hypertension

Lonely path of chronic illness

The Road of Chronic Illness is (Sometimes) Lonely

Posted on by Michelle Fritsch, Pharm.D.
Lonely path of chronic illness
Take these steps to stay motivated in the care of a chronic illness.

Have you experienced this? You have new symptoms, so friends and family are concerned and checking on you. You get a new chronic diagnosis, and friends and family are concerned and supportive.

Then, the ‘new’ wears off. The condition continues. The treatment continues. But, the concerned and supportive people have moved on to other issues.

How do you stay motivated to stay on your therapy? How do you stay focused on the necessary steps to control your medical condition? How do you maintain your resolve to stay healthy?

Chronic Illness can be Silent

Have you been diagnosed with high blood pressure, high cholesterol, diabetes, asthma, or arthritis? Have you had a stroke or a heart attack? There are so many types of chronic medical conditions.

Some of these conditions you don’t feel. Your blood pressure can be high, and you feel completely fine.   The same is true with your cholesterol. Even with diabetes, it can get pretty far from normal with no symptoms for many people.

Then, there is the fact that all medications can cause side effects. So, sometimes people feel worse on their medicine than they do when they don’t take it. Talk about hard to stay motivated!

Chronic Illness requires Understanding

One of the key factors in taking care of yourself is really understanding your condition and the treatment. If you have a chronic illness and you don’t fully understand it, please talk with your doctor, your pharmacist, or call us at Meds MASH. It is very hard to know how to take care of yourself if you don’t understand the what, why, how, when aspects of your condition. And it is VERY hard to stay motivated without this understanding.

In addition to the condition itself, you need to really understand the therapy that is prescribed. This can be medication, exercise, diet changes, physical therapy, counseling, or many other kinds of therapy. You need to know why, how this therapy can help, and what you can expect. If there are common side effects, you should know that. If it will take a month to work, you need to know that.

Chronic Illness is Easier to Manage with Support

I was talking about this with some friends who are in recovery from substance abuse. Addiction is one of many types of chronic illnesses. It is also an area that has repeatedly proven the value of support when conquering chronic illness. The 12-step program of recovery is built around the need for community, accountability, and belief in a higher power.

There are support groups available for most medical conditions. Some are groups that meet in person. Some are led by a health professional, others are peer led. Some are groups that meet and interact online.

It can be helpful to know that you are not alone. Most people benefit from sharing their experience, exchanging tips of what works and what doesn’t for them, and just supporting each other. We all have our good days and bad. In a group, someone will be having a good day and be able to help you through your bad day. Next time, you can be the helper and supporter.

If we can help you find a support group or help you to REALLY understand your condition and treatments, please contact us at www.medsmash.com or 410-472-5078.

BIBLICAL APPLICATION

The path of chronic illness is easier to walk with support – family, friends, and a support group of people with the same chronic illness. Likewise, the path of spiritual growth is easiest to walk in community with other believers.

Having other believers around you helps in many ways:

  • Work through questions
  • Share ideas and insights
  • Hold each other accountable
  • Comfort each other
  • Celebrate with each other
  • Pray together
  • Live life together

1 Thessalonians 5:11 ESV

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

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.

I like the way God created us to work together through life and support each other.

Jesus promises he is with us always. So, no one is ever alone. Having friends, small groups, teachers to remind us of that and share their never alone stories can be very helpful.

1 Peter 5:7 ESV

Casting all your anxieties on him, because he cares for you.

Hebrews 13:5 ESV

Keep your life free from love of money, and be content with what you have, for he has said, “I will never leave you nor forsake you.”

One of the verses that I always find most comforting, especially when I’m feeling lonely, self-conscious, or insecure is this next one.

Romans 8:35-39 ESV

Who shall separate us from the love of Christ? Shall tribulation, or distress, or persecution, or famine, or nakedness, or danger, or sword? As it is written, “For your sake we are being killed all the day long; we are regarded as sheep to be slaughtered.” No, in all these things we are more than conquerors through him who loved us. For I am sure that neither death nor life, nor angels nor rulers, nor things present nor things to come, nor powers, 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.

You and I are never alone. We are unconditionally loved!

Blessings,

Michelle

 

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Sugar, Pressure, and Lipids…Oh My! Metabolic Syndrome

Posted on by Michelle Fritsch, Pharm.D.

Slide1Do you have diabetes, or have you been told you have pre-diabetes? Are you overweight, especially around your midsection? Do you have high blood pressure? Do you have high cholesterol? Did you know they often go hand-in-hand? As a group they are called ‘metabolic syndrome’.

Metabolic Syndrome

This term describes a collection of medical conditions that each impacts the other. These conditions have many negative effects on your body. The primary risks have to do with your possibility of heart disease and stroke.

Risk factors

The biggest risk factor seems to be weight. Our population as a whole has been gaining weight over the last several years. As that has occurred, the number of people with diabetes has rapidly climbed. The number of people with metabolic syndrome has also climbed. Family history of high blood pressure, diabetes, heart disease, and/or high cholesterol also increases your risk of developing these conditions.

Treatment

No matter what medications are used, DIET and EXERCISE are key components of treatment. In particular, less fat, salt, sugar, carbohydrates, and overall calories can help you control this syndrome. Simple carbohydrates are foods like white bread, white pasta, sweets, honey, and fruits.

There have been many new types of medications to treat diabetes in recent years. This is great news if you have type 2 diabetes! The different types of medication help control your blood sugar in different ways. So, you might find that more than one medication is used.

The situation is similar with high blood pressure. There are several different types of medications to lower blood pressure.  These impact the blood pressure from different mechanisms. Using more than one can better lower blood pressure in some patients.

The best type of cholesterol medication depends on which parts of the lipid profile are to be treated. Which are selected is also impacted by liver function.

In addition to those medicines, often a low-dose aspirin is added to further lower risk for heart attack or stroke.

So, if you have metabolic syndrome, you are probably taking several different medications. You also hopefully monitor parts of the syndrome at home – blood pressure and/or blood sugars.

If you would like to better understand your medication regimen, please contact us at www.medsmash.com.

BIBLICAL APPLICATION

There are multiple different types of medications that approach the control of some medical conditions from different angles. Similarly, there are multiple ways to worship. In what ways do you worship the Lord?

Colossians 3:14-17 ESV

And above all these put on love, which binds everything together in perfect harmony. And let the peace of Christ rule in your hearts, to which indeed you were called in one body. And be thankful. Let the word of Christ dwell in you richly, teaching and admonishing one another in all wisdom, singing psalms and hymns and spiritual songs, with thankfulness in your hearts to God. 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.

John 4:24 ESV

God is spirit, and those who worship him must worship in spirit and truth.”

Psalm 95:6 ESV

Oh come, let us worship and bow down; let us kneel before the Lord, our Maker!

Isaiah 12:5 ESV

“Sing praises to the Lord, for he has done gloriously; let this be made known in all the earth.

Worship is so much more than going to church on Sunday. God wants you to get to know Him and to worship in multiple ways. Fully experience the glory and joy of God!

Blessings,

Michelle

Weight – Less of you might mean less in your medicine cabinet

Posted on by Michelle Fritsch, Pharm.D.

…or at

Medicine doses should be adjusted with weight loss
Medicine doses should be adjusted with weight loss

least lower doses.

Healthy weight loss can lead to decreased doses

Unhealthy weight loss can, too. Actually, sudden, unexpected, or drastic weight loss can be even more hazardous. If it is unplanned please talk with your doctor right away.

Fat loving (lipophilic) medicines distribute throughout all of the extra weight in our bodies. The medication finds places to travel and stay stored in all of these fatty areas. Once we lose fat, it takes a lower dose to get the same effect. If the dose is not changed with weight loss, the same dose you have taken for years can actually be toxic. Rather than being stored in the fat, the amount of medicine stays in your blood where it has more effect. I have seen several cases where someone was getting more confused, more sleepy, having more difficulty thinking with no change in their medicine regimen. Upon further analysis, we found they had lost several pounds over the past several months with no reduction in medicine dose. So talk with your doctor as you lose weight to double check doses of meds.

Medical conditions related to weight

There are also several medical conditions that are related to your weight, especially excess weight. For many people diabetes, high blood pressure, and high cholesterol are found when the person is overweight. They get worse with increased weight. If that person then loses weight, those medical conditions can get better. The need for medicines to control these conditions can go down as the body is better able to manage the blood sugar, blood pressure, and cholesterol on its own. This means the number and doses of medicines might also need to be decreased. Blood pressure medicine doses that are too high can lead to dizziness, especially with standing, and falls. Diabetes medicine doses that are too high can lead to low blood sugar, confusion, dizziness, sweating, or even passing out. Cholesterol medicine doses that are too high might increase risk of side effects like liver damage or muscle pain.

If you have diabetes, high blood pressure, or high cholesterol and have lost at least five pounds, ask your doctor if you could take fewer medicines or lower doses.

What are other benefits of weight loss?

Data has shown that a 5% weight loss can help prevent high blood pressure. It can also help control your blood pressure, your diabetes, and your cholesterol. So, if you weigh 200 pounds, this would be a 10 pound weight loss. This can be accomplished through diet and exercise. Fast weight loss fad diets are NOT the diets of choice. Eating healthy foods, vegetables, fruits, and low-fat options are the safest diet changes. Also, exercise does not mean running a marathon tomorrow. Increased movement several times each day can have a huge positive benefit.

I had one patient once who took this message to heart. He gradually changed his diet and started walking. None of his changes were extreme. Over time, he lost weight. We were able to remove EIGHT medicines from his regimen as his own body resumed control of his conditions. Not everyone will have results this dramatic, but small changes can have big positive impacts.

For more information about healthy weight loss and associated medicine reductions, please contact us at www.medsmash.com.

BIBLICAL APPLICATION

In line with these thoughts about the positive benefits of weight loss, consider the benefits of guilt loss! How much of your daily activity is influenced by guilt? Do ayou feel worthy, accepted, loved, precious, and good enough? Or, do doubts cast a shadow over you? Do feelings of guilt or shame impact your confidence and your attitude? Are you as positive and hopeful s you could be?

If you could shed guilt and shame, can you even imagine how much lighter your load would be? Think how much freer you would be to rejoice and praise and live the life you were meant to live!

Here are some of the thoughts in the Bible about guilt.

Romans 8:1 ESV

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

Romans 3:23 ESV

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

Romans 5:1 ESV

Therefore, since we have been justified by faith, we have peace with God through our Lord Jesus Christ.

Rather than being burdened and weighed down by guilt, consider this offer from Jesus.

Matthew 11:28-30 ESV

Come to me, all who labor and are heavy laden, and I will give you rest. Take my yoke upon you, and learn from me, for I am gentle and lowly in heart, and you will find rest for your souls. For my yoke is easy, and my burden is light.”

The past is gone. You are forgiven! You do not need to carry around this guilt and shame. Shed it and see how good you can feel!

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 4:22-24 ESV

To put off your old self, which belongs to your former manner of life and is corrupt through deceitful desires, and to be renewed in the spirit of your minds, and to put on the new self, created after the likeness of God in true righteousness and holiness.

Blessings,

Michelle

Image Source:  National Center for Complementary and Integrative Health; National Institutes of Health; U.S. Department of Health and Human Services

Flu or Cold – What do you take with high blood pressure?

Posted on by Michelle Fritsch, Pharm.D.

‘Tis the season of flu, cough, and colds. I’ll be surprised if you don’t know someone with one of these right now. There are many products lining the shelves of the pharmacies and grocery stores ready to treat your symptoms.

If you have high blood pressure or a heart condition

Does it matter which product you choose to treat your symptoms if you have high blood pressure, heart failure, have had a heart attack, or you have some other heart condition? Actually, it does. Most of the products used to treat your cold or flu contain two main ingredients: decongestant and antihistamine.

Decongestants decrease the swelling of the lining of your nose. When these swell, you feel stuffy and have trouble breathing through your nose. Taking one while you have a cold or flu can help you breath better and relieve that stuffed-up feeling. Decongestants can be found in tablets, capsules, nasal sprays, nose drops, and liquids. They are often found in combination with other medicines for fever, headache, cough, sore throat, and mucous.

Decongestants work by increasing your sympathetic system. This is the part of your system that kicks in to gear when you are angry or afraid. It is called the ‘fight or flight’ response. It also causes your heart to beat harder and faster.   Your veins and arteries get tighter. Your blood pressure goes up.

If you have high blood pressure or heart disease, this is not helpful. It puts you at risk of worse heart disease or even heart attack or stroke.

Antihistamines block histamine. This helps to dry up a runny nose, tearing of your eyes, sneezing, and itching in your nose and eyes. They are helpful with these symptoms for allergies or for colds/flu. They come in tablets, capsules, liquid, eye drops, and nasal spray. Some of the antihistamines (first generation) cause you to be sleepy and slow your thinking. The newer, second generation versions have fewer of these side effects, but they can still make you sleepy. Be very careful if you must drive while taking these.

Antihistamines should also be taken with caution with people in high blood pressure or heart disease.

The cold and flu medicines on the market for people with high blood pressure leave out the decongestant. They have the antihistamine and usually acetaminophen for fever. So, still be careful using these if you have high blood pressure. Check your blood pressure while you are taking them. Let your doctor know what you are taking for your cold and flu.

So, if most of the cough and cold and flu medicines on the market are not good for your heart or blood pressure, what should you do?

What can you do without taking cold and flu medicines?

For your fever, take acetaminophen. Medicines like ibuprofen (brand names Motrin, Advil) or naproxen (brand name Aleve) can raise your blood pressure and increase your risk of heart disease.

For your congestion, try a humidifier. Moist, warm or cool air can help break up the mucous and ease your swollen nasal passages.

Get plenty of rest so your body’s immune system can fight the virus. Drink plenty of fluid.

With or without a decongestant or antihistamine your cold or flu is likely to last about 5-7days.

Wash your hands, especially after being out in public. When you are in public or haven’t washed your hands recently, avoid touching your face (mouth, nose, eyes). And finally, please get your flu shot each year!

For more information about managing a cold or the flu with high blood pressure, please contact us at www.medsmash.com.

BIBLICAL APPLICATION

When you have high blood pressure or a heart condition, your treatment options for a cold or the flu are limited. To avoid letting your blood pressure get even higher, you need to carefully select a treatment that is best for you and your specific medical conditions.

Similarly, in your faith walk, what is best for you might not be best for someone else.

Paul mentioned this in at least two of his letters. After Christ came to reconcile us with God, the rules of the past changed. But, this was easier to accept for some people than for others. In particular, new believers found this transition to be confusing sometimes.

So Paul encouraged all believers to consider their friends and neighbors when making decisions. If something would cause confusion for someone else, then Paul encourages us to not do that thing.

Romans 14:13 ESV

Therefore let us not pass judgment on one another any longer, but rather decide never to put a stumbling block or hindrance in the way of a brother.

1 Corinthians 8:13 ESV

Therefore, if food makes my brother stumble, I will never eat meat, lest I make my brother stumble.

1 Corinthians 8:9 ESV

But take care that this right of yours does not somehow become a stumbling block to the weak.

These verses make even more sense in context, so I encourage you to read them within their chapter.

Remember those around you when making decisions. It is easy to get caught up in your own life and not even think about how your actions impact others. Even when you are making ‘good’ decisions, realize other people younger in their faith might not understand your freedoms and reasons for exercising those freedoms.

Blessings,

Michelle

I have hypertension – so what, I don’t feel any different

Posted on by Michelle Fritsch, Pharm.D.

When your bSlide1lood pressure is elevated, most often you don’t feel anything. It is a silent condition. All medications have the potential for side effects. So many people have chosen to avoid the medications and ignore the hypertension.

So what?

If untreated, high blood pressure (hypertension) can lead to heart attacks, strokes, heart failure, and other cardiovascular conditions. It really is a big deal.

So what can you do if you have hypertension?

First, take your medicine every day as prescribed! If you have side effects or problems taking it, tell your doctor or pharmacist right away.

Second, if you smoke, it is truly important that you stop. Smoking greatly increases your risk of a heart attack or stroke.

Third, if you drink alcohol, limit yourself to 1 drink per day and let your doctor know that you drink. This way your medicine regimen can be chosen with that in mind to reduce any risks to you.

Fourth, limit your salt intake. Ideally stop using your saltshaker, rinse your canned vegetables and
cook them in fresh water, watch sodium content in foods.   Many quick and easy (heat and eat) foods are high in sodium. This can increase your blood pressure.

Fifth, maintain a healthy weight. Being overweight increases your risk for heart disease and makes your blood pressure harder to control. Losing weight usually requires a combination of healthier eating and exercise. Check with your doctor before you start an exercise routine to be sure it is a healthy one for you with your hypertension. (You can calculate your body mass index at this link.)

Sixth, control your diabetes. Many people with diabetes have hypertension and are overweight. Metabolic syndrome is a term to describe having hypertension; obesity, especially around your middle; high cholesterol; and diabetes. Having this syndrome is another risk factor for heart disease and stroke.

So, there are several healthy steps you can take to protect your heart and lower your blood pressure.

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

Biblical Application

Choices. We are faced with them every day. Sometimes the bad choices seem so much easier than the good choices.

Where can you find the strength and willpower to make good choices?

On your own, there are definite limits to what you can do. Temptations can be great. Life changes, whether your diet, your exercise, or a host of other areas, can be a source of great frustration. Words like procrastination, justification, avoidance, and defensiveness come to mind. Have you experienced any of these?

But you do have access to infinite strength and support.

Philippians 4:13 ESV

I can do all things through him who strengthens me.

Deuteronomy 31:6 ESV

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

Isaiah 41:10 ESV

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

Deuteronomy 20:4 ESV

For the Lord your God is he who goes with you to fight for you against your enemies, to give you the victory.’

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.

Rather than trying to make important changes with your own strength and willpower, turn to your true power source. Take that minute by minute journey with God leading you through.

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