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About 6 million Americans, and 26 million people around the world, have congestive heart failure. Heart failure is most often caused, and worsened...
(Read More)
CHF patients are frustrating. Their decisions and behaviors don’t make sense. Instead of resisting salt, taking their medications religiously, exercising when they can, and making every single doctor’s appointment….
(Read More)
There are two areas of at-home disease management that dramatically impact patient stability:
These are some short videos about managing heart failure. The goal is to keep you:
All of these videos are about treatments, symptoms and problems that nearly everyone who has heart failure, or is a caregiver for someone with heart failure, but first, if you're interested, here's a quick outline of:
Century Tree makes a lot of videos and instruction about the basics of disease management. “Features” are a little different: They’re everything from touching dramas to short documentaries to music videos. Some are moving. Others are funny. All of them are entertaining.
Bahala Na is a beautiful animated short film about a Filipina home health aide balancing caring for sick, and sometimes difficult, patients in Los Angeles—While, at the same time, being a long-distance mother to her children half a world away.
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About 6 million Americans, and 26 million people around the world, have congestive heart failure. Heart failure is most often caused, and worsened...
...by coronary artery disease, myocardial infarction (a heart attack), and hypertension. Patients suffer from fatigue, shortness of breath, fluid retention (most significantly in their lungs and lower legs), lower leg skin breakdown and depression.
Treatment revolves around:
The two most effective treatment interventions are:
Caregivers are optimally positioned to reinforce medication adherence, recognize complications when they arise, and work with doctors to resolve problems, in order to return patients to stability.
The first aims of treatment for any CHF patient are managing high blood pressure and fluid overload. Antihypertensive agents include ACE inhibitors, Angiotensin Receptor Blockers, calcium channel blockers and beta blockers offer a variety of advantages, most importantly widening constricted blood vessels. Diuretics, including thiazide, loop, and potassium sparing diuretics help to lower blood pressure by reducing blood volume.
Diuretics are also essential for managing fluid overload, or collection of fluid in the lungs, the lower extremities (feet and legs), and abdomen, along with the blood. This is essential for mediating potentially severe shortness of breath from pulmonary edema and problems associated with lower leg swelling, including non-healing venous stasis ulcers and cellulitis infections that carry a risk for sepsis. Skin breakdown is often treated with ongoing application of creams and bandages, as prescribed.
Depression is also a prevalent, and often devastating, problem for people with CHF. All CHF patients should be assessed for depression and conscientiously treated for it if indicated.
It is also essential to address the medical problems that caused a patient’s heart failure in the first place— these problems will continue to contribute to progressive weakening of the heart, along with posing serious medical threats on their own. Cardiovascular problems, including coronary artery disease (CAD—what is commonly thought of as “heart disease”), high cholesterol, and peripheral vascular disease (PVD-- problems with blood vessels in the legs) are extremely common among CHF patients, often requiring ongoing relationships with specialists.
Common co-morbidities, including diabetes and COPD, also require serious attention and ongoing treatment.
Acute episodes are inevitable for CHF patients. The good news is that episodic problems can almost always be resolved with a temporary change in medication doses, often without even a doctor’s appointment. The bad news is that, when small problems are neglected, they can turn really bad really fast—too often requiring hospital treatment. Complications and warning signs must be recognized early, reported to the doctor immediately, and addressed with diligence.
Patients should be monitored daily by caregivers for increased fluid retention. The most important sign of increased fluid retention is new shortness of breath—New “SOB” should always be reported immediately to the doctor. Caregivers can also assess for new swelling of the feet, ankles and lower legs, pitting edema, and weight gain.
Caregivers should also examine the lower legs daily to assess for new skin irritation, breakdown and wounds.
Because CHF is almost always associated with cardiovascular disease, caregivers should know the warning signs of heart attack and stroke. Similarly, caregivers should be aware of common warning signs and complications of co-morbidities, like diabetes and COPD, if applicable.
Caregivers should also work with the doctor to develop a list of mental health benchmarks for ongoing assessment for depression in a CHF patient.
Your blood vessels
squeeze your blood
like an overstuffed
sausage
Blood Vessels Carry blood all over your body
HEALTHY Blood Vessels
E-Z FLOW
Roomy & Spacious
Its a tight squeeze
Blood pressing
against blood vessel
That "Pressing" is the "Press" in High Blood Pressure
When your pants are too small, they're a tight squeeze for your legs and your butt
Oof! Too Tight!
That's high pants pressure!
But first...
Your Blood Vessels
hold about (1) gallon of blood
You're made
that way!
It's a perfect Fit
WIDE
Free and E-Z Blood Flow
SPACIOUS
1/2 gallon of
red stuff*
1/2 gallon of Water
1 Gallon of Blood
* red blood cells make the red stuff red
Shrunken blood vessels
HEALTHY, wide blood vessel
Shrunken blood vessel (too narrow)
While the amount of blood in your blood vessels stays the same
After your blood vessels shrink, there's less room for that 1 gallon of blood
...GETTING BACK TO "HIGH PANTS PRESSURE"
You buy NEW PANTS!
You Love those New Pants!
But then you put your pants int the Clothes dryer (super hot dry cycle!)
We all know what happens...
Now your pants are a
"Tight Squeeze"
You're still the same size
But
Your pants are a lot smaller
Shrunken Pants
High Blood Pressure
Shrunken Blood Vessels
Is a struggle and a strain
pumping blood into shrunken, high pressure, blood vessels EVERY DAY
You should have about (1) gallon of BLOOD in your BLOOD VESSELS
1/2 gallon of other stuff
(mainly red blood cells)
1/2 gallon of Water
1 Gallon of Blood
Imagine finding your old "Jordaches" from 1978.
110 pounds
Imagine trying to put them on again NOW!
220 pounds
And a strain on your heart
when it pumps blood
into those high blood pressure
blood vessels
Most people
with CHF
have this one
tight squeeze
Shrunken Blood Vessels that are bloated with extra water mixed into the blood
You find those old
1978 Jeans
that fit you
when your were 19...
and you put them in the clothes washer, then dry at super hot heat...
and NOW...
They are both really really shrunk and really really tight
High Blood Pressure
strains your heart
"Pumping blood is really hard for a damaged heart like me"
With every single beat...
day after day
115,00
times a day... Year after Year
Damaging
your heart
Making your heart failure
worse and worse
and worse
Your Heart wants
to be healthy and strong
Your Heart wants your Blood Vessels to be
WIDE • ROOMY • SPACIOUS
With E-Z FLOW, its easy for a healthy heart
to pump blood into your Blood Vessels
Drawing of the weaker heart cycle to come
High Blood Pressure also strains and damages your blood vessels
(Just like it strains and dmages your heart).
That increases your risks of Heart Attack and Stroke.
HEALTHY
BLOOD
VESSEL
Wide - Roomy - Spacious
E-Z Blood Flow
No Extra Water
TBLOOD
VESSEL
SHRINKS
Making the blood vessel too narrow for the amount of blood in it
EXTRA WATER GETS
MIXED INTO
THE BLOOD
With the extra water, there's too much blood for the blood vessel
Shrunk Narrow Blood Vessel
A Tight Squeeze
Take a
Pressure Pill
WIDE
EZ-FLOW
Blood Vessel
Bloated with extra water
Take a
Water Pill
PEE
The Extra water
IS GONE!
"She's a genius!
(anyway, She's really smart!")
CHF patients are frustrating.
Their decisions and behaviors don’t make sense.
Instead of resisting salt, taking their medications religiously, exercising when they can, and making every single doctor’s appointment….
They watch TV. Eat their favorite foods (that are NEVER healthy.) They don’t take their medications unless you remind them every single time. And exercising?....Forget it.
And even though they’re obviously depressed, they never do a single thing to improve their lives.
YOU would do it differently, right?
Maybe. But that’s, perhaps unfortunately, not the issue. You’re not the one who’s sick. You’re not the one who’s dying. It’s not you who committed yourself to lazy self-destruction.
If you’re a caregiver for someone with advanced CHF who isn’t taking care of themselves, it’s difficult not to get frustrated….to get angry….to judge.
Try to remember that it’s also not you who is dying. Right or wrong, wise or not, a person with advanced CHF only has a precious few years, or maybe just months, to live. Help them adhere to treatments as much as you can: Especially the aspects of treatments that are relatively painless, like taking pills.
But when it comes to the more difficult stuff, like changing diet, ask yourself whether buying a little more time is worth giving up simple pleasures like soda with lunch or arroz con pollo for dinner.
And then talk to the doctor about what you decided, because this choice isn’t an easy one. With the possibility of a stroke or a heart attack, early death isn’t the only bad outcome.
But whatever you choose….whether you cede every battleground, or pick up the fight….remember that the ultimate goal should always be finding the best way for you and the person you’re taking care of to find love and peace together.
Waiting on mike
Their decisions and behaviors don’t make sense.
Instead of resisting salt, taking their medications religiously, exercising when they can, and making every single doctor’s appointment….
They watch TV. Eat their favorite foods (that are NEVER healthy.) They don’t take their medications unless you remind them every single time. And exercising?....Forget it.
And even though they’re obviously depressed, they never do a single thing to improve their lives.
YOU would do it differently, right?
Maybe. But that’s, perhaps unfortunately, not the issue. You’re not the one who’s sick. You’re not the one who’s dying. It’s not you who committed yourself to lazy self-destruction.
If you’re a caregiver for someone with advanced CHF who isn’t taking care of themselves, it’s difficult not to get frustrated….to get angry….to judge.
Try to remember that it’s also not you who is dying. Right or wrong, wise or not, a person with advanced CHF only has a precious few years, or maybe just months, to live. Help them adhere to treatments as much as you can: Especially the aspects of treatments that are relatively painless, like taking pills.
But when it comes to the more difficult stuff, like changing diet, ask yourself whether buying a little more time is worth giving up simple pleasures like soda with lunch or arroz con pollo for dinner.
And then talk to the doctor about what you decided, because this choice isn’t an easy one. With the possibility of a stroke or a heart attack, early death isn’t the only bad outcome.
But whatever you choose….whether you cede every battleground, or pick up the fight….remember that the ultimate goal should always be finding the best way for you and the person you’re taking care of to find love and peace together.
The good news is that there are things you can do about your CHF problems:
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SHRUNKEN blood vessels
BLOATED blood vessels
Both SHRUNKEN & BLOATED blood vessels
