Passport to Living with Heart Failure

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www.qegateshead.nhs.uk

Passport to Living with Heart Failure

This booklet has been written to help you understand what heart failure is, how it may affect you, and what you can do to still make the most out of life.

Name: ______________________________________________________

Hospital Number: ______________________________________________________

NHS Number: ______________________________________________________

Date of Birth: ______________________________________________________

Address: ______________________________________________________

______________________________________________________

Telephone Number: ______________________________________________________

Consultant: ______________________________________________________

General Practitioner: ________________________________________________

Nurse: ______________________________________________________

Telephone Number: ______________________________________________________

______________________________________________________

Working hours: ______________________________________________________

Please ring between the hours of 1pm – 4pm.

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If you are unwell outside the hours when your nurse is not available, please contact your doctor or NHS Direct on 0845 4647 or Gateshead Urgent Care Team on 07908414673.

What is heart failure?

Heart failure is one of the most common heart problems in our country. Although it is not completely curable, there is very effective treatment available.

If you have heart failure, you may experience shortness of breath, weakness, fatigue, and swelling of the ankles. These symptoms are caused by your heart muscle not pumping as efficiently as normal.

Understanding your condition and following a few simple guidelines can improve the quality of your life and help you to feel better.

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What causes heart failure?

Heart failure can be caused by a number of things:

1. Heart attacks in the past. 2. High blood pressure. 3. Narrow or leaking heart valves. 4. Excessive alcohol intake 5. Viral heart infection. 6. Coronary heart disease.

In some people the cause is unknown.

What are the symptoms of heart failure?

The symptoms of heart failure may appear quickly, for instance after a heart attack, or may develop slowly over weeks or even months. They include:

Breathlessness / difficulty breathing, especially with exertion or when lying flat in bed.

Waking up breathless at night.

Frequent dry “hacking” cough, especially when lying down.

Fatigue and weakness.

Swollen feet, ankles, legs and abdomen.

Remember: it can be normal to become breathless when you are physically active.

What can you do to help yourself?

A little extra care and a few simple lifestyle changes can make a big difference to how well you will feel and your quality of life. On the following pages are tips and guidelines that you should follow to take good care of yourself.

You should also remember these basic points:

Take your medicine regularly and carefully

Make sure you do not run out of tablets

Keep an eye on your diet – useful advice is given later in this leaflet

Report any sudden weight changes (3lb over two days or 6lb in a week) to your Nurse or GP.

Report any increase in breathlessness to your Nurse or GP.

Report any increase in the swelling of your ankles to your Nurse or GP.

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Keep an eye on your weight

It is important to closely monitor your weight because this will indicate whether you are retaining too much fluid. Weigh yourself every morning after going to the toilet and before getting dressed, and keep a daily record. Ask your Nurse for advice if you are not sure how to do this.

If your weight seems to be increasing over a number of days, you may be retaining too much fluid. This may need treating promptly. Report any weight gain to your Nurse or doctor.

Try to ensure that you weigh yourself at the same time every day.

You may need to lose weight

Being overweight means that the heart has to work harder. If you are overweight, there are several things you can do to lose weight. You will need to change your diet. The good news is that this doesn’t have to be hard work. A few small changes can be made gradually to your daily routine:

Reduce the total amount of fat, especially animal fat, in your diet. This can also help reduce your cholesterol levels. Try to eat more fish, lean meat and poultry. Cut down on pies, sausages and burgers.

Eat more fibre-rich foods like wholemeal bread, pasta, jacket potatoes, fruit, vegetables and high-fibre breakfast cereals like porridge (without the salt).

Eat less sugar. Try to avoid cakes, sweets and biscuits.

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Use less salt

We all need a certain balance of salt (sodium) and water in our bodies. Too much salt or too much water can upset this balance. If you have heart failure, it is important to reduce your salt intake to help you maintain the correct balance.

You must cut down on salt. When you are cooking taste the food before adding salt to see if it really needs it. Try not to add salt to food at the table. Do not use salt replacements. Use herbs, spices, pepper, mustard or lemon instead to add flavour. Avoid foods with salt added by the manufacturer, like ready made meals or canned foods, cheeses and processed meats. Do not use “low salt”.

Some labels give a figure for sodium instead of salt. You can convert sodium to salt by using the salt o’ meter.

A little Moderate A lot

Salt per 100grams

0g 0.25g 0.5g 0.75g 1.0g 1.25g 1.5g 1.75g 2.0g

Sodium per 100grams

0g 0.1g 0.2g 0.3g 0.4g 0.5g 0.6g 0.7g 0.8g

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Drink less alcohol

Alcohol can worsen heart failure. If you have been told not to drink – DON’T. If you have been told that you can have alcohol, you should keep your consumption to a minimum. You should not drink more than 2-3 units per day if you’re a man, or 1-2 units per day if you’re a woman. One unit of alcohol is equivalent to:

Half a pint of beer

A small glass of wine (125mls)

A small measure of spirit (25mls)

If you are unwell the Nurse may ask you to limit your fluid intake and will give guidance on this.

Get some exercise

It is important to keep as active as possible but build up your activities slowly. By being inactive you will gradually feel weaker and less able to do things. Many people with heart failure have said that they actually feel better when they exercise regularly. Try walking, cycling, bowling, golfing, dancing, or join a keep-fit class.

Make sure that you always feel like you would be able to talk while you’re exercising. If, during the exercise, you feel like you’d have difficulty talking and you are getting very breathless, you need to slow down a bit. Feel free to ask your Nurse for more advice on appropriate exercise and referral to the Heart Failure Exercise group.

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Don’t smoke

Smoking harms the heart and lungs. If you smoke, it can lead on to many other health problems. STOP NOW!!

If you need help to stop smoking, talk to your Nurse or your doctor. You may also contact the Smokeline on 0800 848484.

Get immunised

People with heart failure can quickly become very unwell with influenza or pneumonia. It is important that you see your doctor to get the appropriate immunizations (jabs). You can discuss which immunisations you’ve already had and which you’ll need with your Nurse.

Take your medicines carefully

Taking your medicine every day is vital in the treatment of heart failure. You must make sure that you never run out of your tablets. You may need to take more than one tablet, and you’ll probably need to take your tablets every day for the rest of your life. You must keep taking your tablets until you are told to stop by your doctor or Nurse.

Do not take over-the-counter medications without checking with the pharmacist, your doctor or Nurse. Some of these may interfere with your prescribed tablets or affect your heart failure.

On the next few pages you’ll find short explanations of the medicines commonly used to treat heart failure. If you want any more information, ask your doctor or Nurse.

Avoid Non Steroidal Anti Inflammatory drugs including creams and gels i.e. Ibuprofen and Naproxen.

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ACE Inhibitors

ACE (Angiotensin Converting Enzyme) inhibitors have been shown to help heart failure patients live longer and feel better. They relax blood vessels, making it easier for the heart to pump.

Most patients take ACE inhibitors without any problems. Occasionally, some patients will have side effects such as coughing or dizziness. These problems are common in people with heart failure and may not be caused by the medicine. If you have problems, DO NOT STOP taking your tablets. Contact your Nurse or doctor. If you stop taking your tablets without speaking to your Nurse or doctor, your condition may deteriorate rapidly and you may have to go to hospital.

Your Nurse may ask you to go for a blood sample following an increase of your medication.

Your ACE inhibitor ______________________________________________________

Target dose ______________________________________________________

Ramipril

Enalapril Lisinopril

Perindopril

Captopril

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Medication record

DATE DOSE COMMENTS ANY SIDE EFFECTS?

(DESCRIPTION AND DATE)

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Loop Diuretics

These tablets are known to many people as ‘water pills’. They increase the amount of salt and water passed in the urine, keeping fluid from accumulating in your body and causing your feet, ankles, legs and abdomen to swell.

Each dose of your diuretic works for about four hours or so. You may need to pass large amounts of urine regularly during those few hours. For that reason, diuretics are commonly taken in the morning, with sometimes a second dose in the afternoon. This avoids the need to pass urine overnight. However, diuretics often do not need to be taken at a fixed time, so you can schedule your dose to accommodate your plans for the day.

Regular use of some diuretics can lead to the body losing too much potassium. If you are taking diuretics, you may be given blood tests to monitor your potassium levels. If you need to replace lost potassium, you will need to eat more potassium-rich foods like bananas, tomatoes, raisins and fruit juices, or your doctor may give you a dietary supplement.

Potassium-sparing diuretics

Potassium-sparing diuretics have a mild action on the kidneys and, as there name suggests, do not cause the body to lose too much potassium. The most commonly used potassium-sparing diuretic is Spironolactone. They are often given together with other diuretics.

Thiazide diuretics

Thiazides are diuretics with a less rapid and less powerful action on the kidneys than ordinary or loop diuretics, so they are less likely to cause a need to pass large amounts of urine. The most commonly used thiazide is Bendrofluazide. They may be given together with other diuretics.

If you don’t take your diuretic or thiazide tablets as instructed, you may retain fluid, gain weight, and become breathless.

Furosemide

Bumetanide

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Your loop diuretic Target dose

____________________________ _________________________

Your potassium-sparing diuretic Target dose

____________________________ __________________________

Your thiazide diuretic Target dose

____________________________ __________________________

Spironolactone

Bendroflumethiazide

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Medication Record



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Beta-blockers

Beta-blockers cause the blood vessels to open up, making it easier for the heart to pump blood through the body. Certain beta-blockers have been shown to help people with heart failure live longer when they are taken together with ACE inhibitors and diuretics. They have also been shown to reduce the need for hospital admission.

Some people taking beta-blockers for heart failure may experience worsening of their heart failure symptoms at the beginning of their treatment. This may or may not be caused by the beta-blocker. DO NOT STOP taking your tablets. Contact your doctor or Nurse as soon as possible. If the symptoms are caused by the beta-blocker they are usually temporary and can be reduced by your doctor adjusting your medication slightly.

Your beta blocker ______________________________________________________

Target dose ______________________________________________________

Bisoprolol

Carvedilol

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Medication Record



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Digoxin

Also known as digitalis, Digoxin has been used to treat heart failure for over 200 years. It slows and steadies the heart rate in some people and helps the heart to pump more efficiently.

Too much Digoxin can result in nausea, loss of appetite, and an unusual heart rate. If you experience these symptoms, do not stop taking your tablets. Talk to your Nurse or doctor.

Since newer drugs have become available Digoxin has not been used as commonly. However, it is used with heart failure patients who have certain irregular heart rhythms.

Target dose of Digoxin ________________________________________________

Digoxin

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Medication Record



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Initial Clinical Information

DATE WEIGHT BLOOD PRESSURE HEART RATE

Progress at follow-up


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Progress at follow-up


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Next follow up visit with your Nurse:

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Data Protection

Any personal information is kept confidential. There may be occasions where your information needs to be shared with other care professionals to ensure you receive the best care possible.

In order to assist us to improve the services available, your information may be used for clinical audit, research, teaching and anonymised for National NHS Reviews. Further information is available in the leaflet Disclosure of Confidential Information IL137, via Gateshead Health NHS Foundation Trust website or the PALS Service.

NoIL32 Version: 5 First Published: 08/06 Review Date: 06/18

Author: Angela Heads, Cardiac Practitioner

This leaflet can be made available in other languages and formats upon request

Passport to Living with Heart Failure · 2018-11-19 · If you have heart failure, you may...

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Transcript of Passport to Living with Heart Failure · 2018-11-19 · If you have heart failure, you may...