Heart Talk: Living with Heart Failure

1. Heart Talk:Living with Heart Failure Education for patients, families and caregivers

2. An accompanying patient booklet can be downloaded for free at www.Qualidigm.org. Search for it and more under “Heart Talk”

3. What is Heart Failure? • Weakness of the heart muscle • Sometimes also called: • Congestive heart failure • Pulmonary edema • Fluid on lungs • Retention of fluid

4. Common Symptoms of Heart Failure • Hard time breathing • Swollen ankles, legs, or abdomen (edema) • Feeling weak and tired

5. Heart Failure Can Be Treated • Medications • Procedures • Surgery

6. Heart Failure is Chronic It requires lifelong treatment.

7. Heart Failure is Common • More than 5 million Americans have Heart Failure. 1 American Heart Association. 2008 Heart and Stroke Statistical Update.Dallas, TX: American Heart Association; 2008.

8. 6 Tips for Staying HealthyFollowing these tips and doing what your doctor tells you will help keep you healthy

9. 6 Tips to Stay Healthy Take Medications as Ordered by Your Doctor Go to Doctor Appointments Monitor (watch) Your Symptoms and Weight Adapt Diet (eating) and Fluids (drinking) Get Exercise as Directed Limit Alcohol, Caffeine and Tobacco

10. 1. Take Medications as Ordered by Your Doctor

11. What You Need to KnowTake Medications as Ordered Medications for heart failure are necessary even when you are feeling well.

12. How to Keep HealthyTake Medications as Ordered Go over your list of medications with your doctor or nurse Make sure you understand how and when to take them Ask about side effects (reactions) or possible problems with taking medications with other medications and/or vitamins

13. How to Keep Healthy Take Medications as Ordered • Know how to refill your prescriptions • Call your doctor’s office a few days before you run out of your pills • Make sure you have a way to get your medications • How will you get to the pharmacy?

14. How to Keep Healthy Take Medications as Ordered Bring your medications or a list of your medications to all of your doctor appointments Tell your doctor about any side effects or reactions

15. What You Need to KnowTake Medications as Ordered Patients who take their medicines live longer, feel better, and spend less time in the hospital.

16. 2. Go to Doctor Appointments

17. What You Need to Know Doctor Appointments Heart failure is not simple The doctor needs to see you often to keep you well

18. How to Keep Healthy Doctor Appointments Set up an appointment with your doctor before you leave the hospital or other facility Set it up on the best day and time for you Make sure you have a ride to your appointments

19. How to Keep Healthy Doctor Appointments Bring a friend or family member Bring all medications or a medication list to all appointments Ask questions!

20. What You Need to KnowDoctor Appointments Patients who go to doctor appointments live longer, feel better, and spend less time in the hospital.

21. 3. Monitor (watch) Your Symptoms and Weight

22. Monitor Symptoms • Common heart failure symptoms: • Hard time breathing • Swollen ankles, legs, or abdomen (edema) • Feeling weak and tired

23. Monitor Weight • When your body holds extra fluid (water), your weight goes up • Weight gain from fluid can start up to two weeks BEFORE symptoms • By weighing yourself every day, you can avoid getting sick

24. How to Keep Healthy Watch Your Symptoms and Weight Get a scale if you don’t have one Make sure you can read the numbers Write your weight down every day Bring the weight chart to your doctor appointments

25. How to Keep Healthy Watch Your Symptoms and Weight • Weigh yourself every morning at about the same time: • After urinating • Before having anything to drink • In the same amount of clothing • Use the same scale

26. How to Keep Healthy Watch Your Symptoms and Weight • Tell your doctor if you gain: • 3 pounds in one day • 5 pounds in one week

31. What You Need to Know Watch Your Symptoms and Weight By monitoring for symptoms and weight gain, patients with heart failure can live longer, feel better, and spend less time in the hospital

32. 4. Adapt Diet (eating) and Fluids (drinking)

33. Salt and Water • Salt = Sodium • High salt intake will make the body hold extra fluid (water) • Extra fluid leads to swelling and heart failure symptoms • Eating a low salt diet helps patients stay well

34. How to Keep Healthy Eating and Drinking • Do not add salt to any meals • Try to eat less than 2000 mg of sodium a day • One teaspoon of salt = 2300 mg of sodium • If you don’t buy and cook your own food, speak to the person who does

35. Reading a Label • Check to see how many servings are listed on the label • Eating more than one serving size increases salt intake more than what is listed on the label

36. Common Food Salt Sources • Canned foods • Frozen dinners • Deli meats • Hot dogs

37. Other Food Salt Sources • Jar tomato/pasta sauce • Pickles • Sausages and Kielbasa • Ham and Bacon • French fries • Sea salt • Adobo seasoning • Salad dressings • Cheeses • Soy sauce

38. How to Keep Healthy Eating and Drinking • If you do eat salt, tell your doctor • Medications may need to be adjusted • More doctor visits may be needed • You may need to talk with a diet specialist

39. How to Keep Healthy Eating and Drinking • Eating out: choose heart healthy foods • Baked or broiled foods • Salad dressing, sauce or gravy on the side • Safe dishes: baked chicken or fish, steamed vegetables

40. What You Need to Know Eating and Drinking By avoiding salt in your diet, you can live longer, feel better, and spend less time in the hospital

41. Fluid Restriction • Sometimes doctors will limit the amount of liquids patients can have every day • Foods that count as liquids are: yogurt, pudding, ice cream, and gelatin • Some fruits have liquid: 1 orange or ½ Grapefruit = 4 ounces of fluid

42. Fluid Restriction • Space your liquids out over the day • Save liquids to take your medicines • Some patients can take their medicine with applesauce instead of a drink

43. Tips to Battle Thirst • Use ice chips or freeze juice in an ice cube tray • Rinse the mouth • Use a lemon wedge, gum, frozen grapes, strawberries or hard candy

44. 5. Exercise as Directed by Your Doctor

45. Exercise and Activity • Always check with your doctor. Your doctor can tell you what is good for you: • Exercise: Most of the time is safe and good for you • Sex and driving: Most of the time is safe for you

46. 6. Limit Alcohol, Caffeine and Tobacco Use

47. Alcohol and Caffeine • You should check with your doctor about alcohol and caffeine use • Alcohol is usually okay in moderation • Less than 2 drinks per day for men • Less than 1 drink per day for women • Caffeine is usually okay in moderation • Less than 1 or 2 cups per day

48. Tobacco • If you smoke, please STOP! • Bad for anyone, but especially for those with heart failure • Makes the heart work harder • Can lead to heart attacks • Ask your doctor or nurse about help to quit smoking

49. 6 Tips to Stay Healthy Take Medications as Ordered by Your Doctor Go to Doctor Appointments Monitor (watch) Your Symptoms and Weight Adapt Diet (eating) and Fluids (drinking) Get Exercise as Directed Limit Alcohol, Caffeine and Tobacco

50. Credits The Hospital of Central Connecticut • Shelley Dietz RN, MBA Qualidigm • Anne Elwell, RN, MPH • Michelle Pandolfi, MSW, LNHA University of Connecticut Heath Center • Wendy Martinson RN, BSN • Jason Ryan, MD, MPH