Archive for the ‘salt’ Category

Balance

November 14, 2010

My Congestive Heart Failure (CHF) is worse.

I think the problem is correctable. When I was having the Gout flare-ups a few months ago, my Cardiologist took me off of one of my Diuretics. One of the side effects is that it can cause Gout, and I haven’t had very many problems with the Gout since.

But recently I’ve noticed swelling in my ankles, a constant cough, and I feel run down most of the time. So I asked my Cardiologist for permission to start taking that drug again… every other day. That ought to be frequently enough to help me, without causing the Gout.

With a heart defect everything seems to be a balancing act. We discontinued the drug to keep the Gout at bay, but it seems that I’m feeling worse. So I’m taking it again – at half the dosage I was originally taking it. So if my self-diagnosis is correct and resuming the drug will straighten me out, it will take twice as long for it to work (since I’m taking half the dose). If it doesn’t seem to be the solution, I’ll have to talk to my Cardiologist again, and we’ll have to figure out a Plan B. And there is always that thought in the back of your mind: What if Plan B doesn’t work? Plan C might, but even if it works wonderfully, that’s one more option off the table.

Stay hydrated… but with your CHF, don’t drink more than 2000 millilitres (2 liters, or 67 US liquid ounces) per day. Normally that’s more than enough to drink, but what if I pick up a stomach bug that keeps me in the bathroom constantly? Then you can break the 2000 ML rule – but be careful! We don’t want to start having too much fluid in you. You also need to limit your salt intake to no more than 2000 milligrams per day. But when you get that stomach bug, Oral Rehydration will help tremendously… and Oral Rehydration is mainly (you guessed it!) water mixed with sugar and salt.

The goal is to try to keep everything in balance, to give your medications the best opportunity to help your body. If your doctor says to exercise, do so. (I’m one to talk! I have walked very little since hurting my knees in my July fall.) Don’t just fill a new prescription, question the doctor about the medication. What is it supposed to do? How will it help me? And what side effects should I look out for?

And be sure to ask the most important question: What can I do to help myself?

Tougher than a salt shaker!

June 10, 2010

Remember: Grand Rounds hosted on Adventures of a Funky Heart! June 15, 2010! Entry guidelines are HERE.

I hate salt.

Actually, I love a little salt; but salt doesn’t like me. I have Congestive Heart Failure (CHF), which is caused when the heart muscle weakens to the point that it has difficulty pushing the blood through the body.  Think of it like this: You buy a red rubber ball. Day after day you bounce your rubber ball – against the floor, toss it against the wall, ricochet it off the ceiling (I’m assuming you live in a house with unbreakable furniture!) and your rubber ball always works as designed. It always bounces just as high and just as well as the day you bought it. That rubber ball represents a normal heart.

Now imagine that you buy a red rubber ball and bounce it all day long. But as time passes, the ball doesn’t bounce as high as it once did. Either through some flaw in the manufacturing or a flaw in the rubber itself, your ball begins to lose its “bounce” and soon you have to toss the ball twice as hard to get it to bounce as high as it once did. That rubber ball represents a heart going through Heart Failure.

Since your heart can’t pump blood as well as it once did, you have to help it any way you can. One of the ways you help is to go on (and follow!) the diet plan. The diet has two rules: Consume no more than 2000 milligrams of sodium per day, and consume no more than 2000 milliliters of liquid per day. The 2000 milliliters of liquid isn’t that difficult to comply with – that’s a two liter bottle full of liquid per day. I have friends who drink a lot of water, especially when it is hot, and they may find it difficult to keep their consumption to under two liters per day, but for most of us it is not a problem. The problem is the 2000 milligrams of sodium.

How much is 2000 milligrams? A packet of Sweet’n Low contains 1 gram (1000 milligrams). So open up two packets of Sweet’N Low and pour the contents out on your counter. That’s how much sodium you are allowed per day.

You can cry now, I’ll certainly understand!

But you need to follow the diet plan that you doctor give you (your plan may not exactly be 2000 milliliters/2000 milligrams, it will be what your doctor feels is best for you) because you need to have to get the excess fluid out of you. Fluid makes you weigh more, and your heart has to work harder to get your blood through your body. Every pound you can lose helps your heart do its job better. So tighten up, we’re gonna fight this thing.

When you go to the store you are going to learn how to read a nutritional label. For the CHF diet, you are interested in two things: Serving size and sodium content. Both are clearly marked. Be careful – a common strategy to reduce the numbers is to reduce the portion size! So double-check that – can you really limit yourself to 2 ounces of chocolate? (My answer is “No!”)

You will find that many processed meats are no longer your friend. Soups don’t pass the sodium test very easily, either. And when labels brag about how they contain Sea Salt, your response should be “So what?” Sea Salt, Regular Salt, Moon Salt – they all contain sodium!

There are many salt substitutes available; Mrs. Dash is popular. I am not a fan of Mrs. Dash, but that’s just personal. it doesn’t appeal to me, but if you like it, enjoy it. You have to be careful with your salt substitutes – some of them replace the sodium with a little extra sugar, and some of them drop the Sodium Chloride in favor of Potassium Chloride. Some medications don’t mix well with Potassium, so read the label. I use Benson’s Gourmet Seasonings – it tastes really good, I recommend Table Tasty, their salt substitute, and Bravado, their chili seasoning. (And I’m not getting anything from Benson’s if you order, I’m just telling you what I like. You may find something else that appeals to you!)

CHF patients also need to monitor their weight. The best way to do this is after getting up in the morning, go to the bathroom and then weigh yourself. Do this before you shower or get dressed. When you are done, write your weight down and keep track of it day by day. If your weight goes up more than three pounds in a 24 hour period without an explination (birthday party, for example) call your doctor – you probably need a medication adjustment. Most likely you’ll be told to take an extra dose of diuretics (water pills) but the doctor may ask you to come by his/her office. Weight gain is usually a sign of fluid retention, and you already know that is not good for someone dealing with heart failure.

Fighting CHF will not be easy, especially at first when you are trying to get used to the new diet plan. But you can tough it out. After all, you are stronger than a little salt shaker, aren’t you?

More than you think

June 9, 2010

June 15, 2010: Grand Rounds Blog Carnival! Entry Guidelines HERE

Wastin’ away again in Margaritaville, searching for my lost shaker of salt… — Margaritaville, Jimmy Buffett (1977)

Don’t bother looking too hard for that salt shaker, Jimmy.

What did you have the last time you ate out? Or better yet, how much did you have? A 2007 report from the research journal Obesity that states that chefs regularly overestimate portion sizes. To make matters worse, the average diner underestimates the amount of food they have consumed. It’s tempting to try to fight this “portion creep” with willpower – after all, I don’t have to eat everything on my plate, do I? (If you are less than ten years old, the answer to that question is usually “YES!”) We can’t… if it is in front of us, we’ll eat it. Maybe mom and dad really did ruin all of us when they told us to clean our plates.

Portion creep doesn’t help when you are trying to watch your weight or eat healthy. It even affects our beverages – we’ll buy a “single” drink in a 16 ounce or 24 ounce bottle. I serving isn’t nearly that big – read the nutritional label. Or just ask anyone over 30 what a “Short Coke” is. (A 6 and a half ounce bottle of Coca-Cola) Interestingly enough, older chefs routinely serve less food than younger chefs, who honed their skills in the “Supersize me!” era.

Still trying to control your diet? I’m not helping much, am I?

So when we eat out we’re getting a larger portions, and naturally a whole heapin’ helping of ingredients… including our old friend, salt. Most of the salt in our diet comes from processed meat and/or eating out. If you are on the Congestive Heart Failure (CHF) diet, you have to watch the salt. And a nice meal out may not be so nice for your heart. Salt is under attack from all sides, people are calling for manufacturers to lower the amount of salt in foods (gradually; don’t make the entire nation go cold turkey) and there has even been a call for legislation to make this a law. But not so fast – when you remove most of the salt from food, strange things start happening to the food.

So what’s the answer? Ultimately, it is up to us – we’ve got to learn to order and eat smaller portions (Not easy) and complain to the manufacturers. You can also pick up a copy of Corrine Netzer’s Complete book of Food Counts. This book covers most of the national restaurant chains, and lists their menus and the nutritional contest of a lot of their items. It’ll give you a fighting chance the next time you’re heading out for a meal.

(I am not getting anything if you choose to purchase this book)

“Low Sodium” Salt – coming soon!

March 24, 2010

A big announcement came out of a PepsiCo investors meeting yesterday – the company is working on a “Low Sodium salt.” Now I know a bunch of my readers just shouted “There ain’t no such thing!” at their computer screen, so I will try to explain.

PepsiCo’s new salt is designed differently. When you eat a potato chip, only 20% of the salt (if it is “normal salt”) dissolves on your tongue and gives you the salty taste. You chew and swallow before the rest of the salty flavor has a chance to kick in.

PepsiCo’s new salt is shaped and sized to allow more of the salt to dissolve in your mouth – consequentially, they can use less of it. This is also a part of PepsicCo’s plan to cut the amount of sodium in its food products by 25% over the next 5 years. The new low-sodium salt chips will be introduced in a few days.

This could be great news for those of us with Congestive Heart Failure (CHF). When the doctor tells you that you have Heart Failure and puts you on a low sodium diet, the snacks go out the window… at the very least, they have to become an occasional treat. A very occasional treat. Perhaps now we can have a chip or two without worrying if we are bumping into our daily sodium limit.

But this is Pepsico’s newest Secret Weapon (not only against Sodium, but all the other snack producers) so we don’t know what is in their formula. If it contains a lot of Potassium Chloride (a popular “Salt Substitute”, just replace the Sodium Chloride with Potassium Chloride) then it won’t do CHF patients any good. Potassium can affect any number of our drugs. And if you are on Warfarin, then you really need to avoid Potassium Chloride. Potassium is Vitamin K, which causes blood to clot. Warfarin reduces the ability of the blood to clot, and the two substances almost cancel each other out.

Reducing your salt intake is a good choice, especially if you have Heart Failure. It remains to be seen if the new “Low-Sodium Salt” is a step in the right direction or much ado about nothing.