It is possible to lead a normal active life, even if you have heart failure. Taking control of heart failure is key to your success. You can take control by following the treatment plan prescribed for you. Your care is not just the responsibility of your doctor or nurse. In fact, the success of your treatment plan depends on your active involvement.
This module will help you learn to live successfully with heart failure. It will provide information on:
It will help you:
Take charge of heart failure by following your treatment plan. Most heart failure treatment plans include things like taking medicines, changing your diet, weighing yourself every day, and watching for symptoms. Following your treatment plan can make you feel better, prevent your heart failure from getting worse, and help you live longer.
Right now, it may seem hard to follow your treatment plan. Many people feel this way at first. However, taking all of your medicines and making the suggested changes in your life can give you the edge that makes you feel better. Your doctor or nurse can help you overcome barriers that may prevent you from following your treatment plan. That way you can deal with your symptoms before they become a problem, so you can stay out of the hospital.
Your doctor or nurse will develop a treatment plan that is right for you. Your plan may include recommendations to:
* One standard drink is a drink containing 12 grams of alcohol, which usually means 1 can of beer (12 ounces), 1 glass of wine (4 ounces), and 1 shot glass (1.5 ounces) of spirits. One study suggested that this level of alcohol consumption or less was not associated with adverse effects. However, some physicians and nurses believe that these amounts are too much and recommend that patients with heart failure drink no alcohol.
You may have trouble following your treatment plan because you may:
Your doctor or nurse can help you overcome the barriers and hurdles you may face in following your treatment plan.
For example, they can:
Your family and friends can also partner with you. In fact they can be your strongest supporters in helping you overcome barriers to following your program. See Module 7: Tips for Families and Friends for specific information on ways they can help you.
When heart failure patients take their medications, regularly, they feel better and live longer
Many people with heart failure are not as physically active as they once were, because they feel too tired or short of breath. Others were never very active in their daily lives. Although physical activity can be hard for people with heart failure, it is very beneficial and worth the effort. You may find the following tips helpful:
First, talk to your doctor or nurse before starting an exercise program. Then,
See Module 5: Exercise and Activity for more tips and information.
See Module 2: Following a Low-Sodium Diet for more tips and information.
It is important to tend to your symptoms as soon as they begin. Like many people, you may fail to notice symptoms in their early stages, or you may shrug them off. But, ignoring symptoms is risky. Symptoms such as trouble breathing, ankle swelling, bloating, or weight gain can mean that your heart failure is getting worse. Also, heart failure can get worse “silently”. So if you notice any change in your symptoms (even if the changes are mild) take them seriously. These symptoms can lead quickly to urgent problems requiring a hospital stay.
Monitor your weight and body swelling daily. Keep track of all symptoms. If you do these things, you will be able to notice changes in symptoms early and manage them better. The following sections of this module will help you figure out which symptoms indicate an urgent situation requiring immediate action and which are more common. You will also learn what steps to take for different types of symptoms. As you become more confident in your ability to manage your heart failure symptoms, you may be able to avoid going to the hospital.
Heart failure causes many symptoms. Some of them are more serious than others. It is important to recognize when you should call 911 for emergency help and when you should call your doctor or nurse for urgent attention.
The following lists can help you decide what to do when you experience certain symptoms. Print this page and keep it in a convenient spot.
Emergency Symptoms of Heart Failure
Call 911 for emergency help, if you have:
Urgent Symptoms of Heart Failure
Call your doctor immediately, if you have any of the following symptoms:
Or if you:
Some symptoms of heart failure are not emergencies, but they can get worse if you do not pay attention to them. Do not ignore early symptoms.
Call your doctor or nurse if you have any of the following symptoms, so they can be treated before they become urgent:
These symptoms are early signs that fluid is building up and that your body is producing harmful substances (stress hormones) that worsen heart failure. If you have any of these symptoms, let your doctor or nurse know. They may be able to help decrease or get rid of them. Also let your doctor or nurse know if you think your heart failure medicines are causing you to have new symptoms.
It is important to keep track of your heart failure symptoms, so that you can recognize when they are getting worse or whether you are developing new ones.
You may use the chart available on this page to list each of your symptoms. Then rate each one on a scale from 1 to 5 based on how you felt last week:
Example of a Symptom Tracking Chart
Click here for a printable version of this table to keep track of your symptoms.
Using a tracking system like this can help you tell whether your symptoms are getting better or worse, because you will have something concrete to compare them to.
If any of your symptoms are getting worse, contact your doctor or nurse.
Weight gain or swelling (also called edema) are signs that fluid is building up in your body. You should take steps to reduce the amount of fluid in your body before it becomes more serious.
Swelling occurs because there is too much sodium (salt) in your body. Extra fluid causes swelling in your ankles and legs. Your shoes may feel tight. You may also notice that your rings feel tight or that you have other swelling in your hands. Some people develop swelling in their abdomen causing clothing to feel tight in the waist.
Checking for weight gain is important. You can gain weight without swelling. The average person can hold about 8 to15 extra pounds of fluid before developing swelling. That is why one of the best ways to watch for fluid building up is to weigh yourself every day.
The goal is to recognize a change in weight before you develop swelling and other symptoms. That way you can take steps early to remove the extra weight.
To monitor your weight, you should:
If you gain 2 or more pounds in 1 day, or 4 pounds in one week or if you have more swelling than usual, do the following:
If you do not lose the weight you have gained or decrease your swelling in 1 or 2 days, or if you gain another pound within 2 days, do the following:
Questions and Answers About Self-Care
Question: Why is it so important to weigh myself every day?
Answer: Sometimes people with heart failure do not understand why their doctor or nurse has asked them to weigh themselves every day. People usually weigh themselves to find out whether they have gained or lost fat. That is not the reason that people with heart failure should weigh themselves every day.
The reason for weighing yourself every day is to find out whether your body is retaining extra fluid. Your weight changes when fluid builds up in your body. The extra fluid makes your heart work harder.
If you detect fluid build-up early (when you have gained just 2 or more pounds) you can treat it at home and decrease the work of your heart. If you detect it later, you are more likely to develop worsening symptoms and may have to go to the hospital for treatment.
That is why it is important to get into the habit of weighing yourself every day
Fatigue is a common problem for patients with heart failure. You may be surprised to learn that the best treatment for fatigue is physical activity. Refer to the tips for being physically active earlier in this module or see Module 5: Exercise and Activity. (Planned release date: February 2003)
Sometimes fatigue is an early symptom of worsening heart failure. Call your doctor or nurse for overwhelming and increasing fatigue.
If fatigue continues, try these tips:
Question: Am I a candidate for a flexible diuretic (water pill) regimen? (A flexible diuretic regimen is one in which you adjust your water pill dose up or down as needed based on your weight.)
Reason for asking this question: Some patients can monitor their heart failure symptoms well and can tell when they need a little higher dose of their water pill. They are very attuned to their bodies, weigh themselves routinely, and pay close attention to changes in their symptoms.
If you can do these things, your doctor may direct you to take an extra diuretic (water pill), when you gain a specified amount of weight.
Do not do this on your own, because the regimen varies for every person. But, if you believe that you are a candidate for a flexible diuretic (water pill) regimen, ask your doctor.
Should I have a flu shot this year? What about the pneumonia vaccine?
Reason for asking this question: Caring for yourself is all about balance. The goal is to stay well rather than to treat problems. One way to stay well is to avoid getting the flu or pneumonia. Safe vaccines (shots) that can keep you from getting sick are available. Get a flu shot every year. Ask your doctor or nurse if you should get the pneumonia vaccine too.
Question: How much alcohol can I drink?
Reason for asking this question: Alcohol can damage the cells of the heart and make it harder for your heart to pump blood. If you have heart failure, your heart is already pumping less effectively. So it makes sense not to drink alcohol at all or to drink sparingly.
To drink sparingly means to drink less than 2-3 standard drinks/week. One standard drink is a drink containing 12 grams of alcohol, which usually means 1 can of beer (12 ounces), 1 glass of wine (4 ounces), or 1 shot glass (1.5 ounces) of spirits.
Talk to your doctor or nurse if you have questions about alcohol consumption.