grace

Preventing Falls – New Tools and Resources

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

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

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

Falls Risk Factors

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

Medications

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

Medical conditions

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

In your home

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

Other

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

Wow, and this is just a partial list!

New Falls Prevention Resources

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

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

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

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

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

BIBLICAL APPLICATION

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

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

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

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

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

Ephesians 2:1-6 MSG

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

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

2 Corinthians 5:17 ESV

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

Ephesians 2:8-9 ESV

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

Romans 8:38-39 ESV

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

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

Blessings,

Michelle

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

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No U-turn available

When a U-turn is not available – end-of-life care

Posted on by Michelle Fritsch, Pharm.D.
No U-turn available
Supportive options when it’s time for end-of-life care.

Now we turn to end-of-life care.  Last blog we talked about the U-turns available in your life and health. These can help you feel better and live healthier. We learned you can still make changes that have a positive impact on your overall health.

What about when a U-turn is not available?

What about when you get that diagnosis of:

The U-turn is not available.

We can’t stop it. We won’t be able to turn it around. There are a number of conditions that at this moment have no cure or way to get rid of them.

When we run out of options, then the end of life becomes our focus. This is peaceful for some. It is frightening and a huge struggle for others. It impacts not only the person diagnosed but also all of their friends and family. Each person involved deals with a number of feelings during this time. There can be guilt, fear, conflict, regret, and grief, among others.

The support of others, education about what is happening, and sources of comfort are critical.

Resources for end-of-life

Following are some resources for everyone involved in end-of-life care.

  • Support groups – There are support groups for most common diagnoses, for people with the diagnosis and for caregivers and family members, and for various stages of the condition.
  • Caregiver stress and burden – Caring for a loved one near the end of life can be emotionally and physically exhausting. There are many resources that provide assistance (such as in-home care agencies) or respite (short term stays while the caregiver takes a break).
  • Caregiver care – A caregiver can’t fully care for their loved one if they don’t also take care of themselves. Emotional, physical, and spiritual health need attention during this demanding time.
  • Resources – Your community will have various agencies available to provide numerous sources of help. These include direct healthcare, legal guidance, financial aid, spiritual support, placement options, and more. If the person nearing end-of-life is over age 65, your local Agency on Aging could be a valuable source of lists of the resources available in your area.
  • Palliative care – This is care that is focused on comfort and support to accomplish goals toward the end of life.
    • Hospice is one form of palliative care. Your hospice organization can support you, provide education about current and future changes, and help you with preparation for all involved.

When the end-of-life can be anticipated (vs suddenly taken), there is an opportunity to prepare and fully live those final months or days.

For more information about end-of-life options, contact us at www.medsmash.com.

BIBLICAL APPLICATION

What’s different about the people that find peace in the end of life?

Romans 6:23 ESV

For the wages of sin is death, but the free gift of God is eternal life in Christ Jesus our Lord.

This tells us that death of this life is not he end. It is only the beginning of eternity. What does that mean to you? Is it really true?

John 3:16 ESV

“For God so loved the world, that he gave his only Son, that whoever believes in him should not perish but have eternal life.”

The hope we can take through those seasons of palliative care and hospice is the result of anticipating the end of this life and moving on to eternal life.

John 5:24 ESV

Truly, truly, I say to you, whoever hears my word and believes him who sent me has eternal life. He does not come into judgment, but has passed from death to life.

Ephesians 2:8-9 ESV

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

If this life is just the preamble to a life of eternity with Christ, then death loses its sting.

1 Corinthians 15:55-57 NIV

“Where, O death, is your victory?

    Where, O death, is your sting?”

The sting of death is sin, and the power of sin is the law.  But thanks be to God! He gives us the victory through our Lord Jesus Christ.

I pray you find hope and peace as you ponder this perspective of death.

Blessings,

Michelle

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

Posted on by Michelle Fritsch, Pharm.D.
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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

 

Appropriate medications – same at 30, 60, and 90?

Posted on by Michelle Fritsch, Pharm.D.
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Appropriate medications over age 60

Should the same medications and doses be prescribed for all ages? No! However, we find that often they are.   If a medication was a good choice for you at 30, is it still a good choice at 60 or 90? Not necessarily. So, why does age matter?  How do you know that you are taking all appropriate medications?

What changes as we age?

Even if you eat right, exercise regularly, and make good choices about alcohol and tobacco, changes occur over time.

  • 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 comes 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 list is not meant to depress anyone. These are just some of the very natural changes that occur in all of us. So with all of this change, the need for medication, the types of medications that are needed, and the doses of medications are all different.

Nearly all medications leave the body through the urine or the stool. Most medications are changed as they pass through the liver. There are enzymes in the liver that break down those medications. When the kidneys and liver become less functional, it takes longer to get the medications back out of your body. This means a single dose can last longer or have a bigger impact.

Most medications have a preference for water (hydrophilic) or fat (lipophilic). Since body water and fat both change, medication concentrations also change.

Guidelines for taking appropriate medications

There are so many changes to manage that guidelines have been written to try to decrease some of the more common mistakes that are made. These are oriented to people over age 65. The Beer’s List was first developed by a group of doctors in 1991. It has since been updated many times. It contains a list of medications not to use and another list to use with special precautions. There is also a guideline called STOPP that lists medications to avoid in adults over 65. For both guidelines, there are safe options to use in place of the medications on the lists.

If you are 60+, is there a specialist in medication use for people of your age monitoring your medication use? Can you really afford to avoid this review? We have found there is some issue to address 98% of the time we provide an assessment. For your personal assessment, contact us at www.medsmash.com.

BIBLICAL APPLICATION

Medications change as you age. And so do so many other things. Many of these changes are wonderful! You benefit from the many lessons you’ve learned through your life so far. You are able to share those experiences, insights, and lessons with others. You probably sweat the small stuff less. You also tend to enjoy the little things more.

I heard a message today that really captured my attention. A picture was painted about grace and faith and their relationship.

As stated by John Stott, ‘Faith’s exclusive function is humbly to receive what grace offers. Grace gives and faith takes’.

Grace is offered to you on a constant basis. But, it has been my experience, it takes time and lessons learned to really develop faith so that grace can be received. Faith tends to grow with time and experience.

Ephesians 2:8 ESV

For by grace you have been saved through faith. And this is not your own doing; it is the gift of God,

Hebrews 11:1 ESV

Now faith is the assurance of things hoped for, the conviction of things not seen.

Romans 10:17 ESV

So faith comes from hearing, and hearing through the word of Christ.

Salvation by grace is a gift. Faith is how you receive that gift.

Ponder this great news this week!

Blessings,

Michelle

Hypertension ≠ High Tension

Posted on by Michelle Fritsch, Pharm.D.

I have Heart - NIHhad several clients who have interpreted the medical condition hypertension as ‘high tension’. They thought this was a condition related to stress. And then, several thought the condition was only present when they were feeling stressed.

How much stress is there in your life right now? How much stress is there in the world? Some of us feel stressed much of the time. Others take a laid back approach to life and rarely feel stress.

Is it true that the stressed people have hypertension and the laid back people don’t?

NO

Hypertension (also known as high blood pressure) is a medical condition that goes way beyond stress or tension. It is a complex condition that is related to our genes (which we can’t control), our environment (some of which we can control), our behaviors (which we CAN control), and likely other factors that are still to be discovered.

Because it is such a complex condition with so many systems in the body involved, there are many medications that are used to treat it. Each category, or type, of medicaion treats hypertension in a different way. So, for some people, hypertension can be controlled with one medication. For other people, it could take two, three, four, or more medications, each acting on a different aspect of the condition.

How high is too high? The very general answer is a blood pressure over 140/90 is too high based on current guidelines. If someone has a history of heart disease or diabetes or some other conditions, your doctor might give you a lower goal such as less than 130/80.

How low is too low? Too low is not a strict number. Rather, it is more related to symptoms. If you feel dizzy when you stand or turn, have seen a marked decrease in your energy since starting your hypertension medicine, or are having trouble catching your breath, talk with your doctor.

Blood pressure that gets too high can be dangerous. It can lead to a myocardial infarction (heart attack) or stroke.

So what can you do about hypertension if you have it?

Check back next week for a ‘prescription’ for lowering and controlling your blood pressure.

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

Biblical Application

Do you have stress in your life? Do you worry? Does your mind keep you awake at night thinking about all you need to do, or the things you are worried about?

I don’t know about you, but just watching the news can increase my stress level. It all seems so out of control.

It is at those times that we can be assured that God is in control. Ultimately, God wins. This universe, all of history, all current events, and the future belong to Him.

On Sunday our pastor mentioned that you could sum up the entire Bible in two words – GRACE and PEACE. Jesus came to provide access to both. His grace and peace are with us at all times; we just need to quiet ourselves, turn our hearts and minds to Him to experience it.

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.

Matthew 6:34 ESV

“Therefore do not be anxious about tomorrow, for tomorrow will be anxious for itself. Sufficient for the day is its own trouble.

1 Peter 5:7 NIV

Cast all your anxiety on him because he cares for you.

John 14:27 NLT

“I am leaving you with a gift—peace of mind and heart. And the peace I give is a gift the world cannot give. So don’t be troubled or afraid.

Don’t let your hearts be troubled. God is in control.

Blessings,

Michelle

Image Source:  National Heart, Lung, and Blood Institute; National Institutes of Health; U.S. Department of Health and Human Services