Prevention

Your Amazing Kidneys – what do they do exactly?

Posted on by Michelle Fritsch, Pharm.D.

Kidneys - NIH ADAM

Your kidneys clean the blood and manage water

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

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

Your kidneys have several functions

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

Your kidneys have several parts

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

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

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

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

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

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

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

BIBLICAL APPLICATION

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

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

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

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

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

Romans 3:23 (NIV)

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

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

Romans 3:21-24 (MSG)

Since we’ve compiled this long and sorry record as sinners (both us and them) and proved that we are utterly incapable of living the glorious lives God wills for us, God did it for us. Out of sheer generosity he put us in right standing with himself. A pure gift. He got us out of the mess we’re in and restored us to where he always wanted us to be. And he did it by means of Jesus Christ.

Jesus died to cleanse YOU of all of your sin.

1 John 1:9 ESV

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

1 John 1:7 ESV

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

Titus 3:5 ESV

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

2 Corinthians 7:1 ESV

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

Romans 12:2 ESV

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

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

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

Blessings,

Michelle

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

Your amazing liver

Your Amazing Liver – what does it do exactly?

Posted on by Michelle Fritsch, Pharm.D.
Your amazing liver
Your liver breaks down medication and many other functions.

You have a liver. Do you have any idea what it does? I would venture a guess that most people don’t.

The liver sits in the upper right quadrant of your abdomen. When your doctor presses on your abdomen and puts fingers up under your ribs, that is what is being checked. Usually they won’t feel it or maybe just feel the very edge.

The liver has several functions:

  • Clotting factors in your blood are produced
  • Proteins in your blood are produced
  • Triglycerides and cholesterol are made
  • Stores vitamins
  • Removes toxins, such as ammonia, from the blood
  • Processes nutrients from our food
  • Regulates sugar in the blood
  • Metabolizes (breaks down) alcohol and medications

Of course it is the medication part that I am anxious to talk about.

What does the liver do to medication?

There are several types of enzymes in the liver.

These enzymes change the form of medications. They usually break medications down to a less active form. This also allows the medication to be processed and then to leave the body. If this slows down, then the medication stays in active form longer giving the medication a bigger effect and making it last longer.

Different medicines are broken down by different enzymes. Most of these enzymes are cytochrome P450 (CYP450)enzymes. There are several different CYP450 enzymes, each impacting different medications.

Some people have genetic differences that change those enzymes. For instance, a particular enzyme can be less active in some people based on their genes. This will make that medication more active, sometimes even toxic, for that person. It is becoming more common for people to be tested for any genetic changes that can help guide best medication use.

When there is more than one medication that is metabolized by the same enzyme that can change how those medications are broken down. This is where it really gets complicated. Some medications will induce the enzyme, or make it more effective. Others will inhibit the enzyme making it less effective. While others compete for the activity of the enzyme. These actions and interactions impact how well the medicine works and the amount of side effects it will have.

Even tobacco, some food, and herbs can impact the enzymes.

So, when your pharmacist is filling your prescription, there is SO MUCH more they are looking at than just getting the right number of tablets in to the bottle. The potential interactions need to be carefully screened each time any of your medicines are changed.

AND, this screening can only be complete if your pharmacist also knows what herbs, vitamins, over-the-counter, and other substances you take.

Pay attention to the extra instructions on your medicine label. These liver enzymes are often the reason for special instructions such as ‘avoid grapefruit’ or take at particular times of the day (to separate from other medications).

If you would like to know more about the liver and how liver enzymes impact medications, contact us at www.medsmash.com.

BIBLICAL APPLICATION

Just as the liver has a very specific function within the body, each element of the armor of God has a specific function.

Ephesians 6:10-17 NIV

Finally, be strong in the Lord and in his mighty power.  Put on the full armor of God, so that you can take your stand against the devil’s schemes.  For our struggle is not against flesh and blood, but against the rulers, against the authorities, against the powers of this dark world and against the spiritual forces of evil in the heavenly realms.  Therefore put on the full armor of God, so that when the day of evil comes, you may be able to stand your ground, and after you have done everything, to stand.  Stand firm then, with the belt of truth buckled around your waist, with the breastplate of righteousness in place, and with your feet fitted with the readiness that comes from the gospel of peace.  In addition to all this, take up the shield of faith, with which you can extinguish all the flaming arrows of the evil one.  Take the helmet of salvation and the sword of the Spirit, which is the word of God.

To take advantage of the full protection available to you, put on each piece of armor. Keep each functioning in its most complete and efficient form through prayer and reading the Bible.

If you’ve so much as glanced at the news in the last few weeks, you know that the ‘power of this dark world’ seems to be out in full force. People are hurting people all over the place.

Go out into this hurting world with your truth, righteousness, faith, assurance of salvation, and the Word securely in place.

Now is the time to have some scripture memorized or in your phone where you can reinforce your own understanding or reach out to others in an instant. That sword of the Spirit might be just what someone needs.

I’m praying for the hurt, the evil, the grief, the biases, the fear that separates us from each other and from turning to the love of God. May you be a light in this darkness.

Blessings,

Michelle

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

Gratitude

Gratitude – keeps you healthier

Posted on by Michelle Fritsch, Pharm.D.
Gratitude
Being thankful for what you have improves 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 being thankful 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 thankful 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.  Try starting your day with a list of things for which you are thankful.  On those nights you can’t sleep, name all of the good things in your life.  Let that override the worries and things you can’t control.

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

Aging effects

Aging – the good, the bad, the medication issues

Posted on by Michelle Fritsch, Pharm.D.
Aging effects
Changes come with aging – some impact best medication use.

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

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

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

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

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

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

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

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

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

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

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

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

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

BIBLICAL APPLICATION

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

Romans 5:3-5 NIV

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

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

Proverbs 16:31 ESV

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

Psalm 71:18 ESV

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

Psalm 92:12-15 ESV

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

Psalm 71:9 ESV

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

Proverbs 20:29 ESV

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

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

2 Corinthians 4:16 ESV

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

Blessings,

Michelle

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

Sunscreen – Necessary protection or just a nuisance?

Posted on by Michelle Fritsch, Pharm.D.
clipart-sun-opT55BpiB
Protect your skin with sunscreen this summer. Rest in the protection of the Son!

It is that sunburn time of year. Do you wear sunscreen? If you do, do you wear it every day? Do you just wear it when you are going to the beach?

I’ll start by admitting I have made nearly every sun protection mistake, so this blog comes from scientific research, reputable articles, and a little ‘school of hard knocks.’

Sunscreen for Babies

The American Academy of Pediatrics does not recommend sunscreen for infants under 6 months of age. Their skin functions are still developing. It is best to keep them out of the sun. But, if parts of them must be in the sun, a little bit of SPF 15 sunscreen is better than unprotected skin. Sun blocks are most protective. Look for ingredients of zinc oxide or titanium dioxide.

Sunscreen for everyone else

Suncreen is important to protect your skin.

Why?

Sunscreen can protect against skin cancer, age spots, and skin damage from the sun. It can also help prevent actinic keratoses, which are not cancer but are big brown spots. It can also protect against rashes and reactions to the sun (photosensitivity) that some people get.

How much? 

For an average size adult in a swimsuit, the proper amount is enough to fill a 1 ounce (30mL) shot glass.

When?

Chemical sunscreen products need to be applied 30 minutes before sun exposure because they need to be absorbed to protect your skin, but products containing zinc oxide or titanium dioxide protect right away. Reapply after each dip in the water and at least every 2 hours.

Which kind?

Interestingly, SPF 30 is NOT twice as good as SPF 15. When a proper amount is applied (see above), SPF 15 sunscreen absorbs 93% of UVB radiation. SPF 30 absorbs 97%, and SPF 50 absorbs 98%. Using SPF greater than 50 doesn’t really add any benefit.

So, if you put on the recommended amount and replace as recommended, SPF 15 is enough. If you put on a light layer or don’t repeat as often as you should, use SPF 30 or 50.

What if I have dark skin or already have a tan?

Studies have not found that this protects you. Skin protection is still important not only for sunburn but also for cancer and other skin damage. So, keep on wearing that sunscreen, even after you get tanned.

What else can cause me to burn?

There are several medications that cause you to be more sensitive to the sun. If you take these, your risk of sunburn is much greater. Some of the more common ones are:

  • Tetracycline or doxycycline (antibiotic – used for acne and Lyme’s disease and other infections)
  • Hydrochlorothiazide or furosemide (diuretic/water pill)
  • Sulfa antibiotics (SMX/TMZ, Bactrim, Septra)
  • Fluoroquinolone antibiotics (Cipro, Levaquin, and others)
  • Nonsteroidal anti-inflammatory drugs (NSAIDs) – (piroxicam, ketoprofen, maybe ibuprofen or naproxen)
  • Phenothiazines – antipsychotic agents

Check with your pharmacist or look on the written information that comes with your prescription for the word ‘photosensitivity’ in the side effects.

Besides using sunscreen, keeping your skin covered with clothes, hats, or umbrellas can provide protection.

If you have a history of prolonged sun exposure, you have new brown or other colored spots on your skin, or you have spots that are changing, make an appointment with a dermatologist. Skin cancer screening is quick and can save your life. Don’t delay or wait to see with these skin changes.

For more information about sunscreen contact us at www.medsmash.com.

BIBLICAL APPLICATION

The sun is such a critical part of our existence. Yes it can harm us.

The Son is such a critical part of our existence. He can protect us.

What does that protection mean? Will you be without any trouble? If God is on your side, will no one be against you?

No, it doesn’t work like that. We are assured that trouble will come. We are assured we will be tempted,

2 Corinthians 4:8-9 TLB)

We are pressed on every side by troubles, but not crushed and broken. We are perplexed because we don’t know why things happen as they do, but we don’t give up and quit. We are hunted down, but God never abandons us. We get knocked down, but we get up again and keep going.

Knowing who is on our side and protecting us helps us through the trouble.

Psalm 121: 5-8 MSG

God’s your Guardian,

    right at your side to protect you—

Shielding you from sunstroke,

    sheltering you from moonstroke.

 

God guards you from every evil,

    he guards your very life.

He guards you when you leave and when you return,

    he guards you now, he guards you always.

So go on out into the sun relying on the protection of the Son in your life. Go where He leads with the assurance of His love and oversight.

Proverbs 3:5-6 MSG

Trust God from the bottom of your heart;

    don’t try to figure out everything on your own.

Listen for God’s voice in everything you do, everywhere you go;

    he’s the one who will keep you on track.

 

Enjoy these sunny days with confidence!

Blessings,

Michelle

U-Turn ahead – not too late to turn your health around

Posted on by Michelle Fritsch, Pharm.D.
Slide1
Turn your health around. Make changes to improve your health.

Is it too late to turn your health around? Although we were raised certain ways we can still make a U-turn, or at least navigate a big curve. I was raised with dessert every day, lots of processed foods, little to no access to seafood, and limited fresh vegetables beyond summer. Meals were built around meat and potatoes. As for exercise, anyone who knows me can attest to my utter lack of athletic ability. So, should we settle for life-long habits and figure it’s too late to make changes now?

Actually, there is a LOT of evidence that changes, at all stages of life, still help you. Below are just a few of the most common habits/choices that can be changed in a way that really makes you feel better.

Changes to turn your health around

  • Quit smoking –
    • Just 20 minutes after you quit your blood pressure and heart rate decrease.
    • Your risk of a heart attack starts to go down at 24 hours.
    • Taste and smell start to improve at 48 hours.
    • After 1-5 years your risk of heart disease is cut in half.
    • After 10 years your risk of lung cancer is almost as low as a lifelong nonsmoker.
  • Weight loss – short and long term
    • Small weight loss can have big advantages.
    • If you lose 5-10% of your body weight, your blood pressure, blood sugar, and cholesterol all improve.
    • Your risk of heart disease goes down.
    • It gets easier to breathe.
    • Sleep apnea can improve helping you sleep better and be less sleepy during the day.
    • Your sex drive
    • Joint pain
  • Diet changes –
    • Decreasing your daily calories by 500-1,000 per day will decrease weight 1-2 pounds per week. [Faster weight loss is not as healthy and hard to sustain.]
    • Gradually add more interesting fruits and vegetables to your diet.
      • Sudden, drastic changes are not necessary and are hard to do.
      • More variety in fruits and vegetables will increase the types of vitamins and nutrients you get.
    • Change up your fat
      • Exchange some of your red meat meals for fish (your grocery store meat section will likely have instructions on how to prepare whatever is on sale or available in the meat section).
      • Try nuts for snacks over sugary snacks.
    • Sugar
      • Drink more water or unsweetened beverages in place of sugary soda or fruit juice.
      • Eat smaller portions of your dessert, as a starting point to cut back.
  •  Exercise
    • Get moving – it helps with more than just weight control.
    • Decrease joint pain and strain, especially your lower back.
    • Get stronger and be more resilient against small strains and sprains.
    • Be more flexible.
    • Decrease your risk of a fall that could injure you.
    • Stay healthy and independent longer through fitness.
    • Have more energy and stamina.
    • Exercise doesn’t have to mean joining a gym or playing a sport.
      • Get up and move around during commercial breaks on TV.
      • Park farther from the front door.
      • Go for a walk with a friend.
      • Window shop in all of the stores at the mall before making a purchase.

U-turns are allowed in your life. No matter your age and for how long you have been doing things a certain way, make a change. Turn your health around. See how much better you can feel with very small changes starting today.

For more information about healthy choices and making a U-turn, contact us at www.medsmash.com.

BIBLICAL APPLICATION

Are you drowning in your negative self-talk? Are you always striving to do better? Or, are you constantly making excuses and blaming others for your weaknesses?

These are such easy routes to take! They are such easy ruts to fall into.

Will you ever be at peace and feel that all is right in your world? What would that take?

My understanding of the Bible is that the peace and promise you’re seeking is available to you RIGHT NOW.

There is nothing you have done that God doesn’t already know about. You can’t hide. Rather than being terrified by that, realize you are loved. You are loved and accepted and forgivable. Absolutely nothing you have done could make God turn away from you.

1 John 4:18 ESV

There is no fear in love, but perfect love casts out fear. For fear has to do with punishment, and whoever fears has not been perfected in love.

Grace, mercy, and forgiveness are right here waiting for you.

Romans 5:8 ESV

But God shows his love for us in that while we were still sinners, Christ died for us.

You could absolutely never do anything so terrible that would exclude you from the love and grace of Jesus Christ.

It was this love that led to Jesus’ death – all for your sins and mine. And because of that sacrifice, you are saved.

Let’s look again at 1 John 4:17-18 from The Message:

God is love. When we take up permanent residence in a life of love, we live in God and God lives in us. This way, love has the run of the house, becomes at home and mature in us, so that we’re free of worry on Judgment Day—our standing in the world is identical with Christ’s. There is no room in love for fear. Well-formed love banishes fear. Since fear is crippling, a fearful life—fear of death, fear of judgment—is one not yet fully formed in love.

Not only can you take a U-turn in your daily physical health choices, you can take a U-turn in your spiritual health. Stop hiding. Stop beating yourself up. Embrace this love that is completely yours. You are forgiven as soon as you let go and give your all to God who loves you with no conditions.

Blessings,

Michelle

 

Are Your Medicines Improving Your Quality of Life?

Posted on by Michelle Fritsch, Pharm.D.
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Quality of life should be preserved and enhanced with your medication.

Medications have two main purposes.

  • One is to increase your QUALITY of life. They relieve or control the symptoms that make it hard to do our daily tasks. Quality of life is your ability to enjoy and engage in your life. It is your ability to do the things you want to do during the day.
  • The other is to increase your QUANTITY of life. They help control medical conditions so you can live longer.

ALL medications have potential side effects. Some of these side effects are a minor nuisance that goes away. Some of these side effects are so severe you are changed to a different medicine. Then there are some times when another medicine is started to treat the side effects of the first medicine. In most situations I highly discourage this practice. There are a few select exceptions.

Medications and Quality of Life

This blog is about the medications that are prescribed to help you live better. Using them is intended to improve your quality of life. But, they have side effects that keep you from functioning normally. Those side effects actually decrease your quality of life. Here are a few examples:

  • Pain medication for back pain makes you so sleepy you just lay around.
  • Blood pressure medicine makes your blood pressure so low you don’t have the energy to do regular daily tasks or you get really dizzy when you stand up or turn quickly.
  • Anxiety medicine keeps you so groggy you can’t function.
  • Sleep medicine keeps you sleepy all through the next morning.
  • Diabetes medicine makes your blood sugar so low you are weak, shaky, and dizzy.
  • Parkinson’s Disease medicine makes you so dizzy you can’t go out.
  • Incontinence medicines makes you so constipated you are miserable.

It doesn’t make sense for a medicine intended to help to actually cause just as many problems as the thing it was prescribed to treat. Talk to you doctor! Your doctor might not know unless you talk about it. Your relationship with your doctor should include conversations about your goals. Let your doctor know what daily events and tasks are important to you. Then, work together to reach those goals through medication, physical therapy, counseling, diet, or other means.

We are here to help, too! At Meds MASH we will carefully review all of your medicines to be sure you are getting the maximum benefit with the least side effects. Often a dose change or an alternate medication can make a huge difference. We work closely with your doctor to optimize your medicines. You don’t need to live with side effects that hold you down. Contact us at www.medsmash.com.

BIBLICAL APPLICATION

What is your purpose for being? I had a chance to ‘people watch’ for a while this week. It got me thinking about what drives people. We know that EVERYONE has insecurities. Everyone has struggles. God has a purpose for everyone. Society gives a lot of messages that don’t align with the Bible. A lot of people have never even heard about the God who loves them. People have so many reasons for the actions they take. As a whole, people are so confused.

Here are a few reasons for decisions that come to mind:

  • Some people elevate themselves by suppressing others.
  • Others spend all of their time growing their sphere of influence.
  • Some live to serve and please others (sometimes at risk to themselves).
  • Several spend their time protecting themselves.
  • And then some hide from other people and insulate themselves.

Our selfish actions can have unwanted side effects, just like the medications discussed above.

Are we to spend this life racking up points? No! That is exactly why Christ died and rose. He took the ‘rules’ and replaced them with grace and redemption. You don’t have to ‘earn’ your way to Him.

John 3:16-18 The Message

“This is how much God loved the world: He gave his Son, his one and only Son. And this is why: so that no one need be destroyed; by believing in him, anyone can have a whole and lasting life. God didn’t go to all the trouble of sending his Son merely to point an accusing finger, telling the world how bad it was. He came to help, to put the world right again. Anyone who trusts in him is acquitted; anyone who refuses to trust him has long since been under the death sentence without knowing it. And why? Because of that person’s failure to believe in the one-of-a-kind Son of God when introduced to him.

I’m hoping this makes you rethink your purpose for being the way it makes me rethink mine. As I make decisions each and every day, what is my underlying motivation?

I am called to believe, trust, and follow in faith. If I am walking closely with God, He will help me make decisions that make sense. He has this perspective that is so far beyond anything I could imagine.

Proverbs 3:5-6 ESV

Trust in the Lord with all your heart, and do not lean on your own understanding. In all your ways acknowledge him, and he will make straight your paths.

James 1:5 ESV

If any of you lacks wisdom, let him ask God, who gives generously to all without reproach, and it will be given him.

So contrary to what society tells you and where your own flawed thinking might take you, your priority can be God’s plan for you. Staying focused on this can help you avoid decisions that hurt other people. It can help you take the focus off of yourself. It won’t rid you of problems, but it can increase your confidence that you’re not alone.

Just say ‘no’ to the side effects of selfish thinking!

Blessings,

Michelle

Narcotic Addiction – the epidemic and new strategies

Posted on by Michelle Fritsch, Pharm.D.
Meds bathroom
Prolonged use at higher than necessary doses can lead to opioid (narcotic) addiction

Narcotic addiction is now at epidemic proportions. Drug abuse has been with us for all of recorded time. The specifics of the drug(s) most commonly abused change over time. Sometimes the most abused drugs fall out of favor for a while and then reemerge. Common examples from the past few decades include LSD, cocaine, crack cocaine, and inhalants.

Right now, prescription opioid pain medicines (narcotics) are being abused at an alarming rate.

According to the Centers for Disease Control (CDC), 2 million people abused or were dependent on opioid analgesics in 2014.

Refer back to last week’s blog. Terms are very important here. Dependence is a physiologic response to these medications. Anyone who takes them over time will have some changes in how their body handles pain signals. The body’s normal response takes a backseat to the medication. In order for the body to take over again, the medication needs to be titrated off slowly. If you stop the medication all of a sudden, the body goes through withdrawal. It can’t take back over the pain control that quickly. It needs time to gear up. NOTE, this type of dependence and withdrawal is different than ADDICTION.

Addiction

Genetic, psychosocial, and environmental factors all play a role in the creation of an addiction.

Addiction usually occurs when the opioid medication is continued after the pain has gotten better. Sometimes people keep taking the medication for the effects beyond the pain relief. Some people feel a euphoria or high while others are very laid back.   If they keep continuing the medication for this purpose, then addiction can occur. Not only are the body’s receptors letting the medication handle pain it is seeking these other effects. Over time it takes a higher dose more frequently to get the same amount of desired effect. So, doses keep going up and desire to take the medication is very strong.

The FBI and the DEA created a documentary about this addiction. If you would like to know more, I highly encourage you to watch this video. You can find it at this link: https://www.fbi.gov/news/stories/2016/february/raising-awareness-of-opioid-addiction/video/chasing-the-dragon-the-life-of-an-opiate-addict.

In March of this year (2016), the CDC released new guidelines for prescribing of these medications. If you would like to read them, you can find it at this link: http://www.cdc.gov/drugoverdose/prescribing/guideline.html . These guidelines are emphasizing less use.  Use only for moderate to severe pain.  Use at the lowest possible dose for the shortest time possible. There are other, non-addictive options for lesser pain.

When people addicted to prescribed opioid pain medications can’t get more prescriptions, they often turn to heroin. This is another opioid substance that is illegal but sadly, easier to get ‘on the street’. This allows the addicted person to keep getting the effects they are seeking. Note, at this point, addicted people realize this is a miserable, horrifying state. But the demands for more drugs override common sense. Again, I highly recommend watching the video created by the FBI and DEA.

So overcoming this epidemic is being addressed from the prevention side by the new prescribing guidelines. It is also being addressed through new medications and techniques to help people escape the addiction. So, there is hope for the future with this addiction!

If you would like to know more about narcotic addiction, new steps to address it, or similar topics, contact us at www.medsmash.com.

BIBLICAL APPLICATION

Temptation has been part of our world since Adam and Eve, the very first people. It did not take mankind long at all to prove how difficult resistance to temptation can be.

I first want to send a loud, clear message that love, compassion, forgiveness, and constant support are key elements of walking away from addiction. Rather than avoid, isolate, and punish those who find themselves addicted, we have a calling to reach out in love and be part of that crucial support network.

Proverbs 17:17 TLB

A true friend is always loyal, and a brother is born to help in time of need.

1 Peter 4:8 NIV

Above all, love each other deeply, because love covers over a multitude of sins.

I want to write about temptation and the fact that it is a fact of life. God knows all about the temptations in our path. He is also there to help us through. And when we are entangled in a temptation that we did not resist, He is there to bring us back away from it.

1 Corinthians 10:13 ESV

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

1 Peter 5:8 ESV

Be sober-minded; be watchful. Your adversary the devil prowls around like a roaring lion, seeking someone to devour.

James 1:12-15 ESV

Blessed is the man who remains steadfast under trial, for when he has stood the test he will receive the crown of life, which God has promised to those who love him. Let no one say when he is tempted, “I am being tempted by God,” for God cannot be tempted with evil, and he himself tempts no one. But each person is tempted when he is lured and enticed by his own desire. Then desire when it has conceived gives birth to sin, and sin when it is fully grown brings forth death.

1 John 2:16 ESV

For all that is in the world—the desires of the flesh and the desires of the eyes and pride in possessions—is not from the Father but is from the world.

I pray you are always aware of the temptation around you and the help available to you at all times from God. I also hope you find opportunities to reach out to those who have fallen into temptation and love them back out of that snare. That love might be tough love, but the Bible is full of examples of that too. Check out Luke 6:27-49.

Blessings,

Michelle

Flu – Not to be Taken Lightly – It’s NOT too late

Posted on by Michelle Fritsch, Pharm.D.
Flu vaccine CDC
Flu vaccine – it is not too late!

People are dying from the flu! Now, this week!

Do you get an annual flu vaccine?

If yes, does that mean you will not get the flu?

If you do not get a flu vaccine, why not?

Let’s review some common responses to these questions…and the truth based on evidence.

There are several varieties of flu vaccine available. A lot of research in recent years is responsible. Remember within the last 10 years when there was a shortage? Not everyone could even get the vaccine. Then, in 2009, a new strain called H1N1, or ‘swine flu’ emerged making many people very sick. Since all of that, these new options protect against H1N1. They cover more specific strains expected to be active this year. Some are now safe for people with egg allergies. Some are specific for people over age 65.

When you get the vaccine, it is NOT LIVE VIRUS that is injected. It is virus that has been grown then ‘killed’ before injection. Most are placed, via needle, in your upper arm muscle just below your shoulder (deltoid muscle). The injected substance then prompts your immune system to develop antibodies to the virus. Antibodies are the parts of your immune system that fight infections. The antibodies will be specific to the strains of virus in the vaccine.

Some flu vaccines cover three strains of flu while others cover four. The strains selected for the vaccine are the most dangerous. There are other milder strains of the flu not covered by the vaccine. So, you can still get the flu, but not the most deadly types.

The type of flu vaccine that is specific for people over age 65 is a bit stronger. In our 60’s and beyond our immune system often isn’t quite as active. So, the stronger vaccine will provide better protection.

There is also a live version of the flu strains that is given in the nose. This is an option for people who really, really hate needles. Note, people with cancer, compromised immune systems, and some other conditions cannot receive the live version. Please check with your doctor or person providing immunizations.

Who should NOT get the flu vaccine?

There are very few people in this category. For people with egg allergies, there is now a type of flu vaccine that does not contain egg. If you had a severe allergic reaction to a flu vaccine in the past, be sure to talk with your doctor before deciding whether to get one. With several varieties of vaccine available, there might be a version that does not contain the substance to which you are allergic. If you have or have had Guillain-Barre Syndrome, talk with your doctor. There is not currently a vaccine approved for children under 6 months of age. Otherwise, you should be seeking your flu vaccine!

The people who are DYING from the flu usually get the flu then get pneumonia while they are sick. Flu deaths tend to occur most often later in the flu season (so now!). Those who die are usually over age 75 or they have other medical conditions involved. Then there are those who no one would have expected.

Don’t let the flu catch you by surprise. It is NOT TOO LATE to get your flu vaccine!

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

BIBLICAL APPLICATION

Flu vaccines can protect our physical health. What protects our spiritual health?

The armor of God is the first thing that comes to my mind.

Ephesians 6:10-18 ESV

Finally, be strong in the Lord and in the strength of his might. Put on the whole armor of God, that you may be able to stand against the schemes of the devil. For we do not wrestle against flesh and blood, but against the rulers, against the authorities, against the cosmic powers over this present darkness, against the spiritual forces of evil in the heavenly places. Therefore take up the whole armor of God, that you may be able to withstand in the evil day, and having done all, to stand firm. Stand therefore, having fastened on the belt of truth, and having put on the breastplate of righteousness, and, as shoes for your feet, having put on the readiness given by the gospel of peace. In all circumstances take up the shield of faith, with which you can extinguish all the flaming darts of the evil one; and take the helmet of salvation, and the sword of the Spirit, which is the word of God, praying at all times in the Spirit, with all prayer and supplication.

And all through the Psalms you will find cries for protection and rejoicing for the protection offered!

Psalm 5:11 CEV

“Let all who run to you for protection always sing joyful songs.

Provide shelter for those who truly love you and let them rejoice.”

Psalm 34:8 CEV

“Discover for yourself that the LORD is kind.

Come to him for protection, and you will be glad.”

Psalm 118:8 CEV

“It is better to trust the LORD for protection than to trust anyone else,”

I feel so assured when I read these verses! These are good ones to memorize or carry in your wallet for reference at frightening times.

Blessings,

Michelle

Image source: Centers for Disease Control and Prevention; U.S. Department of Health and Human Services

Four Components of True Health – Emotional Health

Posted on by Michelle Fritsch, Pharm.D.
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Caring for and by others is key

The fourth of the four components of health is emotional health. True health requires health in all four components. Over the last three weeks we covered physical, mental, and spiritual health. Striving to attain health in all four areas enhances your overall health.

Emotional health refers to how you deal with life and its ups and downs. Everyone goes through difficult trials. The specifics are different between people. Even for you, there will be a wide variety of difficult times you experience.   Everyone has good days. These can be peaceful, contended days; days where you reach a goal; days where you are celebrated; and days when you feel loved and secure.

Your feelings play a big role in your emotional health. People express their feelings in many different ways. Some people are more visibly emotional. Other people keep their emotions carefully hidden from view. Either way, emotions can impact our behaviors. How we act, how we respond, how we treat people, and how we feel about ourselves can all be affected by our emotions.

Why does my emotional health matter?

When looking at the differences between healthy people and not so healthy people, researchers have found emotional health to be a key factor.

How do you handle your anger? How kind are you to yourself in your ‘self talk’? How do you express your joy? What is your response when someone criticizes you? How often do you put other people’s needs before your own? Do you feel like the world is out to get you? How do you respond when your car breaks down? How do you feel when you forget to send a birthday card on time? What makes you happy? What makes you sad?

Studies have shown that prolonged stress and negativity make you age faster. There are actually measurable changes in your brain (shorter telomere length and less activity). This stress can also make you more susceptible to other diseases. Your blood pressure can go up, risk of heart disease goes up, and risk of diabetes goes up.

Improved health does not come from lack of negative situations. It comes from how you handle those situations.

The research has shown that the people who are more emotionally healthy have:

  • Friend(s) to talk to
  • People who care about you
  • A sense of self-worth
  • Ability to give and receive forgiveness
  • Conflict management skills
  • A desire to be giving toward others
  • Concern for others

As you can see, these are not things you are born with. They are skills and attitudes you can develop. They are choices you can make. They are best navigated with friends and supportive people around you.

Similarly, other researchers found that keys to overall health are:

  • Thinking kindly of people
  • Feeling optimistic
  • Supportive friends & family
  • Ability to bounce back
  • Making healthy choices
  • Being grateful for all you have

I found it interesting that the findings are so similar. Other studies have supported these important areas of emotional health. When you feel good, your thinking of more creative and flexible. You see problems with more possibilities and solutions.

So, I encourage you to take a personal assessment of your current emotional health. Consider the things that delight you and the things that upset you. Where can you incorporate more of the listed items that are shared among people with more emotional health?

Medications can help on a short-term basis when circumstances have you so upset you can’t function or sleep. Long-term emotional health, however, is gained more through self-insight, positive choices, and self-development.

If you would like citations for the studies mentioned or have any questions about the role of your emotional health on your overall health, contact us at www.medsmash.com.

(Note, severe abuse, neglect, and trauma are much different than daily negative situations. This blog is not intended to cover the health effects of these experiences that usually involve severe mental illness of the perpetrator.)

BIBLICAL APPLICATION

Our emotions can guide so many of our behaviors, especially if we don’t have an anchor of hope. Resilience is the result of knowing God’s love and mercy never fail. No matter the situation, you are not alone, and you have the ultimate resource walking with you.

Throughout the Bible we are assured that bad things will happen. Since sin entered the world, this has been a basic fact. Throughout the Bible we are assured there is hope and joy that can get us through any situation.

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.

Joshua 1:9 ESV

Have I not commanded you? Be strong and courageous. Do not be frightened, and do not be dismayed, for the Lord your God is with you wherever you go.”

As we go through difficult times, either big life-altering events or short bursts of anger or frustration, we are encouraged to give those over to God. We aren’t meant to figure it all out or deal with it on our own. Actually, when we do try to handle things ourselves, we often get into trouble.

Proverbs 29:11 ESV

A fool gives full vent to his spirit, but a wise man quietly holds it back.

Proverbs 15:18 ESV

A hot-tempered man stirs up strife, but he who is slow to anger quiets contention.

A focus on God can help calm our storms. Once we learn to navigate the storms, we can be a better support to those around us.

Romans 12:2 ESV

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

Romans 12:15 ESV

Rejoice with those who rejoice, weep with those who weep.

Proverbs 15:13 ESV

A glad heart makes a cheerful face, but by sorrow of heart the spirit is crushed.

I love this visual of Romans 5:3-5. With each time around the circle, we grow in hope and joy and the certainty of God’s love. This can then spill over to others.

Slide1Blessings,

Michelle