An ailing heart affects your body in ways you might not expect, including through rapid weight gain, tiredness and fluid buildup in your lungs that makes it hard to breathe. Heart failure often causes patients to slowly lose the lifestyle they love, as they limit their social and physical activity to cope with the illness.
More of us are reaching old age and surviving life-threatening conditions like heart attacks and cancer, both of which are risk factors for heart failure. According to the Center for Disease Control and Prevention, more than five million Americans now live with heart failure.
Since 2001, Puxiao Cen, MD, a cardiologist at AdventHealth, formerly Florida Hospital, knows treating heart failure is about more than just surviving — it’s about living the life you want, in body, mind and spirit. Dr. Cen is sharing some of the insights she’s learned in treating heart failure to help patients recover some control over their lives.
Dr. Cen’s goal is to help patients meet their own goals in life — like seeing a grandchild get married or enjoying a hobby — and she sees quality of life as an essential part of health care.
1. Understand Your Illness
“Heart failure is really a group of symptoms, so the label by itself does not explain what caused your symptoms to occur. It’s similar to how having a fever is a symptom of an illness, but doesn’t reveal what the illness is,” said Dr. Cen.
Heart failure is caused by damage to the heart, and its origin can be as dramatic as previous heart attacks or as simple as partially blocked arteries caused by fat and cholesterol deposits.
The heart is a muscle that works by contracting and squeezing blood throughout the body. In some cases, the heart is enlarged, which makes it work much harder than it should. In other cases, the heart is normal-sized, but the walls of the heart are stiff, which makes it harder to relax and let blood fill the heart chambers efficiently. Heart stiffness can be caused by a variety of conditions, including high blood pressure, diabetes and heart attacks.
Heart failure can also be caused by problems with your heart valves. Heart valves are responsible for regulating the flow of blood from the heart. If the valves are leaky or too narrow, then the flow can place stress on the heart.
The cause of your heart failure will also determine whether any effective treatments exist. While damage caused by heart attacks typically cannot be treated short of a transplant, heart failure that’s caused by valve issues can sometimes be repaired.
No matter the cause, Dr. Cen believes understanding your heart failure can lead you to be more involved in effective treatment.
2. It’s Your Health — Own It
Dr. Cen finds that patients see the best results when they take control of their health. When patients do not monitor their own health status and actively take steps to maximize wellness, they often end up in the hospital in desperate shape.
“If you have cancer, you get most of your care at the doctor’s office,” Dr. Cen says. “But with heart failure, you can control your own fluid levels every day through diet and medication adherence, so 99 percent of your care is in your own hands.”
A big part of that 99 percent is taking the right medicine at the right times and doses. Dr. Cen has found that those patients who use a pillbox to organize their medication have better overall health. Dr. Cen encourages the use of pillboxes and asks her patients (or, with the patient’s permission, their caregiver) to bring the pillbox into the office so that she and the patient can review the use and identify any opportunities to improve therapies.
3. Arrange Your Furniture With Movement in Mind
It’s natural to set up your furniture to help you relax, but it’s especially important for people with heart failure to stay mobile. Dr. Cen recommends that you arrange your furniture so that you have reasons to get up and move instead of stay seated for hours at a time.
Moreover, your furniture can be a handy mobility aid. If you arrange it so that you’ll always have something to grab onto as you move from room to room, you can reduce your risk of a fall.
Dr. Cen also says her patients tell her that engaging in light exercise gives them an excuse to dance and enjoy music they hadn’t heard in decades. Other options for beneficial activity are walking, pool workouts and lifting light weights, which can even be common household items like a one-liter water bottle.
4. Limit the Salt, But Live Your Life
Eating too much salt can cause your body to retain fluid, making your heart failure symptoms worse. Dr. Cen recommends a low-salt diet, but she also knows how important food can be to quality of life.
As we age, our taste buds tend to lose sensitivity, so the only foods that we enjoy eating are often sweet or savory, like a cheeseburger. While Dr. Cen tends to limit dietary restriction to salt for her patients over 80 years old, she understands that people do not maintain extremely strict diets long-term.
“I don’t encourage patients to go overboard, but I think quality of life is so important and my patients are already deprived of salt so it’s OK to sweeten their diet in other ways.”
5. Measure Your Health
There are two major measurements that people with heart failure can monitor at home: weight and blood pressure. Keeping an eye on these numbers can help you fine-tune your care and prevent painful complications.
Rapid weight gain, usually defined as more than five pounds over two days, can provide a warning sign before physical symptoms like swollen ankles appear. Taking a diuretic, or “water pill,” can help you shed water weight and avoid the shortness of breath that comes from fluid buildup in the lungs.
Furthermore, monitoring your weight will help regulate your water balance through diet, helping you limit your intake of diuretics to only when absolutely necessary. “Your kidneys will thank you,” Dr. Cen says. She recommends patients set up a weighing routine — at a certain time of day, such as right after waking up — so measurements can be compared with each other since your weight will fluctuate throughout the day.
Taking your blood pressure is a little more involved, but home blood pressure kits can make it easy. Taking these measurements allows you to keep tabs on your health, but it does more, too.
“Checking your blood pressure and weight numbers yourself means you are participating in your care. That simple act can encourage you to own your health care and reinforce other healthy steps, like taking medication and staying active,” Dr. Cen says.
6. Plan for End of Life
Planning for the end of your life is not easy for anyone. Dr. Cen believes that when patients have these conversations with their family, they are ultimately encouraged to make the most of their time and determine their priorities. The key is knowing what you want out of life.
If living the life you want is more important than living as long as possible — if quality is more important than quantity — then you can work with your doctor to design a care plan that can slow the progression of disease. For some people, living a higher quality but shorter life is a tradeoff worth making.
Like her colleagues at AdventHealth, Dr. Cen has learned that helping patients live the life they love is a crucial part of treating heart failure. AdventHealth believes expert heart care should be paired with a concern for helping patients achieve feeling whole through emotional and spiritual health.