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Heart failure has a variety of causes, including damage from a previous heart attack, chronic high blood pressure, valve disorders, infections and genetics. In general, a weakened heart isn’t able to pump blood adequately to meet the body’s demands, causing a buildup of fluid that leads to swelling (edema), shortness of breath and severe weakness. Sadly, the body’s feedback mechanisms tell the heart to work harder to compensate, further weakening an already damaged heart.

This cycle often repeats in a downward spiral. In fact, patients with heart failure can often feel like they are in a revolving door that leads back to the hospital. It is estimated that as many as 50% of patients hospitalized for an exacerbation of heart failure will be re-hospitalized within six months. However, by making some changes to your lifestyle you can help manage your heart failure, live longer, feel better and reduce trips through the hospital doors.

Here are some tips to help you manage heart failure:

Medications

  • Refill all of your prescriptions before you run out, and make sure you take your prescriptions exactly as directed at the same time(s) each day.
  • Some medications for heart failure may cause unpleasant side effects, such as a dry, hacking cough or frequent urination. Let your doctor know about side effects that are bothering you. A dosing adjustment, timing adjustment or alternative medication prescribed by your doctor may help decrease side effects.
  • Never stop taking medication or change your medication dose without your doctor’s approval.


Diet

  • Follow your doctor’s orders regarding limits on the amount of fluid you should consume each day. Invest in a mug or cup with volume measurements, and keep a log of your daily fluid intake.
  • Keep your salt intake within the doctor’s limits. Start by making small changes, like taking the salt shaker off the table. Over time, your taste buds will adjust.
  • Replace the salt shaker with salt-free herb mixes found in the spice aisle at your grocery store, or make your own mix. (Some salt substitutes are high in potassium, so ask your doctor which ones are okay for you).
  • Become a food label reader. Look for low-sodium or no-sodium versions of your favorite foods.

Activity

  • Remain as physically active as possible, within the guidelines of your doctor, and listen to your body.
  • Find physical activity that you enjoy, like walking, swimming or riding a stationary bike, and incorporate it into your routine. Start out slowly, with a few minutes of exercise several times a day, and increase the time and intensity as you are able.
  • Alternate your periods of activity with periods of rest. Be sure to sit down, and take a rest whenever you begin to feel tired or short of breath.

Daily Weigh-ins

  • Sudden weight gain, or a steady increase in weight, is a warning sign of fluid build-up in the body. Weigh yourself each day, and keep a record.
  • Weigh yourself each morning at the same time (before eating, after urinating), in the same clothes and on the same scale.
  • Keep a weight record and take it with you to your doctor appointments.

Follow up

  • Keep all follow-up appointments with your primary physician and cardiologist.
  • Pay attention to your symptoms, and update your doctor when things change. Addressing symptoms early may lead to an adjustment in your treatment plan that might save you from a more severe exacerbation or hospitalization.
  • Call your doctor if you gain more than 2 pounds in 1 day, or more than 5 pounds in 1 week (as per physician’s instructions).
  • Monitor swelling, and call your doctor to report any increased swelling in your feet, ankles or legs. You may first notice that your shoes, clothes or rings fit more tightly.
  • Call your doctor if you have difficulty breathing, including shortness of breath during usual activities, trouble breathing when lying flat or waking up breathless at night.
  • Call 911 if you experience chest pain, fainting, severe weakness, severe shortness of breath or coughing up pink, frothy mucus.

For more information and tips on managing heart failure, visit the Heart Hospital of Austin’s online Health Library at http://www.hearthospitalofaustin.com/connect-learn-interact/health-library. By taking an active role in your health, and working closely with your doctor, you can better manage your heart failure diagnosis and stay out of the hospital’s revolving door.

Resources:

Amy McGowan, RN
St. David’s South Austin Medical Center
Intermediate Care Unit

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