Hope and Health during COVID

Posted on April 23, 2020 by Michelle Fritsch, Pharm.D.

How are you? How are you managing your day, your thoughts, your diet, your exercise, your responsibilities? I admit, I just ‘did’ these things as I was caught up in the busy-ness of ‘life before’. I remember oh-so-many-times thinking, ‘If I only had a couple of unstructured days, I could get caught up.’

Well, now I’ve lost count of the number of unstructured days I’ve had, and I’m NOT caught up. Rather, sometimes I feel like I’m in the dryer being tossed around and unable to get my feet solidly under me.

Can you relate?

I propose, even those who are carrying on as if nothing unusual is happening are processing all of this at some level. They might be the ones who crash the hardest when faced with the realities of this pandemic in their own family.

I know, especially during the night, I get these waves of anxiety, what-ifs, grief, panic that try to overtake me.

What do you do when these thoughts creep in (or hit you like an avalanche)? [We will come back to this question soon.]

Health at all times, including during COVID-19

Health is multifaceted, and to be truly healthy, each area needs some attention.

Physical health – This includes your diagnoses, your fitness, your strength, and your immune system.
Mental health – This includes diagnoses, anxiety, depression, and panic.
Emotional health – This includes your coping mechanisms, your reactions, your strategies to manage stress.
Spiritual health – This includes your source of hope, your views about a higher power, your connection with your spiritual side.
Social health – This includes your relationships, your support network, those you care for and those who care for you.

I encourage you to take an inventory. In the past few days, how have you nurtured each of these areas of your health? Which have you given the most attention? Which have you ignored? Which need the most attention today?

There are MANY well-designed studies that have demonstrated the importance of each of these aspects of health. Especially now, during this pandemic, each part needs very deliberate strategies.

Attitude and Health

These studies have repeatedly demonstrated the negative health effects of negativity – fear, holding grudges, blame (conspiracy theories), isolation (huge right now), oppression, resentment, self-pity, rejection, and holding on to negative bad assumptions. There are TOO MANY negative messages in our society right now. Letting these rule your thoughts and emotions is directly damaging to your immune system and your physical health. It’s also damaging to your relationships (social health), spiritual health, and mental health.

In comparison, staying engaged, caring for other people, optimism (which is a choice), having supportive friends/family, maintaining an ability to bounce back (takes some real purposeful effort), learning good conflict management skills, and belief in a higher power or other source of hope are all linked to a healthier immune system, overall well-being, better health, and even longer life.

So, how can you use this knowledge to make a plan for when the waves of anxiety, grief, and worry hit you?

Want to talk more? Please contact me at michelle@retirewellness.com or 410-472-5078. You can schedule a free introductory call here.

BIBLICAL APPLICATION

What do you do when these thoughts creep in (or hit you like an avalanche)?

It is normal, especially in these times, for this to happen sometimes several times per day.

So, should we let it happen? Ride the waves?

Should we chide ourselves for being so weak?

Do we need strategies?

My view is we need strategies. This is a time when we need to exercise our God muscles very deliberately. I have to admit I’ve not memorized scripture a lot in the past. I’ve been familiar with scripture and generally know what is found where, but not to the degree to be able to recite scripture.

That all changed when I went through a very difficult time a few years ago. I would wake up in the night with rapid-fire negative thoughts, imagined conversations, what-ifs, anger, frustration, and such. It felt like I was being attacked in my own mind.

That’s when trusted friends and years of hearing the message sunk in and I started memorizing scripture. I still haven’t memorized as much as I would like, but I’ve memorized some verses that have incredibly deep meaning to me. They feel like weapons I can recite over and over when I’m attacked in the night. I cling to these scriptures and keep them ready at all times.

I’ve since had opportunity to talk with various groups about stress and hope and health. So many people have described similar strategies and what a vital lifeline this is for them. None have been ‘perfect people’ who just naturally have it all together. They, too, have gone through gut-wrenching difficult times and learned the value of being battle ready.

So, rather than sink into the pain and negativity, rather than chide yourself for being susceptible, stand up and take up your weapons. Let’s go to battle with the ONE true source of victory!

My key verses:

Psalm 25:5 NLT

Lead me by your truth and teach me,
for you are the God who saves me.
All day long I put my hope in you.

Psalm 63:6-8 NLT

I lie awake thinking of you,
    meditating on you through the night.
Because you are my helper,
    I sing for joy in the shadow of your wings.
I cling to you;
    your strong right hand holds me securely.

Philippians 4:6-7 NLT

Don’t worry about anything; instead, pray about everything. Tell God what you need, and thank him for all he has done. Then you will experience God’s peace, which exceeds anything we can understand. His peace will guard your hearts and minds as you live in Christ Jesus.

Isaiah 43:2 NLT

When you go through deep waters,
    I will be with you.
When you go through rivers of difficulty,
    you will not drown.
When you walk through the fire of oppression,
    you will not be burned up;
    the flames will not consume you.

What are your strategies? I would love to hear from you. And, if your group would like to take this deeper, ‘Grace & Health in Complex Times’ is a workshop I offer. It is a chance to connect health, hope, and healing during these very difficult days. We take frequent breaks, interact a lot (even virtually), and walk away with very tangible skills to care for ourselves and others. Let’s talk.

Blessings,

Michelle

Isolation Avoidance – You Never Need to be Alone

Posted on June 19, 2017June 19, 2017 by Michelle Fritsch, Pharm.D.

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

Optimal Operating Conditions – Live your Healthiest Life

Posted on March 13, 2017 by Michelle Fritsch, Pharm.D.

What are your optimal operating conditions? How often do you change the oil in your car? How warm/cool do you keep your home? How often do you change your furnace filter? When do you change your car’s tires?

I find we tend to be more aware of these guidelines for our cars and homes than we do for our bodies. Perhaps it is more clearly communicated how to care for your car or your home.

Most people find a temperature of 72 degrees Fahrenheit to be comfortable. Your car’s tires were designed to perform best when driving at the speed limit. You car’s oil is designed to lubricate the moving parts of your engine for 3500 miles (up to 7-10,000 if synthetic).

Our bodies have been designed to operate BEST within certain parameters. Do you know the numbers that will help keep you most healthy? Here are a few.

Your Best Numbers for your Heart

Why are your blood pressure and pulse checked every visit to your doctor? It is because there is an optimal range to help your heart stay in top performance.

Pulse 60-90 bests per minute

Blood pressure under 140/90 without being dizzy

When your heart beats in this range, it is able to fill with the right amount of blood with each beat. It can also send out to the body the right amount of blood with each pump. If your heart pumps too slowly, there might not be enough blood per pump to get enough to all of the other parts of the body. Similarly, when the heart pumps too fast, each squirt is just a small amount of blood rather than a full load. Those small quick squirts don’t get enough blood throughout the body where it is needed.

When your blood pressure is too high, it makes your heart work extra hard. Think about a body builder gradually increasing his muscle mass. If he tries to lift too much weight all of a sudden without working up to that weight, he is likely to hurt himself. He could even rip or harm a muscle to the point his weight lifting days are over. When your blood pressure shoots up quickly or it stays high over time, you move from a strong heart muscle to an injured heart muscle. A heart attack is destruction of part of the muscle wall. Once part of the heart is no longer working correctly, the rest of heart has trouble doing its work. It has to compensate for the wounded part.

Your Best Numbers for your Sugar

At least yearly during your physical, your doctor checks your blood sugar. Sugar (technical term glucose) is essential ‘food’ for your cells. Now, sugar doesn’t just come from eating sugary, sweet food. It is the result of your body breaking down other foods into usable cell ‘food’. There are a lot of other ways the body stores, releases, and breaks down sugar. Also, insulin is what helps that sugar ‘food’ get into the cell. Your body works best when your sugar is in the optimal range, and you have the right amount of insulin to keep it in that range.

Blood glucose 60-110 mg/dL if you do not have diabetes. (Your goal might be a bit higher if you have diabetes – talk with your doctor).

A1c (glycosylated hemoglobin – this gives an indication of your blood sugar over the last 90 days)

4-5.6% if you do not have diabetes

5.7-6.4% your doctor will talk with you about ways to make changes with your diet and exercise to avoid diabetes

less than 6.5% goal for well-controlled diabetes

just over 6.5% for some people with diabetes

– your doctor will help decide your best goal

When your blood sugar is too low, you get dizzy, shaky, sick to your stomach, you sweat, and it is hard to think clearly. When your blood sugar is too high, it causes damage throughout your body. Uncontrolled blood sugar can lead to poor kidney function, blindness, and loss of feeling in your hands and feet and other parts of your body. Also, type 2 diabetes is linked with high cholesterol, heart disease, stroke, high blood pressure, and being overweight.

Your Best numbers for your Weight

Your weight is also checked with nearly all doctor visits. Extra weight is hard on a lot of parts of your body. It creates more work for your hips, your knees, your ankles, and your feet. You are more likely to have diabetes. There are more cells to feed, beyond what your body was intended to feed. Your risk of heart attack and stroke go up. Your risk of falls goes up.

Your ideal weight is linked with your height. There are two best ways to determine if your weight is in a healthy range. One deals with your total weight. The other pertains to where you carry your extra weight.

Body Mass Index (BMI) – you can calculate your BMI here. It is based on your height.

Your BMI should be between 18.5 and 24.9

Waist Circumference – see this link to learn how to measure your waist circumference.

Women should be less than 35 inches

Men should be less than 40 inches

Can you live with numbers that are outside the normal range? Yes, you can. There will be consequences, though. When we live outside of the optimal range, systems don’t function as efficiently. They don’t operate like they were designed to operate.

Note, medications can help with these numbers. And, in all of these circumstances, our daily choices are also important to maintain optimal operating conditions. What we eat, how much we sit, how we exercise, and how we control our stress are also important in staying in these goal ranges. So, you have a lot of ability to help control your numbers!

Please contact us at Meds MASH to learn more about how to stay in your optimal operating conditions! You can reach us at 410-472-5078 or www.medsmash.com/contact.

BIBLICAL APPLICATION

Our body will function best when it can operate at optimal numbers. God designed our bodies and these healthy parameters. God has given us optimal operating guidelines for our spiritual life, too.

This struck me hard this week while I was reading Numbers. [I’ll admit, I don’t love reading some of the Bible chapters like Numbers. They can be dry and tedious. I have accepted the challenge of reading the Bible in a year. I highly encourage you to do this. You can start any time. So many insights jump out each time.]

While reading Numbers it hit me how God REPEATEDLY told the Israelites exactly what He was going to do and what He wanted them to do. He guided them with when to move, when to stay, and where to go. He provided the food while they were in the desert with few food sources. He explained before they reached each place who they would conquer and how He would make that happen.

If they had just listened, things would have been so much easier for them. That time in the desert could have been focused on worship and praise and relaxation waiting for all the wonderful things that they were promised.

Instead, they were impatient, untrusting, and impressionable. They were easily pulled away from God’s message and onto the opinions, concerns, or temptations presented by other people.

[If you’re a Veggie Tales fan, remember the peas in Josh and the Big Wall? They said, ‘silly children’ when addressing the children of God.] Silly children!

Numbers 14:11 ESV

And the Lord said to Moses, “How long will this people despise me? And how long will they not believe in me, in spite of all the signs that I have done among them?

We sit here and read about their mistakes and wonder how they could have been so dense. Through Moses, God spelled out what they needed to do in great detail. It was very clear. What were they thinking?

Then, I remember my own thoughts, actions, impatience, lack of trust, and how gullible I can be. Who am I to judge? Because Jesus died for us and removed the rules of the Hebrew Bible, our access to God is so much easier! We really have no excuse.

Galatians 3:13 ESV

Christ redeemed us from the curse of the law by becoming a curse for us—for it is written, “Cursed is everyone who is hanged on a tree”—

We don’t have to obey the tedious rules and sacrifices of the Hebrew people. Christ removed all of those rules and barriers between God and us. You have a straight link to the creator of the universe through Christ. Day by day, minute-by-minute God will guide you if you just ask.

I’ve mentioned before, my day is entirely different, less stressful, more productive, and more peaceful when I give it all to Christ. So, you’d think I would do that every day. Duh! If I give it to Christ it is an incredible day. If I get into a rush, too busy, too much too do, no time to slow down, then the whole day stays rushed and stressful.

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.”

I encourage you to consider this week how God is calling you to live. How does your ready access and potential relationship with Him change everything? If you look in the Bible, we are given the exact recipe for a life of peace and love. It’s our own decisions, impatience, lack of trust, and distractibility that takes us off that path.

2 Thessalonians 3:16 ESV

Now may the Lord of peace himself give you peace at all times in every way. The Lord be with you all.

Blessings,

Michelle

Image source: Medline Plus, National Institutes of Health, U.S. Department of Health and Human Services.

We NEED to be NEEDED to maintain our HEALTH

Posted on March 6, 2017March 6, 2017 by Michelle Fritsch, Pharm.D.

Have you ever thought about the link between being needed and health? As I’m thinking about it, that link could probably go both ways. I am wanting to tell you about the health benefits of being needed. But, I’m sure you could make a case that being overworked in constant demand can have negative health implications.

Think of a woman you know who went from caring for children and her husband to now being in an empty house with infrequent visits from children.

Think of a man or woman who worked in a very demanding job with a lot of responsibility who has now retired.

Often, we dream of the day everyone is raised and on their own. We dream of the day we reach the point of retirement.

Then, when that day comes you find yourself lonely. It is not as exciting as you expected. Reading books and relaxing can get boring.

Aging joints, accidents, and new medical conditions can create changes to retirement plans. Loss of a spouse can create changes to retirement plans. Children with jobs that take them away can create changes to retirement plans.

Social isolation

Social isolation is a real hazard to your health. Social isolation is when you don’t feel like your belong, don’t have much interaction with other people, don’t have people to call to get out and do something, and no/few close personal friends.

Social isolation can be bad for your health when it leads to drinking, being less active, or eating less healthy meals. It can increase your risk of heart disease, stroke, dementia, or depression.

We all Need to be Needed

A very innovative program was launched in the early 1990’s called Eden Alternative. They call their method, ‘person-directed care’. When I first heard about it in the 1990’s a very clear picture was left in my mind. A senior living facility had enhanced their environment by bringing in a cat, a dog, birds, a garden on the lawn, indoor plants, and a baby chick. There was a woman who wanted to spend all of her time in her wheelchair. The physical therapists were trying all they could think of to encourage her to walk and get stronger. She refused. Then she saw the baby chick. She did not want it to be eaten by the cat, so she put the chick in her wheelchair and pushed it. That chick, of course, became a chicken that continued to get first-class rides in the wheelchair.

Even people who were extremely incapacitated were given ‘jobs’. Even if it was caring for an African Violet. Some planted and worked in the garden. Some fed and cared for the birds. Some brushed the dog. Residents could sign up for the responsibilities that met their interests and abilities.

It was impressive how depression, anxiety, and pain were so much better with these changes. Since that time, the Eden Alternative has grown and spread and documented even more inspiring outcomes.

New Ideas to Decrease Isolation

I know many people who live in areas where they don’t feel safe getting out to walk. Some no long feel safe driving. Some don’t have the desire to get out and about without a partner.

So, some really smart minds have been working on ways to keep all of the health benefits of interacting with other people. Here are some of the creative options:

Virtual senior center. Using technology, you can take art classes, chat with others, participate in yoga or tai chi, and other activities. There are a lot of ways to keep in touch with family, read to someone, discuss topics, and support each other with technology.

Concierge driver options. Uber and other driving services are starting to offer unique options to take the stress out of getting out. There are groups working on strategies to provide more helpful driving service for people with walking aids, ways to coordinate outings such as restaurant or art gallery trips, and ways to make driving services more easy to coordinate.

This is only a very quick overview of the importance of interaction with other people, the dangers of isolation, and some of the many new ideas being developed. Stay tuned; I think we will all be amazed at what is to come.

For more information about the need to be needed and the dangers of isolation, or for updates on the amazing new advances we are hearing about, please contact us at www.medsmash.com or 410-472-5078. We’d love to tell you more!

BIBLICAL APPLICATION

We just discussed how our continued health needs us to stay active and engaged after retirement. Becoming alone is hazardous in many ways. We need each other. We never lose our need for purpose and fellowship.

And, we all have a purpose. We get so caught up in our daily details. We get so discouraged by our limitations, frailties, our weaknesses.

But, we are here for so much more! I’ve always heard this life is just a short, short preamble to a life of eternity in the presence of Christ! Can you even fathom that? I try then find it is so hard to begin to grasp!

We are assured of this truth numerous times in the Bible.

John 3:16 ESV

“For God so loved the world, that he gave his only Son, that whoever believes in him should not perish but have eternal life.”

John 5:24 ESV

Truly, truly, I say to you, whoever hears my word and believes him who sent me has eternal life. He does not come into judgment, but has passed from death to life.

Romans 10:13 ESV

For “everyone who calls on the name of the Lord will be saved.”

And while we are here in this life, we aren’t asked to sit around and twiddle our thumbs. We have a purpose!

Romans 8:28 ESV

And we know that for those who love God all things work together for good, for those who are called according to his purpose.

Jeremiah 29:11 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.

Sometimes we wonder what that purpose might be. In my experience to date, the purpose can even change over time. Things happen that seem strange and nonsensical, then suddenly, it turns into something only God could have planned.

I do my best to not make my own plans but rather stay open to what God has planned. That’s not meant to be pious. I have learned through a lot of changes, huge mistakes, and amazing teachers that my life is more fulfilling when I’m doing what God is calling me to do. It’s become a really wild ride, but I wouldn’t miss it. In the darkest times I need to remember that God can turn it all into his purpose and his plan.

Proverbs 16:9 ESV

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

I’m praying you find comfort in the promise of eternal life when God is Lord of your life. And, I pray you are asking Him for your purpose and blindly trusting Him to lead you on your personal adventure until He calls you to eternal life!

Blessings,

Michelle

Use reflective statements to enhance communication and decrease conflict

Communicate Your Way to Better Health

Posted on February 26, 2017 by Michelle Fritsch, Pharm.D.

How do you handle conflict? For most of us the answer is, ‘not very well’. Conflict can raise your blood pressure, constrict your veins and arteries, and make your heart beat harder and faster.

Did you know that communication is NEARLY ALWAYS at the heart of conflict. As people, we miscommunicate on a regular basis. Part of what makes good communication so difficult is that it involves at least two people. Once is communicating and one is interpreting that communication. Let’s take a look at both important parts.

Communicate a consistent message

I was at a retreat this weekend where we played a game about consistent messaging. Think about a time when someone was talking with you and their message was not consistent. Their words said something that did not match their tone or their face or their body language. Imagine someone saying, ‘I love you’ with a grimace on their face and a mocking tone. Or picture someone saying, ‘So nice to meet you’ while glancing around the room looking for someone else. Has anyone ever tried to express anger with you then started laughing? It is hard to express anger while laughing. Someone was just telling me a story about a toddler rearranging a bunch of decorations and falling into a box headfirst with her feet sticking out of the top. The decoration was too heavy and pulled her over. This parent had to stifle giggles and get a picture before retrieving and correcting the toddler.

So, when you are communicating, carefully think about saying the same message with your words, your tone, your eye contact, your facial expression, and your body language. That will help avoid misinterpretation.

Check for understanding

When you are the one communicating, make sure the receiver actually understands what you are saying. It is ok to ask them to repeat it back. Or to ask what questions they have. If we assume the other person understood exactly what we were thinking and trying to communicate, we can often be disappointed. Think about the last time you thought someone understood and they did something completely different than what you asked.

If you are the listener, this is a critical step to assure you are understanding the message.

Reflective Statements

When you are the listener, one of the best techniques you can use is ‘reflective statements’. State back to the person communicating with you what you hear them saying. Put it in your own words. Here are some examples:

You are saying you are upset about _________ because _________.
You are asking me to _________________ and have it done by _________.
___________ frustrates you when he/she ______________.
You want to ________________ before you agree to a hip surgery.
You heard that I ______________, and it has upset you.
Your son forgot to _______________, and not you don’t know what to do.

When you respond with a reflecting statement, you are making sure you understood the person’s message. It is a chance for them to clarify if you misunderstood. It is also a chance for them to feel heard and understood if you are correct.

Making sure you understand before taking any action, even before getting angry, and help avoid a lot of conflict.

If someone is upset or angry and respond also upset and angry, the situation escalates quickly. I have seen this happen where the two people don’t even realize they are saying the same thing. Neither is listening, they are just yelling. Now that will really get your blood pressure up!

I have found that FREQUENTLY, what I think I heard and what the person really intended were different. Especially when the topic is emotionally charged. It is our natural reaction to get defensive when someone comes at us angry. It is very hard to listen well in that state. So, a really deep breath and a calm reflecting statement can often help the situation calm back down. Sometimes when we are angry or frustrated we just want to vent. Once the venting is done, and the recipient reflects understanding, the situation doesn’t seem so bad.

Communicate with your Healthcare Team

These same techniques are very helpful when you communicate with your doctor. Sometimes the news we receive from our doctor can be upsetting. The words used in medicine are big and scary all by themselves. It can be hard to understand all of the technical information.

I highly encourage you to state back to your doctor what you just heard. Say it in your own words. This will help the doctor know where to clarify. I have had many patients get upset by a medical term that was actually no big deal. It just sounded scary. My grandfather, after 40+ years of smoking, a heart attack, a stroke, and stomach ulcers quit smoking cold turkey. We had been trying to get him to quit for years. None of those scary medical issues made him quit. But, when he was diagnosed with hiatal hernia he quit on the spot. [Hiatal hernia is when the sphincter between the esophagus and the stomach can’t close all the way. This allows stomach acid to come back up giving you heartburn. For him, this was the mildest of his issues.] I ask him why. His answer, ‘That’s a really scary word.’ I was in pharmacy school at the time. I had all sorts of scary words I could have given him. Who knew that was all it would take to get him to quit.

So, I encourage use to be clear and consistent with your communication. And, ask clarifying questions and use reflective statements when you are receiving communication. Especially if it seems upsetting, make sure you really understand the message before you make any decisions. This could help you avoid a lot of conflict.

Your heart will thank you for managing conflict better and keeping your blood pressure down.

For more information about communication techniques for your health, please contact us at Meds MASH at 410-472-5078 or www.medsmash.com/contact.

BIBLICAL APPLICATION

When we react without first understanding, we often get ourselves into trouble. Throughout the Bible we see examples of people making bad assumptions followed by bad actions.

The people of Israel, after God had gotten them out of slavery and out of Egypt and led them through the desert supplying food and water and protection, still made bad assumptions. While Moses was on the mountain with God himself, they assumed he wasn’t coming back, so they made a golden calf to be their god.

Exodus 32:1 NIV

When the people saw that Moses was so long in coming down from the mountain, they gathered around Aaron and said, “Come, make us gods[a] who will go before us. As for this fellow Moses who brought us up out of Egypt, we don’t know what has happened to him.”

When Jesus was talking with his disciples about what was coming next for him, including his death, Peter jumped right in and disagreed.

Matthew 16:21-23 NIV

From that time on Jesus began to explain to his disciples that he must go to Jerusalem and suffer many things at the hands of the elders, the chief priests and the teachers of the law, and that he must be killed and on the third day be raised to life.

Peter took him aside and began to rebuke him. “Never, Lord!” he said. “This shall never happen to you!”

Jesus turned and said to Peter, “Get behind me, Satan! You are a stumbling block to me; you do not have in mind the concerns of God, but merely human concerns.”

In the bible we are also told to expect miscommunication in the future. There will be false prophets and all sorts of misinformation.

Matthew 7:15 ESV

“Beware of false prophets, who come to you in sheep’s clothing but inwardly are ravenous wolves.

1 John 4:1 ESV

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

We are called to be discerning. Ask questions. Get the full story. Make sure you understand and that what you hear matches the messages of the Bible.

I feel better when I read this passage. There will be no doubt when Jesus returns. Other people can claim what they want. I won’t believe it until it is this obvious:

Matthew 24:29-31 ESV

The Coming of the Son of Man

“Immediately after the tribulation of those days the sun will be darkened, and the moon will not give its light, and the stars will fall from heaven, and the powers of the heavens will be shaken. Then will appear in heaven the sign of the Son of Man, and then all the tribes of the earth will mourn, and they will see the Son of Man coming on the clouds of heaven with power and great glory. And he will send out his angels with a loud trumpet call, and they will gather his elect from the four winds, from one end of heaven to the other.

That doesn’t sound too subtle. So, until it is extremely obvious and visible to all of creation, let’s not fall for false messages.

Blessings,

Michelle

The Road of Chronic Illness is (Sometimes) Lonely

Posted on January 29, 2017January 29, 2017 by Michelle Fritsch, Pharm.D.

Have you experienced this? You have new symptoms, so friends and family are concerned and checking on you. You get a new chronic diagnosis, and friends and family are concerned and supportive.

Then, the ‘new’ wears off. The condition continues. The treatment continues. But, the concerned and supportive people have moved on to other issues.

How do you stay motivated to stay on your therapy? How do you stay focused on the necessary steps to control your medical condition? How do you maintain your resolve to stay healthy?

Chronic Illness can be Silent

Have you been diagnosed with high blood pressure, high cholesterol, diabetes, asthma, or arthritis? Have you had a stroke or a heart attack? There are so many types of chronic medical conditions.

Some of these conditions you don’t feel. Your blood pressure can be high, and you feel completely fine. The same is true with your cholesterol. Even with diabetes, it can get pretty far from normal with no symptoms for many people.

Then, there is the fact that all medications can cause side effects. So, sometimes people feel worse on their medicine than they do when they don’t take it. Talk about hard to stay motivated!

Chronic Illness requires Understanding

One of the key factors in taking care of yourself is really understanding your condition and the treatment. If you have a chronic illness and you don’t fully understand it, please talk with your doctor, your pharmacist, or call us at Meds MASH. It is very hard to know how to take care of yourself if you don’t understand the what, why, how, when aspects of your condition. And it is VERY hard to stay motivated without this understanding.

In addition to the condition itself, you need to really understand the therapy that is prescribed. This can be medication, exercise, diet changes, physical therapy, counseling, or many other kinds of therapy. You need to know why, how this therapy can help, and what you can expect. If there are common side effects, you should know that. If it will take a month to work, you need to know that.

Chronic Illness is Easier to Manage with Support

I was talking about this with some friends who are in recovery from substance abuse. Addiction is one of many types of chronic illnesses. It is also an area that has repeatedly proven the value of support when conquering chronic illness. The 12-step program of recovery is built around the need for community, accountability, and belief in a higher power.

There are support groups available for most medical conditions. Some are groups that meet in person. Some are led by a health professional, others are peer led. Some are groups that meet and interact online.

It can be helpful to know that you are not alone. Most people benefit from sharing their experience, exchanging tips of what works and what doesn’t for them, and just supporting each other. We all have our good days and bad. In a group, someone will be having a good day and be able to help you through your bad day. Next time, you can be the helper and supporter.

If we can help you find a support group or help you to REALLY understand your condition and treatments, please contact us at www.medsmash.com or 410-472-5078.

BIBLICAL APPLICATION

The path of chronic illness is easier to walk with support – family, friends, and a support group of people with the same chronic illness. Likewise, the path of spiritual growth is easiest to walk in community with other believers.

Having other believers around you helps in many ways:

Work through questions
Share ideas and insights
Hold each other accountable
Comfort each other
Celebrate with each other
Pray together
Live life together

1 Thessalonians 5:11 ESV

Therefore encourage one another and build one another up, just as you are doing.

Hebrews 10:25 ESV

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.

I like the way God created us to work together through life and support each other.

Jesus promises he is with us always. So, no one is ever alone. Having friends, small groups, teachers to remind us of that and share their never alone stories can be very helpful.

1 Peter 5:7 ESV

Casting all your anxieties on him, because he cares for you.

Hebrews 13:5 ESV

Keep your life free from love of money, and be content with what you have, for he has said, “I will never leave you nor forsake you.”

One of the verses that I always find most comforting, especially when I’m feeling lonely, self-conscious, or insecure is this next one.

Romans 8:35-39 ESV

Who shall separate us from the love of Christ? Shall tribulation, or distress, or persecution, or famine, or nakedness, or danger, or sword? As it is written, “For your sake we are being killed all the day long; we are regarded as sheep to be slaughtered.” No, in all these things we are more than conquerors through him who loved us. For I am sure that neither death nor life, nor angels nor rulers, nor things present nor things to come, nor powers, 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.

You and I are never alone. We are unconditionally loved!

Blessings,

Michelle

Peace, Joy, and Health – What is the Link?

Posted on December 22, 2016December 22, 2016 by Michelle Fritsch, Pharm.D.

Merry Christmas! Happy Hanukkah! Happy Holidays! For many this is a season of wonder, excitement, friends, and family. It is a time of joy and celebration. The comforts of the season, and for many, the reasons for the season, are a source of peace.

Then, for others, this is a difficult season. It can be a reminder of loss, a lonely time, or a negative experience. I am regularly horrified at how people can hurt people. And hurt people tend to hurt people. It is a devastating trend.

Hurt and Health

The obvious connection between peace and health pertains to war. I am happy to see survivors finally being moved to safety away from Aleppo. War is definitely hazardous to health. Aleppo has been an example of how horrible things can get in the midst of war.

Conflict, abuse, hurtful words, neglect, oppression, and bullying are bad for your health, too. Anxiety, depression, and loss of hope are some common themes.

These cycles are hard to break. It can be challenging to find the hope.

I have seen in MANY patients that when this hurt is kept inside, it DOES come out. It can come out as depression, social anxiety, avoidance of people, and very often pain.

Peace and Health

Finding peace in life doesn’t only happen when things are perfect. Name the times in your life that absolutely everything was perfect. I’ll be surprised if you can find any at all. Rarely if ever are you in a place where there is absolutely no hurt, no mess, and all is good. So how do you ever find peace?

I have had the privilege of knowing many people, including many patients, who have found peace in spite of very turbulent events in their life.

Finding faith, meaning, and peace has been shown to improve quality of life in people with cancer. Some people bring these qualities into their cancer experience. Others find it in the midst of their cancer. I believe if this is true in cancer, it will be true with other chronic illnesses as well.

Another link is the association between giving to others and finding joy for yourself. Altruism and giving are linked with improved health. We often associate happiness with getting gifts. Now, it appears you will find even more joy if you focus on the giving of the season. Who could benefit from your giving today?

So, on this holiday weekend, seeking your source of peace and joy can actually improve your health. You physical, mental, emotional, and spiritual health will all benefit.

For more information about the health benefits of finding peace in the midst of life, contact us at 410-472-5078 or www.medsmash.com/contact.

BIBLICAL APPLICATION

I know a lot of Christians who struggle to find the peace and joy of Christmas. The busy-ness, stress, expectations, obligations, traffic, and events can be overwhelming.

None of that sounds like peace.

The birth of Jesus wasn’t surrounded by shopping, parties, pressure, or obligations. There might have been some traffic with the census. 🙂

The songs like ‘O, Holy Night’, ‘Silent Night’, and ‘It Came Upon a Midnight Clear’ paint a peaceful, serene event. The rich and famous were not present. The finest china and silver were not set in a well-decorated setting. No one compared value of gifts given and received.

Peace was mentioned to the very first people told about his birth.

Luke 2:14 ESV

“Glory to God in the highest, and on earth peace among those with whom he is pleased!”

Jesus had several messages about peace during his ministry.

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.”

John 14:27 ESV

Peace I leave with you; my peace I give to you. Not as the world gives do I give to you. Let not your hearts be troubled, neither let them be afraid.

Jesus’ brother James understood the types of things that lead to our stress and frustration at Christmas.

James 4:2-3 ESV

You desire and do not have, so you murder. You covet and cannot obtain, so you fight and quarrel. You do not have, because you do not ask. You ask and do not receive, because you ask wrongly, to spend it on your passions.

Paul tells us what we should do instead.

Galatians 5:22 ESV

But the fruit of the Spirit is love, joy, peace, patience, kindness, goodness, faithfulness,

Jesus demonstrated this kind of life. Christmas is a time of love, joy, peace, patience, kindness, and goodness. How delightful if we can stay focused on these principles as we celebrate with our loved ones.

I pray Paul’s blessing for you and your family this blessed Christmas.

Romans 15:13 ESV

May the God of hope fill you with all joy and peace in believing, so that by the power of the Holy Spirit you may abound in hope.

Blessings,

Michelle

To feel better – do for someone else – altruism

Posted on August 15, 2016 by Michelle Fritsch, Pharm.D.

Altruism helps others and improves your health

I am just back from Jamaica, and I need to write about altruism. I was working with a mission group called TEAMS. You can learn more about them at www.t4mm.org. This medical mission group included 3 physicians, 1 nurse practitioner, 2 nurses, 3 pharmacists, 3 for registration, 2 to be with the children while their parents received care, and 2 to provide prayer and emotional support to those coming for care.

We were serving in St. Mary Parish, one of the poorest of the country. Clinic was held in churches in four different areas of the Parish. A Parish is similar to a state in the United States. Sheets draped over ropes often separated exam rooms for physicians. I counseled people about their medications as they sat among many other people. So this was not a private setting. But, excellent practitioners provided individualized care with great compassion.

Each clinic served a particular community. Within that community you could look out at all who were waiting and see the way they cared for each other. Babies would be passed around, older members would be assisted with steps, others in nearby seats would assist with understanding when I was struggling with the Patois (English with a thick dialect spoken very quickly).

It was very hot. Fans helped to stir the air. There was no running water. (I am so thankful for hand sanitizer). Some children had lice or scabies yet they waited patiently with their family. You know they had to be miserable between the heat and the intense itching. Some people had to wait from early morning until mid afternoon to be seen.

Yet, I didn’t hear one person complain. No one was demanding to know why their wait was so long. No one was complaining about the conditions. No one was asserting their needs or rights before someone else’s.

On the medical team, several people were struggling with their own health issues. One was on crutches due to a broken leg; one was recovering from bronchitis; one had a cold; several had various aches and pains. The age range of the care team was 22 to 82. Personally, my leg is still recovering from a ripped calf muscle, and my back has been hurting from all of the time that I was on crutches and a boot.

What struck me was how none of that mattered! Rather than thinking about our issues, we were completely focused on all of the people who had arrived to receive care. My leg did fine the entire week, even carrying heavy tables and boxes and fans to set up and take down clinic every day up steep hills and steps. I didn’t do my back stretches or sit around rubbing my back the way I do at home. That is because I wasn’t even thinking about my back.

Altruism

Altruism is, ‘feelings and behavior that show a desire to help other people and a lack of selfishness’ as defined by Merriam-Webster. I have read several articles linking altruism as a factor in happiness, health, and how long you live. In general, studies have shown that people who focus on others are happier and even live longer, in general. In 2005, Stephen Post published an article in the International Journal of Behavioral Medicine entitled, ‘Altruism, Happiness, and Health: It’s Good to be Good’. A quote from the article is, ‘The article concludes, with some caveats, that a strong correlation exists between the well-being, happiness, health, and longevity of people who are emotionally and behaviorally compassionate, so long as they are not overwhelmed by helping tasks.’

I have seen truth in this in many instances. While I was doing post-graduate training in Wisconsin a study demonstrated that home-bound elders who were in a calling circle. Those who called to check on each other and remind each other to take medications felt less isolated and more valued. A project called the Eden Alternative long ago demonstrated the value in having daily purpose for everyone in a nursing home setting. Depending on ability level residents would care for a cat or dog, garden, water plants, feed birds, feed fish, or other activities. It was a huge success and continues today! Everyone needs to be needed. That sense of purpose and belonging plays a big role in overall health, including anxiety levels, pain, and depression.

When was the last time you focused on the needs of someone else? I encourage you to find a way each day this week to meet someone else’s needs. Some examples are to check on an older neighbor; take a meal to someone who recently had surgery; call a mom with small children to see if you can grab some things for her when you go to the grocery store and save her a trip.

For more information about how altruism is connected to health, contact us at www.medsmash.com/contact.

BIBLICAL APPLICATION

It is no surprise that altruism is linked to enhanced health. Jesus told us many times about the importance of selflessness.

John 15:12-14 ESV

“This is my commandment, that you love one another as I have loved you. Greater love has no one than this, that someone lay down his life for his friends. You are my friends if you do what I command you.”

Daily devotions, a lot of singing, and prayer with each community were cherished parts of this mission. The care was among providers, among recipients, among those at the church helping with coordination, and among those providing protection. My visual each day was being filled up with the Spirit to be completely poured out by the end of the day.

Some say Christian selflessness is not true altruism because we will be rewarded for such care and compassion. Ultimately, eternally a reward is waiting. But while here in this life, you might not see a reward. In fact, your giving isn’t meant to be for show.

Matthew 6:2-4 MSG

“When you do something for someone else, don’t call attention to yourself. You’ve seen them in action, I’m sure—‘playactors’ I call them—treating prayer meeting and street corner alike as a stage, acting compassionate as long as someone is watching, playing to the crowds. They get applause, true, but that’s all they get. When you help someone out, don’t think about how it looks. Just do it—quietly and unobtrusively. That is the way your God, who conceived you in love, working behind the scenes, helps you out.

Paul, Peter, Luke, John, and many other writers in the New Testament extol the virtues of giving to others.

Philippians 2:4 ESV

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

Luke 6:35 ESV

But love your enemies, and do good, and lend, expecting nothing in return, and your reward will be great, and you will be sons of the Most High, for he is kind to the ungrateful and the evil.

1 Peter 3:8 ESV

Finally, all of you, have unity of mind, sympathy, brotherly love, a tender heart, and a humble mind.

What can you do today to help someone else?

Proverbs 19:17 ESV

Whoever is generous to the poor lends to the Lord, and he will repay him for his deed.

Blessings,

Michelle

Your Amazing Kidneys – what do they do exactly?

Posted on July 24, 2016July 24, 2016 by Michelle Fritsch, Pharm.D.

Your kidneys clean the blood and manage water

Kidneys – most people have two. Their function is essential for life. If they stop working, then other types of filtration have to be used. We will talk about these back-up plans in a bit.

Think of your kidneys are filters, really good filters. They are about the size of your balled up fist. They are under your rib cage in the back.

Your kidneys have several functions

Filter waste and toxins from the blood
Remove extra water from the blood
Turn the waste, toxins, and extra water into urine
Urine removes all of those wastes and extra water from the body

Your kidneys have several parts

Nephrons in your kidneys are the filtering units. You have about a million of them – in each kidney! The nephrons have tubes that carry the urine. They also have small blood vessels that bring the blood past these tubes. The tubes can determine what to keep and put back in the blood and what to send on in the urine out of the body. They determine how much potassium, sodium, water and some other chemicals to keep or release. This is all regulated through a process called the renin-angiotensin-aldosterone system (RAAS).

Keeping and releasing the right amounts of these chemicals and fluids maintains balance in many other parts of your body. In particular, they have a big impact on your blood pressure. Your blood pressure is one important factor in how hard your heart has to work. When your heart has to work too hard for too long, damage can be done leading to heart disease.

The class of kidney-impacting medications that first comes to mind is diuretics. Many people call these ‘water pills’. They work directly in the tubes in the nephron that decide how much water to keep. The diuretics cause more water to be released into the urine and removed from the body. Lowering the total water in the blood lowers the blood pressure. [Note, this is NOT the same as changing the amount of water you drink. If you drink less you put yourself at risk of dehydration, and your kidneys will just hang on to the water it has causing you to urinate less rather than lower your blood pressure. So keep drinking plenty of water on these hot days even if you have high blood pressure. Your kidneys will take care of the rest.] There are a few different kinds of diuretics. Some are used primarily for blood pressure, some for heart failure, and some for edema or other conditions with large amounts of fluid retention.

Two other classes of medications that work through the RAAS system are angiotensin converting enzyme inhibitors (ACE Inhibitors) and Angiotensin II Receptor Blockers (sometimes called ARBs). Some examples of ACE Inhibitors are lisinopril, ramipril, enalapril. Note, the generic names of these medications end in ‘pril’. Some examples of ARBs are losartan and candesartan. Note, the generic names of these medications end in ‘sartan’. Both of these classes of medications have a direct impact on RAAS. This means they help control the amount of water that is excreted through the urine. They also impact the potassium (causing more to be kept in the blood) and have some other actions that lower blood pressure. They cause arteries and veins to open up more relieving pressure on the heart, kidneys, and other organs that have to work harder when these are squeezed tight. By opening them, the pressure slows down and the blood goes through these organs with less force. So these medications are used to treat high blood pressure, heart failure, kidney disease, and to protect the heart for people with diabetes.

When the kidneys just can’t work properly, then dialysis is used to provide the essential filtration. There are two main types of dialysis. One is hemodialysis that is performed in an infusion center. Someone requiring hemodialysis will go to the center about three times per week to be hooked to a machine which will filter the blood. This typically takes at least 2-4 hours. The other type is peritoneal dialysis that can be done at home. This requires an exchange of fluids through the abdominal area about four times per day. Each exchange takes about 30-40 minutes. You can learn a lot more about dialysis from the National Kidney Foundation at this link.

There is obviously a lot more detail needed to completely understand the function of the kidneys. The purpose of this article is to raise awareness of how very important those kidney-bean shaped organs are. It is well worth the effort to protect them. Some ways you can protect them are by keeping your blood pressure and diabetes controlled, staying well hydrated, and maintaining a healthy weight.

To learn more about your kidneys and medications that impact your kidneys, contact us at www.medsmash.com/contact.

BIBLICAL APPLICATION

The kidneys clean the blood. They remove waste, toxins, and extra water from the body.

We are called to be cleansed as Christians. How does that work?

First, what needs to be cleansed? Take an internal inventory on the following items to get started:

Judgmental thoughts
Angry words
Hurtful actions
Not helping when you could have helped
Selfish motives
Jealousy
Lustful thoughts

Whew, that list could go on forever, couldn’t it! Yep, you’re a sinner. So am I.

Romans 3:23 (NIV)

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

So, should you just give up and go home? Or, should you give up and just do what you want since you can’t get it right anyway?

Romans 3:21-24 (MSG)

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.

Jesus died to cleanse YOU of all of your sin.

1 John 1:9 ESV

If we confess our sins, he is faithful and just to forgive us our sins and to cleanse us from all unrighteousness.

1 John 1:7 ESV

But if we walk in the light, as he is in the light, we have fellowship with one another, and the blood of Jesus his Son cleanses us from all sin.

Titus 3:5 ESV

He saved us, not because of works done by us in righteousness, but according to his own mercy, by the washing of regeneration and renewal of the Holy Spirit,

2 Corinthians 7:1 ESV

Since we have these promises, beloved, let us cleanse ourselves from every defilement of body and spirit, bringing holiness to completion in the fear of God.

Romans 12:2 ESV

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

You can’t do it for yourself! Take all the baths you want. Do all of the good things you want for other people. Deny yourself all sorts of things. None of this will cleanse you.

But Jesus can. And He did! Just for you…

Blessings,

Michelle

Image source: National Library of Medicine, National Institutes of Health, U.S. Department of Health and Human Services.

Aging – the good, the bad, the medication issues

Posted on June 19, 2016June 19, 2016 by Michelle Fritsch, Pharm.D.

You are aging. No matter your overall health, your lifestyle choice, your beliefs about the medical system, you are aging.

If you do EVERYTHING right when it comes to healthy living, will aging stop? No.

Here are some changes that occur in all of us with aging.

Kidney function starts a very gradual decline in your late 30’s or early 40’s.
Liver size and blood flow to your liver diminish. The number of cells shrinks. There is less activity of the enzymes that break down medications.
Food and medications move through the intestine more slowly.
The volume of urine that the bladder can hold decreases. Bladder muscles weaken.
For men, the prostate gland increases in size.
For women, the urethra shortens and becomes thinner. So, risk of urinary tract infection goes up.
Muscles weaken as growth hormone levels decline.
Aldosterone levels decrease, so risk of dehydration goes up.
The immune system slows down. So, risk of infection and cancer go up. Also, it can take longer to treat an infection.
Heart muscle and blood vessels get stiffer. This can increase risk of high blood pressure. Also, with exercise, the heart can’t pump as much blood or speed up as much as it did at younger ages. So, exercise capacity is lower.
The muscles involved in breathing weaken. There is a decline in the number of small sacs in the lungs where oxygen is passed to the blood.
The amount of water in the body goes down while the body fat goes up.

This is not intended to alarm or depress you. With aging also comes wisdom, experience, tolerance, and the benefits of many life lessons. So, celebrate the process with its good and challenging elements.

As a pharmacist, I want you to understand how and why medications should be prescribed differently at different ages. Any medical conditions; habits such as smoking or excess alcohol consumption; excess weight; and other factors can further impact how medication actions change over time.

The first step of a medication’s actions comes when it is presented to the body. Most often it is swallowed and then has to be absorbed. Absorption is not impacted very much by normal aging, but it is impacted by medications that lower stomach acid, change the rate of the gastrointestinal tract, or by stomach or intestine procedures.

The second step is distribution. The medication, once absorbed, is distributed throughout the body. Some medications prefer fat and other prefer water. As we age, we have more body fat and less body water. So, medications that love water are more concentrated in the overall smaller total amount of water. The medications that love fat are distributed to more places and can be harder to gather it all back together to get rid of it.

The third step is metabolism. This is how the medication is broken down in the body. Some medications have to be broken down in order to get rid of them. Others have to be broken down in order to reach their more active form. Metabolism happens in the liver. Over time, the liver becomes less active, so it takes longer to break down some medications.

The fourth step is elimination. This is how the medication leaves the body. Most medications are either eliminated through the urine or through the feces (stool). So, any decrease in kidney function will slow down the elimination through the urine. Any slowing, shortening, or other issues with the intestines and colon can impact the elimination through the feces.

The important point of mentioning all of this is to make you aware that medications act differently in your body as you age. The medication, the dose, the timing that was good for you 10 years ago might not be the best for you now. Your doctor shouldn’t prescribe medications in the same way for a 70 year old person as prescribed for a 30 year old person.

I encourage you to ask your doctor and your pharmacist to carefully review your medications to be sure all are correct for your age and your unique set of medical conditions.

We would also be happy to provide that very thorough assessment for you. You can contact us at www.medsmash.com.

BIBLICAL APPLICATION

A life of faith is a long pursuit. It often takes time to develop perseverance and character, hope and joy in all circumstances.

Romans 5:3-5 NIV

Not only so, but we also glory in our sufferings, because we know that suffering produces perseverance; perseverance, character; and character, hope. And hope does not put us to shame, because God’s love has been poured out into our hearts through the Holy Spirit, who has been given to us.

Throughout the Psalms and Proverbs age is revered with dignity and honor.

Proverbs 16:31 ESV

Gray hair is a crown of glory; it is gained in a righteous life.

Psalm 71:18 ESV

So even to old age and gray hairs, O God, do not forsake me, until I proclaim your might to another generation, your power to all those to come.

Psalm 92:12-15 ESV

The righteous flourish like the palm tree and grow like a cedar in Lebanon. They are planted in the house of the Lord; they flourish in the courts of our God. They still bear fruit in old age; they are ever full of sap and green, to declare that the Lord is upright; he is my rock, and there is no unrighteousness in him.

Psalm 71:9 ESV

Do not cast me off in the time of old age; forsake me not when my strength is spent.

Proverbs 20:29 ESV

The glory of young men is their strength, but the splendor of old men is their gray hair.

At the end of this life we have the promise of a glorious eternity. It makes the aging and the waiting easier to dwell on what is to come!

2 Corinthians 4:16 ESV

So we do not lose heart. Though our outer self is wasting away, our inner self is being renewed day by day.

Blessings,

Michelle

Image source: National Institute of Aging; National Institutes of Health; US Department of Health and Human Services.