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helpful hints for managing CHF


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Lisa Salberg Find out more about Lisa Salberg
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  • helpful hints for managing CHF

    Monitoring Your Health When You Have Heart Failure

    This handout provides a summary of ways you can actively treat your heart failure, including:

    Weighing yourself at the same time each day and recording your weight
    Monitoring your fluid intake
    Managing breathing problems
    Getting the flu shot and the pneumonia vaccine
    Seeing your doctor regularly
    Not smoking or chewing tobacco
    Weigh yourself every day.

    Use the same scale.
    Wear similar clothing each time you weigh yourself.
    Weigh yourself at the same time each day (for example, when you get up in the morning) before eating and after urinating.
    Record your weight in a diary or on a calendar.
    Self-Care Guidelines

    1. Call your doctor if you gain two pounds in one day or 5 pounds in one week.

    2. Follow the guidelines below if you notice any signs of increased swelling or fluid retention, including: your belt seems tighter, your belly seems more swollen, your clothes don't fit as well, your feet and ankles become swollen, your shoes become tight; or your shoe laces seem shorter.

    Eliminate 500 mg of sodium* from your diet for two days (today and tomorrow) and
    Decrease the liquids you drink by 360 cc (1 and 1/2 cups) for two days (today and tomorrow).
    If you do not notice a decrease in body fluid or a decrease in weight after restricting sodium and fluid for two days, call your doctor. Your doctor may need to adjust your medications.
    *Ask your health care provider for a complete listing of foods high in sodium.

    Monitor your fluid intake
    If your doctor requires you to restrict your fluids, record the amount of liquids you drink/eat every day. You may need to restrict your fluids to 8 1/4 cups (which is equal to 2 liters OR 66 ounces) every 24 hours.

    Recording your intake will help ensure that you are not taking in more fluids than expected.

    To properly record your fluid intake, you will need to learn the number of cc's or ml's in common servings. Some sample measurements are included in the box below.

    Note that some foods are considered to be "fluids" (see box below).

    Fluid Measurements
    1 ml = 1cc
    1 ounce = 30 cc
    8 ounces = 240 cc
    1 cup = 8 ounces = 240 cc
    4 cups = 32 ounces = 1 quart or liter = 1000 cc

    Sample Measurements

    coffee cup = 200 cc
    clear glass = 240 cc
    milk carton = 240 cc
    small milk carton = 120 cc
    juice, gelatin or ice cream cup = 120 cc
    soup bowl = 160 cc
    popsicle half = 40 cc

    Note that some foods are considered to be "fluids"

    Gelatin (Jello-O)
    All soups (thin or thick)
    Ice Cream
    Keep a record of daily fluid intake until you feel comfortable with your fluid restriction and can accurately determine your fluid intake without measuring liquids.

    One way to keep track of your fluid intake: Fill a 2-quart pitcher or 2-liter soda bottle to the top with water and place it in an accessible place in the kitchen. Every time you drink or eat something that is considered a fluid, remove the same amount of water from the pitcher/bottle. When the pitcher/bottle is empty, you have had your limit of fluids for the day.

    Note: being thirsty does not mean your body needs more fluid. You need to be careful NOT to replace the fluids that diuretics (water pills) have helped your body get rid of. Here are some tips for decreasing thirst:

    Nibble on frozen grapes or strawberries
    Suck on ice chips (not cubes), a sucker or washcloth soaked in ice-cold water
    Cover your lips with petroleum jelly, flavored lip balm or lip moisturizer
    Suck on hard candy or chew gum (sugarless)
    Avoid milk or ice cream products, as they increase thirst
    Record your urine output, as recommended by your doctor. Recording your urine output will help ensure that you are not taking in more fluids than expected.

    Manage breathing problems

    If you have increased breathlessness at night, try sleeping in a recliner chair, use more pillows or use a supportive cushion so you are resting more upright.

    Tips to improve breathing:

    -- Listen to your body and slow down when you are short of breath.
    -- Conserve your energy by taking breaks throughout the day: read, pay bills, write letters, use the computer for fun.
    -- Relax: use music, meditation, yoga as alternative ways to decrease stress.
    If you have increased breathlessness, shortness of breath or difficulty breathing, follow the guidelines below:

    1. Eliminate 500 mg of sodium from your diet for two days (today and tomorrow) and

    2. Decrease the liquids you drink by 360 cc (1 and 1/2 cups) for two days (today and tomorrow).

    3. If you still have difficulty breathing after restricting sodium and fluid for two days, call your doctor. Your doctor may need to adjust your medications.

    See your doctor regularly

    Keep all scheduled appointments with your health care providers. Frequent contact with your doctor or nurse will increase your chances of staying on track with your treatment plan.
    If you have questions about your condition, write them down and bring them with you to your appointments. If you have urgent questions, call your health care provider.
    If you see any other doctor, notify him or her about your heart failure medications, diet or fluid restrictions. Keep your list of medications (names, dosages and times taken) and allergies in your wallet or purse to answer questions that the doctor or nurse may ask you.
    Call your heart failure doctor if you are prescribed any other medications by another doctor.
    Make sure you know how to treat yourself if you have a virus, the flu or a fever. Remember, do not take any over-the-counter drugs unless you ask your doctor first.
    Talk to your doctor if you are having sexual problems or depression.
    Get the flu shot and the pneumonia vaccine
    Talk to your doctor about getting the flu shot every year and the pneumonia vaccine so you can stay healthy.

    Quit smoking and using tobacco
    You've probably heard how smoking can be harmful. For a person with heart failure, smoking and using tobacco causes your blood pressure to rise and increases your risk for heart disease. Here are some ways quitting can be helpful. If you quit, you will:

    Prolong your life
    Improve your health (Smoking increases your risk of lung cancer, throat cancer, emphysema, heart disease, high blood pressure, ulcers, gum disease and other conditions.)
    If you quit, you will:

    Feel healthier (Smoking can cause coughing, poor athletic ability and sore throats.)
    Look better (Smoking can cause face wrinkles, stained teeth, yellow-stained fingers and dull skin.)
    Improve your sense of taste and smell
    Save money
    How can I quit?
    There's no one way to quit that works for everyone. Setting a plan will help. Before you quit cold turkey:

    Pick a date to stop smoking and then get ready for it.
    Record when and why you smoke. You will come to know what triggers your urges to smoke.
    Record what you do when you smoke. Try smoking at different times and different places to break the connections between smoking and certain activities.
    List your reasons for quitting. Read over the list before and after you quit.
    Find activities to replace smoking. Be ready to do something else when you want to smoke.
    Ask your health care provider about using nicotine gum and patches. Some people find these aids are very helpful.
    When you quit

    On the day you pick to quit, start that morning without a cigarette.
    Don't focus on what you are missing. Think about what you are gaining.
    Tell yourself you are a great person for quitting. Remind yourself of this when you want a smoke.
    When you get the urge to smoke, take a deep breath. Hold it for ten seconds, then release it slowly.
    Keep your hands busy. Doodle, play a sport, knit or work on a computer.
    Change activities that were connected to smoking. Take a walk or read a book instead of taking a cigarette break.
    Don't carry a lighter, matches or cigarettes.
    Go to places that don't allow smoking.
    Eat low-calorie, healthful foods when the urge to smoke strikes. Carrot and celery sticks, fresh fruits and fat-free snacks are good choices.
    Cut down on alcohol and caffeine. They can trigger urges to smoke. Select water, herbal teas, caffeine-free soft drinks and juices.
    Exercise. Exercising will help you relax.
    Hang out with non-smokers.
    Get support for quitting. Tell others about your milestones with pride.

    stay healthy...stay happy... and stay in touch with the HCMA!
    Knowledge is power ... Stay informed!
    YOU can make a difference - all you have to do is try!

    Dx age 12 current age 46 and counting!
    lost: 5 family members to HCM (SCD, Stroke, CHF)
    Others diagnosed living with HCM (or gene +) include - daughter, niece, nephew, cousin, sister and many many friends!
    Therapy - ICD (implanted 97, 01, 04 and 11, medication
    Currently not obstructed
    Complications - unnecessary pacemaker and stroke (unrelated to each other)

  • #2
    Re: helpful hints for managing CHF

    Hey that was great information!

    My local cardiologist never told me anything about fluid restrictions. I also started getting severe muscle cramps day before yesterday and found it was due to low potassium. There is a lot to manage with this.

    Also, can you get swelling just in the abdominal area? I've never really seen swelling in my ankle but on my bad days my shorts seem pretty tight any other time they sag a little because I have lost 16 pounds since January! Slow but sure.

    Thanks for the input!