People with heart failure have to know how the disease works and what their treatments are supposed to do if they're going to achieve the best outcome.
Otherwise, quality of life suffers severely.
Heart failure is a debilitating, chronic disease in which the heart does not pump enough blood to fuel the body. The result is an array of symptoms that includes exhaustion, shortness of breath, ankle swelling, water retention, dizziness and more. It can also kill.
It's also the subject of the Deseret News/Intermountain Health Care Hotline today. Dr. Stephanie Moore, cardiologist, and nurse practitioner Kismet Rasmusson, both of LDS Hospital's Heart Failure program, will discuss treatment options and improving quality of life when you have heart failure. They'll take calls from 10 a.m. to noon.
"One of the most important things is for patients to weigh themselves every day," Rasmusson said. "They are looking for fluctuations that may represent water retention. Fluid retention can cause symptoms of shortness of breath, stomach bloating and ankle swelling. If they are aware of changes in their weight daily, then medications can be adjusted to keep the weight stable and avoid letting it get out of hand."
It's also crucial to have a low-salt diet, since water follows salt. People who take in more salt retain water.
In the past, Rasmusson said, heart failure patients were taught not to exert themselves for fear of putting too much stress on the heart. They're still told to avoid extremes but to be as active as possible and do it most days a week.
"Exercise has been proven to improve symptoms, decreasing problems with the disease process itself," she said.
Medications have to be taken as directed and not skipped unless a physician says to.
People with water retention need to limit fluid intake.
Alcohol abstention is important because alcohol is a depressant and the heart muscle that is weak can be further weakened. Some doctors recommend that someone who has had a myocardial infarction should drink a glass of wine daily. "When the heart muscle is weak, it's a different scenario," Rasmusson said.
One of the most important parts of the education process is learning when to call a doctor.
Proper treatment sometimes turns the condition around. Rasmusson talks about a 28-year-old man who had been healthy and then had heart failure. He was diagnosed quickly and treated promptly. Now his heart squeezes blood in the normal range. He has married, has a baby and is back at work and living a very functional life, she said.
"Early diagnosis, early and appropriate treatment can improve outcomes. It can contribute to some people leading a very normal life," according to Rasmusson.
Learning to live with the condition takes a team effort. The patient learns about self-manage-ment and care. Social workers can help with some of the social issues, while nurse practitioners deal with frontline problems. Mild problems can be managed with a phone call. The physician oversees the team and the management plan.
The disease is most commonly found in people who are elderly, primarily because the most common cause is coronary artery disease and they are the ones most at risk for that. In men, it doesn't usually show up before age 45, while in women it's seldom seen before 55.
E-mail: lois@desnews.com