Many doctors patients get very glum when they are told that they have “heart failure” and that is understandable, -it sounds terrible doesn’t it? However it is not as bad as it sounds.
“Heart failure” means that the heart is not pumping as well as it once was. The heart is weakened, and will need some special care.
Your GP and cardiologist can work out a personalised program, for what your heart really needs – and does not need – to work well. However here are some basic things that most people with heart failure will need to be aware of.
- Fluid intake – most will do well with around 1.5L daily. Too much fluid, and the heart will have trouble pumping it around the body, leading to swollen ankles, high blood pressure, breathlessness and coughing. Too little and kidneys will be too dry. Ask your doctor what they would suggest you drink in a day. Keep a fluid diary for a day or two of everything you drink, to help them out.
- One easy way to monitor you daily fluid intake is to fill a jug with water in the morning you have a cuppa, fill the kettle from the jug, if you have a cup of juice, tip an equal size cup out of the jug…and then you will be able to pace your fluid intake over the day.
- Weigh yourself each morning. Try to weigh yourself at the same time every day, without any clothes – for instance when you get up in the morning.
- We can all gain or lose weight over time, but any sudden increase or decrease in weight could indicate you are keeping fluid and may need to talk to your doctor or nurse.
- Alcohol – sorry to say despite what you read about red wine being good for the heart, the best amount of alcohol if you have heart failure is none. Alcohol has extra fluid you do not need, and the alcohol itself is poisonous to heart muscle fibers. People with heart failure should not drink any alcohol.
- Reduce salt intake.
- Salt makes you thirsty and makes you retain fluid. If you need help working out how much food you can eat, how much salt you are eating now, a dietician can be a big help. They can help you make sense of food labels, and find hidden sources of salt.
- You can reduce salt by taking the salt shaker off the table, not adding salt during cooking, and eating food you prepare at home. If you prepare fresh foods at home you will know how much salt is in it….packet foods and takeaway often have way too much salt. It is amazing how fast your taste buds can adjust to no added salt – you will soon be able to enjoy the natural salt and flavour in foods.
- Keep your weight under control – the more there is of you, the more your heart has to work hard to pump the blood around. Most of us carry too much weight – ask your doctor what your ideal weight would be, and for some help making a plan to get to it.
- Watch blood pressure – if the blood pressure is high, the heart has to pump hard against it, and will wear out sooner. Ask your doctor what blood pressure you should aim for, but most people will need to keep in the 120/100-140/80 range. Blood pressure can be kept low by – you guessed it – keeping a watch on slat and fluid, watching weight, and taking medications as directed.
- Medications – your doctor may recommend some medications for your heart failure. It is important to take them as directed, and quickly tell your doctor if you have any problems with them. These medications will strengthen the heart and make it last longer. Missing medication can be a cause of the heart being overloaded.
How will I know if my heart failure is getting worse? What are the dangerous signs? The symptoms below are not good – if you have theses symptoms or are getting worse, you need to see your doctor.
- Suddenly putting on weight, 1 or more kilos in only 24-48 hours
- Becoming much more breathless, even if you do small things
- Waking up in the night gasping for breath
- Having to sit up in bed or sit out of bed to breath at night
- Getting very swollen ankles and legs
- Feeling nauseated
- Feeling very fatigued
Many people with heart failure are frustrated early in the course of their illness that they need to come to the doctor often, and often have their medications changed each visit. Medicine can do a great deal, but it is not as good as the body and all the natural adjustments it makes each day without us even knowing. When you are first diagnosed, or if your heart failure has been playing up, you may to see the doctor every few days, change medications several times in a week , and keep a close track on your weight and fluids.
You can help your heart to get on stable track by keeping a diary of weight, fluid intake and symptoms, taking your medications as directed and keeping in close contact with your doctor. It wont’ always be so labor intensive!
How can I get all this organised?
See your GP and get a care plan and Team Care arrangement. This document will make sure you get all your instructions for the next year, and that your doctor, nurse, cardiologist and pharmacist are all on the same day. This should have your specific fluid, blood pressure weight and exercise targets. You should also carry a copy of your current medications – even thought this may need to be often updated!
Educate yourself and your family about heart care, the following resources are very helpful for you and your family to optimise your heart:
