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Winning the Game with Heart Failure

The words “heart failure” sound ugly, scary, and hopeless. Unfortunately, the words have been around too long to change them now, but the meaning of the words has changed remarkably over the past decade. While “heart failure” at one time represented a condition for which there was little treatment other than trying to relieve symptoms, research over the past several years has enabled us to make dramatic advances in treatment and as a result, people with heart failure are living longer and better than ever before.

Cindy Adams,
RN, MS,
PhD Candidate

The most successful treatment of heart failure happens through a team approach… you might think of heart failure as a “team sport”. It takes cooperation from everyone on the team to be successful. The healthcare team may include any or all of the following: primary care physicians, cardiologists, nurse practitioners, registered nurses, nursing and medical assistants, pharmacists, dieticians, exercise specialists, social workers, pastoral caregivers, and others. However, the MOST important member of the health care team is YOU! You are the team captain. Even the world’s most talented experts in the field of heart failure depend on you to eat right, exercise, take your medications, and pay close attention to signs and symptoms that require reporting to the rest of the team quickly, to avoid problems. Don’t fall into the trap of being a passive bystander in your own care! Take the situation into your own hands and take ownership! Ask questions and make sure you understand the answers. If you don’t, ask again! You are in the position to make a bigger difference than anyone in how you succeed in this game – prepare yourself well and do your homework. It will pay off!

First Things First: Preparing for the Game

Make sure you understand what heart failure means. (we could put a link here to an explanation) Also, ask why you have it. There are many potential causes of heart failure and it is important to understand what may have caused it. It is also important to understand that there may not be a clearly identifiable cause. If your doctor tells you your heart failure is “idiopathic”, that means the cause is not known.

Understand the signs and symptoms of heart failure and when you should call the doctor or your heart failure team. Make sure you know who and how to call – ask for the number and hours of operation. Clarify what to do after hours. Understand which symptoms require an immediate call and when it is OK to wait until Monday.

The Game Plan: Understanding Your Treatment Regimen

A complete treatment plan for heart failure includes the proper medications, special diet instructions, and staying physically active.

Medications

It is important to understand what your heart failure medications are for, what common side effects to watch for, and when and how to take the medicines (that is, with food or on an empty stomach, what time of day…). Ask your health care team for advice on how to time your medications so that they interfere the least with your activities. For example, diuretics are very common in the treatment of heart failure. These medications increase urination. It is important not to take diuretics before bed, because you may be up all night for trips to the bathroom rather than getting a much-needed good night’s sleep. This and other helpful tips will come from experience and from good communication with your health care team.

Diet

A low sodium diet is important to help your body avoid congestion. You need details on how to follow a low sodium diet. Just being told to “watch your salt” isn’t enough – ask for help in reading labels, knowing how to handle dining out, and what to do when you “fall off the salt wagon”. Many health care teams include dieticians that can be of great help in making your low sodium diet manageable. Being on a lower sodium diet does NOT mean that you will never enjoy food again. There are tasty and enjoyable alternatives to high salt food. Again, ask questions, try new recipes, and ask the dietician to help alter your favorite recipes so that they contain less salt.

Physical Activity

Years ago, it was believed that people with heart failure should not exert themselves, for fear that this would cause undue “strain” on the heart. This is an old, outdated way of thinking. Exercise is very important for heart failure patients. Many studies have been done that have shown significant improvements in the way the muscles use oxygen for energy, and improved ability to perform daily activities, with exercise. It is also important to understand how to exercise safely and effectively. Ask your healthcare team if there is a cardiac rehabilitation program in your area that could help to teach you how to exercise safely. Medicare and many commercial insurance companies do not pay for cardiac rehabilitation for heart failure unless there has also been a recent heart attack, bypass surgery, or stable chest pains with physical exertion. If insurance will not cover a full cardiac rehabilitation program for you, at least see if you can consult an exercise specialist for guidance, or at minimum, ask your health care team how you should be exercising.

Huddle Up!!

Now you know the basics. It’s time to win the game. Don’t forget you are in charge – call on the rest of your team when you need them but don’t count on them to carry you through. By knowing and understanding your condition and the critical parts of the treatment program, you are your best bet in winning the game with heart failure.