Written by SMH Heart Failure Nurse Specialist Stacey Daggett
Heart failure can be overwhelming.
There is a range of disease management methods available, and it can get frustrating when you’re in that limbo time period where your doctor is still trying to figure out which management tools work best for you. With all the ups-and-downs and bumps along the way, it’s easy to feel like you’ve lost control over your body—and your life. But, have you thought about the things that you can control?
Lifestyle choices (smoking, poor diet, etc.) are the most common reasons heart failure patients are re-admitted to the hospital. And they are something you can control. Have you made the behavior changes that are essential for properly managing heart failure?
If you’re among the thousands with heart failure who are reluctant to modify their style of living, try the following 10 behavior tweaks to start managing your disease better today:
1. Eat a heart healthy diet.
Excess salt intake is often a factor when a heart failure patient is re-admitted. Salt attracts water; the more salt you put into your body, the more water you will retain. We generally recommend not adding salt to foods because there is so much sodium already in prepared foods and beverages. An average patient with heart failure should have no more than 2,000 mg of sodium in a day, as a general rule of thumb; however, each person is different, and a physician might restrict salt intake even further.
Focus on eating foods that are low in saturated fat, trans fat and cholesterol. Instead of red meat, eat more poultry and fish. When you do eat red meat, choose the leanest cut that you can get.
2. Lose/maintain body weight.
Try to stay within a healthy body mass index (BMI). Obesity increases your risk of developing heart disease. Obesity keeps the body from efficiently circulating blood, making your fluid levels harder to manage and putting you at a higher risk for diabetes, heart disease, certain cancers and sleep apnea—all of which can impact your heart failure and your quality of life. Talk to your doctor to find out your ideal weight range.
Remember, a sudden weight gain generally means you are retaining fluid, and you could be having a heart failure flare up. If you gain more than 2 pounds overnight or 5 pounds in a the week, you could be retaining fluid and should call your doctor to see whether your medication needs adjusting.
3. Track your fluid intake.
There is a fine line between drinking too much fluid and not drinking enough. With heart failure, we aim at keeping fluid from building up in your body; however, it can be dangerous not to drink enough as well.
We typically recommend no more than six to eight, 8-ounce glasses of fluid per day, or 64 total ounces. As always, this depends on the individual, so ask your doctor how much fluid you should have each day. (Be sure to pay attention to how much you’re drinking throughout the day as the doctor may ask you this on your follow-up visit.)
4. Avoid alcohol.
Alcohol can be a natural toxin to your heart and can aggravate heart failure. Always talk to your doctor to determine whether it’s safe for you to consume alcohol. Many physicians will say alcohol is OK in moderation, which would be no more than two drinks per day for men and no more than one drink per day for women.
Exercise is recommended for heart failure patients, and many doctors even advise patients to enroll in cardiac rehabilitation. (For some types of heart failure, cardiac rehab is even covered by some insurance plans now.)
We always recommend exercising to your tolerance level. Never over-do or push yourself when you have heart failure. If you can tolerate only 10 minutes of walking, do the 10 minutes, rest and then try to do more after resting. This will also build your endurance level. Talk to your physician to see whether you would qualify for cardiac or cardiopulmonary rehab in your area.
6. Manage stress.
Too much stress can affect heart failure patients’ condition. It can even cause a certain type of heart failure in women called “takotsubo cardiomyopathy.”
Try to reduce your stress level by relaxing for 15 to 20 minutes each day. You can also do stress-relieving activities such as yoga or meditation to better manage stress and prevent further heart-failure complications.
7. Monitor and track blood pressure.
Uncontrolled blood pressure can cause—and aggravate—heart failure. It is important to monitor your blood pressure (BP) at home, between doctor visits. Keep a log of the readings, so you can track it and share with your doctor. Evaluating your BP trends enables your doctor to determine whether any changes need to be made in your medications.
8. Develop a support system.
It’s important to have a support system when dealing with heart failure. The disease can change many aspects of your life, and it’s good to have people to lean on. Many hospitals and health centers have support groups for people dealing with heart failure. At Sarasota Memorial, our Heart Failure Support Group meets monthly and features an informative presentation followed by group discussion. (Look for upcoming meeting dates on the events calendar.)
9. Get vaccinated.
Getting regular vaccinations against pneumonia and flu has been proven to reduce hospitalizations in heart failure patients. Talk to your doctor about the appropriate time to get vaccinated.
10. Get enough rest.
It is vital for those managing heart failure to get adequate rest. If you’re waking up throughout the night with a dry cough or shortness of breath, talk to your doctor; you could need medication changes.
If you have been diagnosed with sleep apnea, it is crucial to get you on Cpap at night. Untreated sleep apnea has been shown to increase hospitalizations in heart failure patients. Talk to your doctor if you are concerned about your sleeping habits at home.
Stacey Daggett, RN, BSN, PCCN, CHFN, is a heart failure nurse specialist at Sarasota Memorial Hospital. She provides in-depth education specific to each patient’s individual diagnosis and needs.