Do you find yourself breathless when you lie flat or extremely winded climbing the stairs to your bedroom? Have you decided to just stay downstairs and sleep in the recliner? Are your legs and ankles swollen keeping you from doing activities that were once easy for you? Have you told yourself, “I’m getting old – I’ll just slow down”? Have you been told you have a heart murmur, had a problem with your heart valves, or had a heart attack? If so, you may have heart failure.
Now, don’t get confused – I’m not saying that if you’ve had a heart attack or have trouble climbing stairs you automatically have heart failure. Shortness of breath can be caused by many things such as asthma, pneumonia, or COPD and many heart attacks do not damage the heart at all. However, there are a number of heart problems that can contribute to or cause heart failure – a weakening of the heart muscle or mechanical problem that damages the heart’s ability to pump blood efficiently.
This inefficient pumping of blood can manifest in a range of symptoms from mildly swollen ankles in the case of right sided heart failure, to devastating left sided failure whose only remedy is a heart transplant. Many people today live with moderate left sided heart failure or what is commonly called congestive heart failure or CHF. If you are one of those people, you may need some help.
Managing your CHF involves carefully maintaining a low volume of fluid in the blood. Because the left side of the heart is weak and can’t pump the blood forward, it backs up to where it came from – your lungs. Keeping the volume low is very important because being overloaded with fluid not only causes you to have difficulty breathing but can weaken your heart further and make your CHF worse. Watching your salt intake and limiting excess fluid is the key to staying out of the hospital and maximizing your heart function.
If you have heart failure or CHF, your doctor probably prescribed diuretics, what some people call their “water pills”, to help get rid of the extra fluid in your blood. I hear a lot of complaints that this is inconvenient as activities may be interrupted by frequent trips to the bathroom. However, you need to make taking these pills a priority as they are really helping you. An extra trip or two to the bathroom isn’t as inconvenient as spending an evening in the ER on oxygen and IV diuretics. You may have to plan a little more carefully to stay active and still manage your heart failure. Hint – Lasix lasts 6 hours – so take it a little earlier on days when you have activities planned.
You may have been told to weigh yourself daily, if so, you must do this faithfully and accurately, and you have to follow the instructions given by your doctor or clinic if you have a weight gain. If you gain more than 2 pounds in a day, or 5 pounds in 5 days, this is an indication of fluid buildup that needs to be addressed before it gets out of hand. If your weight is up, you may be instructed to take an extra dose of your diuretic. On the other hand, if you become light-headed or dizzy with low blood pressure and a weak pulse, call your doctor right away as you may be dehydrated. Managing your fluid balance can be tricky so let your doctor or HF management team know about any dramatic changes in how you feel. Hint – a digital scale with software tracking can be a real help in monitoring your weight accurately.
If you are on a fluid restriction, be careful not to exceed it. Be sure you know exactly how much you are allowed to drink each day and keep the limit where it’s visible – perhaps on the refrigerator door. Keep in mind if you are on a fluid restriction it is not recommended you drink beer or alcohol for obvious reasons. Also, keep track of anything you drink while you’re out – maybe in a small notebook or on your mobile phone. Watch out for ice or frozen treats as that counts too. Anything that melts at room temperature is considered liquid. Try taking pills with applesauce instead of water if you’d rather save the liquid for a more enjoyable drink. Hint – keep a measured container in the fridge filled with water to keep track of how much you’ve consumed during the day. Pour out amounts equal to other fluids you drank that didn’t come out of the container. When its empty, you’re done for the day.
Heart failure, of any degree of severity, can be a devastating condition which may completely change your ability to function. Unfortunately, though there are some promising medicines beginning to appear, there is no cure, it is a chronic condition that must be managed carefully to prevent it from getting worse. With the right outlook, you can manage quite well, but it will take some adjustment both psychologically and physically. A good relationship with your practitioner and regular visits to a Heart Failure clinic or program can go a long way toward helping you maximize your health and well-being. Be encouraged, because with a little bit of diligence and careful self-monitoring, you can stay out of the hospital and live a full and happy life.