Nearly 6 million adults in the U.S. have heart failure according to the CDC (Center for Disease Control.) By 2030, that number is expected to increase to 8 million. So what is congestive heart failure? A very simplistic answer is that congestive heart failure (CHF) is a condition in which the heart does not pump as it should. It is one of the leading causes of hospitalizations (and re-hospitalizations) in the country. According to Medicare, from 2009 to 2013 23% of patients discharged from the hospital with CHF returned within 30 days! Nobody wants that. Frequent hospitalizations are hard on patients, families, employers, clients, co-workers, and pocketbooks.
If you or a loved one has been diagnosed with CHF, you are probably feeling overwhelmed. You can search the internet to find all the information you want about the exact mechanisms of heart failure, the different classes and stages of CHF, details about signs and symptoms, and information on current medications and treatments. My goal for this particular article is to provide you with practical tips for dealing with congestive heart failure. My hope is that when you finish reading you will feel a sense of increased power and control over your CHF. Read on for tips on how to manage the symptoms and how to recognize early warning signs so you can stay out of the hospital.
Signs and symptoms of CHF can include any or all of the following:
- Shortness of breath
- Swelling in the legs/feet
- Feeling fatigued and zapped of energy
- Tenderness and swelling of the abdomen
- Trouble sleeping caused by difficulty breathing
- Excessive urination (peeing!) at night
- Increased confusion and memory problems
- Nausea with decreased appetite
- Persistent cough with or without blood in the mucus
So what can you do to manage your congestive heart failure?
1.) Manage your risk factors:
CHF risk factors include hypertension (high blood pressure), hyperlipidemia (high cholesterol), diabetes, smoking, obstructive sleep apnea, and alcohol/drug abuse.
- If you’ve been prescribed medication for high blood pressure or high cholesterol, take it!
- Monitor your blood sugars closely if you’re a diabetic, and manage your diet accordingly.
- Consider abstaining from smoking, drinking, and using drugs. (Of course you should do this anyway, but be extra aware of these bad habits if you’re dealing with CHF)
- If you’re supposed to wear a CPAP (a breathing machine) when sleeping, then wear it. Many people don’t wear their CPAP because it’s broken or doesn’t fit correctly. If this scenario describes you, follow up with your doctor so the problem can be fixed.
2.) Elevate your head:
It can be particularly difficult to breathe when lying flat because the position causes extra load on your heart. That’s not good when your heart is already not pumping well. If you can’t tolerate sleeping flat in your bed, elevate your torso and head with pillows until you find the sweet spot that allows you to breathe. If you’re unable to find a good spot, you may need to sleep in a recliner.
3.) Elevate your legs:
The more you’re in a dependent position (sitting or standing with your legs below your heart), the more opportunity there is for your legs and feet to fill with fluid. Without regular elevation of the legs, it is very difficult for this fluid to make its way back up from the legs. This is especially important if you sleep in a recliner as your legs might then be below the level of your heart 24 hours/day! Prop your legs up every few hours, even if it’s just for 15-30 minutes. Click here to see a leg rest wedge pillow that I highly recommend. It’s comfortable, easy to position, and positions the legs high enough to actually make a difference in the swelling. Added bonus: the same leg rest pillow can be used with a couple of regular pillows to elevate your torso and head when you lie in bed.
4.) Consider compression socks:
Ask your doctor about this one before you make any purchases. Compression socks can be very helpful for managing swelling in individuals with CHF. However, it’s important to talk to your doctor to make sure that you don’t have any medical conditions that might be made worse by adding compression to the legs.
5.) Monitor your blood pressure:
For best results, measure and write down your blood pressure at the same time every day. Normal blood pressure is technically 120/80, but ask your doctor what you should expect your normal range to be. You want to watch for higher than normal as well as lower than normal blood pressures. If your blood pressure is increasing, it may indicate worsening of your heart pumping problems. If it’s lower than normal, you may be dehydrated or having adverse side effects to one of your medications. Either way, let your doctor know. Click here to see an easy to use, home blood pressure cuff.
6.) Monitor your oxygen saturation:
Checking your oxygen saturation is a way of measuring the amount of oxygen being carried by your blood. Anything from 90-100% is considered normal. This is important to check throughout the day as well as whenever you are feeling short of breath. If your oxygen saturation is below 90%, temporarily relax from the activity that you were doing. Concentrate on breathing deeply and slowly while you continue to monitor your oxygen level. If you find that it is consistently below 90%, or dropping well below 90% and not coming back up when you stop and breathe, contact your doctor. Click here for a simple, inexpensive way to monitor your oxygen level.
7.) Be prepared for frequent trips to the bathroom:
Some of the common medications used for treating CHF cause the elimination of excess fluid through urination. If you’re on one of these medications, you’ll likely feel like you’re running to the bathroom every few minutes. You may benefit from purchasing disposable pads or incontinence briefs just in case you have a near accident. You might also need a bedside commode (potty chair) to cut down on trips across the house, especially if your mobility is impaired. These are especially handy to have at night. You can keep it right by your bed or your recliner until you’re back in control of your bladder. Click here to see a sample of a simple, standard commode. They come in bariatric versions as well.
8.) Weigh yourself daily:
This is really important! Often, rapid weight gain is the first sign of backed up fluid on your lungs or throughout your body. If you ignore this sign, it will eventually lead to other signs and symptoms listed above. Then you’re likely to end up back to the hospital. Weigh yourself at the same time every day and keep a written log. Talk to your doctor for your specific details, but generally a weight gain of 2-3 pounds over 2-3 days warrants an immediate call to the doctor. Click here for an easy to read scale with a 400 pound weight limit, a wide base, and a non-slip surface.
9.) Watch your salt intake:
Excess sodium in your diet can cause you to retain fluids. Ask your doctor what your target sodium intake is, and then try to stay within that target. Here are some tips for limiting sodium:
- Cut back on fast food (avoid it altogether if you can)
- Be really careful with sauces, toppings, and salad dressings.
- Avoid processed meats such as bacon and deli meats.
- Limit frozen dinners
- Eat fresh, whole foods as much as possible
- Avoid salting your food. Use non-sodium spices instead
- Research restaurant menus and nutrition facts before dining out.
- Read labels. Click here to see where sodium can be found on an example nutrition label
10.) Drink the right amount of water:
The general population is typically advised to drink plenty of water. You might have heard “drink 8 glasses per day” or “drink half your body weight in ounces.” However, that may not be the case if you’ve got CHF. Individuals with CHF may need to limit their liquid intake in order to prevent excess fluid storage. Ask you doctor what your target is, and then work to stay within that target. On the other hand, don’t limit your liquid intake more than you need to. Not drinking enough water can cause complications such as low blood pressure and urinary tract infection.
- FYI: There are “smart” water bottles on the market that measure exactly how much water you drink. They can link the data to an app on your smart one. I don’t have one in particular that I recommend, but look around on the internet if you want to get fancy!
Again, talk with your doctor about what you’re allowed to do regarding exercise. In the past, people with CHF were advised to limit their activity. These days, research shows that exercise is beneficial in controlling the disease process. Moving, even if it’s just walking for a few minutes at a time, helps the pumping mechanism of the circulatory system (your heart, lungs, veins, and arteries). This aids in the movement of fluid in your legs and feet that might otherwise remain stagnant. It also helps prevent dangerous complications of inactivity such as blood clots (click here to learn about signs of blood clots) and pneumonia.
12.) Get vaccinated:
Follow your doctor’s recommendations regarding yearly flu (virus affecting the lungs, nose, and throat) and pneumonia (infection in the lungs) vaccinations. Pneumonia prevention is particularly important for individuals with CHF. Often, people have their CHF under control by utilizing the tips above, but then their heart is expected to work even harder when they develop pneumonia. This scenario is a common one that causes people with CHF to be hospitalized.
There you have it. 12 Practical Tips for dealing with congestive heart failure. If you or your loved one have been diagnosed with CHF, try not to feel overwhelmed by this list. Take it one day at a time and one tip at a time. If you are not following any of the above guidelines yet, pick one and make it a habit before attempting to add another. If needed, add 1 new item per month and within a year you’ll be doing so many things right.