Patients who work to control their symptoms, studies have shown, have improved outlooks and fewer symptoms than those patients who just “go through the motions.” Speak to your doctor, nurse, and pharmacist. Learn all you can about your disease, what your symptoms mean, and how to treat them.

Find out how you can help yourself. It will pay off. Some suggestions of taking control of your disease and your life include:

• Be aware of your body. A great way to avoid worsening of your symptoms is to detect them early and then do something about it. Every CHF patient should have an accurate scale in his or her house. They should weigh themselves every day at the same time of day.

Increases of 3 lbs in 24 hours or 5 lbs in a week should prompt a call to your doctor. Watch out for increased shortness of breath, swelling in the hands and feet, or an inability to lie flat in bed. These are symptoms of worsening CHF and they will not improve without treatment.

• Eat a healthy diet. Limit your consumption of sodium (salt) to less than 2,000 milligrams (2 grams) each day. Eat foods high in fiber and potassium. Limit foods high in fat, cholesterol, and sugar. Reduce your total daily intake of calories to lose weight if necessary.

• Exercise regularly. A regular cardiovascular exercise program, prescribed by your doctor, will help improve symptoms and strength and make you feel better. It may also decrease heart failure progression. A cardiac rehabilitation program is a good place to start.

• Conserve your energy. Plan your activities and include rest periods during the day. Certain activities, such as pushing or pulling heavy objects and shoveling, may worsen heart failure and its symptoms. Learn what your limitations are and don’t overdo it. Too much exercise or emotional stress can worsen your symptoms.

• Prevent respiratory infections. Although CHF patients don’t necessarily get more respiratory infections, they can suffer more with the symptoms than someone who does not have CHF. Annual flu shots and a pneumococcal vaccine every 5 years are recommended. Ask your doctor about getting these vaccines.

• Take your medications as prescribed. Learn about your medications. Studies show that patients who are more familiar with what their medications do and why they have to take them are more compliant with their doctor’s recommendations and spend less time in the hospital with heart failure symptoms.

Your physician and pharmacists are excellent sources of information. Many times the manufacturer of the drug has a telephone number you can call for more information. Do not stop taking medications without first contacting your doctor.

• Get emotional or psychological support if needed. An episode with heart failure can be difficult for your whole family. Many people with CHF suffer from depression; counseling and antidepressant medication can help. If you have questions, ask your doctor or nurse.

If you need emotional support, social workers, psychologists, clergy, and heart failure support groups are a phone call away. Ask your doctor or nurse to point you in the right direction.

Is exercise helpful for patients with heart failure?

CHF is often associated with shortness of breath and fatigue. As a result, patients with CHF are often sedentary. They sit and lie down through much of the day. They may even be told not to exercise because it is dangerous. This sedentary lifestyle affects your heart, lungs, and skeletal muscles, making it even harder for patients to get around and do the things they enjoy.

Being sedentary can also put the patient at risk for the development of blood clots in the legs and in the lungs. In the past, physicians encouraged patients to rest and avoid strenuous exercise. However, recent studies have shown that some exercise is good for CHF patients and can even extend their lives.

For patients with CHF, moderate exercise may be the best therapy, say the authors of a study published in the medical journal Circulation in 1999. The authors’ study showed that CHF patients in a 14-month exercise program lived longer, had less risk of heart-related death, and had fewer hospital readmissions than a control group during a 3 1/2-year follow-up.

One of the physicians in the study reported that exercise not only improves blood flow in the heart but also increases blood flow to the skeletal muscles. This increases the CHF patient’s ability to function. Another study on CHF patients found that heart failure changes distribution of skeletal muscle fibers.

In general, there was less muscle as well as fewer of the tiny capillaries that feed the muscles. When CHF patients participated in regular exercise on a stationary bicycle, scientists found that the patients had an improved exercise capacity and that the amount of muscle in their legs increased.

Similar studies have demonstrated other benefits to regular exercise in heart failure patients such as increased endurance, less shortness of breath, less fatigue, and a higher life satisfaction. Physicians at Duke University Medical Center studied CHF patients who participated in regular exercise and compared them to similar patients with CHF who did not exercise.

They concluded that regular exercise in CHF patients improves survival. These physicians reported that regular exercise in CHF patients was safe. The American Heart Association (AHA) now recommends exercise for heart failure patients. An AHA committee reviewed medical literature that showed that exercise training in CHF patients improves exercise capacity and quality of life.

Because all CHF patients are not the same, the AHA stressed that the exercise regimen must be individualized for each heart failure patient and cannot simply rely on heart rate as a measure of exercise intensity. Instead, more complicated tests need to be employed, such as the gas exchange measurements, Vo2max and peak Vo2, or functional ability should be used.

This is why exercise testing by your doctor is so important before starting an exercise program. It is recommended that every CHF patient enroll in a cardiac rehabilitation program. These programs are able to accurately assess a CHF patient’s ability to exercise and to prescribe an exercise regimen at a safe intensity.

Tips on exercise for CHF patients

Exercising will improve your quality of life and lower your risk of death. How much exercise and the type of exercise you should do depend upon your situation. You should discuss these issues thoroughly with your physician or cardiac rehabilitation specialist before engaging in any exercise regimen.

The following are suggested topics to discuss with your physician about your exercise plan. For aerobic exercises like walking, find out:

• What tests do I need to take before I begin my regimen?
• What should my exercise goals be?
• What exercises are most appropriate for my level of fitness?
• Are there exercises I should avoid?
• How often should I exercise?
• Should I eat before or after exercising? How long before or after exercising?
• Is it important to monitor my heart or breathing rate during or after exercise?
• Should I change my medication regimen to accommodate my exercise schedule? Are some medications better to take before or after exercise?
• When do I know if I’ve exercised too much? What are the danger signals?
• Should I be lifting weights to increase my strength?
• What weightlifting exercises should I do?