Prevention

Serenity

Happy in 2017 – Let Go of Control to Find Health

Posted on by Michelle Fritsch, Pharm.D.
Serenity
Let go of control and let go of anxiety, depression, and pain

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?

CONTROL

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.

BIBLICAL APPLICATION

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.

Amen.

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.

Philippians 4:6-7 ESV

Do not be anxious about anything, but in everything by prayer and supplication with thanksgiving let your requests be made known to God. And the peace of God, which surpasses all understanding, will guard your hearts and your minds in Christ Jesus.

1 Peter 5:7 ESV

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.)

Matthew 11:28-30 ESV

“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.”

Blessings as you Let it Go,

Michelle

Image source: Winter Icon by Gwebwt.blogspot.com

Thanksgiving – Gratitude keeping you Healthy

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

Gratitude, grateful, thankful, thanksgiving, appreciation

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

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

What is gratitude?

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

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

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

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

Expressing gratitude can:

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

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

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

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

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

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

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

BIBLICAL APPLICATION

We have so many reasons to be grateful!

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

1 Thessalonians 5:18 ESV

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

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

Lamentations 3:23 ESV

They are new every morning; great is your faithfulness.

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

Psalm 118:24 ESV

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

Colossians 3:17 ESV

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

Psalm 136:1 ESV

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

Ephesians 1:16 ESV

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

James 1:17 ESV

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

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

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

Blessings,

Michelle

 

The Dominoes of Medication – Avoid the Tipping Point

Posted on by Michelle Fritsch, Pharm.D.
slide1
Follow these steps to prevent sudden confusion in the hospital like a series of falling dominoes.

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

Hospitalization and memory or behavior changes

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

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

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

Elective procedures

Another all-to-familiar scenario is similar:

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

How can you better navigate these scenarios?

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

Talk with the healthcare team about taking the following steps:

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

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

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

BIBLICAL APPLICATION

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

1 Corinthians 14:33a ESV

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

David and other Psalm writers struggled to understand.

Psalm 119:169 ESV

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

Psalm 119:34 ESV

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

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

Romans 3:21-24 MSG

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

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

Hebrews 13:8 ESV

Jesus Christ is the same yesterday and today and forever.

Blessings,

Michelle

Emergencies and Medications – Are You Prepared?

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

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

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

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

Preparing for Emergencies

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

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

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

Prescription Medications

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

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

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

BIBLICAL APPLICATION

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

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

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

Matthew 8:23-27 ESV

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

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

2 Corinthians 12:9 ESV

But he said to me, “My grace is sufficient for you, for my power is made perfect in weakness.” Therefore I will boast all the more gladly of my weaknesses, so that the power of Christ may rest upon me.

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

Psalm 46:10 ESV

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

Nahum 1:7 ESV

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

Deuteronomy 31:6 ESV

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

Praise be to God, our strength in the storm.

Blessings,

Michelle

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

 

 

 

 

Quality of Life – your attitude and health

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

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

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

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

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

Your attitude

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

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

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

Great example

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

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

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

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

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

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

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

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

(Copied from this source.)

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

BIBLICAL APPLICATION

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

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

Doesn’t that negatively impact your day?

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

1 Timothy 6:6-7 ESV

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

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

1 Timothy 6:11-12 MSG

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

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

Ephesians 4:31-32 MSG

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

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

Ephesians 4:1-3 MSG

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

Blessings,

Michelle

 

 

 

Preventing Falls – New Tools and Resources

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

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

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

Falls Risk Factors

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

Medications

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

Medical conditions

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

In your home

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

Other

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

Wow, and this is just a partial list!

New Falls Prevention Resources

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

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

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

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

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

BIBLICAL APPLICATION

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

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

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

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

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

Ephesians 2:1-6 MSG

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

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

2 Corinthians 5:17 ESV

Therefore, if anyone is in Christ, he is a new creation. The old has passed away; behold, the new has come.

Ephesians 2:8-9 ESV

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

Romans 8:38-39 ESV

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

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

Blessings,

Michelle

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

30 Days – CMS and Hospitals Share Risk – Input Desired

Posted on by Michelle Fritsch, Pharm.D.
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Technology is being developed to help you stay healthy and out of the hospital 30 days.

The Centers for Medicare and Medicaid Services (CMS) are striving to keep healthcare affordable. Healthcare is expensive. Healthcare is necessary. We all need it at some time or another. It is best if medical conditions that require hospitalization are fully treated while in the hospital. CMS wants to pay for these conditions just once. So, to help make sure they are fully treated and that patients are sent home with all they need to stay healthy, there is now a shared risk payment model. If someone returns to the hospital within 30 days of discharge, then CMS will not pay for that second visit. (Of course it is all more complex than this paragraph describes).

So, there are a number of very smart people working hard to increase the success of people going home from the hospital to help them not return. At least making sure people don’t return for the same problem within 30 days.

There are people working on tools to help keep medication regimens straight. Others are working on ways to monitor health so if it starts to get worse an adjustment can be made at home. This could prevent a need to go back to the hospital. These tools can monitor blood pressure, blood sugar, weight, oxygenation, and more. There are also tools to monitor in-home activity, measure falls risk, and respond when someone has fallen. Much of the follow up after a hospitalization can occur more frequently and simply with telehealth. This means talking with your doctor, nurse, pharmacist, or other provider over the computer.

There is an explosion of new technology. The issue now is to determine which types of technology are most effective. It is also to determine which types really help people get better. And ideally, the best technology will help people stay better for a long time.

Then there is the issue of how people, the patients, feel about the technology. Some are very excited to have new ways to monitor their own health. Look at the growth and acceptance of wearable devices. Some popular examples are Fitbit, Apple watch, and Garmin Forerunner, and TomTom. Spark.

  • I can find a lot of information about how the technology is proposed to help people safely go home and stay healthy enough to stay out of the hospital.
  • I can find some information demonstrating that these really do cut down on the number of people that bounce back to the hospital.
  • I can find very little data about how people feel about the use of such technology, especially for at least 30 days.

Hospitals are preparing to spend millions of dollars on these solutions. For the money saved by reducing readmission, the hospital and the solutions companies will share those dollars.

  • So what do you think?
  • Are you excited about the use of technology to help you stay healthy?
  • Do you see more advantages or disadvantages?
  • Have you experienced some of these technologies when you or a loved one has been discharged from the hospital?

I would love to hear your thoughts. Please send your questions, your ideas, and your opinions to us at www.medsmash.com/contact.

BIBLICAL APPLICATION

Another thing that I’ve been pondering about 30-day readmission rates is the usefulness of short term solutions. I might have to write about that next week.

I find that topic to be really relevant in my Christian life as well. I love the ‘mountaintop’ experiences. These are the times when you are absolutely on fire for God. They are the times when you are closest to God. They are the times when you most directly feel God’s presence.

At those moments, what do you plan to do? Do you agree with me that it feels like you’ll be able to stay in that intimate place for a long time? How long do those intentions really last?

Have you ever made plans during those times when you felt most intimate with God? Did you make some promises? Did you decide your were going to make big changes in your life? I know I have.

Even now, just two weeks back from a life-changing experience in Jamaica, I’ve fallen back into old habits. I’m putting my needs and desires before other people. I’m way less focused on all that I could be doing for others. I’m more focused on my own aches and pains again. This is not what I intended. It is not what I told myself or God I would do when I got back.

Romans 8:5 ESV

For those who live according to the flesh set their minds on the things of the flesh, but those who live according to the Spirit set their minds on the things of the Spirit.

I really, truly want to live according to the Spirit. Yet my progress often feels like two steps forward, one step back.

Do you have the same experiences?

So each day, I strive to stay focused. I try to keep my eyes on God.

Colossians 3:2 ESV

Set your minds on things that are above, not on things that are on earth.

Every day I fail at some point, or a lot of points. But, I also have more of those moments of intimacy. I feel better in every way when I make that time for God. (And knowing that, I still charge right past that time to get on with the to-do list of the day).

Proverbs 16:3 ESV

Commit your work to the Lord, and your plans will be established.

So today, I will strive again to stay focused on God’s plans. I will strive to keep my ‘spiritual eyes’ on and see the needs of those around me. I will keep working toward the long-term goal rather than a short-term solution.

Blessings,

Michelle

Hate and Health – Surviving These Days

Posted on by Michelle Fritsch, Pharm.D.

Hate and ugliness can shape your life. It often comes out of nowhere. How you deal with it has a huge impact on your health.

You often can’t prevent it. You can’t predict. It hits you out of nowhere, so you can’t prepare for it. Yet, hate and ugliness touch most, if not all, of us at some time at least once.

What is the ugliest event that has occurred in your life? How have you been touched by hate? How did you handle it at the time? How have you handled it since?

As a nation and a global community we have seen and experienced acts of hate in so many forms recently. There is unrest stirred by fear, threats, and acts of terror. If this fear takes over in your life, your stress levels increase, your heart works harder, your risk of depression goes way up, anxiety increases, sleep is impaired, and your overall health declines.

Last week I talked about the health benefits of thinking about other people and their needs rather than focusing just on yourself. Altruism is very directly linked to improved health.

The other thing that was directly related to this particular medical mission to Jamaica from which I just returned was a tragic act of hate. The group with whom I worked, Teams for Medical Missions, www.t4mm.org, has been served for many years by long-term missionary couples in Jamaica. These couples have developed programs for children, programs for youth, programs to train ministers for local churches, built many houses, provided chronic and acute medical care by hosting medical mission teams, and so much more. They are Christian missionaries with a real passion for the people of Jamaica, in particular those in the more rural and underserved area of St. Mary Parish.

At the end of April, the two men of these couples were riding their motorcycles on some trails at the top of a mountain known to have beautiful views of the island. Two young men were in that area and heard the motorcycle motors. They decided to wait in a particular place where the motorcycles were sure to pass and ambush them. Both missionaries were killed. It was not a targeted act, just a needless act of hate.

This shook the entire island. The young men who had been actively served by events hosted by these couples for years now stay close to the wife who remains, and they have been staying at her house so she is not alone. The Prime Minister, head of island security, and many others have come to show their respect. Many people have expressed their sorrow in many tender ways.

These medical teams typically provide care in provisional clinics in four local churches once a quarter. People are given a 3-month supply of medication for chronic illnesses, and acute illnesses are treated. Many people in that Parish rely on those clinics for their medical care. I had the humbling experience of seeing the love and gratitude shared with the missionary wife and all of the team members. (All had been on these teams several times and knew the slain missionaries well. This was a very emotional trip for all who were simultaneously grieving and expressing the desire to keep moving forward.) Many residents expressed surprise the clinics were continuing. There was an expectation the mission would fold and return to the US after these deaths.

In spite of these acts of hate, the hope continues. Teri, an incredibly strong and faithful woman is staying and planning what the future can hold in this completely new scenario. Her grief is real and raw. Yet, she is not curled in a corner refusing to move forward.

Health in the midst of hate

The elements that are associated with maintaining health in the midst of hate are:

  • friends to talk to
  • people who care about you
  • a sense of self-worth
  • forgiveness
  • security
  • conflict management skills
  • religion/spirituality

These have all been linked with improved health.

And I will add having a source of HOPE. I believe hope is powerful in the midst of difficulty.

So, knowing that hate and ugliness can strike at any time, the best you can prepare is to take care of yourself, cherish your friends and family, develop your conflict management skills, and forgive others. Find your personal source of hope.  Like Teri, find ways to find hope and stay positive and undeterred in the face of hate.

For more information about hate and health, contact us at www.medsmash.com/contact.

BIBLICAL APPLICATION

Hate, terror, oppression, racism, and other ugliness are all around. And, the Bible gives us indication this will only get worse.

2 Timothy 3:1-5 MSG

Don’t be naive. There are difficult times ahead. As the end approaches, people are going to be self-absorbed, money-hungry, self-promoting, stuck-up, profane, contemptuous of parents, crude, coarse, dog-eat-dog, unbending, slanderers, impulsively wild, savage, cynical, treacherous, ruthless, bloated windbags, addicted to lust, and allergic to God. They’ll make a show of religion, but behind the scenes they’re animals. Stay clear of these people.

I believe our role in these days is three fold:

  1. Be prepared

1 Peter 3:14-16 ESV

But even if you should suffer for righteousness’ sake, you will be blessed. Have no fear of them, nor be troubled, but in your hearts honor Christ the Lord as holy, always being prepared to make a defense to anyone who asks you for a reason for the hope that is in you; yet do it with gentleness and respect, having a good conscience, so that, when you are slandered, those who revile your good behavior in Christ may be put to shame.

  1. Be discerning

Matthew 24:4-8 MSG

Jesus said, “Watch out for doomsday deceivers. Many leaders are going to show up with forged identities, claiming, ‘I am Christ, the Messiah.’ They will deceive a lot of people. When reports come in of wars and rumored wars, keep your head and don’t panic. This is routine history; this is no sign of the end. Nation will fight nation and ruler fight ruler, over and over. Famines and earthquakes will occur in various places. This is nothing compared to what is coming.

  1. Be reaching out

Philippians 2:1-4 MSG

If you’ve gotten anything at all out of following Christ, if his love has made any difference in your life, if being in a community of the Spirit means anything to you, if you have a heart, if you care— then do me a favor: Agree with each other, love each other, be deep-spirited friends. Don’t push your way to the front; don’t sweet-talk your way to the top. Put yourself aside, and help others get ahead. Don’t be obsessed with getting your own advantage. Forget yourselves long enough to lend a helping hand.

And another version of my favorite verses of the year about hope!

Romans 5:3-5 MSG

There’s more to come: We continue to shout our praise even when we’re hemmed in with troubles, because we know how troubles can develop passionate patience in us, and how that patience in turn forges the tempered steel of virtue, keeping us alert for whatever God will do next. In alert expectancy such as this, we’re never left feeling shortchanged. Quite the contrary—we can’t round up enough containers to hold everything God generously pours into our lives through the Holy Spirit!

Blessings,

Michelle

To feel better – do for someone else – altruism

Posted on by Michelle Fritsch, Pharm.D.
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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

Vaccines – Important part of your travel plans

Posted on by Michelle Fritsch, Pharm.D.
Flu vaccine CDC
Ask your doctor or pharmacist about vaccines needed before international travel.

What are your views about vaccines? Are you up-to-date? When was your last check-up appointment with your primary care provider?

What exotic locations are on your bucket list?

There has been a lot of discussion, many articles, and many opinions shared about vaccination.

Vaccines protect you from communicable diseases. Vaccines also protect other people. For each kind of vaccine, there are some people who have medical conditions that prevent them from receiving the vaccine. So, they rely on those around them to not have the disease and spread it to them.

The Centers for Disease Control (CDC) monitors diseases across the country and the world. Viruses and bacteria can change over time. If these changes make a former vaccine less effective, then guidelines change. So, your vaccine needs change based on these recommendations.

Then there is the issue of travel. Different parts of the world pose risk of various diseases.

I have been updating my understanding of the importance of travel vaccines as I prepare for this medical mission trip to Jamaica. The vaccines recommended for Jamaica are different than those recommended for other areas.

I heard a very sad story recently about two very charitable and successful brothers who traveled to Ghana. One chose to not take precautions for malaria. Once home he acquired a fever and felt poorly.   He saw his doctor who gave him some self care strategies. His condition then declined further. Once it was realized he had malaria, it was too late. So, when you do travel abroad and become ill, immediately tell healthcare providers exactly where you have been. In the US we so rarely see some diseases that we don’t look for them.

I encourage you to travel and explore the world! I also highly encourage you to talk with your doctor and your local pharmacist about any travel vaccines you should obtain prior to your travels. You can learn more about CDC recommendations at this link.

As fall approaches we will talk more about flu, pneumonia, and shingles vaccines in more detail. These are important even if you don’t travel.

For more information about vaccines, please contact us at www.medsmash.com/contact.

BIBLICAL APPLICATION

Vaccines protect you against disease. And God provides you with protection against evil dark forces. We are reminded again and again of His constant love and protection.

Isaiah 41:10 ESV

Fear not, for I am with you; be not dismayed, for I am your God; I will strengthen you, I will help you, I will uphold you with my righteous right hand.

Doesn’t that sweep over you like a big wave of calm? Fear not. God has your back.   God has plans for you. God is with you in each and every circumstance. God is with you no matter where you are or what is happening.

2 Timothy 4:18 ESV

The Lord will rescue me from every evil deed and bring me safely into his heavenly kingdom. To him be the glory forever and ever. Amen.

We all make mistakes. We all sin. These promises and assurances of rescue are so comforting.

2 Thessalonians 3:3 ESV

But the Lord is faithful. He will establish you and guard you against the evil one.

James 4:7 ESV

Submit yourselves therefore to God. Resist the devil, and he will flee from you.

You have a God who loves you and will protect you.

Blessings,

Michelle

Image source: Centers for Disease Control, Department of Health & Human Services, US Public Health Service