Filters – living through the stresses in our society

Posted on May 16, 2019May 16, 2019 by Michelle Fritsch, Pharm.D.

Filters - so you can hear the love — Use filters to manage stress and bad news to preserve your health.

I was sitting at a stoplight one block from UNC-Charlotte preparing to turn on to WT Harris Boulevard when it felt like at explosion of sirens went off. Suddenly there were rescue vehicles coming from everywhere. There were fire trucks, police cars, ambulances, marked and unmarked vehicles with lights and sirens. It was completely disorienting. I then watched motorists make all sorts of bad decisions. Some tried to speed through intersections in front of emergency vehicles. Some pulled to the right, some pulled to the left, some just stopped where they were. It was complete chaos with these first responders trying to weave their way through the confused masses to get to the emergency.

It was a couple of hours before I learned that a gunman had entered campus and started shooting in a classroom on the last day of classes for the semester.

It was a few hours after that when I learned of the heroism of Riley Howell who ran toward the gunman and saved many lives while losing his own.

And it was a few hours after that when another life was lost just off campus in an altercation. This lost life didn’t receive as much attention, but was still a precious life lost.

Then, as were moving our daughter back from Clemson a couple of days later, she received notice of a senior killed when he hit the back of a stopped dump truck on the highway.

In the midst of all of this loss I have talked with several parents of college students. Some are grieving and throwing themselves into remembrance events. Some are shocked and having difficulty resuming daily life. Some are having nightmares and anxiety. Some are carrying on as if nothing happened.

Healthy Responses

What are healthy responses to the events around us? Certainly no day carries a guarantee of safety or ease. And, rarely does a day carry a certainty of difficulty. Most days arrive, and we use our toolbox of skills and emotional intelligence to get through them.

So what is in your toolbox of skills?

Who are the key people who support you?
How do you relieve stress?
How much attention do you give to the news?
How have you been hurt in the past?
How have you dealt with that past hurt?
What is your source of hope?

Filters as tools

As a healthcare provider, I have encountered countless people with negative health outcomes related to a lack of tools to handle stress and negative events.

Some of these negative health outcomes have included chronic pain, anxiety, depression, isolation, heart attacks, strokes, phobias, and deep anger.

Consider these filters to enhance a healthier response –

Gratitude– What is going right in your life? For what can you be thankful?
Who/what is higher than you– deity, person, other that can help guide and protect you?
Past events– When have you been stressed or in a bad situation in the past and now you are on the other side? You survived. If all of those events in the past were survivable, how can that bring you hope in this situation?
Perspective– What is the worst possible scenario you can imagine? If you can imagine that, your reality is most likely to be much better than that.
Let it go– How have you learned to forgive and move on?This is one of the most freeing acts you can take for your own health.

Retirement stress

Are you nearing or past retirement and feel like you’re surrounded by stress and worry? We can help!

BIBLICAL APPLICATION

I have this mental image of the devil with a bullhorn blasting messages of doubt, insecurity, worry, what-if’s, self-deprecation, and other ugliness right into my brain. His messages are so noisy and chaotic! They can pull me down and sit on me to pin me to the ground if I don’t take action.

Do you ever feel the same way?

Jesus is speaking into my other ear with messages of love, acceptance, strength, mercy, and grace. He does not use a bullhorn. In fact, if I don’t make an effort, I won’t even hear his sweet call.

This is what I picture is happening to each person I meet.

So, how do we tune out the bullhorn and relax into the loving messages?

Here are a few tips that I know to be true. (Now don’t ask if I practice them every day. I 100% know that my day is so much better when I do, and I still mess up and skip these life-sustaining practices regularly.)

Thanks to the advice of a Godly friend, I use an app called ‘Remember Me’ to keep favorite verses on my phone. When I have a minute here, 5 minutes there, I work to memorize these key verses.
Spend TRULY quiet time focused on God and hearing His voice each day.
Stay in the Word. Keep dedicated Bible reading time and really pray and think about what you are reading, asking God to explain. It’s amazing what you will learn!
Think outside of yourself. Be aware of the people around you. Reach out to friends in need. Reach out to friends who you don’t know are in need (they all have the bullhorn in their ear).
Let God guide your path. Satan will keep you so busy you can’t catch your breath. Let God quiet you and focus you on what matters.

Here are some favorite verses about God’s deep, unfathomable love for you to get you started!

Romans 5:8 ESV

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

1 John 4:19 ESV

We love because he first loved us.

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.

1 John 4:16 ESV

So we have come to know and to believe the love that God has for us. God is love, and whoever abides in love abides in God, and God abides in him.

Use those filters and have a blessed week!

Michelle

Hanging by a Thread

Posted on December 19, 2018December 19, 2018 by Michelle Fritsch, Pharm.D.

Do you ever feel like you’re barely hanging on by your fingernails? All might even look right when people look at you, but you’re really enduring a great struggle? I think that is true of many people. In this case, knowing you’re not alone doesn’t help the current situation.

What leads to this situation?

Wow, the number of ways someone can find him/herself in this situation is large and diverse. Here are a few:

Loss of a loved one, friend, dear colleague
Loss of a job
Major life transition
Financial pressures
Unrealistic expectations
Isolation
Constant negativity
Not finding a source of hope
Situation that seems endless

What are the signs?

Sometimes people find themselves at this point and are surprised. The loss or life change might have come out of nowhere. Or, the slope to hanging by a thread might have been gradual and barely noticeable.

Some of the signs I hear clients talk about include:

Waking up with anxiety during the night
Loss of energy
Changes in appetite
Thoughts that are hard to quiet
Worry
Stress
Depression
Hopelessness
Decreased sense of self worth

There are physical effects of being in this dark place. Blood pressure and blood sugar are harder to control. When sleep patterns change, risk of depression, pain, and anxiety go up. Productivity declines, so there are lost days of work or decreased work getting done (and that can further increase the stress). Relationships can suffer.

Taking the next steps forward

The first step in recovery is to recognize the signs. Realize you are in this place.

The next step is to realize you don’t need to walk this path alone. If you have trusted family or friends, let them help you. Call your doctor and explain the situation and how you are feeling. Reach out!

The step that is most important is to find your source of hope and meaning.

Finding and focusing on hope and things beyond yourself

Life contains many struggles. That is true for everyone no matter their occupation, the country where they live, their religion, their political beliefs, or their hair color.

People really struggle to handle the ups and downs of life alone. The tendency is to get more and more focused on yourself and your situation. This is a deep, dark, downward spiral. We have probably all found ourselves on that dark path at least once. Some people live in this vicious cyclone of self.

If you’re there now, make a real effort to reach out the do something for someone else today. It can be something as simple as holding a door or giving them a place in front of you in line. Small and large acts of kindness toward other people is one of the best remedies for our own difficult times. Try it and see!

The other is finding your source of hope. Hope is what gets us through the tough times. It is what changes our perspective beyond ourselves and our current situations. It is liberating!

Hope through Christ is central in the Christian beliefs.

Hope is a critical element of the Jewish tradition.

Hope is integral in the Muslim faith.

Hope is a common theme in Buddhism.

If you aren’t sure of your source of hope, I encourage you to invest some time to reflect on this area of your life.

Retirement Wellness Strategies

A growing number of retirees are finding themselves disgruntled, disillusioned, and hanging by a thread. Startlingly, the suicide rate is rapidly escalating. One of the primary purposes of Retirement Wellness Strategies is to facilitate finding meaning, relevance, and peace in retirement.

You can reach us at www.retirewellness.com, michelle@retirewellness.com, or call at 410-472-5078.

BIBLICAL APPLICATION

When have you last been, or why are you now ‘hanging by a thread’? We’ve all been there. Throughout the Bible, we are assured we will have trouble.

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.”

Romans 12:12 ESV

Rejoice in hope, be patient in tribulation, be constant in prayer.

1 Peter 5:10 ESV

And after you have suffered a little while, the God of all grace, who has called you to his eternal glory in Christ, will himself restore, confirm, strengthen, and establish you.

These verses tell us trouble is just going to happen. You are definitely not the only one enduring trouble. You are not being specifically punished while the rest of the world goes on their merry way.

[Side note, the world you see people portray on social media is not all reality. Those are the super great moments of people’s lives. They have ugly, messy, stinky, troubling moment, too – just like you.]

These verses also tell us God knows we are living through difficult times. God knows we struggle. And, God has not left us alone. He loves us! He is looking out for us! He is here to help us!

James 1:12 ESV

Blessed is the man who remains steadfast under trial, for when he has stood the test he will receive the crown of life, which God has promised to those who love him.

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.

1 John 5:14 ESV

And this is the confidence that we have toward him, that if we ask anything according to his will he hears us.

Jesus was born to offer the ultimate sacrifice to save us. It is in this HOPE that we can endure difficult times and rest assured of His unconditional love!

Jeremiah 29:11 ESV

For I know the plans I have for you, declares the Lord, plans for welfare and not for evil, to give you a future and a hope.

Romans 15:13 ESV

May the God of hope fill you with all joy and peace in believing, so that by the power of the Holy Spirit you may abound in hope.

I’m praying you take the time in your busy-ness and struggles to reach for God and His promises. May you find that peace that surpasses understanding!

Blessings,

Michelle

Why is DIVORCE during and after retirement on the rise?

Posted on July 6, 2018July 6, 2018 by Michelle Fritsch, Pharm.D.

Protect your marriage from the stresses of divorce

Divorce around retirement – You’ve seen it in pop culture, in famous people. And, you’ve likely seen it in your own community. It won’t be surprising if you are seeing this trend in your own family, even your own marriage.

The incidence of divorce over age 50 is experiencing a sharp rise. It has nearly TRIPLED since 1990. (Interestingly, the divorce rate among younger adults under age 40 is declining). So, why are the Boomer’s divorcing at an unprecedented rate?

The role of RETIREMENT in divorce

Retirement is one of the top 10 biggest life adjustments. It is a time of huge transition ranking right up there with marriage, having children, moving, and loss of a loved one.

Many people enter retirement unprepared. They often haven’t thought about the daily changes, the sudden loss of routine, and the sudden increase in togetherness time with their spouse.

In a perfect, romantic world, more time together is exactly what each couple wants. Nothing in life is perfect, at least not for long.

That’s not to say that marriages can’t thrive in retirement. They absolutely can. But that usually requires some communication, compromise, and adjusted expectations.

A healthy marriage in retirement

Both partners have a lot of change to navigate with retirement. Time spent together usually increases. Either partner might find that restrictive. The more we are together, the more complicated communication can be as well. (It is much easier to say the wrong thing when you’re talking more).

The most important step to a healthy marriage in retirement is to talk about it before it happens, or at least before relations get very hurtful after retirement. Rarely do both partners have a clear picture of what retirement will really be like. But, both have some ideas of what they want it to be like. How much have you talked about this?
Until it happens, sometimes people don’t even know what might annoy, frustrate, or stifle them in retirement. Agree to be open with one another as these stumbling blocks present themselves. Recognize that they will occur, and before they are personal or hurtful, calmly talk about them.
Plan for how you will maintain some independent interests and activities. If you have had only a few hours in the evening and on the weekends together for decades, 24/7 togetherness can be overwhelming.
Talk about expectations. What are common aspirations, plans, and desires? Unmet expectations are almost always at the center of a divorce. Often, one doesn’t know what the other was expecting until the relationship is too far-gone. Don’t let that happen.
1. I’ve seen examples where one person wants to travel while the other wants to stay home.
2. Sometimes one has always dreamed of taking couples dance lessons and the other would rather do anything but that.
3. A big issue I’ve seen is one spouse wants a lot of togetherness going and doing things while the other wants to spend most time with the grandchildren.
Include the more intimate parts of your relationship in your planning. This is an area of frequent mismatch in expectations. There is NO truth that sex ends at a particular age. It is very helpful when partners can open discuss these expectations and honor what motivates the other partner to share the same desires.

Planning is key

Don’t leave your marriage to chance after retirement. Recognize that retirement is a major life transition. Respect the wide range of emotions and adjustments each partner will make.

Retirement Wellness Strategies is here to help! Let us help you preserve your health and strategically plan for all aspects of your retirement such that it is Meaningful, Active, Sustained, and Healthy!

Learn more at www.retirewellness.com, michelle@retirewellness.com, or call 410-472-5078.

BIBLICAL APPLICATION

Marriage is sacred. Marriage vows are committed in the presence of God and witnesses.

Yet, marriage can be very hard. Marriages go through good and bad times (as usually stated in the vows).

Today’s culture values feelings over commitment. Culture supports and sometimes even promotes greater focus on self than on a partner.

I know so many lovely people who have experienced the trauma of divorce. Know that you are deeply loved. God knows the details. Give the grief, disillusionment, and any other feelings over to him who can heal all wounds.

Where have you made mistakes in your marriage?

When have you put yourself above your spouse?

When have you been hurtful and unkind?

When have you taken your marriage for granted?

I believe all married people have done these things. We all have difficult days.

The commitment of marriage doesn’t mean sunshine and roses.

1 Corinthians 13:4-7 ESV

Love is patient and kind; love does not envy or boast; it is not arrogant or rude. It does not insist on its own way; it is not irritable or resentful; it does not rejoice at wrongdoing, but rejoices with the truth. Love bears all things, believes all things, hopes all things, endures all things.

There’s a reason these verses list all of the ways we mess up in marriage or any love relationship.

If you feel like you’ve done it all wrong, don’t give up hope. Love comes from God, and He can fill your love bucket at any time…just ask. Love is so much more than a mushy feeling.

Ephesians 5:33 ESV

However, let each one of you love his wife as himself, and let the wife see that she respects her husband.

1 John 4:7 ESV

Beloved, let us love one another, for love is from God, and whoever loves has been born of God and knows God.

I pray your love and marriage are resilient. If your marriage has officially ended, I pray you find healing, forgiveness, and hope for a bright new future. God is good!

Blessings,

Michelle

Finding true JOY this Christmas 2017

Posted on December 17, 2017December 17, 2017 by Michelle Fritsch, Pharm.D.

Joy — Find and experience the true joy that can be yours this Christmas and forever – no matter what 2017 has brought your way.

This has been a complex year; downright difficult for many people.

Yet this is a season of hope and joy. (Not the happy, exuberant, all is perfect kind of joy; the hope in the one-true-God type of joy).

Joy Defined

“Joy isn’t like happiness which is based upon happenings or whether things are going well or not. No, joy remains even amidst the suffering. Joy is not happiness. Joy is an emotion that’s acquired by the anticipation, acquisition or even the expectation of something great or wonderful. It could be described as exhilaration, delight, sheer gladness, and can result from a great success or a very beautiful or wonderful experience like a wedding or graduation but the definition of joy that the world holds is not nearly as amazing as biblical joy but joy is also gift.”

Why is Christmas so special? Christmas is the birth of the joy and a demonstration of God’s love for each of us:

For those who lost loved-ones who were senselessly murdered

His love endures forever

For those whose loved ones were killed in the hurricanes

His love endures forever

For those whose loved ones were killed in the fires

His love endures forever

For those who lost loved ones from any means

His love endures forever

For those whose lives were turned upside down by natural disasters

His love endures forever

For those who experienced major disappointments

His love endures forever

For those who are disillusioned by the political divide in this country and elsewhere

His love endures forever

For those who are disgusted by the reports of harassment

His love endures forever

For those who feel like they are spiraling out of control

His love endures forever

Romans 8:31-32, 38-39 NLT (I encourage you to read this whole chapter)

³¹What shall we say about such wonderful things as these? If God is for us, who can ever be against us? ³²Since he did not spare even his own Son but gave him up for us all, won’t he also give us everything else?

³⁸And I am convinced that nothing can ever separate us from God’s love. Neither death nor life, neither angels nor demons,^[p] neither our fears for today nor our worries about tomorrow—not even the powers of hell can separate us from God’s love. ³⁹No power in the sky above or in the earth below—indeed, nothing in all creation will ever be able to separate us from the love of God that is revealed in Christ Jesus our Lord.

We are going to face terrible trials in this life. No one is exempt. Yet we are given countless opportunities in this life to experience God’s never-ending love. That is where we find the peace and joy.

I pray you seek and find this JOY this Christmas!

Blessings,

Michelle

Celebrating the Glory of Today – Gratitude and Love

Posted on October 23, 2017October 23, 2017 by Michelle Fritsch, Pharm.D.

We spend so much of our time thinking about tomorrow, planning for tomorrow, working for tomorrow, hoping and dreaming for tomorrow. But tomorrow is never here, and we’ve learned that over and over.

We’ve seen so many examples lately of the value of living in the moment. There is value in loving those around you each and every day. You never know which is that last day.

Rather than be depressed about that, we can claim the joy and the opportunities of each day that presents itself to us.

Seasons of Loss

We have lost a dear friend in the last couple of weeks. He was someone who was always thinking of and giving to others. He was a very strong-in-his-faith man. He died in a freak accident doing what he does best – helping others. He was building a Habitat for Humanity house. We will never know what happened. The freak accident occurred, and he was suddenly gone.

A tiny baby died in his sleep at two months. There was so much promise there. Why was that child taken at such a young age?

Then we see the news stories of people harming one another. It seems there are more and more stories of mass deaths and of people managing conflict with murder.

The tragedies of nature have taken even more lives and wreaked havoc in many parts of the world.

It’s been such a heavy season of so many people taken at a time no one would have expected.

How do we keep moving forward?

So with that in mind, how can we live each day to its fullest? The more we live in gratitude and love and recognize the joys that are around us in spite of the tragedies, the more healthy we are. It lowers our blood pressure and anxiety levels. It lowers our risk for heart attack and stroke.

Gratitude and Love

Gratitude and love allow us to think so much clearly. They take us out of that worry mode and in to a more creative space in our brain. We think more clearly, can be more rational, and recognize the good when our brain is fully functioning at calmer times. This calm allows our breathing to slow. It allows us to really see the things around us rather than be so focused on what’s ahead.

I encourage everyone to take a deep breath. Love on the people who are around you. Look around with joy and gratitude at the many blessings that you do have.

Remember with fond memories, and hopefully with some tears and laughter, those who we’ve lost.

Let this be a day of renewed health and joy and love.

At Meds MASH we would love to talk with you more about the benefits of gratitude and love. You can reach us at www.medsmash.com/contact; michelle@medsmash.com; or 410-472-5078.

BIBLICAL APPLICATION

As worshippers and faithful followers of Christ, we are instructed over and over the Bible to praise and worship and show our love through gratitude.

1 Thessalonians 5:18 ESV

Give thanks in all circumstances; for this is the will of God in Christ Jesus for you.

Have you tried making gratitude your very first morning event, before you even crawl out of bed? I find when I start my day in thanks it sets the tone for a much better day. I can be grateful for the fact that a whole new day is before me, and once I get started, there are SO many things to list. Even the warm bed and blankets are a gift that not everyone shares. It’s so easy to take home and family and jobs and clothes and food and friends for granted.

James 1:17 ESV

Every good gift and every perfect gift is from above, coming down from the Father of lights with whom there is no variation or shadow due to change.

Start your day with gratitude and joy and just see where it heads from there!

Psalm 118:24 ESV

This is the day that the Lord has made; let us rejoice and be glad in it.

When you are sad, overwhelmed, frustrated, or feeling your hope dampen, count your blessings.

Colossians 3:15-17 MSG

Let the peace of Christ keep you in tune with each other, in step with each other. None of this going off and doing your own thing. And cultivate thankfulness. Let the Word of Christ—the Message—have the run of the house. Give it plenty of room in your lives. Instruct and direct one another using good common sense. And sing, sing your hearts out to God! Let every detail in your lives—words, actions, whatever—be done in the name of the Master, Jesus, thanking God the Father every step of the way.

And finally, remember, His love endures forever!

Psalm 118:1-18 ESV

Oh give thanks to the Lord, for he is good; for his steadfast love endures forever! Let Israel say, “His steadfast love endures forever.” Let the house of Aaron say, “His steadfast love endures forever.” Let those who fear the Lord say, “His steadfast love endures forever.” Out of my distress I called on the Lord; the Lord answered me and set me free. …

Blessings,

Michelle

Kindness, Care of Others, and Your Health

Posted on August 21, 2017 by Michelle Fritsch, Pharm.D.

When was the last time you did something for someone else? When is the last time you were kind? When did you do something for someone else expecting nothing in return? Kindness is so good for your health!

This is not just my idea. Kindness and thinking of others rather than always thinking about yourself is promoted by most of the world’s religions. All of the major religions encourage treating other people the way we want to be treated. If we would find something hurtful, then we shouldn’t do that thing to other people.

In my mind, if all of the major religions of the world agree to this basic principle, then it might truly be good for you!

Kindness is a choice

Good, beautiful things happen all around you every day.

Discouraging, annoying, negative things happen all around you every day.

Which do you notice more?

Is your first, natural reaction a kind one – or – a negative one?

We might tell ourselves that events are happening TO us, but the reality is, we get to choose our reaction. Our response is in our own control.

Maybe you haven’t always exercised that control, but you can choose kindness over a more negative response.

When we focus on other people, we both benefit!

Kindness and health

As I’ve researched this I have been amazed at all of the studies, literature, and measurements of the health benefits of kindness. Noticing, caring for, and being kind to other people has a positive benefit throughout our whole body.

Kindness is good for your mental and your physical health!

Here are just a few of the changes that YOU will experience when you are kind:

More relaxed
Less focused on your own pain, mood, worries
More positive outlook
Feel better about yourself
Decreased loneliness and helplessness
Sense of feeling connected

Kindness has also been shown to:

Help with weight control
Lower your blood pressure
Decrease your acid reflux in your stomach
Boost your immune system
Help you sleep better
Decrease your pain

Truly, there is so much to gain! When you are kind, the whole world feels like a brighter place.

I have seen medication use decrease, overall health increase, and people love their life so much more when they decided to practice kindness.

For more information, a list of references, or just to chat about this topic, please contact me at michelle@medsmash.com; 410-472-5078; or www.medsmash.com/contact.

BIBLICAL APPLICATION

Kindness is at the heart of the Golden Rule. When Jesus was asked which commandment was the greatest, here was his response:

Matthew 22:37-39 NIV

Jesus replied: “‘Love the Lord your God with all your heart and with all your soul and with all your mind.’ This is the first and greatest commandment. And the second is like it: ‘Love your neighbor as yourself.’

If you are loving your neighbor as yourself, then you are good, kind, helpful, understanding, forgiving, and loving.

We all long to be loved. We all like when kindness is shared with us.

I propose we were designed to express and experience kindness as a key element of our lives.

Ephesians 4:32 ESV

Be kind to one another, tenderhearted, forgiving one another, as God in Christ forgave you.

Proverbs 11:17 ESV

A man who is kind benefits himself, but a cruel man hurts himself.

Kindness is one of the fruits of the spirit.

Galatians 5:22-23 NLT

But the Holy Spirit produces this kind of fruit in our lives: love, joy, peace, patience, kindness, goodness, faithfulness,gentleness, and self-control. There is no law against these things!

I encourage each of us to practice kindness. When tempted to have an angry, frustrated, or negative response, stop and consider the choice of kindness.

Blessings,

Michelle

When Something so SIMPLE is NOT so simple – Tylenol®

Posted on July 25, 2017 by Michelle Fritsch, Pharm.D.

How often have you reached for simple acetaminophen (brand name Tylenol^®) in your life? It is the go-to remedy for so many symptoms. It will reduce a fever, help with a headache, and help with general aches and pains.

Note, acetaminophen is the generic name. The generic version works just the same as the brand Tylenol® version. It is sometimes abbreviated APAP. So, Tylenol^® = acetaminophen = APAP.

#1 treatment of osteoarthritis

Do you have arthritis? I know I do. Most of us (about 90%) have osteoarthritis. This is a condition where the cartilage coating our joints has worn away. There is now pain where bone is rubbing against bone. Your main symptoms are usually pain when you use the joint, stiffness, weakness (from your tendency to use it less), and crackling sounds.

I know I can no longer sneak up on my teenagers when I climb the stairs. My gravely sound in my knees is easy to hear.

The American College of Rheumatology, the main group of specialist doctors who treat arthritis, recommends acetaminophen for osteoarthritis.

Safer than NSAIDs (ibuprofen = Motrin®, Advil®; naproxen = Aleve®, Naprosyn®)

Nonsteroidal anti-inflammatory drugs (NSAIDs) are commonly used for pain. They treat pain in a way just like acetaminophen, and they also help with inflammation.

There are three big risks associated with these that I want you to know about:

They can be hard on your kidneys. Be sure your doctor and your pharmacist know that you take these, how much you take, and which ones you take. They will monitor your kidney function and likely ask you to stop taking them if your kidneys show signs of injury.
They can be hard on your stomach. Your risk of stomach ulcer goes up when you take these. ALWAYS take them with FOOD. If you develop stomach pain, more indigestion, reflux, or burning, tell you doctor.
They can raise your blood pressure. This in turn can increase the stress on your heart. If you have high blood pressure or a heart condition, talk with your doctor and pharmacist BEFORE choosing to take an NSAID.

Risks of acetaminophen – not so simple

Acetaminophen is safe, but not completely safe. It has some risks. The biggest risk is when we take too much. And taking too much, is VERY EASY to do.

Sometimes people don’t realize that Tylenol® and acetaminophen are the same thing. When in pain, they take both thinking they are different medicines.

Many opioid pain medicines contain acetaminophen (APAP). Here are some examples:

Percocet® (oxycodone and APAP)
Roxicet® (oxycodone and APAP)
Endocet® (oxycodone and APAP)
Norco® (hydrocodone and APAP)
Vicodin® (hydrocodone and APAP)
Lortab® (hydrocodone and APAP)
Lorcet® (hydrocodone and APAP)
Tylenol #3® (codeine and APAP)
Tylenol #4® (codeine and APAP)

Many cough/cold/flu medicines also contain APAP. Some examples are:

Contac Cold & Flu
Theraflu
Alka Selzer plus Cold
Vicks Sinex
Comtrex

Too much acetaminophen in a day can damage your liver. The most that should be taken in a day is 4,000 mg (8 Extra Strength 500mg tablets). A group of experts is supporting a change so people use 3,000 mg or less. This will decrease the chance of people taking too much if their combination medicines have some ‘hidden’ acetaminophen.

The other important factor is alcohol. It is best to not drink alcohol when taking acetaminophen. Both make the liver work hard. Each can damage the liver when the liver is overworked. It can hurt your kidneys, too. If drinking while taking acetaminophen, please not every day and not beyond 1-2 drinks.

For more information about best use of acetaminophen, contact us at www.medsmash.com/contact, 410-472-5078, or michelle@medsmash.com. We can assess all of your medication regimen to screen for hidden acetaminophen.

BIBLICAL APPLICATION

Oh my, isn’t this also true of our Christian walk? The rules are ‘simple’ – Love the Lord your God and your neighbor as yourself.

Love, love, love!

It is good for you, it is good for others, it’s so simple!

I can give a list of the people I have hurt, offended, taken for granted, or overlooked in the last day or two. I get distracted, frustrated, caught up in work, or frazzled. There is no excuse. My intention is to spend each day expressing God’s love. And, each day, I fall short of my well-intentioned goal.

Paul describes his own struggle with this in Romans Chapter 7.

Romans 7:14-25 NIV (underline emphasis mine)

We know that the law is spiritual; but I am unspiritual, sold as a slave to sin. I do not understand what I do. For what I want to do I do not do, but what I hate I do. And if I do what I do not want to do, I agree that the law is good. As it is, it is no longer I myself who do it, but it is sin living in me. For I know that good itself does not dwell in me, that is, in my sinful nature.^[c] For I have the desire to do what is good, but I cannot carry it out. For I do not do the good I want to do, but the evil I do not want to do—this I keep on doing. Now if I do what I do not want to do, it is no longer I who do it, but it is sin living in me that does it.

So I find this law at work: Although I want to do good, evil is right there with me. For in my inner being I delight in God’s law; but I see another law at work in me, waging war against the law of my mind and making me a prisoner of the law of sin at work within me. What a wretched man I am! Who will rescue me from this body that is subject to death? Thanks be to God, who delivers me through Jesus Christ our Lord!

So then, I myself in my mind am a slave to God’s law, but in my sinful nature^[d] a slave to the law of sin.

Why can’t we follow this simple rule of love?

Living in love means turning away from fear and selfishness*. We are so hardwired to think of ourselves first and foremost. It is a true choice (sometimes a very difficult choice) to put other people first. True love as demonstrated by Jesus is not selfish.

1 Corinthians 13:4-7 NIV

Love is patient, love is kind. It does not envy, it does not boast, it is not proud. It does not dishonor others, it is not self-seeking, it is not easily angered, it keeps no record of wrongs. Love does not delight in evil but rejoices with the truth. It always protects, always trusts, always hopes, always perseveres.

Can you imagine our world if we all lived in perfect love, as we were designed to live? Can you imagine each person you see treating you with love and respect? Can you imagine a world without conflict?

It is coming!

Blessings,

Michelle

* This is a reminder of a book I have been recommending that addresses this conflict between fear/selfishness and love. The God-Shaped Brain by Timothy R. Jennings, MD.

Serenity- Exploring this component of your health

Posted on July 17, 2017July 17, 2017 by Michelle Fritsch, Pharm.D.

Where do you find serenity? Webster defines

serenity as, ‘the state of being calm, peaceful, and untroubled’.

I have just returned from a trip of celebration with my Mom (70), me (50), and my daughters aged 18 and 16. We have been planning this trip for over a year. One of my favorite aspects was the serene places we found. While in the Redwood Forest it was awe inspiring and silent. Even though there were other people in the forest, somehow we couldn’t hear them if we weren’t beside them. To be in the midst of those giant trees and surrounded by giant ferns, it was so calm, awe-inspiring, and yes, serene.

The Redwoods were protected from excess logging by conservation efforts including the formation of the Redwood National Park in 1968. Then President Nixon dedicated a grove in the park to Lady Bird Johnson. Here is a quote on a plaque in that grove that struck me:

‘One of my most unforgettable memories of the past years is walking through the Redwoods last November – seeing the lovely shafts of light filtering through the trees so far above, feeling the majesty and silence of that forest, and watching a salmon rise in one of those swift streams – all our problems seemed to fall into perspective and I think every one of us walked out more serene and happier.’ Lady Bird Johnson, July 30, 1969

The part that grabbed my attention was, ‘all our problems seemed to fall into perspective…’

When was the last time you felt truly serene? How often do you slow down and allow yourself to just truly relax? What are the places or activities that bring you to that place of serenity?

Serenity and health

When you are calm, peaceful, and untroubled your whole body benefits. Your blood vessels relax, your blood pressure lowers, you breath more deeply, and your think more clearly. Your immune system is more active and you sleep more deeply.

I have been fascinated by the book, ‘The God-Shaped Brain’ by Dr. Timothy R. Jennings who is a psychiatrist and psycho-pharmacologist. He makes a compelling case that directly relates to serenity and health. He describes which part of your brain is working for you to think, reason, and plan. There is also a part that allows you to experience empathy, compassion, and love. When you are serene, these parts of your brain are fully operating.

When you are stressed, other parts of your brain take over. They put you in ‘fight or flight’ mode so that you are fully alert and ready to tackle the source of the stress. You were designed to have this stress alarm triggered only in rare truly life-threatening situations. However, in today’s society, so many of us are under constant stress. This system starts taking over our brain on a regular basis. As this stress system takes charge of your brain, your ability to think clearly, calmly, and to genuinely relate to others declines.

You have the power to give your stress signals a rest. As you do, and the more you do, the better your brain will function. You will be able to think through problems, plan, and prioritize. You will feel more connected to your own feelings, be able to manage them, and relate more to other people.

One of the best parts is that you will be free to think less about your own needs and more about the needs of others. That has been explored in previous blogs and will be explored again. There is a mountain of evidence that this is very good for your health!

The Role of Medications

There are many medications available to you that in some way target your mood, your anxiety, your depression, your anger, your emotions, and/or your reactions. These have a role. They cannot produce serenity. They cannot remove your stresses or your responses to them. They can help you cope. They are most effective when combined with therapy that can help you decrease the control of your stress response in your brain and let your thinking and loving parts of your brain resume control.

When medications are used, they should be used with great care and at the best doses. Your best medication and dose depend on several factors:

your kidneys and how they function
your liver and how it functions
side effects you might experience
your allergies
interactions with your other medications and your other medical conditions
evidence (studies that have been done to demonstrate what works best in a situation like yours)

The Role of Meds MASH

At Meds MASH a medication-use expert who is specialized in people over age 60 will help you and your doctor make sure the best, safest, most effective medication is used and only for the time period necessary. Meds MASH specialists can also help you find the counseling component you need to go with your medications.

BIBLICAL APPLICATION

With each moment of our lives we have one basic decision to make. Will you make a choice for yourself or a choice for others? Jesus tells us our basic guiding principles are:

Luke 10:27 NIV

He answered, “‘Love the Lord your God with all your heart and with all your soul and with all your strength and with all your mind’; and, ‘Love your neighbor as yourself.’”

I mentioned the book I have been reading, ‘The God-Shaped Brain’. Dr. Jennings focused the book on how our brain functions when we are living according to God’s plan of love vs when we are not.

We get further and further from God’s plan the more we focus on ourself. Pride, envy, harbored resentment, anger, judgmental attitudes, and lust are just a few of the ways we turn our focus to ourself and our own needs.

Galatians 5:19-21 ESV

Now the works of the flesh are evident: sexual immorality, impurity, sensuality, idolatry, sorcery, enmity, strife, jealousy, fits of anger, rivalries, dissensions, divisions, envy, drunkenness, orgies, and things like these. I warn you, as I warned you before, that those who do such things will not inherit the kingdom of God.

1 Timothy 6:4 ESV

He is puffed up with conceit and understands nothing. He has an unhealthy craving for controversy and for quarrels about words, which produce envy, dissension, slander, evil suspicions,

1 Corinthians 3:3 ESV

For you are still of the flesh. For while there is jealousy and strife among you, are you not of the flesh and behaving only in a human way?

God’s plan is rooted in love and turns our focus outward. It also promotes the ‘best’ function of our brain, reduced stress, lower blood pressure, enhanced immune system function, and overall joy.

1 Corinthians 13:4 ESV

Love is patient and kind; love does not envy or boast; it is not arrogant

Galatians 5:22-23 NIV

But the fruit of the Spirit is love, joy, peace, forbearance, kindness, goodness, faithfulness, gentleness and self-control. Against such things there is no law.

It sounds so simple, but it is so hard to pursue and maintain. It is a daily, moment-by-moment decision to love and keep the focus turned outward. God is with you each of those moments ready to guide you and enable you to make those positive decisions.

Blessings,

Michelle

Taking 9 Key Steps to Your Best Health

Posted on April 23, 2017 by Michelle Fritsch, Pharm.D.

I know you want to feel good. I’ll bet you have a whole list of experiences in your plans for the future. You might be feeling great these days. You might be struggling with some health issues. You might be navigating some transitions in your life or some emotional conflicts.

I want you to be the healthiest version of you, in your best health! As I’ve been thinking about this, I’ve broken a process into steps. I’m hoping by following these steps, your health continues and gets even better.

Steps to your Best Health

Pay attention to your body. Remember when a new symptom starts; what makes it better; what makes it worse; how long it lasts; what you think caused it.
If it is severe, scary, or won’t go away, be sure to tell your doctor.
Before you see your doctor, make a list of the items in #1 so you won’t feel pressured to remember. Write your list and make 2 copies – one for you and one for your doctor.
Take to all healthcare visits a complete list of all medicines and other substances you take, how you take them, and when you take them. This includes your vitamins, supplements, recreational substances, and over-the-counter medications. Include even the ones you only take for a stomachache, allergies, or a headache.
Take notes during your visit. We all know how easy it is to miss something, forget, or get it all confused when trying to remember it all from memory.
Make sure it all makes sense to you and you clearly know what you are to do next before you leave. It is ok to ask to hear it all again until you really understand. Once your doctor explains what is causing your symptoms and recommends a plan, ask when you should feel better.
1. Too many times I have asked people what their doctor said and heard, ‘I have no idea; I couldn’t understand him/her.’
If you receive a prescription for a new medication, make sure you know the name, what it is for, how to take it, and what you can expect. All medications have the potential for side effects, at least right at first, so know what these might be. Know if you will be taking it for a short time or a long time. Ask your pharmacist to be sure this new medication is not going to interact with your current medications. (Be sure your pharmacist knows everything you take.)
Keep track of your original symptoms and any other changes you notice after you start your new treatment. If you don’t feel better in the timeframe the doctor told you, call and report that. If you feel worse when you start a new medication, let your doctor and pharmacist know. Either of them can help you determine if your new problem is caused by the medication and what you should do (do something to stop the side effects or give you a different medication).
Take care of yourself! Once you are feeling better, make an effort to take even more healthy steps such as healthy eating and regular exercise. I know we hear that all of the time. That is because these are the changes that will truly help you feel your very best.

What is the link between medications and your best health?

You’ll note that some of the steps specifically include medications. Medications can:

Cure
Control medical problems
Make symptoms better
Prevent problems
Harm

Depending on the medical condition and the medication, any of these four good purposes or the bad effect can occur.

Medications are prescribed for at least one of the positive effects of medications. Your doctor and your pharmacist want the medication to play a direct role in you reaching your best health.

Medications can interact with other medications. The ONLY WAY your doctor or pharmacist can check for this is if they know absolutely EVERY medication you take. Medications can interact with other medications, with food, or with other medical conditions. That is why you want your healthcare team to know everything about your prescription medicines, your over-the-counter medicines, your supplements, you herbal remedies, your vitamins, and any recreational substance use. It is all important!

This is one of the key services we offer you at Meds MASH. If you want someone to very carefully evaluate all of your medications, your symptoms, and things you think might be caused by your medications, we can do that!

To get started, contact us at 410-472-4078 or www.medsmash.com/contact. Let’s talk about how we can help you reach your best health!

BIBLICAL APPLICATION

I am reading a book that led to an interesting insight as I have been thinking about the stepwise approach to best health. The steps outlined above are each important to reaching your best health.

What about your best spiritual health? After all, true health has physical, mental, emotional, and spiritual components. Nothing outranks your relationship with Christ.

The book I have been reading is related to our brain. A neuroscience physician has studied the brain and its function in the light of both science and the Bible. If you haven’t read, ‘The God-Shaped Brain’ by Timothy R. Jennings, M.D., I highly recommend it.

In a very insufficient summary, our brains are at their peak function when we are in a secure, peaceful, loving environment. The brain is a very adaptable organ. There is one part of the brain that drives our ‘fight or flight’ response. This is what happens when we sense we are in danger. When this part of the brain is functioning, all deep reasoning is blocked. All brain effort is focused on primal survival. It is when we are more relaxed that other parts of our brain creating deep thoughts, logical decision-making, and empathy can function.

I was in high school when Pac-Man was first available. We had to go across the state line to another nearby town to play it in a pizza restaurant. The object is to maneuver Pac-Man through a maze to eat as many ‘points’ as possible. Some of the turns lead to danger for Pac-Man or to dead-ends.

Strangely enough, living in love, peace, and harmony made me think of our life like Pac-Man. Picture, if you will, a large canvas with a circuitous, clear path that has no obstacles that you can see when you look down on the entire canvas. This path is full of points, many points. Surrounding this path, at every turn, there are obstacles. Many of these obstacles are distractions. They are things that feel good, things that look good, or things that feel necessary. From within the maze, you can’t see the clear path. You can only see what is right around you. Those distractions look so good! They often seem to be on the easiest route. They promise you lots of points. So, you easily get off track with the distractions.

Our brain, our life, and our health are at their best when we are on the clear path. And yet there is not one human on the planet who has not left the path and made mistakes. Not ONE! Only Jesus was ever able to do that.

We can each be so much more at peace and living in love when we stay on the path. There is only one tour guide. Jesus can and will tell you step by step which way to turn. He will tell you which items are distractions and which are on his planned path for you. Your brain will be functioning at higher levels as you live in peace and love.

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.

God knew from the beginning, as soon as Adam and Eve ate the fruit, that we would be on this path with many distractions. Eden, before that fruit eating, was the only place where people ever lived in perfect harmony, peace, and love. As soon as those first people used their own will to go outside God’s command, everything changed.

To allow your brain to operate in its most effective way, and to live in love and peace, let Jesus be your tour guide.

Psalm 119:15 ESV

I will meditate on your precepts and fix my eyes on your ways.

Philippians 4:8 ESV

Finally, brothers, whatever is true, whatever is honorable, whatever is just, whatever is pure, whatever is lovely, whatever is commendable, if there is any excellence, if there is anything worthy of praise, think about these things.

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.

Here’s to being in your best health – physical, mental, emotional, AND spiritual!

Blessings,

Michelle

Wrong Assumptions lead to Bad Medicine

Posted on December 14, 2016 by Michelle Fritsch, Pharm.D.

When was the last time you made and acted on wrong assumptions? It is so easy to do. You see something from your perspective and your mind fills in the details of the who, what, when, how, and why. It’s often long after you have acted that you are provided with a different perspective that makes the entire situation look different.

A quick, fun example is in this picture. Another proof that I am a geek. I get such a kick out of these pictures. If I believed my eyes I might run in to help the poor guy being lifted into the air.

This happens in healthcare, too. Keep in mind, the provider that is making decisions in the emergency department or the hospital usually knows VERY LITTLE about you. Any information you or a loved one or friend can give is all they have at first.

One day, hopefully soon, these providers will be able to access your medical records and make much more informed decisions. Right now, your doctor has to be contacted then the information sent to the hospital. If it is the weekend or an evening, that can take hours to days. The information then needs to get to your hospital provider from the fax machine or the electronic messaging system. Even then, there might be important information about you that is not even in your doctor’s record.

This leaves those of us making decisions about your care to rely heavily on what we see right now.

I have seen SEVERAL examples in the last few weeks of an older adult reaching medical care confused. The quick wrong assumption has been that the person has dementia. When confused, behaviors often change. A confused person can yell, pull at catheters and IV’s, try to get out of bed, and generally not cooperate. Since the assumption has already been made that dementia is the cause, calming medications are given. These then assure further confusion (but calmer) and make it very hard for the person to get to a point of no confusion.

What can you do to prevent wrong assumptions?

Carry in your wallet a list of your:
1. Allergies
2. Medications
3. Diagnoses
4. Emergency contact information – name, phone number(s)
If you are accompanying someone to the hospital who is newly confused, explain this to the medical team. Help them understand what this person was like before this event. They need to know the ‘baseline’. If this person was living independently, driving, managing their finances the team needs to know that. If this person was unable to do those things and was getting frequently confused at home, the team needs to know that.
Share any known history about the current event. If you have been feeling worse and worse for the past three days, make sure they know that. If you have been having pain, explain that including what it feels like, how often you feel it, what makes it better or worse.
If you have been taking different medications for the past few days, make sure they know that. This often happens when we are in pain or have a cold. We take over-the-counter medications or left-over medications from prior prescriptions. These can cause confusion when mixed with our normal medication regimen.

Speak Up

Again, I have seen several instances in the past few weeks where assumptions are made when someone gets to the emergency department or hospital that make a situation worse.

In one instance the person’s confusion started as soon as a particular medicine was given. The family member noted that but didn’t speak up. Then medications were added to treat the confused behaviors. We are still trying to taper off of those medications and get this person independent again.
In another instance, the person had a urinary tract infection. These are famous for making older adults confused. But since no one was there to explain how odd this confusion was for this person, the team assumed this was normal and didn’t find the infection for a while. By then, a couple of medications had been added to treat the confused behaviors. It will take us weeks to taper her back off of these medications.
In a third instance, the collection of pain medications given after a surgery left the person sleeping most of the day and unable to think clearly. The spouse was dutifully giving the prescribed medicines around the clock. The wrong assumption made here was that this very healthy person over 60 could handle these medications like someone in their 30’s.
One more instance involved using a medication to treat the side effect of another medication. The second medication (the one used to treat the side effect) is on a list of medicines to avoid in people over 60. Rather than treat the side effect, it made the person nearly unresponsive. In this case, as in several of the others, rather than treat the underlying issue, wrong assumptions were made and actions were taken to treat the symptoms without understanding the back story.

Why ‘Bad Medicine’

Just a side disclaimer. When I was contemplating this blog I saw it as a chance to use the terms, ‘Bad Medicine’. I am a big Bon Jovi fan. I am also a pharmacist. So, I have to admit I love the song, ‘Bad Medicine’.

For more information about how to protect yourself from wrong assumptions leading to bad medicine, contact us at Meds MASH at 410-472-5078 or www.medsmash.com/contact.

BIBLICAL APPLICATION

I can think of a lot of bad assumptions leading to bad decisions in the Bible. One of the first is Eve’s decision to eat the apple. The Israelites made bad assumptions continuously. A few that come to mind are thinking slavery would be better than ‘suffering’ in the desert; people in lands they were to conquer were too mighty to overcome; Moses was not going to return so a golden calf was needed. The list goes on.

So, how often do you make bad assumptions? I suggest we all do it every day. We don’t act on all of them. I don’t think we realize most of them.

I am consulting right now in a place that serves a highly diverse and unique population of people. Assumptions about gender, culture, religion, socioeconomic status, or just about anything will quickly lead you down an incorrect path. It has been an adventure of constant striving to avoid any assumptions.

These verses are good ones for me to remember each day:

Proverbs 18:2 ESV

A fool takes no pleasure in understanding, but only in expressing his opinion.

Matthew 7:1 ESV

“Judge not, that you be not judged.

Proverbs 25:8 ESV

Do not hastily bring into court, for what will you do in the end, when your neighbor puts you to shame?

Bad assumptions and temptations to act on them are one more test.

As I understand the Word, truth trumps all of the assumptions. Love trumps all of the wrong actions.

1 Corinthians 13:6 ESV

It (love) does not rejoice at wrongdoing, but rejoices with the truth.

1 Corinthians 13:7 ESV

Love bears all things, believes all things, hopes all things, endures all things.

The laws in Deuteronomy give us good advice even here in 2016.

Deuteronomy 17:13 ESV

And all the people shall hear and fear and not act presumptuously again.

I encourage you (and me) to guard against assumptions and focus on truth and love.

Blessings,

Michelle