wellness

Your Doctor’s Advise – Misunderstanding can lead to BAD Decisions

Posted on by Michelle Fritsch, Pharm.D.
Good communication with your doctor
Let us help you avoid misunderstanding with your doctor.

Have you ever experienced misunderstanding with someone?  Did that lead you to make a bad decision?  If you had understood the original message, would you have made a different decision?

I have had two client examples this week.

Misunderstanding what the doctor said

In one instance, the doctor had said something about the pain medicine and the stomach acid medicine should not be taken together.  This person has had a long history of Barrett’s Esophagus – a severe inflammation of the esophagus cause by extreme gastroesophageal reflux disease (GERD).  To break that down, this person’s stomach acid was going back up the esophagus – the tube from the mouth to the stomach.  Normally there is a sphincter that closes to keep the acid safely in the stomach.  In many of us, that sphincter can become loose or have a condition that keeps it from completely closing.  When that happens, the acid can go back up the esophagus. Indigestion, burping, pain and/or burning in the mid chest area can result.  The acid inflames the esophagus lining.  When that inflammation becomes severe, the inflammation can lead to Barrett’s Esophagus.  So the stomach acid medicine was VERY important!

This person’s other issue was low back pain due to a herniated (bulging) disk and sciatic pain. Sciatic pain results in pain and burning from the lower back and spreading through the buttocks and the leg. It is caused by irritation of the sciatic nerve, common with lower back issues.

When this person heard the doctor say the stomach acid medicine and the pain medicine shouldn’t be taken together, the person decided to STOP the stomach acid medicine.  The sciatic pain was the ‘bigger issue’, so if both couldn’t be taken, the pain medicine took priority.  The doctor was not told.

The client heard ’these medicines shouldn’t be taken together’.  The more complete answer is, the pain medicine will make the stomach acid and esophagus irritation even worse.  There are safer pain medicine options that won’t make the Barrett’s Esophagus worse.  The person should DEFINITELY be on both a stomach acid medicine and a pain medicine. The pain medicine should just be changed to a safer option.

This was explained, and this person is now on a safer medication regimen for both conditions.

Another Misunderstanding Example

Another recent example was a man with severe vascular issues and lung cancer.

The lung and cancer doctors had together told him and his family there is no more they could do. They recommended hospice care. Hospice care was accepted.

The vascular issues caused very little blood flow to the feet.  As a result, one foot and lower leg had been amputated a few months ago. The second leg and foot are now very infected.  The foot infection is causing severe pain.  Hospice is treating the pain with morphine.  The morphine makes the patient’s stomach upset and dulls his thinking.

His wife understands that the hospice doctor is now his doctor rather than his specialists and primary doctor from before.  The hospice nurses visits regularly, but the doctor has not.  His wife is very upset that the doctor is doing nothing to heal the infection.  She also feels he is very overmedicated since his memory and decision making are slowed due to the morphine.

When we discussed goals – quality vs quantity of life – they each indicated the specialists who recommended hospice had asked that.  They chose quality.  However, they didn’t understand that this would mean a rather rapid decline with the untreated lung cancer and foot infection.  They thought he would be able to back to the things he loves like working on projects around the house and cooking.   They see a decline in quality of life rather than the expected increase.

Now they want to go back to the specialists and change their minds.  It has been six months of no curative treatment.  There is most likely no way to alter the pending outcome.

Essential Clear Communication

Healthcare visits can feel fast and pressured.  Any time there is bad news involved, it is hard to fully hear and process all that is being communicated.  These and other communication issues lead to misunderstanding of healthcare information. This is NOT an uncommon problem.

Another contributing factor is difficulty reaching the doctor after getting home to request clarification.  Most doctors are given schedules that make it difficult to squeeze in phone calls.  So, it is always best to receive, process, and fully understand the information while you have the doctor’s full attention during an appointment.

At Meds MASH and Retirement Wellness Strategies, we are your advocate.  You have guidance to prepare for medical visits by assuring you have your questions ready and the information your doctor needs organized and clear.  We also attend the visit with you by video when you want that.

After the visit, we can provide a wealth of information to further explain any new conditions or medications.  We can even contact your doctor(s) on your behalf to obtain any needed clarification.

Call today at 410-472-5078 and ask for Michelle Fritsch, Pharm.D.  Or e-mail at michelle@medsmash.com.   Check out more at www.medsmash.comor www.retirewellness.com.

BIBLICAL APPLICATION

Miscommunication and misunderstanding can lead to so many preventable problems.  I often ask this question of students in the health professions. ‘Tell me about a time miscommunication led to a bad outcome.’  Usually the answers involve people going to different restaurants or friends having an argument.  One time, while teaching active duty military healthcare providers, the example was of an international hunt for a notorious terrorist.  The terrorist had been found and surrounded, but a delay in the order to detain him resulted in his escape.  What an example!

The Bible has much instruction about good communication.

This Psalmist knows exactly how much trouble our words can cause:

Psalm 141:3 ESV

Set a guard, O Lord, over my mouth; keep watch over the door of my lips!

Our communication is instructed to build people up and turn them to Christ.

Ephesians 4:29 ESV

Let no corrupting talk come out of your mouths, but only such as is good for building up, as fits the occasion, that it may give grace to those who hear.

Colossians 4:6 ESV

Let your speech always be gracious, seasoned with salt, so that you may know how you ought to answer each person.

I know I have spoken in frustration and said words I regretted.  I know I have neglected to speak up when my support could have been very helpful to someone else.  I know I have said the wrong thing and caused more harm than good, usually out of complete ignorance or insensitivity.

Proverbs 15:2 ESV / 176 helpful votes

The tongue of the wise commends knowledge, but the mouths of fools pour out folly.

One of my frequent prayers in the morning is, ‘Lord please fill me up and pour me out today.’  I ask to be poured out with the Lord’s words and attitudes and sensitivities.

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.

I certainly can’t be trusted to do this on my own, but with the Lord’s guidance, excellent communication can make a huge positive difference in the lives we meet!

Blessings,

Michelle

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Why is DIVORCE during and after retirement on the rise?

Posted on by Michelle Fritsch, Pharm.D.
Protect your marriage
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).

  1. 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?
  2. 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.
  3. 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.
  4. 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.
  5. 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