Heart Failure

“You’re in heart failure,” the doctor told me in the spring of 2002. Oh, boy… I wasn’t sure what heart failure was but I knew that the last time I had it, I was rushed to Johns Hopkins for surgery. That’s a comforting thought. And the doctor said it calmly, casually, as if he had just told me a fact that was common knowledge. Don’t take it so hard, doc.

I learned later that my first bout with heart failure was because I was five months old and I hadn’t had any surgical intervention yet. Once the surgery was done and I stabilized, my heart was functional enough to do its job. What I had this time was Congestive Heart Failure (CHF). Back then my heart was failing rapidly, really just coming apart at the seams. With CHF, my heart is failing again… just very, very slowly.

Imagine that you have a rubber ball. Day after day, you bounce your ball for hours on end. It’s nice and rubbery and no matter how many times you bounce it, it always bounces as high as the day you bought it. That’s how a normal heart works.

Now imagine you have a rubber ball, and you bounce it all the time. But this rubber ball has a flaw – maybe it isn’t formed well, or maybe the  rubber isn’t the highest quality, almost anything – but you begin to notice that your ball is losing its bounce. It takes more and more effort to make it bounce as high as it once did, and eventually no matter how hard you slam it into the floor, it just won’t bounce as high. That’s a heart going through Congestive Heart Failure.

If you google Congestive Heart Failure, you are going to get scared: A lot of the studies say that the average survival rate after a CHF diagnosis is five years. Obviously, you have to read deeper to find the truth. The studies that show a five-year survival rate usually take into account all diagnoses of heart failure during the study period – including the people who are already in the hospital with another illness and then receive the CHF diagnosis shortly before they pass. Since Heart Failure is fairly common in the late stages of life, they get counted in the study, even if that is not the main cause of their death.

Survival and quality of life with CHF relies heavily on the patient. You will be prescribed diuretics to keep fluid from building up in your body, and these will cause you to go to the restroom more often. You will also be put on a diet to help your heart beat easier, the standard CHF diet usually has two rules: consume less than 2000 milliliters of liquid and less than 2000 milligrams of sodium per day. That’s the standard diet, everyone is different.

The 2000 milliliters isn’t hard – that’s a two liter bottle of any liquid. (A friend of mind says that the 2000 milliliter part is harder, because she drank about a gallon of water a day before developing CHF.) Many people keep a two liter bottle in their home, and when they have a drink, they pour an equal amount into the bottle. This gives them a quick visual guide to how much that have consumed. Others just scribble the amount on a piece of paper (A 12 ounce can of soda is 355 milliliters, for example; almost all liquid products list the amount in ounces and milliliters) or do the math in their head.

The sodium restriction is much harder. For a few weeks, you’re going to have to read the nutritional labels on the food you buy closely, to check out the amount of sodium per serving. Processed meats are loaded with sodium, so if you are a fan of sub sandwiches… well, that might have to become an occasional treat, rather than lunch every day. And do yourself a favor and split it with a friend.

The best thing you can do is to stop using salt when you cook and allow everyone to season their own meal. And make sure that the salt shaker stays at the other end of the table. Mrs. Dash seasoning is popular when you are on a low sodium diet. Personally, I am not a fan of Mrs. Dash, so I use a Garlic and Herb salt free seasoning.

Every morning, a CHF patient should go to the restroom immediately after getting up, and then weigh themselves. Keep track of your weight, and if you gain more than 3 pounds in one 24 hour period that you can’t explain, call your doctor. The doctor will probably tell you to take a larger dose of diuretics that day, and if you are still up tomorrow morning, come by the office. After you get used to your diet and medications, you’ll know what to do and you won’t even call unless the weight just won’t come off.

The two most important factors in living a good life in spite of heart failure are a good initial examination and diligent self care. The people who are able to adhere to the diet, take their medications, and get some exercise do much better than those who don’t. Congestive Heart Failure requires a lifestyle change, you don’t get a vacation, and you can’t take a day off. Even if you are traveling and do not have easy access to a scale for your daily weight, that doesn’t mean that you can ignore all the other rules. In fact, maintaining your CHF control can be very difficult while away from home. But if you are determined to not let it beat you and to live your life to its fullest, Congestive Heart Failure can be controlled.

It’s all up to you.

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