Living with Heart Failure
Managing your heart failure symptoms and feeling your best begins with establishing a healthy lifestyle.
Lots of things can make your heart failure better. Some things you cannot change, but there are some things that you can change to help you live a longer and better life with heart failure.
The list below are things you can change to help improve symptoms of heart failure.
Improving your diet
Healthy food choices begin with knowing what is in the food you are buying. The nutrition information of most food can be found on the “Nutrition Facts” label found on the back of food packages.
The Nutrition Facts label provides information on the amount of calories, fat, carbs (carbohydrates), protein, cholesterol, sodium and key vitamins found in the product.
Below is an example of a Nutrition Facts label:
Salt
Salt (also called “sodium”) is a major cause of high blood pressure, which makes heart failure worse. Studies show that the more salt you eat, the higher your blood pressure gets. Therefore, reducing the amount of salt consumed in your diet is an essential aspect of living with heart failure.
But I don’t put salt on my food….Approximately 70% of the salt we eat comes from inside the foods we buy at the store, not from the salt (sodium) we add at the table. You can learn how much salt (sodium) is found in your food by looking at the Nutrition Facts label located at the back of most products. In addition to the Nutrition Facts label, some products have nutrition messages on the packaging. Below are examples of nutrition messages you may come across and what they mean:
- "No added salt/unsalted"= No salt added, and none of the ingredients contain a significant amount of salt.
- "Salt free/sodium free"= No more than 5 mg of sodium per 100 g of food
- "Low salt/low in sodium= 50% less sodium than their regular product or no more than 40 mg of sodium per 100 g of food
How much salt should I eat?
The general guideline for those with heart failure is to have less than 2 g of salt per day. Remember to include the amount of sodium in the packaged food that you eat. The TOTAL amount allowed ends up being less than 3/4 of a teaspoon of salt.
How can I reduce the amount of salt (sodium) I eat?
- Throw away the salt shaker
- Instead of salt, use herbs, spices, garlic or salt substitutes (just make sure they do not contain potassium chloride, which could be harmful for your heart)
- Separate the amount of salt (sodium) in the food you eat throughout the day:
- Breakfast 400 mg
- Lunch 600 mg
- Dinner 600 mg
- Snack 100 mg
- Choose products that have less than 10% daily value (DV) of sodium (salt)
- Eat fresh foods instead of processed or canned
- Add a serving of fresh vegetables and fruits to your lunch and dinner
- Take care when eating out. Stick to steamed, grilled, baked, boiled and broiled foods.
- Use oil and vinegar, rather than bottled dressings, on salads
- Reduce the amount of processed foods consumed, as they tend to be high in sodium. Other foods and condiments to avoid due to a high sodium content include:
- Cheese
- Ketchup
- Lunch meat
- Pickles
- Barbeque, soya and Worcestershire sauces
- Salad dressing
HF patients taking high doses of diuretics may need to increase the amount of potassium in their diet. HF patients with poor kidney function may need to decrease potassium in their diet. Check with your doctor to determine if you need to increase your potassium intake. Potassium is found in:
- Chicken
- Fish
- Meat
- Bananas
- Citrus juice/fruits
- Prune juice
- Dates
- Raisins
- Mushrooms
- Potatoes
- Spinach
- Squash
- Tomatoes
Another useful tool you can use to make better healthy food choices is "Canada’s Food Guide."The food guide separates food into four major groups:
- Vegetables & Fruits
- Grain Products
- Milk and alternatives
- Meat and Alternatives
Eating a variety of foods from all four food groups will help you get enough vitamins and minerals, reach or maintain a healthy weight as well as achieve overall health and vitality.
To print a copy of Canada's Food Guide, click on the following images:
Monitoring the Fluid you Drink and Eat
It is very important that people with heart failure limit the amount of fluids (also called water or liquid) they consume on a daily basis. Fluid consumption results in an increase in the amount of blood in a person’s body, which requires that the heart must work harder to pump the extra blood. This extra work puts strain on the heart of people with heart failure.
People with heart failure often have fluid (also called water or liquid) build-up in their body. This fluid builds-up because the heart can not pump strongly enough to get rid of the extra fluid through the kidneys. Fluid can build up in different parts of the body; most often it builds up in the following parts:
Therefore, monitoring how much fluid you drink and eat each day is very important. Remember that fluids are anything that has liquid in it or that is liquid at room temperature. Even the water you drink to take your pills should be counted.
The following items should be considered liquids when you are calculating your daily fluid intake:
- Water/Ice cubes
- Milk
- Coffee/Tea
- Juice/Soft drinks
- Alcoholic drinks
- Fresh/Frozen fruit
- Broths/Soup
- Jell-O/Pudding
- Popsicles
- Ice cream/Sherbet/Frozen yogurt
Most people with heart failure should not have more than 6 to 8 cups of fluid per day (including the fluid in foods). Speak to your health care professional to know how much fluid you should take in.
Dry mouth is common in heart failure patients with fluid restrictions. Here are some tips to help relieve dry mouth and feel more comfortable:
Tracking Your Weight, Blood Pressure and Heart Rate
Tracking Your Weight
Monitoring body weight is important in heart failure because it helps to see if you are retaining fluid. People with heart failure should weigh themselves every day because an increase in weight could mean that too much fluid is building up in the body.
If you notice a weight increase or decrease of more than 2 pounds (1 kg) in 2 days, or 5 pounds (3 kg) in a week, contact your health care professional immediately as this is a sign of fluid build-up.
Remember these tips when monitoring your weight:
Click on the image below to print your weight log
Tracking Your Blood Pressure
Monitoring blood pressure is of importance as it a sign for how your heart is functioning. If your blood pressure seems to be outside of the normal range, your doctor may advise you to keep track of it. If this is the case, you must ensure that you are using an accredited blood pressure monitor.
A normal blood pressure is normally 120/80 mmHgthough, with heart disease, lower and higher blood pressures can occur and may need to be corrected.
Tracking Your Heart Rate
Similarly to blood pressure, your doctor may want you to record your heart rate if it is outside of the normal range. A normal heart rate should be between 60 and 100 beats per minute.
All that is needed to measure your heart rate is a watch with a second hand or a digital stop-watch. After finding a quiet place where you are not distracted, sit down and rest for at least 10 minutes (this ensures that you are recording your resting heart rate). Gently place two fingers on the inside of your other wrist directly below your thumb. Proceed to count the number of beats for 30 seconds. Double the number of beats that you counted and you will have your resting pulse for number of beats per minute.
Physical Activity
People with heart failure often worry that they can’t exercise because of their “bad heart”. In most cases, this is not true. In fact, physical activity is beneficial for your heart and your general health. A regular program of physical activity will enable you to increase your strength gradually and avoid overtaxing your heart.
Exercise can:- Help increase muscle tone and strength
- Improve your ability to function on a daily basis
- Reduce your HF symptoms (such as shortness of breath and fatigue)
- Discuss it with your HF clinic physician or nurse, and set realistic goals
- Plan your exercise period when you feel the most energetic, i.e. first thing in the morning, or after an afternoon nap
- Perform activities, such as stretching, while sitting down whenever possible
- Rest frequently between periods of exercise.
Engaging in low to moderate intensity activities most days of the week for 30 to 45 minutes are recommended for those with stable heart failure. Being physically active may help improve heart failure symptoms, quality of life and keep you out of the hospital.
DEPENDING ON YOUR HEART FAILURE, ASK YOUR DOCTOR WHAT YOU CAN DO
Getting Started
Setting personal goals and habits can be a great way to get into a healthy rhythm of exercising. The following are examples of goals that you can set:
- Make exercise part of your daily routine, just like brushing your teeth and showering
- Choose a friend to exercise with
- Choose a type of exercise you enjoy
- Keep a journal of your activities. This not only reinforces your exercise habits, it will also show your doctor the progress you are making (Download and print our daily exercise chart shown below as a way of staying on top of your daily activities)
Stretching
After being physically active it is important to give you muscles a good stretch. Stretching helps to increase your flexibility which helps to improve posture and reduce injuries.
It’s important that stretching be done after being active when the muscles are warmed up. In order to benefit from stretching, it’s important that they are done properly.
The following are a few examples of exercises that you can perform:- Side-to-side looks: Look straight ahead, slowly turn your head to one side, hold for 10 seconds, then return to centre. Repeat 3 times on each side.
- Shoulder shrugs: Sitting in a chair, slowly lift your shoulders up to your ears by squeezing your shoulder blades together, pause, then lower. Repeat 5 to 10 times.
- Shoulder circles: Extend both arms sideways at shoulder height. Rotate arms 10 times in small forward circles. Repeat circling back.
Precautions to Take
- Stop exercising immediately if you:
- Become short of breath
- Feel weak, tired, or dizzy
- Feel any physical discomfort at all
- Feel your heart rate speeding up
- Have palpitations
- Are in pain
- Heavy lifting
- Pushing heavy objects
- Shoveling snow
- Climbing stairs
- Sit-ups or push-ups
- Competitive sports
- Heavy housework – washing windows, scrubbing floors
- Racquetball, squash, tennis
Sexual activity
Heart failure does not mean you can’t enjoy sex and being close to your partner. In general, you may continue your normal sexual activities; however, it is recommended that your heart failure be stabilized prior to engaging in sexual activity
Some drugs used to treat heart failure could cause difficulty in achieving an erection. There are drugs available that help men achieve an erection, but sometimes these drugs interfere with heart medications. Please talk to your doctor if you are worried about this.
Sex is a kind of exercise, so it should be avoided for the same reasons outlined earlier. Other times when sex should be avoided:
Other Ways to Protect Your Heart
Immunization
The flu and pneumonia may seriously aggravate heart failure. Getting immunized against both can further protect you from becoming sick. For more information about immunization programs, visit the Public Health Agency of Canada’s website.
Quitting Smoking
People with heart failure should not smoke as it causes further damage to the heart. Smoking is a major killer of people with heart disease. Quitting smoking is the most effective way that you can improve your health. Quitting smoking will also save you money and improve your sense of taste and smell, as well as increase the amount of exercise you can do.
Here are some useful websites to help you get started:
Decrease Alcohol Consumption
Alcohol consumption can have many negative effects on the health of your heart. Therefore, decreasing or eliminating this can serve to be very beneficial for heart failure patients. It is also important to eliminate addictive or harmful drugs as these can also negatively impact your heart’s health.
Tips for Coping
Controlling the anxiety you may be feeling after being diagnosed with Heart Failure is very important to your overall well-being. There are many ways to control anxiety. Here are some suggestions:
- Write a list of your worries or causes of anxiety. Sometimes just putting pen to paper will help ease your concerns and put things in perspective.
- Try to think of solutions in keeping with the requirements and restrictions of your illness. For example:
- Surround yourself with positive people
- Learn relaxation techniques – such as deep breathing or meditation
- Talk about your frustrations with those you love and trust
- Consult a resource person – your clinic nurse, social worker or counsellor
- Know and accept your limitations: learn to say no without feeling guilty
- Indulge yourself without feeling guilty. Fulfill a desire in keeping with your lifestyle and pocketbook – for example, go to the theatre, take a holiday, buy an item of clothing or object you’ve been craving
- Join a support group. Having the chance to meet with other heart failure patients can be a comforting experience in knowing that you are not alone in your anxiety. These groups can also serve as a useful source of information. Ask your doctor if they know of a local group in your area.
Follow-up Care (See Doctors Regularly)
If your heart failure has been determined to be stable, you should be visiting the heart failure clinic every three to six months, or you may be asked to see your family doctor. Your doctor or nurse will tell you how often you should visit the clinic. During these visits certain procedures will be done, including:
- Doing blood tests
- Checking your medications
- Reviewing your diet
- Discussing your exercise routines
If your heart failure has been determined to be unstable, you should be visiting the heart failure clinic daily or weekly. Your doctor or nurse will tell you how often is appropriate. During these visits certain procedures will be done, including:
- Assessing your physical state
- Discussing how well you’re following your medication schedule
- Adjusting your medications, if necessary
- Doing lab tests, if required
- Reviewing your diet
- Discussing what exercise/activity you can do
The clinic’s main aim in seeing you frequently during this time is to ensure you don’t have to be admitted to hospital, and to help you function better at home.
Your clinic's 'telemanagement' program: Telemanagement means that should you need to call your clinic with any questions or concerns, feel free to do so at any time. A clinic nurse will be available to assist you.
Your clinic’s telephone support hotline number is: ____________________
Should you need to call after hours, the pager number is: ________________
Your clinic support group: Your HF clinic has started a support group to help you meet other patients and to learn more about your disease from health care experts.
The next support group meeting will be held: _______________________
The speaker will be: ______________________________________
She/he will be speaking about: ________________________________
We look forward to seeing you there!