unconditional love

To feel better – do for someone else – altruism

Posted on by Michelle Fritsch, Pharm.D.
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Altruism helps others and improves your health

I am just back from Jamaica, and I need to write about altruism. I was working with a mission group called TEAMS. You can learn more about them at www.t4mm.org. This medical mission group included 3 physicians, 1 nurse practitioner, 2 nurses, 3 pharmacists, 3 for registration, 2 to be with the children while their parents received care, and 2 to provide prayer and emotional support to those coming for care.

We were serving in St. Mary Parish, one of the poorest of the country. Clinic was held in churches in four different areas of the Parish. A Parish is similar to a state in the United States. Sheets draped over ropes often separated exam rooms for physicians. I counseled people about their medications as they sat among many other people. So this was not a private setting. But, excellent practitioners provided individualized care with great compassion.

Each clinic served a particular community. Within that community you could look out at all who were waiting and see the way they cared for each other. Babies would be passed around, older members would be assisted with steps, others in nearby seats would assist with understanding when I was struggling with the Patois (English with a thick dialect spoken very quickly).

It was very hot. Fans helped to stir the air. There was no running water. (I am so thankful for hand sanitizer). Some children had lice or scabies yet they waited patiently with their family. You know they had to be miserable between the heat and the intense itching. Some people had to wait from early morning until mid afternoon to be seen.

Yet, I didn’t hear one person complain. No one was demanding to know why their wait was so long. No one was complaining about the conditions. No one was asserting their needs or rights before someone else’s.

On the medical team, several people were struggling with their own health issues. One was on crutches due to a broken leg; one was recovering from bronchitis; one had a cold; several had various aches and pains. The age range of the care team was 22 to 82. Personally, my leg is still recovering from a ripped calf muscle, and my back has been hurting from all of the time that I was on crutches and a boot.

What struck me was how none of that mattered! Rather than thinking about our issues, we were completely focused on all of the people who had arrived to receive care. My leg did fine the entire week, even carrying heavy tables and boxes and fans to set up and take down clinic every day up steep hills and steps. I didn’t do my back stretches or sit around rubbing my back the way I do at home. That is because I wasn’t even thinking about my back.

Altruism

Altruism is, ‘feelings and behavior that show a desire to help other people and a lack of selfishness’ as defined by Merriam-Webster. I have read several articles linking altruism as a factor in happiness, health, and how long you live. In general, studies have shown that people who focus on others are happier and even live longer, in general. In 2005, Stephen Post published an article in the International Journal of Behavioral Medicine entitled, ‘Altruism, Happiness, and Health: It’s Good to be Good’. A quote from the article is, ‘The article concludes, with some caveats, that a strong correlation exists between the well-being, happiness, health, and longevity of people who are emotionally and behaviorally compassionate, so long as they are not overwhelmed by helping tasks.’

I have seen truth in this in many instances. While I was doing post-graduate training in Wisconsin a study demonstrated that home-bound elders who were in a calling circle.  Those who called to check on each other and remind each other to take medications felt less isolated and more valued. A project called the Eden Alternative long ago demonstrated the value in having daily purpose for everyone in a nursing home setting. Depending on ability level residents would care for a cat or dog, garden, water plants, feed birds, feed fish, or other activities. It was a huge success and continues today! Everyone needs to be needed. That sense of purpose and belonging plays a big role in overall health, including anxiety levels, pain, and depression.

When was the last time you focused on the needs of someone else? I encourage you to find a way each day this week to meet someone else’s needs. Some examples are to check on an older neighbor; take a meal to someone who recently had surgery; call a mom with small children to see if you can grab some things for her when you go to the grocery store and save her a trip.

For more information about how altruism is connected to health, contact us at www.medsmash.com/contact.

BIBLICAL APPLICATION

It is no surprise that altruism is linked to enhanced health. Jesus told us many times about the importance of selflessness.

John 15:12-14 ESV

“This is my commandment, that you love one another as I have loved you. Greater love has no one than this, that someone lay down his life for his friends. You are my friends if you do what I command you.”

Daily devotions, a lot of singing, and prayer with each community were cherished parts of this mission.  The care was among providers, among recipients, among those at the church helping with coordination, and among those providing protection.  My visual each day was being filled up with the Spirit to be completely poured out by the end of the day.

Some say Christian selflessness is not true altruism because we will be rewarded for such care and compassion. Ultimately, eternally a reward is waiting. But while here in this life, you might not see a reward. In fact, your giving isn’t meant to be for show.

Matthew 6:2-4 MSG

“When you do something for someone else, don’t call attention to yourself. You’ve seen them in action, I’m sure—‘playactors’ I call them—treating prayer meeting and street corner alike as a stage, acting compassionate as long as someone is watching, playing to the crowds. They get applause, true, but that’s all they get. When you help someone out, don’t think about how it looks. Just do it—quietly and unobtrusively. That is the way your God, who conceived you in love, working behind the scenes, helps you out.

Paul, Peter, Luke, John, and many other writers in the New Testament extol the virtues of giving to others.

Philippians 2:4 ESV

Let each of you look not only to his own interests, but also to the interests of others.

Luke 6:35 ESV

But love your enemies, and do good, and lend, expecting nothing in return, and your reward will be great, and you will be sons of the Most High, for he is kind to the ungrateful and the evil.

1 Peter 3:8 ESV

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

What can you do today to help someone else?

Proverbs 19:17 ESV

Whoever is generous to the poor lends to the Lord, and he will repay him for his deed.

Blessings,

Michelle

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Posttraumatic Stress Disorder (PTSD) – Is It Real?

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

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

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

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

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

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

We all sat and cried for a long time.

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

Post Traumatic Stress Disorder (PTSD)

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

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

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

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

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

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

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

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

BIBLICAL APPLICATION

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

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

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

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

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

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

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

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

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

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

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

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

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

Blessings,

Michelle

Sleep – To Medicate or Not to Medicate

Posted on by Michelle Fritsch, Pharm.D.
sleepingproblems
Regular sleep helps you think clearly and make better decisions

AAAhhhhh, there is nothing like a good night’s sleep. Don’t you feel refreshed and ready to conquer the world when you are well rested? How do you feel when you haven’t been sleeping well? Irritable, short-tempered, unfocused, …?

Feeling extra sleepy is linked to:

  • Motor vehicle accidents
  • Poor test performance
  • Poor decision making
  • Difficulty concentrating
  • Difficulty solving problems
  • Mood changes
  • Pain intolerance
  • Mistakes
  • Errors in judgment

So, it is not all in your head if you think you don’t have such a great day when you don’t sleep well.

The TV commercials tell you to grab one of the over-the-counter sleep medicines. I want to DISCOURAGE you from doing that. Most of the over-the-counter sleep options contain either diphenhydramine (Benadryl) or a sedating antihistamine like doxylamine. These medications are not recommended in people over 60. Not only do they make you really sleepy, they are very anticholinergic.

Anticholinergic

Anticholinergic medications are very drying. They cause dry mouth, dry eyes, constipation, and difficulty urinating. They also make your thought process fuzzy. Medications with anticholinergic side effects greatly increase risk of falls. There are MANY studies showing that people who take these sleep aids are more likely to fall.

Zzz sleep medications

There are some newer prescription sleep medications available. Three are referred to as the ‘zzz’ medications. They are zaleplon (Sonata), exzopiclone (Lunesta), and zolpidem (Ambien). Note the ‘z’ in each name. These are options when all good sleep habits have been tried and failed; or when insomnia occurs regularly or for a prolonged time. When they are used, the lowest possible dose for a short time is best. Each of these medications is linked to falls (especially if you get up during the night to go to the bathroom while sedated). Each is linked to car accidents if you drive while still under the effect of the medication. Each can cause odd behaviors in come people such as sleep driving or other tasks while asleep. I had a patient once who awoke to find Wal-Mart bags full of merchandise all over her living room floor. She had gone to Wal-Mart in her sleep and had a shopping spree. She brought it all home and into the house then went back to bed. She could remember none of it.

So use these medications only when necessary, at the lowest possible dose, for a short time under the careful guidance of a prescriber. Only take one when you are able to stay in bed and sleep for a full night (7-8 hours). These are NOT for a short sleep and get-up-and-go kind of night.

BEST sleep habits

Prior to considering adding medications, these habits can help you sleep better.

  • Keep your sleep schedule regular – Go to bed and get up at the same time each day.
  • Keep your bed for sleep and sex only.
  • Avoid daytime naps.
  • Avoid caffeine, chocolate, alcohol, or spicy food.
  • Avoid TV, reading your phone, using your computer right before bed. The light of the electronics triggers your brain to be active. There are several studies linking use of electronics before bed to poor sleep.
  • Get some exercise during the day so your body is tired as well as your brain.
  • Try deep breathing. Take slow, deep breaths in and slowly blow them out.
  • Try progressive muscle relaxation. Start at your toes. Squeeze your toes tightly then let them relax. Keep going with all of the muscles as you work up your body.
  • There are several other techniques available in the links on this page.

I highly encourage you to try all of the sleep techniques that don’t involve medications first. Then, if you do need medication, get a prescription from your doctor for a low dose. Use it only when truly needed for a very few days. Be sure you can dedicate a full night to sleep before taking a dose.

One other option when good sleep habits aren’t enough is melatonin. Melatonin is a natural product that improves sleep in some people. It takes up to a month to see the full effects. It can help you fall asleep quicker, sleep better, and sleep longer. Each dose won’t necessarily make you feel sleepy. The impact is more gradual over time. The starting dose is 2-3 mg at bedtime.

For more information on sleep options, contact us at www.medsmash.com.

BIBLICAL APPLICATION

It’s amazing how the eternal confidence of unconditional love can enhance sleep.

All of us have our overwhelming days, our painful nights, our frightening challenges.

We also have a source of hope and joy to see us through all circumstances. In Christ, you know who is ultimately in control. You know where you will be spending eternity.

So, on those bad, sleepless nights, give your burdens to the One who is asking you to give them over.

Proverbs 3:24 ESV

If you lie down, you will not be afraid; when you lie down, your sleep will be sweet.

Psalm 4:8 ESV

In peace I will both lie down and sleep; for you alone, O Lord, make me dwell in safety.

Psalm 121 CEV

The Lord Will Protect His People

I look to the hills!

    Where will I find help?

It will come from the Lord,

    who created the heavens

    and the earth.

The Lord is your protector,

    and he won’t go to sleep

    or let you stumble.

The protector of Israel

doesn’t doze

    or ever get drowsy.

The Lord is your protector,

there at your right side

    to shade you from the sun.

You won’t be harmed

by the sun during the day

    or by the moon[a] at night.

The Lord will protect you

    and keep you safe

    from all dangers.

The Lord will protect you

    now and always

    wherever you go.

 

Sweet dreams and blessings,

Michelle

Image source: Source:  National Library of Medicine; National Institutes of Health; U.S. Department of Health and Human Services

Happiness, Hope, and Health

Posted on by Michelle Fritsch, Pharm.D.

Slide2What defines your best days?

When do you feel the most happy and free?

In your darkest days, what is your source of hope?

Scientists, philosophers, and every-day people have been asking these questions for centuries.

Interestingly, studies have shown that more money is not linked to happiness. Actually, more money is associated with higher depression and anxiety rates.

Thinking kindly about other people and helping other people is linked to health, living longer, and overall well-being. Rather than focusing on yourself and your own problems, who could benefit from your care?

Studies have repeatedly demonstrated that happier people are healthier people. It is fascinating that happier people don’t necessarily have more stuff, live with more innovations, or have more resources. This is especially true for psychological and emotional health.

Proposed keys to a happier and healthy life:

  • Feelings of enthusiasm, engagement, and hope
  • Feeling optimistic that good things are going to happen
  • Having supportive family and friends
  • Being able to bounce back from bad situations and make healthy choices

Some aspects of health go beyond diagnoses and medications. Perhaps those elements are at our deepest core and the ones that need the most attention.

Hope is integral to happiness. It is also a key aspect of recovery. It is the element that pulls you away from the slippery slope to negativity. Many people with hope usually believe in a higher power with a sense of spirituality.

So, again, ask yourself, what makes you happy? For what are you grateful? What is your source of hope? What changes can you make today to do something helpful for another person?

The answers could be your source of health.

For more information about the literature on this topic and the relationship between happiness, hope, and health, contact us at www.medsmash.com.

BIBLICAL APPLICATION

So what are the answers to the questions? God, your loving, merciful, forgiving, creator is the source of all hope. Have you experienced that grace? Are you confident in that unconditional love?

It is hard to imagine life without this source of hope. What would each day be like not knowing the God of the universe?

If you do not have a daily, personal relationship with God, keep reading.

God can be your source of hope to get beyond anything that has happened in the past, of strength in the present, and of excitement for the promises of the future.

Romans 12:12 ESV

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

Romans 15:13 NIV

May the God of hope fill you with all joy and peace as you trust in him, so that you may overflow with hope by the power of the Holy Spirit.

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.

You are deeply and unconditionally loved. God has big plans for you.

Bad things will still happen. Some days will be harder than others. Most of the future will be unknown. (But we know the ultimate outcome is eternal life in Christ!)

Romans 5:2-5 ESV

Through him we have also obtained access by faith into this grace in which we stand, and we rejoice in hope of the glory of God. More than that, we rejoice in our sufferings, knowing that suffering produces endurance, and endurance produces character, and character produces hope, and hope does not put us to shame, because God’s love has been poured into our hearts through the Holy Spirit who has been given to us.

May this hope and love be your source of happiness and health!

Blessings,

Michelle