In Maryland, the leaves are turning beautiful fall colors. The air is crisp more often, and that fuzzy blanket feels good at night! The move from summer to autumn makes itself known in obvious and in subtle ways.
Throughout life, your body makes changes, too. Some are obvious. Some are subtle.
Many of these changes increase your risk for falls and/or injury with a fall.
Joints get stiffer
Lung capacity gradually decreases – you might get short of breath easier
Skin gets drier as overall body water content decreases
Vision changes, especially your ability to see up close
Skin and tissues get looser
These changes are usually caught when your doctor monitors your labs, your urine, or does a physical exam.
Kidneys slow down
Liver slows down
Bones get less dense (hard)
Reflexes aren’t as quick
Risk for urinary track infection goes up
Hormone production changes – for men and women
Association with falls
As we move slower, have more joint pain, lose some of our range of motion, and reflexes slow, the risk of falls goes up. As senses such as vision, hearing, touch, smell, and even taste change, these also increase the risk of falls.
The kidney and liver changes are especially important as we think about the impact on how our body handles medications. The liver is the key organ that breaks down medicines in our body. The kidney is one of the primary ways they are then removed. So, as our kidneys and liver slow down, for many medicines, we need lower doses. Sometimes, at some point in the decline of kidneys or liver, some medications should NOT be used at all.
Falls can lead to losing your ability to walk, run, climb stairs, and be as active as you would like to be.
Remember, with accumulated years we also grow in wisdom, in maturity, and learn to count the blessings in our lives! Graceful aging is a beautiful thing. I just don’t want you to fall!
Call us at Meds MASH for a thorough assessment of your current changes, your medications, and ways to decrease your risk of falls. This is one of our specialties! Michelle is one of the creators of a comprehensive falls risk assessment.
Our bodies aren’t the only things that change with time. Our Christian walk is also a journey with twists and turns. Ideally it is an uphill climb to more maturity. But without practice and several bumps in the road, it can be a very flat journey.
So that we may no longer be children, tossed to and fro by the waves and carried about by every wind of doctrine, by human cunning, by craftiness in deceitful schemes. Rather, speaking the truth in love, we are to grow up in every way into him who is the head, into Christ,
Growing, learning, and changing take effort and dedication. Practice makes perfect. I don’t expect any of us will reach perfect until Heaven, but practice can certainly help us with improvement.
For though by this time you ought to be teachers, you need someone to teach you again the basic principles of the oracles of God. You need milk, not solid food, for everyone who lives on milk is unskilled in the word of righteousness, since he is a child.
To grow and change, we take risks, learn from our mistakes, and gain confidence as God sees us through each obstacle.
James, a servant of God and of the Lord Jesus Christ, To the twelve tribes in the Dispersion: Greetings. Count it all joy, my brothers, when you meet trials of various kinds, for you know that the testing of your faith produces steadfastness. And let steadfastness have its full effect, that you may be perfect and complete, lacking in nothing. If any of you lacks wisdom, let him ask God, who gives generously to all without reproach, and it will be given him. …
There is a lot of talk about and emphasis on being ‘transparent’ today in our society. It has taken me months to clearly, succinctly state what we do at Meds MASH. I am still honing the message so that it really makes sense to people. We need to be able to put things in someone’s own perspective to help them really understand.
If an alien from Mars came to visit and talked to you about places, customs, and politics on Mars, it is unlikely you would understand very much of it. You would have no perspective of how things look or operate on that planet.
I had this same thought this week as I was reading the Psalms, especially the ones written by David. David was the king. He was responsible for all of the people. His perspectives were oriented around keeping people safe and alive.
He frequently talks about enemies and God’s protection in wars. I’m sure they were attacked, or at risk of being attacked, most of the time. God made it clear that when the people of Israel went into battle with God’s protection, then they would prevail.
“The Lord will cause your enemies who rise against you to be defeated before you. They shall come out against you one way and flee before you seven ways.
When they went into battle on their own, the outcomes were not so good.
Numbers 14:39-45 ESV
Israel Defeated in Battle
When Moses told these words to all the people of Israel, the people mourned greatly. And they rose early in the morning and went up to the heights of the hill country, saying, “Here we are. We will go up to the place that the Lord has promised, for we have sinned.” But Moses said, “Why now are you transgressing the command of the Lord, when that will not succeed? Do not go up, for the Lord is not among you, lest you be struck down before your enemies. For there the Amalekites and the Canaanites are facing you, and you shall fall by the sword. Because you have turned back from following the Lord, the Lord will not be with you.” But they presumed to go up to the heights of the hill country, although neither the ark of the covenant of the Lord nor Moses departed out of the camp. Then the Amalekites and the Canaanites who lived in that hill country came down and defeated them and pursued them, even to Hormah.
Our personal battles aren’t with swords, but they are still battles. And if God is for us and leading us, then our outcomes are infinitely better than when we do battle on our own without Him.
David also makes frequently reference to rain, crops, vineyards, and grain. We don’t tend to spend our days focused on those things. Our grocery stores and markets are filled with all we need.
But what are the daily struggles in your life that mean just as much to you as ability to grow crops meant in David’s time? Is it your finances, your job, career opportunities, relationships, finding your meaning in life? Our daily struggles are no less important that David’s. Our world and our perspectives are just different.
So, whatever your battles, lay them before the Lord. Honestly lay it all out there. Be completely transparent and clear in your requests before God. He already knows. He loves the trust you place in Him as you bring it all to Him.
With the mighty deeds of the Lord God I will come;
I will remind them of your righteousness, yours alone.
O God, from my youth you have taught me,
and I still proclaim your wondrous deeds.
If you’re ever at a loss for what to pray, consider the Psalms. They are the prayers and songs of praise of David. Put it in today’s perspective, and you’ll find they are completely relevant to your needs today.
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 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!
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.
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.
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!
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.
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.
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.
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.
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.
“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.
I have been talking with a lot of groups and individuals about ways to prevent falls. Falls come out of nowhere most of the time. You don’t even think about them until they happen.
According to data from the Centers for Disease Control, there are over 2.8 million older adults seen in the emergency department for falls every year! Yes, 2.8 million!!! And these are not always the obvious people who can just look at and tell they could easily fall. Many would consider themselves health, active, and not at risk.
You CAN determine your risks and take action now to lower them.
So, how do you determine if you have this falls risk?
The Center for Disease Control tackled that question and developed the Stopping Elderly Accidents, Deaths, and Injuries. They created a toolkit with several resources. Some of the resources are for your doctor or other healthcare provider. Others are for YOU to help find and minimize your personal risks.
You can find access to these tools on our Meds MASH website. Or you can follow this link: https://www.cdc.gov/steadi/patient.html. You will find information about falls, how often they happen, and many of the risk factors. You will also find tools to help you assess yourself and your home.
I especially encourage you to complete the Check for Safety checklist. It has you walk room to room through your house looking for specific risk factors. It also has several tips to help you avoid falls.
Next, I encourage you to complete the Stay Independent checklist. This will ask you a series of 12 questions. You will answer each with a ‘Yes’ or a ‘No’. Then, take this list with you to your next doctor’s appointment. This will help you to have a very focused talk with your doctor about ways to minimize your falls risk.
Finally, read the What You Can Do to Prevent Falls brochure. This will give you even more tips to help you avoid a fall.
What can you do to lower your falls risk?
There are four different assessments in the toolkit that your doctor can use to better understand how to help you decrease your risks. One of these you can do yourself.
It is called a Chair Rise Exercise. It can help you gain strength in your thighs and buttocks. This will help you be more stable when you walk. Here are the instructions from the CDC STEADI guide:
How to do it:
Sit toward the front of a sturdy chair with your knees bent & feet flat on the floor, shoulder-width apart.
Rest your hands lightly on the seat on either side of you, keeping your back & neck straight & chest slightly forward.
Breathe in slowly. Lean forward & feel your weight on the front of your feet.
Breathe out & slowly stand up, using your hands as little as possible.
Pause for a full breath in & out.
Breathe in as you slowly sit down. Do not let yourself collapse back down into the chair. Rather, control your lowering as much as possible.
What about medications?
There are so many medications that can increase your risk for falls. That’s one of our specialties at Meds MASH. We can take a thorough look at all of your prescribed medicines, your over-the-counter medicines, your vitamins, your herbal medicines, and any other substances. Even the doses you take, your kidney function, and your liver function will be assessed. We will also look at the timing of your medicines and your diet. All of these things work together to impact your falls risk.
One of the best ways to avoid falls is to know your risks and take steps to minimize them. You need to do some work, and usually get some professional input, to fully analyze those risks. Then, it takes personal motivation to do the exercises, change the shoes, use the assistive device, or work with your healthcare team to make the medication changes to lower your risks.
What are your risks to fall off the path of Christ? I’m thinking of the parable of the seeds found in Matthew 13.
My son, be attentive to my words; incline your ear to my sayings. Let them not escape from your sight; keep them within your heart. For they are life to those who find them, and healing to all their flesh.
“The person who knows my commandments and keeps them, that’s who loves me. And the person who loves me will be loved by my Father, and I will love him and make myself plain to him.”
What is your grasp of the Word of God? If that is the key to ‘letting our seed grow’, what is your growing potential? I know I have rocks and thorns and birds that try to snatch my seeds away in my life.
It takes motivation and discipline to stay in God’s Word on a regular basis. It takes discussion and study with others to really understand it from varying perspectives. And, it takes talking about it with other people to apply it.
People, instructors, pastors, mature Christians can help you gain the self-insight needed to really determine where your stumbling blocks are. Sharing and accountability help us stay focused and commit to the spiritual exercise, assistive devices, and work required to maintain ‘fertile soil.’
I’ve mentioned before, the three types of medications prescribed most commonly in the United States treat anxiety, depression, and pain. I propose CONTROL is in the midst of this frequent prescribing.
What happy, exciting things do you anticipate for 2017?
What fears, concerns, or dread do you have for 2017?
How much control do you have over the good things you anticipate?
How much control do you have over the things that concern you?
How well do you deal with the instances where you have no control?
I have had patients who rarely leave their house for fear of what could happen while out that they wouldn’t be able to control. Some fear injury or accident. Some fear having to interact with other people. Some fear having to make a decision for which they’re not prepared.
Other patients have had bad experiences they were unable to control. Someone they loved died, left, or now rejects them. In other cases, they were in an accident, hurt by someone, or had some other negative event they fear could repeat.
All of this worry directly impacts rates of anxiety, depression, and even pain. When worry doesn’t find an outlet, it can lead to pain, often chronic pain.
Letting go of control
Want to ease into 2017 with less burden and more lighthearted joy? Try letting go!
The Serenity Prayer that is prayed in 12-step programs is:
‘God grant me the serenity to accept the things I cannot change,
Courage to change the things I can,
and the Wisdom to know the difference.’
This is a powerful prayer. It acknowledges that there is so much beyond our control. Try as we might, we just cannot control or change some things.
For instance, I know a lot of people are incredibly tense about the implications of a new president in2017. They stew about the ‘what-ifs’. They worry about all of the things that could go wrong. They read each prediction, especially from the sources that don’t support the newly elected official. It’s all they think about, talk about, read about, watch on TV. They get more and more anxious as they continue on this circular path.
I know people who fear certain diagnoses such as cancer, heart disease, or Alzheimer’s Disease. They jump on any unusual symptom. Their frequent use of the medical system often leads to the prescribing of several medications. All of these medications interact causing problems of their own. As the person feels worse, the more they fall down this negative slippery slope.
Hope for 2017
Consider how the Serenity Prayer could be your mantra for 2017. Spend your energy, thoughts, and time on things that are positive. Do the things you enjoy. Spend time with those who love and support you. Reach out and help others.
For the many, many things in this world that could go wrong – Let It Go! If you can’t control it, admit that and let it go.
This change could actually mean less anxiety, less depression, and less pain.
For more information about the link between control and health, please contact us at 410-472-5078 or www.medsmash.com/contact.
Here is the full Serenity Prayer. I had never heard/read it until recently.
God, give me grace to accept with serenity
the things that cannot be changed,
Courage to change the things
which should be changed,
and the Wisdom to distinguish
the one from the other.
Living one day at a time,
Enjoying one moment at a time,
Accepting hardship as a pathway to peace,
Taking, as Jesus did,
This sinful world as it is,
Not as I would have it,
Trusting that You will make all things right,
If I surrender to Your will,
So that I may be reasonably happy in this life,
And supremely happy with You forever in the next.
I love this! I plan to print it and keep it where I can read it frequently until I can memorize it. What a beautiful prayer for each and every day.
Let Go and Let God!
This is a prime example. Give up control and give it all to God who actually knows what to do with it all.
Peter and Paul very directly give us guidance on how to handle our anxieties.
Do not be anxious about anything, but in everything by prayer and supplication with thanksgiving let your requests be made known to God. And the peace of God, which surpasses all understanding, will guard your hearts and your minds in Christ Jesus.
Casting all your anxieties on him, because he cares for you.
As hard as it is to let go of our very human desire to control, WOW, we will feel so much better when we truly give it all to God! (Please keep reminding me as I’ll keep reminding you. Satan DOES NOT want you to remember and apply this on a daily basis.)
“Come to me, all who labor and are heavy laden, and I will give you rest. Take my yoke upon you, and learn from me, for I am gentle and lowly in heart, and you will find rest for your souls. For my yoke is easy, and my burden is light.”
What do these words mean to you? What role do they play in your everyday life?
Wow, I am amazed how much information is available on this important link between gratitude and health. Just search for these two terms and see what all you will find.
What is gratitude?
This is being aware of all of the good things in your life. And it is being thankful for those things. Have you considered being grateful for:
A safe place to sleep
Food to eat
Clothes to cover yourself
Having a friend to call
Your job – current or past
A beautiful day
This simple awareness of and being thankful for these ‘little’ things can boost your health.
Note, it doesn’t have to be the biggest house or the softest bed or the tastiest food or the latest fashion clothing to be grateful. Gratitude focuses on what you have – all of the good things – rather than what you don’t have.
There are many ways you can make gratitude part of your life. Here are a few recommended in a Harvard Mental Health newsletter:
Write a thank-you note
Go up and thank someone
Keep a gratitude journal
Keep a list of your thanks = count your blessings
See your day and your health improve by focusing on the positive.
Even therapy for mood disorders and approaches to negative thinking know this truth. I am quoting this from Rick Warren, “When you change the way you think, it changes the way you feel. And when you change the way you feel, it changes the way you act.”
On this Independence Day weekend, as a country, we have much reason for gratitude!
Have you ever been in a ‘funk’ having a bad day and then remembered to be grateful? I have done this so many times. When all looks dark and gloomy, make yourself think about all of the things that are good and right.
Give thanks in all circumstances; for this is the will of God in Christ Jesus for you.
I’ll quickly admit I don’t always think to do this. I stay in that dark place far too long. Later, once I’m out I realize I had the ‘magic potion’ to leave that darkness behind. It was given to us by Christ when he died to erase our sins. It was given to us by God who maintained His love and focus on the good in the Jews through centuries of missteps (just as we live a series of missteps).
Every good gift and every perfect gift is from above, coming down from the Father of lights with whom there is no variation or shadow due to change.
I feel energized, positive, and excited just reading these verses full of hope and promise! I am thankful for each person who takes the time to read this. May you be blessed by these assurances from God!
I pray you can stay focused on the many good things in your life this week and that can keep you out of the dark, gloomy places.
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.
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.
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.
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.
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
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
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
Warm, dry change of clothes and a blanket (in a water proof bag if in wet conditions)
Written list of:
allergies, including what happens if you take that medication or eat that food
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.
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!
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?
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?
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.
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?
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.
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:
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.
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.
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.