counseling

Fear of Failure, Hidden Truths, and Your Health

Posted on by Michelle Fritsch, Pharm.D.
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Fear and hidden truths are bad for your health.  There is GOOD news!

This is a major religious holiday week for two of the most prevalent religions in the world – Judaism and Christianity. Jews are commemorating the Passover and God’s leading the Israelites out of slavery in Egypt. Over the following 40 years they were in the desert on the way to the promised land with delays due to disobedience. Their mistakes and wayward decisions had many consequences.

The Jews were enslaved and mistreated by the people of Egypt. They then were ungrateful and easily distracted from the miracle of their deliverance. They continued to make mistakes.

Christians are celebrating Easter, the risen Christ after a brutal betrayal and death 3 days earlier.

The people who celebrated Jesus’ entry into Jerusalem were the same ones who cried ‘Crucify Him’ a few days later. And even after this supreme sacrifice, Christians continue to sin. We continue to sin, make mistakes, and get absorbed in ourselves.

So, it wasn’t just the people in Biblical times that made mistakes. We ALL continue to do that every day. How do you handle your mistakes? How do you handle the things you choose to do that you later regret? How do you handle the things that are done to you that hurt you?

Fear of Failure

I have known many people who are afraid of failing. Often, they are even more afraid of anyone finding out that they failed. There seem to be two extremes of ways to handle this fear.

#1 – Avoid any situation that could result in failure. Do you shy away from any risk? Do you avoid variation in your life and avoid all opportunities since you aren’t guaranteed success? How deep does this fear run? Do you eat the same meals repeatedly rather than try something new? Do you keep the same schedule to minimize an unexpected situation?

#2 – Hide any hint of failure. Do you take some risks but hide or deny anything that goes wrong? Do you maintain the illusion of perfection? Do you push away people who might get close enough to see your weaknesses?

Fear of failure is a prime source of anxiety. The fear is so intense just the thought of taking a risk provokes stress, rapid heart rate, sweating, feelings of overwhelm.

Fear of failure can lead to depression due to self-selected isolation. Or, if you hide and deny your failures, you can get caught in a web of lies that gets beyond your control.

Hidden Truths

I don’t want to count the number of people I’ve talked with who have a sad secret hurt from their past. These hurts changed their lives. They are terrible things like abuse, rape, molestation, abandonment, or neglect. They have ‘dealt’ with these issues by trying to deny they happened. Or, they have been told by family to keep quiet and never talk about it. Other times the hidden truths are of marital affairs, lost jobs, drug abuse, or heavy drinking.

Whatever the hidden truth, there is no denying the impact. Our conscience knows and doesn’t forget.

Like before, if you keep it hidden, suppressed, and don’t release it, all of that pain comes out another way. I have known so many people with chronic pain that was related to these hidden truths. Others suffered from anxiety and/or depression. There was an ever-present fear and ‘dark cloud’ in their life.

Counseling and Medication

Many people choose to ‘treat’ these fears and hidden truths with medication. Sometimes it is with prescribed medication such as antianxiety or antidepressant medications. Other people choose to self-treat with alcohol, marijuana, or other substances.

The medication can help in many instances. In others, it just dulls the thinking. The memories, the guilt, or the hurt isn’t as sharp when under the influence of the medication or other substance.

Your life is meant to be lived fully aware and present. You miss out on so much when you aren’t engaged in your life.

That is very often where counseling comes in. These fears and hidden truths need to be released. Counseling, clinical or faith based, can be that outlet to help you really deal with these hurts, mistakes, or ongoing issues. Through counseling you can confront these items, face them, learn to process them, and then learn to live beyond them. (Note, I am not suggesting your hurts, fears, and pain are not real. I am not suggesting you will just walk away and forget them. I am suggesting you can benefit from counseling +/- medication.)

This is one of those areas that can’t be ‘fixed by a pill.’ The medication can help, but it is unlikely to actually resolve the problems. A trusted, skilled counselor can help you get back to really living.

To learn more about the role of medication and for help finding a good counselor, contact us at Meds MASH, LLC at www.medsmash.com/contact or 410-472-5078.

BIBLICAL APPLICATION

Christ is risen!!!!!! He is alive and active and so very present in our world today.

I am writing this on Easter. It is such a beautiful day. Not only is it warm and sunny outside, but what an amazing day to reflect and let is sink down deep that Jesus went through the worst people can do to other people all because of his love for me, for you, for all of us!

He put himself in the situation to endure physical pain in the extreme over many hours, rejection, slander, betrayal, humiliation, abuse, and complete degradation. I don’t know about you, but I fear ANY of those things. I can’t imagine purposefully enduring any of that.

I am the sinner for whom he died. I am the sinner – each and every day – who he loves and forgives over and over and over and over…

James 4:17 ESV

So whoever knows the right thing to do and fails to do it, for him it is sin.

Romans 8:1 ESV

There is therefore now no condemnation for those who are in Christ Jesus.

I can’t deny it. I might try to pretend to avoid sin, but you know better. We ALL sin, in spite of our best efforts to not. You are not perfect. I am not perfect. Only Christ was ever on earth as a perfect human.

Let’s get real with each other. Let’s be honest and support each other through the mess of life. We all have our joyful, peaceful times. We all have our dark, difficult times.

1 Thessalonians 5:11 ESV

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

Ecclesiastes 4:9-12 ESV

Two are better than one, because they have a good reward for their toil. For if they fall, one will lift up his fellow. But woe to him who is alone when he falls and has not another to lift him up! Again, if two lie together, they keep warm, but how can one keep warm alone? And though a man might prevail against one who is alone, two will withstand him—a threefold cord is not quickly broken.

Hebrews 10:25 ESV

Not neglecting to meet together, as is the habit of some, but encouraging one another, and all the more as you see the Day drawing near.

My purpose today is to encourage you to celebrate your new life in Christ! He is alive and loving you right this moment. Claim your new life in Christ. Open up to your Christian friends, teachers, and supports. Live the on-purpose, fully alive life Christ died to give you.

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.

If your story includes fear of failure, fear of risks, or any of a multitude of hidden truths, Christ died for you. You can live beyond the worst this world can give you. You are loved. You are not alone. An eternity of joy and peace and love awaits you!

Blessings,

Michelle

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Break the Circle of Self

Depression, Pain, Anxiety – the Circle of Self

Posted on by Michelle Fritsch, Pharm.D.
Break the Circle of Self
The Circle of Self can lead you into a dark self-absorbed place with pain, depression, and anxiety.

I was teaching health profession students this week about mental health and pain. The Circle of Self was a good visual way to capture a current phenomenon. One of the very important things we talked about was the LIMITS of MEDICATION! The students were very insightful about the reasons so many people are struggling with depression, anxiety, and pain. And, the more we talked, the more it made sense that this is a common pattern.

STRESS

We made a list of reasons why the incidence of depression, pain, and anxiety are so common. I would love to hear what you would add to this list. Current themes in our society that contribute are:

  • Stress
  • Anxiety
  • Decreased coping skills
  • Social media – most posts are either deceptively positive to look good or very negative
  • News, especially so much bad news
  • Poor sleep hygiene
  • Expectation of instant gratification
  • Reliance of medications or techniques to ‘just fix it’

THE CIRCLE OF SELF

When someone experiences depression, anxiety, and/or pain, several things tend to happen:

  • Less movement – more sitting or lying around
  • Decreased social activities – stay home more, reject offers to get out
  • Nod off or purposefully take a nap during the day
  • Have interrupted sleep at night
  • Experience pain – either pain when there was none or worsening pain

These changes lead to more and more focus on self. How do I feel? What is happening to me? Why me? Why do I feel this way? Why can’t I sleep? Why can’t I get motivated? Woe is me…

This common pattern of self can also impact heart disease, diabetes, obesity, and more.

The role of SLEEP

Most adults need 7-9 hours of sleep per night. As we age, more and more things seem to interrupt this sleep. You might need to go to the bathroom more often during the night.   Pain can wake you up or keep you awake. Napping during the day can mess with your nighttime sleep.

Too little sleep can increase your risk of depression. It can also make your recovery from depression most difficulty.

Too little sleep can limit your ability to manage with pain. Pain can feel worse, be more frustrating, and limit your activities more when you’re extra tired. Also, the more you hurt, the hard it is to sleep, and a vicious cycle is started.

The role of MEDICATION

Low amounts of key neurotransmitters in the brain can lead to depression and/or anxiety. There are medications that can help increase the amounts of those neurotransmitters. Note, this process takes about 8 weeks, so starting medicine doesn’t make you feel better right away. Usually your energy gets better before your depressed or anxious thoughts.

In the studies that showed that these medications can help, counseling was also a key part of therapy. The medications by themselves don’t help as much as they do when you also have counseling. It is the counseling that can help you find some different ways to think, stop the negative thoughts, and help you focus on more positive aspects of your life.

For pain, some medications block some of the pain signals going between the site of the pain and your brain. Others decrease the intensity of those signals. The pain medication should match the type and intensity of the pain. This means the same pain medication is not the best option for all types of pain. There have been huge issues in our society of overuse of pain medicine, especially opiate medications. These have a role in some types of pain. Once the pain starts to decline, the medication should be decreased and stopped. In another blog, I’ll review all of the many types of pain medications and when/how to use each.

Breaking the Cycle

Breaking the circle of self
Think of others to break the circle of self.

Medications are part of breaking the cycle for many people. Note, medication is often helpful to start the process. It might not be needed long term. Ask you doctor about how long it will be helpful for you.

Counseling is part of breaking the cycle. Learning to change your thinking patterns is key. Having support is also key.

Then, I want to share something that has repeatedly been shown to effectively break this cycle. Do something for someone else! Focus on self leads into the negative circle that gets tighter and tighter, isolating you from others. To purposefully think about others can help you out of this dark place. Call to check on a friend. Help someone with a project. Visit an older relative or friend. Take a meal to a new parent or someone who is sick. Make a donation. Write a letter to a soldier. Plan a special outing with a friend. Join a club that works on a social issue.

There are many options! The point is to find someone else you can think about and help. Distraction is helpful for pain tolerance, anxiety reduction, and depression treatment. Thinking about someone else helps you out of the dark focus on self.

For more information about breaking the circle of self, contact us at www.medsmash.com/contact or 410-472-5078.

BIBLICAL APPLICATION

I believe the circle of self can and does impact all of us. It is one of Satan’s best weapons. How distracted do you get when you are in pain? How about when you are feeling down or anxious? Even a common cold can be very distracting. And, once you are distracted, how hard is it to pull back out of the negative cycle?

Peter encourages us to recognize all of this and to learn to think more like Jesus.

1 Peter 4:1-2 MSG

Since Jesus went through everything you’re going through and more, learn to think like him. Think of your sufferings as a weaning from that old sinful habit of always expecting to get your own way. Then you’ll be able to live out your days free to pursue what God wants instead of being tyrannized by what you want.

In these complex times, we are bombarded with information that can keep us stressed, anxious, and/or depressed. Paul tells us to not focus on these things. He encourages us to focus instead on what comes next. How much time do you spend thinking about your future in Heaven?

2 Corinthians 4:14-18 MSG

 We’re not keeping this quiet, not on your life. Just like the psalmist who wrote, “I believed it, so I said it,” we say what we believe. And what we believe is that the One who raised up the Master Jesus will just as certainly raise us up with you, alive. Every detail works to your advantage and to God’s glory: more and more grace, more and more people, more and more praise!

So we’re not giving up. How could we! Even though on the outside it often looks like things are falling apart on us, on the inside, where God is making new life, not a day goes by without his unfolding grace. These hard times are small potatoes compared to the coming good times, the lavish celebration prepared for us. There’s far more here than meets the eye. The things we see now are here today, gone tomorrow. But the things we can’t see now will last forever.

Thinking about others, loving others as much and in ways we love ourselves, and putting others before ourselves are common themes in the Bible.

Philippians 2:3 ESV

Do nothing from rivalry or conceit, but in humility count others more significant than yourselves.

Romans 12:10 ESV

Love one another with brotherly affection. Outdo one another in showing honor.

1 Peter 3:8 ESV

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

I’m praying we can all keep our focus outside of ourselves. Love others and keep your eyes on the future – eternity in Heaven!

Blessings,

Michelle

Posttraumatic Stress Disorder (PTSD) – Is It Real?

Posted on by Michelle Fritsch, Pharm.D.
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There are growing resources, help, and hope for those with PTSD.

Posttraumatic Stress Disorder (PTSD) is finally becoming a topic that is discussed – in public. It finally has ‘a voice’ and several avenues of treatment to address it.

I was fortunate to serve about seven years of my career in the Veterans Affairs system. I worked alongside some of the best, most caring providers and the most robust interprofessional teams. These teams consisted of physicians (geriatricians who focus on people over 65, in my case), nurses, pharmacists, dieticians, physical therapists, occupational therapists, social workers, psychologists, psychiatrists, and every level of trainee – students, residents, and fellows. Together we provided care to aging adults in the clinic, the acute care hospital, the intermediate unit, long-term-care (nursing home), and the domiciliary. The ‘dom’ was long term, independent housing for veterans who did not have a family to live with after the war.

I am thankful for every veteran that has served our country in one of the countless ways our uniformed services care for this country every day. The stories I heard during those years were enlightening, empowering, endearing, and sometimes gut wrenching. I have heard others say this: In my experience, those who talked the least about their service saw the most ‘action’ and devastation.

One day I was in clinic with a student. It was a very normal day. As the pharmacist, my visits mostly pertained to medications – why, how, when they are taken and the result. On this day, during a normal pharmacy clinic visit, one of our veterans told his story. It forever changed my life. Here is a paraphrase. I will leave out the specific war, because the story could fit any of them.

“I was assigned the night guard shift for my platoon. It was my duty to walk around the perimeter of the base to look for anyone (of the enemy) who might try to attack at night. It was typically uneventful. One night, as I rounded a corner, I was face-to-face with a man from the ‘other side.’ In a split second I thought about my family – my wife and children. I thought about how I just want to go home to them. I thought I don’t know this man. I don’t hate this man. He probably has a wife and children waiting for him at home, too. We might even be friends in other circumstances.’

We all sat and cried for a long time.

After this event, this man, this veteran had a mental breakdown. He was sent to an island where soldiers not able to function in combat were stationed during that war. While there he started trying to stop reliving the event through alcohol. When he finally got home to his wife and children, he was an alcoholic. He had posttraumatic stress disorder. But, it wasn’t recognized, diagnosed, and treated as it is now. I certainly don’t know all of the details, but he and his family were not able to reunite and stay together. It broke my heart to see what had happened. I wonder if his wife and children ever knew what happened? I wonder if knowing could have changed the outcome for their family. No doubt he would be forever changed after an experience like that.

Post Traumatic Stress Disorder (PTSD)

PTSD is a condition where there is stress and symptoms for more than three months after a trauma or highly stressful event (or series of events). The stress and symptoms disrupt regular daily activities and are distressing. PTSD can result from war (as in the example above), natural disasters, sexual or physical assault, horror, accidents, or other terrifying event. PTSD can present in about four different ways.

  1. Reliving the event – nightmares, flashbacks, triggers
  2. Avoiding any reminders of the event – driving if in a car crash; crowds if they cause insecurity; fireworks if associated with gunfire; movies related to the event
  3. Negative feelings or changes in feelings about the world and the future; suppressing or forgetting parts of the event
  4. Feeling keyed up (hyperarousal) – easily startled, trouble sleeping, difficulty concentrating

Treatment has multiple components. Understanding PTSD is an important step. Counseling and cognitive behavioral therapy can help. In cognitive behavioral therapy, people can become aware of thoughts and feelings, and that allows them to be processed and better understood. Then skills to face those feelings and make changes in a way that allows them to have less impact are developed. For each person, this process is different. There are highly trained, experienced therapists who will work with each personal individually.

For medication treatment, selective serotonin reuptake inhibitors (SSRIs) are most commonly used. These are medications that are also commonly used to treat depression and anxiety. They are unlikely to resolve symptoms alone. They are an important part of the multiple components of treatment.

Other components might be exposure therapy, group therapy, family therapy, and more.

A recommended site to learn more about PTSD is through the VA.

Again, there is a growing number of resources available to anyone who might be experiencing PTSD. If you or someone you know might have PTSD, please seek help right away. To suffer alone is not the answer. Alcohol, drugs, and suicide are not the answer. Help is available!

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

BIBLICAL APPLICATION

PTSD is a real disorder. It is estimated about 3.5% of adults in the US have PTSD. Over 9% of people ages 50-65 have now or have experienced PTSD.

It can be hard to think rationally when suffering from PTSD. The terror, stress, and anxiety can keep the brain in ‘fight or flight’ mode. When in this mode, reflection, perspective, and problem-solving functions are very limited.

So, how can you support someone suffering from PTSD? Understanding the disorder and being a source of compassion and love are good places to start.

No platitude or Bible verse makes PTSD go away. Some Christian leaders have implied PTSD is something that can be chosen or can be avoided with a focus on God. I strongly disagree. Sinful people can hurt, traumatize, and destroy other people. Even people who know and love God can be traumatized.

But as people of God, we can support people who have suffered. If you have PTSD, know you are not alone. If you know someone who has (or you suspect may have) PTSD, approach with God’s unconditional love. Support through the many stages and steps of recovery and learning to cope. PTSD doesn’t just go away at some point; it might take a lifetime of coping and skill building to live in spite of past trauma.

There are many stories of violence, war, and crimes in the Bible.

These are followed by God’s restorative grace and mercy.

There are many verses about love, strength, deliverance, and rest for our soul.

In time, with treatment and a strong support network, these conversations can be had.

Until then, in the more acute phases when the brain is so busy with ‘fight or flight’ mode, prayer, presence, and unconditional love are ways you can start the story of grace.

Be on the lookout for people who may have PTSD who are not yet receiving treatment. Pray for the many people in our world who are PTSD victims. Love and care for those with PTSD in your life.

1 John 4:11-12 The Message (MSG)

My dear, dear friends, if God loved us like this, we certainly ought to love each other. No one has seen God, ever. But if we love one another, God dwells deeply within us, and his love becomes complete in us—perfect love!

Blessings,

Michelle

Four Components of True Health – Mental Health

Posted on by Michelle Fritsch, Pharm.D.
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Mental health is one of four components of total health

Mental health is the second of the four components of health. True health requires health in all four components. Last week we covered physical health. Over the next two weeks we will talk about each of the others separately.

Mental health is getting more attention as an essential component of health.  It requires a health system of diagnosis, treatment, and management similar to physical health. Insurance has historically not provided as much coverage for mental health compared with physical. But, finally, that is changing in a very positive way!

A new set of diagnostic standards was published in 2013. This update came after over 10 years of work to refine and identify diagnoses since the previous set of guidelines. The standards cover everything from neurodevelopment disorders (such as autism), schizophrenia, bipolar disorder, and depression to anxiety.  They also cover obsessive-compulsive disorder, trauma and stress-related disorders, eating disorders, substance abuse, phobias, and personality disorders.

There are several classes of medications that are prescribed to manage mental health conditions. Some examples include neuroleptics (also called antipsychotics), antidepressants, antianxiety medications, and some medications that are also used to treat seizures.

So what can you do to improve your mental health?

Consistency is very important with mental health. Accurate diagnosis is obviously also key.

These conditions are complex. They are true biologic medical conditions. Sometimes people think these conditions are something someone can control by him/herself. That can lead to shame, denial, or avoidance of these complex conditions. They DO require medical care.

From mentalhealth.gov:

Myth: Personality weakness or character flaws cause mental health problems. People with mental health problems can snap out of it if they try hard enough.

Fact: Mental health problems have nothing to do with being lazy or weak and many people need help to get better. Many factors contribute to mental health problems, including:

  • Biological factors, such as genes, physical illness, injury, or brain chemistry
  • Life experiences, such as trauma or a history of abuse
  • Family history of mental health problems

People with mental health problems can get better and many recover completely.

Counseling is often an essential component of care for these conditions. Qualified counselors listen, coach, and strategize. They can also help diagnose and participate in therapy decisions. They can educate and work with the person with the  condition and with all family and caregivers, as approved by the patient.

So mental health conditions are medical conditions just like cancer and diabetes are medical conditions. They are treated with counseling, procedures, and medications. Many require lifetime management (versus one time treatment). So, relationships with the healthcare team are important. You want providers with whom you are comfortable and can be open.

Note, for many mental health conditions, especially depression, medication needs to be taken every day for up to two months to see the full benefit. The medication very gradually changes transmitters in the brain back to healthy amounts. So, please be patient and take the medicine faithfully.

For more information about mental health, please contact us at www.medsmash.com.

BIBLICAL APPLICATION

Mental illness impacts people of faith just as it impacts people who have never heard about Christ. So, can God use mental illness for His glory? Can anything good come from struggling with mental illness?

I believe God can use any of our weaknesses, any of our conditions, to His glory. Nothing is beyond His ability.

John 16:33 ESV

I have said these things to you, that in me you may have peace. In the world you will have tribulation. But take heart; I have overcome the world.

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.

Luke 1:37 ESV

For nothing will be impossible with God.

In the Bible, mental illness is sometimes referred to as having an ‘afflicting demon’. Understanding of mental health continues to grow. The medical/biological understanding of these conditions is much better understood than they were in Biblical days, but there are still questions to be answered.

Matthew 4:24-25 The Message (MSG)

He also healed people of their diseases and of the bad effects of their bad lives. Word got around the entire Roman province of Syria. People brought anybody with an ailment, whether mental, emotional, or physical. Jesus healed them, one and all. More and more people came, the momentum gathering. Besides those from Galilee, crowds came from the “Ten Towns” across the lake, others up from Jerusalem and Judea, still others from across the Jordan.(emphasis mine)

The multiple components of total health – physical, mental, emotional, spiritual – are recognized throughout the Bible. Mental health conditions require treatment and must be addressed to reach a state of true health.

There is no shame. Again, these conditions have biological sources. We are called to love and support each other.   Education, understanding, and unconditional love can help us help each other find God’s purposes in each of our afflictions.

Blessings,

Michelle

Image Source:  National Institute on Aging; National Institutes of Health; U.S. Department of Health and Human Services

Life Transitions = Depression Risk

Posted on by Michelle Fritsch, Pharm.D.

car-clip-art-879As my son returns to college I am fighting tears and happy at the same time. It is such a big adjustment to be away from him for several weeks at a time. I am sitting here thinking about the big impact of life transitions. We all experience them.

It is common knowledge that loss of a loved one and tragedies can increase risk of depression.

Moving, marriage, child moving out, job loss, retirement, and functional changes can increase risk of depression.

Diagnosis with a chronic illness can increase risk of depression.

As age increases, these life transitions can become more frequent.

When not recognized and addressed, depression can make you feel tired with too little energy, make it hard to concentrate and cause you to lose interest in things that you used to enjoy. It can also lead to you feeling sad and hopeless.

Depression is NOT a normal part of aging.

You do NOT have to just tolerate it and think this is your new normal.

Depression does NOT mean you have done something wrong.

There is help, and there is hope! Effective depression treatment usually requires support from people and medications. Medications that treat depression take about 8 weeks to work, so please be patient and take them every day until they work.

To further complicate things, depression is common in someone experiencing memory decline. As stated above, depression makes it harder to concentrate and remember. Cognitive or memory decline often leads to depression as the decline is recognized. Professional diagnosis and treatment is imperative to sort through what is causing what symptoms and the best course of action.

Remember, you do not have to live with depression.

If you’re interested in a depression screening, contact www.medsmash.com.

Biblical Application

If you are depressed, are you a bad person? NO!

Are you a weak Christian? NO!

Have you done something wrong? NO!

Throughout the Bible there are stories of people dealing with difficult situations, life transitions, illnesses, chronic problems. These include David and Paul and Joseph. You are not alone.

Also found throughout the Bible are messages about joy and hope. You have an eternal source of this joy and hope.

I believe part of God’s design for helping you through these difficult times is medical and psychological treatment. God gave these abilities and resources to your treatment team for your benefit.

Psalm 28:7 (NLT)

The Lord is my strength and shield.

I trust him with all my heart.

He helps me, and my heart is filled with joy.

I burst out in songs of thanksgiving.

Hebrews 6:19 (CEV)

This hope is like a firm and steady anchor for our souls. In fact, hope reaches behind the curtain and into the most holy place.

Romans 12:12 (NLT)

Rejoice in our confident hope. Be patient in trouble, and keep on praying.

I’ll be praying you find the eternal joy that is yours in Christ. And I encourage you to seek God’s blessing through treatment by your healthcare providers.

Blessings,

Michelle