Studies have shown that patients who are involved in their own treatment plan are much more likely to comply with the treatment plan. Further, when the patient collaborates with the doctor, the patient gains a sense of control over the illness. This has been shown to increase a sense of well-being and quality of life.

If all patients with CHF take an active role in the management of their disease, they can expect to achieve optimal results from medications and therapies and avoid the debilitating effects of sedentary living. See the following list; it contains information that you should share with your doctor at each visit and questions you should ask at each visit.

Before visiting your doctor, review these items and make lists of things you want to discuss with your doctor. Remember, you’re both interested in keeping you healthy. It is a good idea to keep a notebook to write the answers to these questions in. Bring that notebook with you to your doctor’s appointment.

Questions to consider before seeing your doctor:

• Have I been following my doctor’s recommendations about diet, exercise, and medication schedule? (Be honest. If you discuss these issues with your doctor, they often can suggest strategies to help you get—or stay—on track.)
• Have I had any new symptoms (fatigue, chest pain, swelling, palpitations)?
• Am I unable to do something recently that I was always able to do?
• What was my last blood pressure reading?
• Have I had any problems getting my medications?
• Have I had any problems affording my medications or other health care?
• Has there been a change in my insurance?
• Has there been a change in my financial status?
• Have I had any problems taking my medications? Have there been any side effects?
• Have I had any problems keeping my medication schedule straight? Have I gotten confused, taken the wrong medication, or missed doses?
• Have I been prescribed any new medications by other doctors?
• Have I been taking any new medications, vitamins, cold pills, home remedies, herbs, and so forth?
• Have I been doing any more work or more exercise than normal? How did this make me feel?
• How has my mood been? Have I been feeling blue or depressed? Do I feel hopeless about my condition?
• Have there been any changes in my household or family? Any births or deaths, more responsibilities, more work, or causes for stress or anxiety?
• Have there been any changes in my “support network”: people who check in on you, help you out when necessary, take you shopping, or just come over and visit?
• Am I still able to take care of myself? Do I need extra help to get the usual things done? Who would I talk to if I did need help?
• When was my last influenza vaccine?
• When was my last pneumococcal vaccine?
• When was my last EKG?
• Have I had all my cancer screening done lately (such as colonoscopy, prostate exam, Pap smear, mammography)?

You should take notes during your doctor visits. This will allow you to review key information and instructions later. If you don’t understand a word, idea, or direction, ask your doctor to explain it fully. For example, keep asking questions until you fully understand the doctor’s instructions for taking medications— when, how often, and in what amounts.

Your doctor may have printed information or instructions available to give you, so you don’t have to write so much. Some patients find it helpful to bring a family member or friend to doctor visits. Friends or family members can offer moral support, help take notes, or ask questions.

Questions to ask your doctor at the office:

• What’s my diagnosis?
• Is my heart failure mild? moderate? severe?
• Will my condition stay the same or get better or worse?
• Will I be able to do the things I usually do and enjoy such as exercise, hobbies, shopping, caring for the house?
• What is the most important thing I can do to help manage my disease?
• Do you recommend a cardiac rehabilitation program? If so, where will it take place? How often?
• If my symptoms get worse, what should I do? Should I take any medication?
• If any symptoms seem to get worse or change suddenly, what’s the best way for me to contact you?
• If I need to go to the emergency room, what hospital should I go to?
• What if the health insurance plan doesn’t cover the treatment or medication you’re recommending? What’s our next step?
• AIf I need advice on financial, legal, or family issues, whom do I ask? Can this person also assist with finding outside help for household tasks and deciding whether to go to a nursing home or retirement community?
• What will this new drug, therapy, or treatment cost? Will it be covered by my insurance? Will it hurt?
• When should I make an appointment to come back and see you?
• Do I need to see other specialists? Why? What will they do for me? When do I need to see them?

It is helpful when you get home to sit down and review this list of things to do.

Things to do when you come back from the doctor’s office:

• Review your notes. If there is anything you don’t understand, call your doctor back and ask him or her to explain it again.
• Get your prescriptions filled. Call the pharmacist or your physician if there is any confusion about type, dosage, or side effects of medication or problems with affordability.
• Place all your prescriptions in an area that is convenient for you to get to. In this area you should have a medication schedule posted that lists times and doses. There are many types of “pill organizers” available at your pharmacy. If you have several different medications, you may find these helpful in keeping your dosages straight.
• Make any follow-up appointments or clinic visits as soon as you get home. Place the appointments on your calendar or day planner.
• Post the phone numbers for your primary care physician and cardiologist by your telephone, along with a list of your current medications, other medical conditions, and allergies.
• Call the doctor right away if you experience a sudden change or your symptoms get worse.