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Most of us are familiar with the United States Food and Drug Administration (FDA). This agency is largely responsible for the regulation and safety of food and drugs in this country.  

Occasionally, the FDA attracts controversy. I am not going to step in to the storm of opinions about the FDA. Rather, I want to call readers’ attention to another organization, one without government ties: the Institute for Safe Medication Practices (ISMP).

ISMP is the first non-profit organization dedicated to the collaborative development, education, and advocacy of safe medication practices. It has been in existence for more than30 years. ISMP has an impressive record of improving safe medication practices.

Most recently, I received a notice of ISMP’s campaign to increase awareness about drugs that look-alike and sound-alike (LASA). ISMP has named these the List of Confused Drug Names.

ISMP recommends using the list to determine which medications require special safeguards to reduce the risk of errors and minimize harm. This may include strategies such as:

  • Using both the brand and generic names on prescriptions and labels
  • Including the purpose of the medication on prescriptions
  • Configuring computer selection screens to prevent look-alike names from appearing consecutively
  • Changing the appearance of look-alike product names to draw attention to their dissimilarities

Some of the drugs on the list are extremely common. Further, they aren’t medicines that I would want my doctor or pharmacist to confuse. For instance, if I am taking the anti-inflammatory medicine Celebrex, Cerebyx or Celexa would not be welcome substitutes.  It would be disastrous to confuse epinephrine and ephedrine.

You can reduce your risk of a medication error by taking an active role in your own health care. Here is how:

  • Learn about the medications you take. Read the package information. Ask questions and discuss your concerns with your doctor, pharmacist and other health care providers.
  • Be sure your health team knows all the prescriptions, supplements, recreational drugs and over-the-counter medication you are taking. Ask if there is potential for interactions between your drugs or any food that you might take.
  • Notify you health care provider about any medications that you’re allergic to or that have caused problems for you in the past.
  • Let your doctor know if you may be pregnant.
  • Never cut, crush or chew a pill unless your doctor or pharmacist says it’s safe.
  • When possible, use the same pharmacy for all your prescriptions.
  • Before taking a medication, check to see if it is on the LASA list. If so, ask your pharmacist to confirm that the drug he or she filled is indeed the one prescribed.
  • Report side effects or other reactions to your doctor.
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Health and Happiness

Last year I gave up pursuing happiness and I am happier for it. Actually, I gave up pursuing everything. Instead of trying to be a better meditator, exerciser, sleeper and eater, I removed all the shoulds, whips and carrots, and just let myself be alive. The irony is that now I am a better meditator, exerciser, sleeper and eater.

I attribute the change to 65 years of trying things that didn’t work. I think I just ran out of ways to fail and found something that works.

The other helpful tool is that I stumbled upon teachers that inspire me. It’s the proverbial, “When the student is ready, the teacher will appear.” The teachers appeared in Dan Harris’s 10% Happier podcast. Then I read his book. After that,  I downloaded a 7-day free trial of the 10% Happier app. It was so helpful, I plopped down the money for a year’s subscription. After 45 years of trying to meditate and spending most of the time wishing it was over, I now have an incredible meditation experience. I look forward to it, and am often surprised at how quickly the time passes.

Meditation is more than a tool for happiness; it’s a tool for health. Research reports solid evidence that meditating can help lower blood pressure, and decrease pain. Meditators demonstrate better cognition as well as improved immune systems. And these are just a few of the benefits.

Here are the really cool parts about meditation: it doesn’t cost anything, there are no negative side effects, and you can do it anywhere, anytime. A big upside with no downside other than it takes a few minutes every day. Is there anything stopping you from giving it a try?

Tip: If the 10% Happier app doesn’t fit in your budget, there are lots of free meditations on the 10% Happier podcast. And many of the guests on this podcast have their own podcasts and free meditations.

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Precious Sleep

I have a problem with an annual event that is around the corner. It isn’t tax day or any of the holidays; it’s the day when daylight savings begins. And it’s going to happen this Sunday, March 10. I call it Daylight Wasting Time.

I don’t like losing an hour of sleep, but even worse, I am irritated by the loss of morning light. On Saturday, March 9th, the sun will rise in my part of the world at 6:24 AM. The next day, my groggy body will greet the sun at 7:22 AM.

You may point out that I’ll get the extra hour of light on the other end, that instead of a 6:03 PM, the sun will set at 7:04.  To me, that is nonsense. My body doesn’t reset its clock with the digital world. My body won’t be hungry just because my analog timekeeper tells me it’s dinnertime.

My sleep cycle won’t have had enough darkness to prepare for my usual bedtime. I usually find myself reading an hour later. The next morning I wake up to an annoying alarm, necessary because my body’s circadian rhythms are still intact. Missing another hour of sleep, I’ll blunder through the day. It will take me a few weeks to catch up.

Perhaps you think I am protesting too much. However, I have the weight of scientific research on my side. Scientists have rigorously studied sleep, and anything that affects quantity or quality of sleep is a health threat.  In Why We Sleep, Matthew Walker provides a litany of what insufficient sleep can do. These include:

  • Loss of concentration, memory and increased risk of dementia
  • Increased risk of cancer, heart attack, stroke, colds, flu and other diseases
  • Weight gain and all the weight-related health problems, such as diabetes
  • Premature death

The Bottom Line:  Sufficient sleep is the bedrock of health. Without it, life can be shorter and miserable.

To learn more about the importance of sleep, I recommend an article in the Washington Post by Carolyn Y. Johnson titled, “Go to bed! Brain researchers warn that lack of sleep is a public health crisis.” (January 24, 2019)

As for daylight savings time, I’ve been preparing for the last two weeks by going to bed earlier. Also, I am not laying awake at night complaining about something I can’t control. I’ll get that hour back in the fall. Perhaps I should move to Arizona and stop complaining altogether.

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What Does Quitting Look Like?

One of the joys of being a hospice volunteer is that sometimes it turns everything I know upside down. People who are on the edge of death see things that I haven’t yet seen. And sometimes I get a window of opportunity to learn from them.

A case in point. Often when people are diagnosed with cancer, they tell me that they will do everything they can to stay alive. For example, a friend who was told she only has a few months left to live told me, “I am not a quitter.”

I hear that a lot. Family and friends feel the need to encourage the sick to “not give up.” Patients reassure family and friends by telling them that they are fighters and will give it everything they got.

I wonder if we tell someone to give it the good fight because it makes us feel like we are doing something. It creates an illusion of control when feeling powerless. On the patients’ side of the equation, staying in the fight even when they are miserable and fighting against the odds, can feel like a huge contribution towards reassuring others, even if it goes against their sense of what is right for themselves.

The big problem with this is that people sometimes feel blindsided when death comes. “But he was fighting it.” Or, “Maybe she died because I didn’t encourage her enough.”

I think the problem is with the word ‘quitting.’ There is the kind of quitting that involves giving up. It is passive. But letting go and taking charge of the kind of death you want is entirely different. Dying with dignity is not quitting; it is an opportunity to embrace death, and in doing so, embrace life. It bestows a legacy of bravery and peace to those we leave behind.

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Lifted from my depression, I recall the vivid starlit sky, as if seeing it for the first time.

I lived with depression for roughly 20 years. The last two of those years were beyond description, other than it was soul-crushing. In his book, Darkness Visible, William Styron describes his depression this way, “The pain is unrelenting, and what makes the condition intolerable is the foreknowledge that no remedy will come—not in a day, an hour, a month, or a minute. If there is mild relief, one knows that it is only temporary; more pain will follow. It is hopelessness even more than pain that crushes the soul.”

Depression is the most common serious psychiatric illness. It is also one of the most treatable. Depression is a disorder that may affect your feelings and outlook on life. Persistent feelings of sadness, a loss of interest in life, hopelessness, and pessimism are common warning signs of depression. The symptoms can vary from person to person. Anyone can feel sad or blue from time to time. However, a persistent or unexplained bout of malaise—the blues—is not normal and should be evaluated.

The following are some common symptoms of depression:

  • Feeling sad or “empty”
  • Feeling hopeless or pessimistic
  • Fits of crying with no reasonable explanation
  • Feelings of guilt, worthlessness, or helplessness
  • Feeling anxious, irritable, or restless
  • Loss of interest or enjoyment in hobbies, social activities, or sex
  • Fatigue or decreased energy
  • Difficulty concentrating, sometimes accompanied by decision-making and memory problems
  • Insomnia or other sleep-related problems
  • Appetite loss and/or weight loss
  • Overeating and/or weight gain
  • Thoughts of death or suicide; suicide attempts.

Depression may be accompanied by a number of other psychological as well as physical complaints. Persistent physical symptoms that do not respond to treatment—such as headaches, digestive disorders, and chronic pain—may be related to depression. Other physical complaints that may be related to depression include:

  • Panic attacks or phobias
  • Tight chest or throat
  • Difficulty breathing or swallowing
  • Dizziness
  • Shaking or tremors
  • Gastrointestinal complaints such as nausea, diarrhea, intestinal gas, and stomach pain
  • Muscle aches and pains

According to the National Institutes of Mental Health, many people with a depressive illness never seek treatment. But the majority, even those with the most severe depression, can get better with treatment. Medications, psychotherapies, and other methods can effectively treat people with depression.

Don’t be one of the many people who don’t seek treatment. Get help. I’ve been free of depression for more than 30 years, and there is no better feeling than to love waking up and feeling alive. Describing his recovery from depression, Styron quotes Dante, “And so we came forth, and once again beheld the stars.”

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A Valentine to Myself

This Valentine’s Day I am giving myself the gift of self-care. No one can care for me better than I can care for myself. I am the one responsible for how much I move, sit, eat, sleep and relax. This Valentine’s Day I can stuff myself with unhealthy foods, but the consequences are weight gain, high blood pressure, diabetes, heart disease, or stroke. Are potato chips worth the risk of losing my health? Do I really want to wreck my heart on Cupid’s holiday?

I think the expression ‘comfort foods’ needs to be expunged. Losing a foot to diabetes is horribly uncomfortable. Instead, I propose replacing the expression ‘comfort foods’ with ‘risky foods.’ This stops me short; makes me think. Is the food I want to eat worth the consequences? What about the amount?

Aristotle said, “We are what we repeatedly do. Excellence is not an act, but a habit.” I can break my health routine  today, but is falling off the health wagon a good substitute for excellence? I think not.

Here’s what I am trying: Before I eat something, I try to pause and think about the consequence of the food or the amount of food I am about to eat. This little action has huge results. Do I do this all the time? Hell, no; not even close to all of the time. But I am getting better at this.

I am not going to deprive myself on this day of hearts and flowers. I have a good walk planned, a nice dinner with small portions, and a delicious piece of high-quality artisan chocolate to end my day. Seems like excellence to me.

How are you caring for yourself today?

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