Coping With Heart Failure

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Treatment of heart failure is far advanced from where it was a few decades ago, which has improved the quality of life for those living with the condition. Still, most people who have heart failure experience physical limitations, depression, and anxiety that affect their quality of life. From making diet changes to reaching out for support to exploring the use of personal monitoring technology, there are several strategies that can help you cope with these concerns and to help manage your condition to the best of your ability.

Emotional

The impact of heart failure can be emotional as well as physical. Symptoms can require you to change your routine, preventing you from engaging in activities you may have enjoyed before or making them more challenging, for example. Necessary changes for the proper management of heart failure can also become overwhelming.

Common emotional issues associated with heart failure include:

  • Stress: Too much emotional stress can be damaging for your heart. Stress raises your blood pressure and exacerbates coronary artery disease (CAD), both of which worsen heart failure. Though a certain amount of stress is a normal, unavoidable part of life, unnecessary stress should be avoided. Learning methods to cope with stress can be helpful.
  • Depression: People with heart failure have a high chance of developing chronic depression. If you experience sadness, feeling down, guilt, a lack of hope for the future, or a sense that you are a burden, you may be depressed. Signs of depression lasting for more than a week should prompt you to talk to your doctor about getting treatment. 

Coping with emotional issues begins with identifying them and then using effective strategies to modify them, just as you would address a physical problem. This means seeking professional attention, openly explaining your symptoms to a healthcare professional, and following through with any recommended therapy or prescribed medication.

A worthy goal? A positive outlook. A 2017 study found that a sense of optimism improved quality of life in people with heart failure. Interestingly, optimism was also found to be a modifiable trait, meaning that you can have a more positive outlook about things, even if you have not always considered yourself optimistic.  

Physical

A key to living well with heart failure is carefully monitoring your symptoms. Medication adjustments or simple lifestyle changes are often all that's needed to address new or increasing symptoms, but ignoring them or hoping they will go away can result in a permanent worsening of your heart condition.

If new symptoms appear or if chronic symptoms change in their frequency or intensity, it is very important for you to alert your healthcare team right away. Some to watch for include:

  • Swelling
  • Weight gain
  • Shortness of breath
  • Weakness, fatigue
  • Loss of appetite
  • Dizziness
  • Irregular heartbeat 
  • Chest pain 

Your diet and physical activity play a crucial role in coping with heart failure. Once you have developed the disease, taking some very concrete actions in your daily life are central to preventing the condition from worsening. 

  • Diet and salt restriction: For most people with heart failure, a heart-healthy diet such as the Mediterranean-style diet can help keep off excess weight and reduce blood vessel inflammation that often contributes to cardiovascular disease. Salt restriction is also especially important. Speak with your doctor about what an optimal diet is for you, and consider meeting with a dietitian who can provide further advice and discuss how to manage a low-sodium diet; salt is ubiquitous in Western diets, so it's easy to eat too much of it even when you ditch your salt shaker. You may need more specific dietary advice if you have an additional concern like diabetes or high cholesterol.
  • Weight: Getting down to a healthy weight can be helpful for reducing excess stress on your heart, helping improve your symptoms and your overall condition. Keeping a close eye on your weight by stepping on the scale daily can also help you detect changes in your cardiac condition, as weight can rapidly increase when additional sodium and water are being retained due to heart failure.
  • Exercise: Regular, moderate exercise can improve your overall cardiovascular fitness and reduce chronic strain on your heart. Walking, using an exercise bike, and even lifting light weights can greatly improve your overall wellness. If you have not exercised recently, you may want to ask your doctor about beginning with a formal cardiac rehab program. Avoid exercising in extreme heat or cold, and avoid very strenuous activity unless you are cleared by your doctor.
  • Quit smoking: In addition to causing several forms of cancer, as well as lung disease, exposure to smoke causes damage to your blood vessels, including the coronary arteries. If you smoke, it is important that you learn the most effective ways to quit.
  • Alcohol: Alcohol can be toxic to the heart muscle, and in some people can itself produce dilated cardiomyopathy. Depending on the severity of your heart failure, your doctor might recommend that you completely abstain from alcohol or only drink moderate amounts.

Social

The physical limitations of heart failure can make it difficult for you to get around as much as you used to. You may find yourself bowing out of social activities because of your lack of energy and shortness of breath, for example. This is often an isolating experience.

Considering this, prioritizing and planning get-togethers that are doable for you is essential to keeping up social ties—and an essential effort for your overall happiness.

Also, consider viewing things in a different light: You might not be able to participate in family events or activities with your friends as often or for as long as you used to, but that doesn't necessarily mean these opportunities are entirely off limits. You might consider selecting activities that are nearest to your home. Or you might attend a function, but volunteer to take part only in activities that don't tire you out. You can also think about attending and simply leaving early if you're not feeling well.

Many with heart failure also find it helpful to network with people who are going through the same thing. In a heart failure support group, you can learn various strategies that have worked for others managing lifestyle changes, taking medications, dealing with complications and side effects, working with insurers, and more. It may also simply be helpful to speak about your condition among those who know about it firsthand.

Your doctor or hospital may be able to recommend a local heart failure support group, or you can check with the Heart Failure Society of America or the American Heart Association.

Practical

When it comes to living with heart failure, there are several practical considerations related to the logistics of managing your condition. Developing a system for taking your medications, monitoring your health, and keeping track of your progress are just a few.

Medications

With the fairly complicated drug regimen you may be prescribed, it is best to have a system that can prevent you from forgetting to take the necessary medications or from taking too much medication. You also need to know exactly what you are on, so you can share that information with other doctors who may look to prescribe something new for you.

Keep a current list of all the medications you have been prescribed. This list should include the brand name and generic name of each drug, the prescribed dose, the time you are supposed to take it, what it is for, possible side effects, and which side effects need to be reported to your healthcare team right away. This information can be obtained from your doctor or pharmacist if you don't have it already.

You also need a system for taking the right medications at the right time. Some people find a simple daily checklist to be helpful, while others use smartphone calendar reminders or apps for this purpose. Alternatively, you can use a special dispenser that portions out medication by day. Choose whatever method will work best for you.

Other important tips:

  • Never change your medicines or doses without discussing it first with your doctor. Heart failure medications tend to interact with one another, and even a simple change can have far-reaching consequences.
  • Ask your doctor what to do if you inadvertently skip a dose of one of your medications. Your doctor may have different instructions depending on the drug.
  • If you are traveling, always make sure you have enough medicine with you to get you through your entire trip. When flying, it is best to carry it with you, rather than place it in a checked bag.

Personal Technology

Personal technology that can help you better manage your heart failure is growing. While it may be a while before your doctor considers integrating some of these devices, apps, and tools into routine medical care, you may consider using them on your own to monitor your condition and advise conversations with your physician:

  • At-home vital signs: Automated blood pressure devices or pulsometers have been available for years, and most of them are reasonably accurate. They can be found in most pharmacies. If your blood pressure fluctuates, routinely measuring your blood pressure at home may give your doctor a more comprehensive idea of your blood pressure pattern.
  • Activity monitors: Small devices such as Fitbit, Apple Watch, and others, in addition to smartphone apps, can help you make sure you are getting a sufficient amount of exercise each day by measuring your steps, distance walked, calories burned, and more.
  • Data collection tools: Technology can help you record and track various aspects of your health so that you, your doctor, or a specialist can observe trends over time and modify your management plan accordingly if needed. Wireless weight scales that sync to your phone are one example, as are digital food logs.
  • Mobile heart function: Some smartwatches can not only measure your heart rate but also alert you if your sustained heart rate goes above a threshold value. Combined with a device such as the Kardiaband from AliveCor, the Apple Watch can even record and transmit an EEG so that a doctor can see exactly what kind of heart rhythm is associated with the rapid heart rate. These devices may turn out to be particularly useful if you are having unexplained episodes of palpitations or dizziness. 
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