your area

  • Aging-in-Place/Home Safety
  • Assisted Living Placement Services
  • Assistive Technology Devices
  • Certified Care Management
  • Computer & Technology Services
  • Daily Money Management
  • Estate Liquidation & Cleanout
  • Financial Services & Insurance
  • Fitness and Balance Classes
  • Home Modification and Repairs
  • In-Home Primary Care Provider
  • Legal Services
  • Licensed Massage Therapy
  • Medicaid Planning
  • Medical Alert Systems
  • Medication Management
  • Mortgage & Reverse Mortgage
  • Move Coordination from your home
  • Nutrition
  • Occupational Therapy
  • Personal Historian
  • Physical Therapy
  • Private Duty & Home Care
  • Real Estate
  • Senior Living Communities
  • Transportation

Ways to find senior service providers

Again, this is not an exhaustive list. If you want to modify a home to make it safer, there are specialists that can help you. Look for the ‘Aging in Place’ certification. If you want to know what resources are available in your particular community, find a local Lifecare Manager at www.aginglifecare.org. If you are faced with downsizing, moving from home to assisted living or in with children, or arranging for someone to move in with you, there are a host of specialists to help. There are realtors specialized in homes designed for safe aging; mortgage and reverse mortgage specialists to help find the best rates, companies that specialize in helping you sort through your belongings and sell those you don’t plan to keep to convert them to cash; and companies that specialize in sorting through horded materials. There are companies that will pack you, move your belongings, and unpack them so that they are right where you want them.

There are lawyers specializing in the sensitive needs of older adults making financial and legal decisions. You can find specialists that will manage your bills and finances for you in your home – http://aadmm.com.

Note, some of these services are covered by insurance while others are out-of-pocket. Be sure to ask about costs as you research your options.

And, as promised, I want to tell you about Aging 2.0. This organization is pulling together innovative people with any kind of solution that will enhance healthy aging. It gives those innovators a platform to share their innovation, perhaps find funding, and network with other providers so they can collaborate and offer a more robust service. You can learn more at https://www.aging2.com/about-us/.

I have been amazed at all of the available resources. I hope you find hope in the many kinds of senior service providers that can help you in your quest for healthy aging. For more information about options, please contact us at www.medsmash.com/contact.

BIBLICAL APPLICATION

As Christians, we have a lot of resources at our disposal, too. Within the body of believers we have every kind of gift and skill. In Acts the believers supported each other and shared everything. We don’t do that, but we can use our gifts to help each other in whatever God is calling us to do.

Acts 4:32-37 ESV

Now the full number of those who believed were of one heart and soul, and no one said that any of the things that belonged to him was his own, but they had everything in common.  And with great power the apostles were giving their testimony to the resurrection of the Lord Jesus, and great grace was upon them all.  There was not a needy person among them, for as many as were owners of lands or houses sold them and brought the proceeds of what was sold and laid it at the apostles’ feet, and it was distributed to each as any had need.  Thus Joseph, who was also called by the apostles Barnabas (which means son of encouragement), a Levite, a native of Cyprus, sold a field that belonged to him and brought the money and laid it at the apostles’ feet.

The messages about helping each other are found in the New Testament and the Hebrew Bible.

Hebrews 13:16 ESV

Do not neglect to do good and to share what you have, for such sacrifices are pleasing to God.

Philippians 2:4 ESV

Let each of you look not only to his own interests, but also to the interests of others.

It is through going to Church, being part of small groups, participating in Bible studies, and other times of fellowship that we can find out about the needs. Then, as we consider our own gifts, we can align ourselves with the needs where we can be of assistance. We can also help connect those with needs to those with matching gifts among our Christian community. It is so beautiful when those matches come together!

Blessings,

Michelle

Image source: National Eye Institute, National Institutes of Health, U.S. Department of Health and Human Services