Numbers: Do you know the importance of each of your numbers?

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Know how your numbers are key to your health.

What are the key numbers in your life? I just turned 50. That is a number that seems like a real turning point. I like a viewpoint a friend shared with me: the first half-century is training and preparation for the better half!

Also, my daughter is graduating from high school. So, in her world the key numbers are GPA, SAT, ACT, and college fees.

Other numbers we keep close to us are phone numbers, bank balances, addresses, and birthdays.

Numbers and Health

Now I want to make sure you are aware of key numbers for your health. There is a reason for those labs at your annual physical. And there are goals for those numbers. When you see your lab results you will see your number and a range that contains all of the normal numbers. Ideally, your number falls in this range. If your numbers are little bit outside this ‘normal range’ for a little while, just talk with your doctor. If your numbers stay outside the range, your doctor will probably take action with medication, exercise changes, diet changes, or other plans.

Blood pressure – If you are under age 65, normal is less than 140/90. If you are over 65, some experts agree it’s ok for your systolic blood pressure (top number) to get as high as 150. Your blood pressure is one indicator of how hard your heart has to work. There are several medications that can be used to lower your blood pressure and protect your heart from having to work too hard. I am often asked about how low is too low for your blood pressure. That is not really determined by a number. It is found through symptoms. If you get really dizzy when you stand up, turn around, or try to walk faster, talk with your doctor. A little bit of this is expected with the medicines that are protecting your heart. If it is causing you to fall or keeping you from doing your normal activities, then let your healthcare team know.

Pulse – This is usually between 60 and 90 beats per minute. You can quickly check your own by touching the center of your neck and letting your fingertips slide to the soft area just to the side. Your carotid artery is there, and you can count the beats for 15 seconds then multiple by 4. The more you exercise, the more efficient your heart gets. So, really fit people tend to be at the bottom of this range. This should be measured when you are really at rest. If you are worried, in pain, stressed out, or in a conversation your heart rate will be higher. So, when this is measured, think quiet thoughts and don’t talk. If it gets and stays high, your doctor will order some more tests to check why. The same is true if your heart rate is slower than 60 beats per minute. Tests will be ordered to see what your heart is doing to cause the slow rate.

Cholesterol – We all have cholesterol, or fats, in our blood. This is normal. But there are healthy amounts and unhealthy amounts. These are the key numbers. For most people, your low density lipoproteins (LDL) number should ideally be under 100 mg/dL. If you have a strong history of heart disease, your doctor might have you try to reach an even lower goal. This is your ‘bad cholesterol’. Your high density lipoproteins (HDL) is your ‘good cholesterol’. Ideally you want this number to be over 40 mg/dL. Another cholesterol number is your triglycerides. This tends to go up if you have diabetes that isn’t well controlled. This number should be less than 150 mg/dL. Diet, exercise, and medications are all key in keeping these numbers in the goal range if you have high cholesterol (also called hyperlipidemia).

Blood sugar – Speaking of diabetes, this is a very important number for people with diabetes. It is important whether you have type 1 (requires insulin) or type 2 diabetes (can be treated with medicines you take by mouth, by inhalation, or by injection). Your blood sugar changes throughout the day. It is usually lowest before a meal and highest after. When you have not eaten for at least 8 hours, your blood sugar should be less than 100 mg/dL. (This is a ‘fasting blood glucose’.) Your healthcare team might ask you to measure your blood sugar at home. There are several types of monitors to do this. They might want you to check sometimes before you eat, sometimes after you eat, sometimes before bed, and sometimes when you first wake up. This will give them the best look at what your blood sugar does throughout the day.

Glycosylated hemoglobin (A1c) – This is another way to see what your blood sugar does over a period of time – about 3 months. It is a reflection of your average blood sugar over those months. People who do not have diabetes have an A1c under 6%. Current guidelines encourage a goal of less than 6.5% for people with diabetes. However, if someone is at risk for their blood sugar being too low your doctor might increase this goal closer to 7%. When people with diabetes also have other medical conditions, sometimes ‘tight control’ to under 6.5% is not possible or safe. Talk with your healthcare team for your specific goal and why that is the goal for you.

Body Mass Index (BMI) – This measurement is a reflection of your height, your weight, and your gender. It helps to define what is a healthy weight for you. The goal BMI is between 18.5 and 24.9. If your BMI is 25 to 29.9 you are overweight. If it is over 30 then you are obese. Your healthcare team will help you with a plan to get to a healthy weight and stay in that healthy range.

Blood Urea Nitrogen and Serum Creatinine (BUN and SCr) – These are important measures of your kidneys. They determine if your kidneys are clearing extra fluid, medications, and toxins from your body as they should. They can also tell your doctor if you are dehydrated from not drinking enough. As a pharmacist, I always look at these numbers when deciding if a medication is safe and at the right dose. When your kidneys are not working as they should, then it is hard to get some medications back out of the body. Another interesting numbers – Our kidneys start to very gradually slow down when we are in our late 30’s or early 40’s. This happens to everyone. So, with each birthday in our 50’s and beyond, these are important numbers to assess.

Aspartate aminotransferase and alanine aminotransferase (AST and ALT) – These are measures of how your liver is working. Many medications are metabolized (broken down) in the liver. If these numbers are very high, then the liver is not able to do its job to break down the medication. These are numbers I always look at when evaluating someone’s medication regimen. It helps determine what medicines should be avoided and what doses are best for you based on your liver.

Number of Medications – Sometimes several medications are needed to treat all of your medical conditions. Sometimes they are not. The more medications someone takes, the more risk of medications interacting and causing problems rather than helping them. There is no ‘magic number’, but most experts agree that taking more than 4 medications regularly means you need to have an expert very carefully evaluate your regimen. This is to double check that your medication regimen is providing optimal good with minimal risk.

An Evaluation of YOUR Numbers

Are you curious about your numbers? At Meds MASH we specialize in these evaluations, especially in anyone over age 60. Do you want to better understand your particular numbers? Do want to know that your medicines are providing optimal good and minimal risk? Call us today! We have found that over 50% of our clients need a medication adjustment once an expert evaluation is done. These adjustments come from your own doctor with our collaboration.

You can call for your appointment at 410-472-5078 or e-mail at michelle@medsmash.com or through our website www.medsmash.com/contact.

BIBLICAL APPLICATION

Have you read the entire Bible? I am on my second journey through the whole book. In the past I have read my favorite parts, read parts pertaining to Bible studies I was in, or read parts that others have recommended. After years of this focused reading, I thought I knew the Bible fairly well. But, here I am reading it all and learning so many new things!

I was recently working my way through the book of Numbers. I have to admit, I don’t find this to be the most exciting book. It can be downright hard to get through. But, I was hit by a new insight.

In Numbers God directed Moses through the exact, meticulous details of building the temple and the Ark of the Covenant.

  • He provided exact measurement for each aspect of the temple.
  • He described elements of the temple in extreme detail.
  • He gave exact specifications for each furnishing.
  • Each bowl and utensil was described in detail.
  • The role of each person in service to the temple was directed.
  • The clothing of each priest was designed to the last thread.

It hit me how incredibly precise is our God. Not any detail was left with precise design. God is perfect in every way.

Then, I thought about how sloppy I am in my communication with God. I pray, read my Bible, focus when I find the time. I squeeze God into the nooks and crannies of my day. Some days are much better than others. Even now as I am reading through the Bible in a year, I find myself rushing rather than deeply meditating on what I read.

Sloppy is NOT what God wants from me. He is more important than ANYTHING else in my life. My to-do lists, dirty house, and work schedule are not the priorities per God’s plan. They are the distractions. They are Satan’s best weapon to keep me away from a deep, life-sustaining life with my Creator.

How about you? Is your relationship with God truly all-in? What are your distractions?

Paul knew we would all face these distractions and temptations.

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.

Paul also knew we wouldn’t do it just because anyone said so. Rather we are encouraged to stay focused on God to find and lead the life of peace and joy that is ours if we choose this path.

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.

I pray we can all keep striving to keep God at the center as in the words of David:

Psalm 19:14 ESV

Let the words of my mouth and the meditation of my heart be acceptable in your sight, O Lord, my rock and my redeemer.

Blessings to you my sloppy but trying to be better friends!

Michelle

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

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Turn your health around. Make changes to improve your health.

Is it too late to turn your health around? Although we were raised certain ways we can still make a U-turn, or at least navigate a big curve. I was raised with dessert every day, lots of processed foods, little to no access to seafood, and limited fresh vegetables beyond summer. Meals were built around meat and potatoes. As for exercise, anyone who knows me can attest to my utter lack of athletic ability. So, should we settle for life-long habits and figure it’s too late to make changes now?

Actually, there is a LOT of evidence that changes, at all stages of life, still help you. Below are just a few of the most common habits/choices that can be changed in a way that really makes you feel better.

Changes to turn your health around

  • Quit smoking –
    • Just 20 minutes after you quit your blood pressure and heart rate decrease.
    • Your risk of a heart attack starts to go down at 24 hours.
    • Taste and smell start to improve at 48 hours.
    • After 1-5 years your risk of heart disease is cut in half.
    • After 10 years your risk of lung cancer is almost as low as a lifelong nonsmoker.
  • Weight loss – short and long term
    • Small weight loss can have big advantages.
    • If you lose 5-10% of your body weight, your blood pressure, blood sugar, and cholesterol all improve.
    • Your risk of heart disease goes down.
    • It gets easier to breathe.
    • Sleep apnea can improve helping you sleep better and be less sleepy during the day.
    • Your sex drive
    • Joint pain
  • Diet changes –
    • Decreasing your daily calories by 500-1,000 per day will decrease weight 1-2 pounds per week. [Faster weight loss is not as healthy and hard to sustain.]
    • Gradually add more interesting fruits and vegetables to your diet.
      • Sudden, drastic changes are not necessary and are hard to do.
      • More variety in fruits and vegetables will increase the types of vitamins and nutrients you get.
    • Change up your fat
      • Exchange some of your red meat meals for fish (your grocery store meat section will likely have instructions on how to prepare whatever is on sale or available in the meat section).
      • Try nuts for snacks over sugary snacks.
    • Sugar
      • Drink more water or unsweetened beverages in place of sugary soda or fruit juice.
      • Eat smaller portions of your dessert, as a starting point to cut back.
  •  Exercise
    • Get moving – it helps with more than just weight control.
    • Decrease joint pain and strain, especially your lower back.
    • Get stronger and be more resilient against small strains and sprains.
    • Be more flexible.
    • Decrease your risk of a fall that could injure you.
    • Stay healthy and independent longer through fitness.
    • Have more energy and stamina.
    • Exercise doesn’t have to mean joining a gym or playing a sport.
      • Get up and move around during commercial breaks on TV.
      • Park farther from the front door.
      • Go for a walk with a friend.
      • Window shop in all of the stores at the mall before making a purchase.

U-turns are allowed in your life. No matter your age and for how long you have been doing things a certain way, make a change. Turn your health around. See how much better you can feel with very small changes starting today.

For more information about healthy choices and making a U-turn, contact us at www.medsmash.com.

BIBLICAL APPLICATION

Are you drowning in your negative self-talk? Are you always striving to do better? Or, are you constantly making excuses and blaming others for your weaknesses?

These are such easy routes to take! They are such easy ruts to fall into.

Will you ever be at peace and feel that all is right in your world? What would that take?

My understanding of the Bible is that the peace and promise you’re seeking is available to you RIGHT NOW.

There is nothing you have done that God doesn’t already know about. You can’t hide. Rather than being terrified by that, realize you are loved. You are loved and accepted and forgivable. Absolutely nothing you have done could make God turn away from you.

1 John 4:18 ESV

There is no fear in love, but perfect love casts out fear. For fear has to do with punishment, and whoever fears has not been perfected in love.

Grace, mercy, and forgiveness are right here waiting for you.

Romans 5:8 ESV

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

You could absolutely never do anything so terrible that would exclude you from the love and grace of Jesus Christ.

It was this love that led to Jesus’ death – all for your sins and mine. And because of that sacrifice, you are saved.

Let’s look again at 1 John 4:17-18 from The Message:

God is love. When we take up permanent residence in a life of love, we live in God and God lives in us. This way, love has the run of the house, becomes at home and mature in us, so that we’re free of worry on Judgment Day—our standing in the world is identical with Christ’s. There is no room in love for fear. Well-formed love banishes fear. Since fear is crippling, a fearful life—fear of death, fear of judgment—is one not yet fully formed in love.

Not only can you take a U-turn in your daily physical health choices, you can take a U-turn in your spiritual health. Stop hiding. Stop beating yourself up. Embrace this love that is completely yours. You are forgiven as soon as you let go and give your all to God who loves you with no conditions.

Blessings,

Michelle

 

I have diabetes – let the pills fix it!

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Diabetes – let the pills fix it

 

Medications to treat diabetes have revolutionized the treatment of this condition. The number of people with diabetes has been increasing for many years. So, a lot of emphasis has been put on finding new treatments. The number of new types of medications to treat diabetes has greatly increased even in the last five years. This is GREAT news!

So, with all of these new and the older tried and true treatments, diabetes is in good control, right? Surely with all of these options, diabetes is a problem of the past.

Unfortunately, it’s more complex than that. The same things that are causing this increase in number of people with diabetes need to be at the core of the treatment. So what are these things?

At the core of diabetes management

The primary link to the growing number of people with diabetes is the growth of the population. I’m not referring to number of people, I’m referring to SIZE of people.

Obesity has been on the rise. As a population we have gained significant weight. This is one of the main risk factors for diabetes. It is also a risk factor for high blood pressure, high cholesterol, heart disease, and stroke.

So, besides medications to treat diabetes, changes in diet, exercise, and weight are key parts of treatment. Diet and exercise changes are the best way to manage weight. They are not always the most fun and certainly not the easiest. There are all sorts of ‘quick fix’ schemes for weight management that sound very enticing. But, after all is considered, none of these are as safe or effective as true, daily, positive changes in food and movement.

Daily changes

Move every day. Spend less time in a chair and more walking, participating in dance or games, cleaning, or doing other things that are active.

Diet changes are best made in moderation. Sudden, huge diet changes are very hard to sustain. A few simple changes can make a big different. Try some of these:

  • Avoid second helpings
  • Eat a bit smaller portions
  • Cut back on white bread, crackers, pasta
    • Replace with those with higher grain content
  • Eat some more vegetables in place of bread and sweets
  • Eat some more fruit in place of sweets

It is important to make changes that you can make new habits. Keep up these gradual changes over time.

Be good to yourself. If you occasionally slip and fall back in old habits, pick yourself up, forgive yourself, and try again. As you adopt healthier habits, your weight decreases, and you move more, you will start to feel better and more energetic. That will made it easier to continue to make positive changes.

If you want to talk about more details aobut how you can start making these changes, contact us at www.medsmash.com.

BIBLICAL APPLICATION

Just as it is tempting to let pills fix medical health, it is tempting to let Sunday church fix our spiritual health.

If you go to church most Sundays, you have all you need for spiritual growth and development, right?

Peter had some very insightful instruction about spiritual growth.

1 Peter 2:1-5 ESV

So put away all malice and all deceit and hypocrisy and envy and all slander. Like newborn infants, long for the pure spiritual milk, that by it you may grow up into salvation— if indeed you have tasted that the Lord is good. As you come to him, a living stone rejected by men but in the sight of God chosen and precious, you yourselves like living stones are being built up as a spiritual house, to be a holy priesthood, to offer spiritual sacrifices acceptable to God through Jesus Christ.

I encourage you to read the rest of this chapter of 1 Peter.

2 Peter 1:5-8 ESV

For this very reason, make every effort to supplement your faith with virtue, and virtue with knowledge, and knowledge with self-control, and self-control with steadfastness, and steadfastness with godliness, and godliness with brotherly affection, and brotherly affection with love. For if these qualities are yours and are increasing, they keep you from being ineffective or unfruitful in the knowledge of our Lord Jesus Christ.

2 Peter 3:18 ESV

But grow in the grace and knowledge of our Lord and Savior Jesus Christ. To him be the glory both now and to the day of eternity. Amen.

Another verse with some instruction about spiritual growth is:

2 Timothy 3:16-17 ESV

All Scripture is breathed out by God and profitable for teaching, for reproof, for correction, and for training in righteousness, that the man of God may be competent, equipped for every good work.

Growing in your faith is a lifelong quest. With each new thing you learn, your perspective changes and you realize there is so much more to learn.

Sundays, church, and fellowship are incredibly important! And so are all of the other ways you spend time with God and the Bible and other growth opportunities.

Blessings,

Michelle

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

…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