Numbers: Do you know the importance of each of your numbers?

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Know how your numbers are key to your health.

What are the key numbers in your life? I just turned 50. That is a number that seems like a real turning point. I like a viewpoint a friend shared with me: the first half-century is training and preparation for the better half!

Also, my daughter is graduating from high school. So, in her world the key numbers are GPA, SAT, ACT, and college fees.

Other numbers we keep close to us are phone numbers, bank balances, addresses, and birthdays.

Numbers and Health

Now I want to make sure you are aware of key numbers for your health. There is a reason for those labs at your annual physical. And there are goals for those numbers. When you see your lab results you will see your number and a range that contains all of the normal numbers. Ideally, your number falls in this range. If your numbers are little bit outside this ‘normal range’ for a little while, just talk with your doctor. If your numbers stay outside the range, your doctor will probably take action with medication, exercise changes, diet changes, or other plans.

Blood pressure – If you are under age 65, normal is less than 140/90. If you are over 65, some experts agree it’s ok for your systolic blood pressure (top number) to get as high as 150. Your blood pressure is one indicator of how hard your heart has to work. There are several medications that can be used to lower your blood pressure and protect your heart from having to work too hard. I am often asked about how low is too low for your blood pressure. That is not really determined by a number. It is found through symptoms. If you get really dizzy when you stand up, turn around, or try to walk faster, talk with your doctor. A little bit of this is expected with the medicines that are protecting your heart. If it is causing you to fall or keeping you from doing your normal activities, then let your healthcare team know.

Pulse – This is usually between 60 and 90 beats per minute. You can quickly check your own by touching the center of your neck and letting your fingertips slide to the soft area just to the side. Your carotid artery is there, and you can count the beats for 15 seconds then multiple by 4. The more you exercise, the more efficient your heart gets. So, really fit people tend to be at the bottom of this range. This should be measured when you are really at rest. If you are worried, in pain, stressed out, or in a conversation your heart rate will be higher. So, when this is measured, think quiet thoughts and don’t talk. If it gets and stays high, your doctor will order some more tests to check why. The same is true if your heart rate is slower than 60 beats per minute. Tests will be ordered to see what your heart is doing to cause the slow rate.

Cholesterol – We all have cholesterol, or fats, in our blood. This is normal. But there are healthy amounts and unhealthy amounts. These are the key numbers. For most people, your low density lipoproteins (LDL) number should ideally be under 100 mg/dL. If you have a strong history of heart disease, your doctor might have you try to reach an even lower goal. This is your ‘bad cholesterol’. Your high density lipoproteins (HDL) is your ‘good cholesterol’. Ideally you want this number to be over 40 mg/dL. Another cholesterol number is your triglycerides. This tends to go up if you have diabetes that isn’t well controlled. This number should be less than 150 mg/dL. Diet, exercise, and medications are all key in keeping these numbers in the goal range if you have high cholesterol (also called hyperlipidemia).

Blood sugar – Speaking of diabetes, this is a very important number for people with diabetes. It is important whether you have type 1 (requires insulin) or type 2 diabetes (can be treated with medicines you take by mouth, by inhalation, or by injection). Your blood sugar changes throughout the day. It is usually lowest before a meal and highest after. When you have not eaten for at least 8 hours, your blood sugar should be less than 100 mg/dL. (This is a ‘fasting blood glucose’.) Your healthcare team might ask you to measure your blood sugar at home. There are several types of monitors to do this. They might want you to check sometimes before you eat, sometimes after you eat, sometimes before bed, and sometimes when you first wake up. This will give them the best look at what your blood sugar does throughout the day.

Glycosylated hemoglobin (A1c) – This is another way to see what your blood sugar does over a period of time – about 3 months. It is a reflection of your average blood sugar over those months. People who do not have diabetes have an A1c under 6%. Current guidelines encourage a goal of less than 6.5% for people with diabetes. However, if someone is at risk for their blood sugar being too low your doctor might increase this goal closer to 7%. When people with diabetes also have other medical conditions, sometimes ‘tight control’ to under 6.5% is not possible or safe. Talk with your healthcare team for your specific goal and why that is the goal for you.

Body Mass Index (BMI) – This measurement is a reflection of your height, your weight, and your gender. It helps to define what is a healthy weight for you. The goal BMI is between 18.5 and 24.9. If your BMI is 25 to 29.9 you are overweight. If it is over 30 then you are obese. Your healthcare team will help you with a plan to get to a healthy weight and stay in that healthy range.

Blood Urea Nitrogen and Serum Creatinine (BUN and SCr) – These are important measures of your kidneys. They determine if your kidneys are clearing extra fluid, medications, and toxins from your body as they should. They can also tell your doctor if you are dehydrated from not drinking enough. As a pharmacist, I always look at these numbers when deciding if a medication is safe and at the right dose. When your kidneys are not working as they should, then it is hard to get some medications back out of the body. Another interesting numbers – Our kidneys start to very gradually slow down when we are in our late 30’s or early 40’s. This happens to everyone. So, with each birthday in our 50’s and beyond, these are important numbers to assess.

Aspartate aminotransferase and alanine aminotransferase (AST and ALT) – These are measures of how your liver is working. Many medications are metabolized (broken down) in the liver. If these numbers are very high, then the liver is not able to do its job to break down the medication. These are numbers I always look at when evaluating someone’s medication regimen. It helps determine what medicines should be avoided and what doses are best for you based on your liver.

Number of Medications – Sometimes several medications are needed to treat all of your medical conditions. Sometimes they are not. The more medications someone takes, the more risk of medications interacting and causing problems rather than helping them. There is no ‘magic number’, but most experts agree that taking more than 4 medications regularly means you need to have an expert very carefully evaluate your regimen. This is to double check that your medication regimen is providing optimal good with minimal risk.

An Evaluation of YOUR Numbers

Are you curious about your numbers? At Meds MASH we specialize in these evaluations, especially in anyone over age 60. Do you want to better understand your particular numbers? Do want to know that your medicines are providing optimal good and minimal risk? Call us today! We have found that over 50% of our clients need a medication adjustment once an expert evaluation is done. These adjustments come from your own doctor with our collaboration.

You can call for your appointment at 410-472-5078 or e-mail at michelle@medsmash.com or through our website www.medsmash.com/contact.

BIBLICAL APPLICATION

Have you read the entire Bible? I am on my second journey through the whole book. In the past I have read my favorite parts, read parts pertaining to Bible studies I was in, or read parts that others have recommended. After years of this focused reading, I thought I knew the Bible fairly well. But, here I am reading it all and learning so many new things!

I was recently working my way through the book of Numbers. I have to admit, I don’t find this to be the most exciting book. It can be downright hard to get through. But, I was hit by a new insight.

In Numbers God directed Moses through the exact, meticulous details of building the temple and the Ark of the Covenant.

  • He provided exact measurement for each aspect of the temple.
  • He described elements of the temple in extreme detail.
  • He gave exact specifications for each furnishing.
  • Each bowl and utensil was described in detail.
  • The role of each person in service to the temple was directed.
  • The clothing of each priest was designed to the last thread.

It hit me how incredibly precise is our God. Not any detail was left with precise design. God is perfect in every way.

Then, I thought about how sloppy I am in my communication with God. I pray, read my Bible, focus when I find the time. I squeeze God into the nooks and crannies of my day. Some days are much better than others. Even now as I am reading through the Bible in a year, I find myself rushing rather than deeply meditating on what I read.

Sloppy is NOT what God wants from me. He is more important than ANYTHING else in my life. My to-do lists, dirty house, and work schedule are not the priorities per God’s plan. They are the distractions. They are Satan’s best weapon to keep me away from a deep, life-sustaining life with my Creator.

How about you? Is your relationship with God truly all-in? What are your distractions?

Paul knew we would all face these distractions and temptations.

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.

Paul also knew we wouldn’t do it just because anyone said so. Rather we are encouraged to stay focused on God to find and lead the life of peace and joy that is ours if we choose this path.

1 Corinthians 7:35 ESV

I say this for your own benefit, not to lay any restraint upon you, but to promote good order and to secure your undivided devotion to the Lord.

I pray we can all keep striving to keep God at the center as in the words of David:

Psalm 19:14 ESV

Let the words of my mouth and the meditation of my heart be acceptable in your sight, O Lord, my rock and my redeemer.

Blessings to you my sloppy but trying to be better friends!

Michelle

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Newer diabetes options

Are You TOO Sweet? Newer Options for Diabetes

Newer diabetes options
Newer diabetes medications to consider if you’re too sweet.

Do you remember when the treatment options for your type 2 diabetes were medicines that could make your blood sugar too low – oral medicine or insulin? The available options would also make you gain weight.

Those treatments are still available, and now there are improved versions of each. So, if you and your doctor and your healthcare team haven’t talked about options recently, now might be the time. The experts in the field, using the information from the latest studies, release guidelines. The latest guidelines from the American Diabetes Association have tables that provide comparisons between the options. These tables make a nice display to help you have a conversation with your doctor about which options might work best for you.

Those early medication options mentioned before would either help your pancreas release more insulin or would be an extra source of insulin.

Newer diabetes medication options

Here are ways other, newer medicines help control your diabetes:

  • control how your liver stores extra glucose (sugar) and when and how it lets it back out
  • control how your kidneys let your glucose out in your urine
  • impact how sugar is absorbed from the food you eat
  • mimic hormones that control how your body responds to sugar and insulin
  • slow down the rate food moves through your body keeping you feeling full longer
  • increasing how a cell responds to insulin

The body has many different steps in the way it handles the food you eat and how that food is turned from sugar into energy for your cells. Now, with these newer options, your diabetes can be treated with medicines that address more than one of those steps.

Combinations of medications can help control your diabetes more than one way at a time. Also, when you use combinations of medicines, you can usually use a lower dose. This helps cut down on side effects.

New insulin options

If a combination of medicines you take by mouth don’t help you reach your diabetes control goals, there are new insulins. The old insulins were dosed either around meals or twice a day. There are now basal insulins. These are dosed just once per day. They then provide some support to control your blood sugar all day and all night. Then, when you eat, your blood sugar does not climb as high.

Often, people who have been taking higher and higher doses of oral medicines find they can be on lower doses. The basal insulin helps decrease the need for so much oral medicine.

And, like we said before, using several different medicines helps you use lower doses of each. This is often easier to tolerate than high doses of one or two medicines.

NOTE, this information is all for type 2 diabetes. If you have type 1 you need insulin therapy only because your pancreas has quit working. The insulin is absolutely required. The oral medicines mentioned above won’t control your diabetes.

We have much more we can tell you about diabetes and treatment options. For more information, please contact us at www.medsmash.com/contact or call at 410-472-5078.

BIBLICAL APPLICATION

Diabetes (and other medical conditions) can be best treated with medication using different mechanisms. Treat different parts of the condition from all directions for the most comprehensive care.

I have been embarking on some new (to me) techniques for Bible study. Wow, there are so many ideas and methods out there! I am intrigued by all of the different ways we can approach the same scripture. And, as only God could do, I learn something different every time. Part of the reason I keep learning new things from the same scripture is that I am different every time I read it. The things happening in my life, the things that are exciting me, the things that are concerning me, the things happening with my friends and family are different. This changes my perspective. Also, my moods change. That can definitely impact how I approach anything I read or hear.

Then, there are all of these techniques and approaches I have been reading about. Some are obvious, and some, to me, seem really innovative. Here are some that I have been trying to incorporate:

  • When reading a small bit of scripture, read it over and over emphasizing a different word each time to see how that changes the meaning.
  • Research the history at the time it was written. Historical context helps to understand the culture and surrounding events.
  • Write down in a journal (or I write in the margins) insights, events, or ideas you get from that verse or chapter. (Date it so you can see it later. Often I find it strikes me a completely different way the next time I read it because I’m in a different frame of mind in different circumstances.)
  • Consider how the scripture you’re reading could be incorporated into your life today.
    • Sometimes this is an action, sometimes an new idea, sometimes a reflection on how great is our God, sometimes a prayer, sometimes a question to ponder.
  • Put yourself in the scripture. Try to imagine being there at that time. How did it probably look, sound, feel. How might you have gotten there? What are you probably wearing? Who else is there?
  • Read about the author of that chapter of the Bible. What do we know about that person? What was their perspective?
    • I like the Life Application Bible. It has information at the start of each chapter to start answering these questions. It has helped me dig a lot deeper and understand more concepts. There are application tidbits on each page.
  • Where else is this theme, story, or concept in the Bible?
  • Listen to the Bible being read to you. There are many online apps that include an audio version. Especially if you like to learn through hearing, this is a great method.
  • Read the same scripture as a friend and talk about it. Or better yet, talk about it in a Bible study group. I am always amazed at how we can read the very same thing and have completely different insights.

No doubt, there are many more.

God gave us his Word to be an integral part of our life.

2 Timothy 3:16-17 ESV

All Scripture is breathed out by God and profitable for teaching, for reproof, for correction, and for training in righteousness, that the man of God may be competent, equipped for every good work.

God’s Word can be a huge source of answers when you’re feeling lost, alone, hurt, confused.

Psalm 119:105 ESV

Your word is a lamp to my feet and a light to my path.

There’s not just one right way to study scripture. Like a combination of meds approach to diabetes, try a combination approach to reading your Bible.

Hebrews 4:12-13 MSG

 God means what he says. What he says goes. His powerful Word is sharp as a surgeon’s scalpel, cutting through everything, whether doubt or defense, laying us open to listen and obey. Nothing and no one is impervious to God’s Word. We can’t get away from it—no matter what.

My prayer is you’ll find it exciting and refreshing to try all sorts of new ways to get into your Bible. There is a never-ending amount of great information in there. It is always pertinent.

Blessings,

Michelle