February 2015

Oftentimes, we find ourselves caring for a friend or family member who is living with heart failure. Moreover, it’s an unfamiliar role and one that most of us go into without completely understanding what all is involved — especially if it’s taken it on as a full-time job. Here’s an idea of what you can expect if you become a caregiver:

Help with daily activities

Shop for and prepare food
Many people with severe heart failure cannot leave the house to go grocery shopping. You can help shop for low-fat, low-salt, and low-cholesterol foods. You may also be involved with preparing these types of meals.
Help clean
Simple cleaning tasks can be too physically demanding for someone with heart failure. You may want to help clean your loved one’s house regularly or hire a cleaning service.
Be a driver
A person with heart failure may no longer be able to drive because of irregular heart rhythms, fainting spells, or other complications of heart failure. But he or she will need to go to frequent doctor appointments and will need someone else to drive to these appointments and to other destinations too.
Prescription management
Most people with heart failure require multiple medicines to control their symptoms. Many of these drugs must be taken several times each day. Help your loved one by organizing the drugs, perhaps using a pillbox with one compartment for each day of the week or marking a calendar to help keep track of when to take medicines.
Symptom monitoring
If your loved one cannot keep track of his or her own weight, you may need to help. Even small changes in weight can signal a dangerous buildup of fluid. You should encourage your loved one to weigh himself or herself at the same time every day and to call the doctor if there is a sudden increase in weight. Call the doctor if other symptoms of heart failure get worse.
Getting around the house
If your loved one has trouble getting around because of heart failure, you may need to consider rearranging his or her house to make daily tasks easier to do. People with severe heart failure should not have to climb stairs on a routine basis. If possible, move your loved one’s bedroom to the main floor of the house. If the bathroom and bedroom are on different floors, a bedside commode may be very helpful.
Temperature
Symptoms of heart failure often get worse during hot, humid days. Use an air conditioner during the summer.

Provide emotional support

Offer encouragement
Adopting the lifestyle changes that doctors recommend for heart disease can be difficult for your loved one. Encourage him or her to start slowly and gradually build up to an overall goal. Even though your loved one may have physical limitations, he or she should still try to stay as active as possible. Moderate exercise and doing simple tasks around the house can be safe. This can help your loved one feel better both physically and mentally. If you are concerned about what activities are safe, talk with the doctor.
Participate in doctor visits. Ask your loved one if you can attend doctor visits. You can offer support by being with him or her and taking notes. This can help your loved one remember important instructions. He or she may also feel less alone during recovery.

Take care of yourself

Being a caregiver can be mentally and physically challenging. There are steps you can take to help make the situation more manageable for yourself. Remember that you will be an effective and loving caregiver only if you are in good physical and mental shape.
Ask for help when you need it and if possible, don’t take on all the responsibilities yourself. You may be able to involve other family members or a visiting nurse.
Or you may be able to hire a food delivery or housekeeping service to help with the shopping and cleaning. There may be services available within your community to help. Check with local government agencies, service clubs, and churches.
Take time for yourself. Being a caregiver can be stressful and time-consuming. It’s important to take time for activities that you enjoy so you can continue to provide care and support for your loved one.
Seek emotional support if you need it. Being a caregiver to a loved one whose health is deteriorating can be emotionally difficult. If you are having trouble coping with your feelings, seek advice and counseling from family members, trained mental health professionals, or spiritual advisors.

Seek outside help

Some families need outside help to care for a loved one with heart failure. If all of your family members work, it may not be possible to care for your loved one at home. Some people with heart failure require more care than their family can reasonably be expected to provide. In these cases, you may consider placing your loved one in a long-term care facility.
The available long-term care options depend on your loved one’s level of independence and need for supervision. Some people with heart failure are relatively independent and able to perform basic activities on their own, but they need assistance in preparing meals and sorting their medicines. These people may be well cared for in a supervised living facility that provides food and staff but not routine nursing care. Other people may have difficulty performing basic activities and may get better care in a nursing home where the staff can assist them with eating and bathing. In a nursing home, nurses can track your loved one’s symptoms and make sure that they take their medications.
It is important for people who are in long-term care facilities to feel that they are still a part of their family. Frequent visits by family members or day trips to the family home go a long way in improving these people’s emotional health.
Remember, you are not alone and if you need help, there are many resources available to you in your community.

As we continue the topic of Heart Awareness for the month of February, we revisit an important topic: Exercise.
It seems like no matter the topic we cover here, staying healthy always includes a proper diet and exercise. Both of which draw the most excuses.
Here are some tips to help encourage you to include exercise as part of your daily routine to improve your mental and physical health:
Physical activity boosts mental wellness. Regular physical activity can relieve tension, anxiety, depression and anger. You may not only notice a “feel good sensation” immediately following your physical activity, but most people also note an improvement in general well-being over time during the weeks and months as physical activity becomes a part of their routine.
30 minutes at least 5 days a week. You can even divide it into three 10-minute periods of activity daily which is just as beneficial to your overall fitness as one 30-minute session.
Becoming more active can help lower your blood pressure and also boost your levels of good cholesterol.
30 minutes of daily exercise such as brisk walking improves blood circulation, which reduces the risk of heart disease and —

• Keeps weight under control
• Helps in the battle to quit smoking
• Prevents bone loss
• Promotes enthusiasm and optimism
• Counters anxiety and depression
• Helps you fall asleep faster and sleep more soundly
• Improves self-image
• Increases muscle strength, increasing the ability to do other physical activities
• Provides a way to share an activity with family and friends
• Reduces risk of developing heart disease by 30-40%
• Reduced risk of stroke by 20% in moderately active people and by 27% in those who are highly active
• Establishes good heart-healthy habits in children and counters the conditions (obesity, high blood pressure, poor cholesterol levels, poor lifestyle habits, etc.) that lead to heart attack and stroke later in life
• Helps delay or prevent chronic illnesses and diseases associated with aging and maintains quality of life and independence longer for seniors

So why not see for yourself? Once you get over the inertia and find creative ways to fit physical activity into your life, we think you’ll agree that the effort to get moving is worth it!
Without regular physical activity, the body slowly loses its strength, stamina and ability to function well. People who are physically active and at a healthy weight live about 7 years longer than those who are not active and are obese.
Walking is safe for most people, but check with your healthcare provider if you’ve experienced chest pain in the past month or have a chronic condition. Cardiac patients should definitely consult a healthcare provider before heading out in the cold, since exerting yourself in the cold weather does put an added strain on your heart.
If walking isn’t your speed you may enjoy Circuit training.
Circuit exercise is a cycle of 5-6 exercises that you run through a few times. It’s a great way to alleviate boredom and get a lot done in a short amount of time.
You can create your own mini-circuits at home. Ideally, your circuit will include a cardio burst of 1–2 minutes, followed by 3–5 exercises that work various parts of your body.
For example:

• Jump rope, jog in place or run your steps (start with 1 minute and progress to 2)
• 10 push-ups (You can modify with knees down if you are having trouble holding a straight body push-up position)
• 20 crunches (with feet flat and knees up, legs bent in the air at 90 degrees or straight up, or your favorite variation)
• 20 hip lifts (flat on your back, arms down on the ground at your sides with fingertips pointing toward feet, feet flat with knees bent at 90 degrees; press feet and shoulders into floor as you lift your hips as high as you can; lift and lower)
• 30-second plank hold (holding a push-up position; body as a straight line, or with knees down)
• 10 triceps dips on a chair/couch (Sit on chair with feet flat and knees bent at 90 degrees; hands at sides, palms pressed into the chair with fingertips facing forward; take one large step with right foot, and join left foot beside it. Bend your arms to 90 degrees as you lower and lift; keeps abs tight.)

Too much sitting and other sedentary activities can increase your risk of cardiovascular disease. One study showed that adults who watch more than 4 hours of television a day had a 46% increased risk of death from any cause and an 80% increased risk of death from cardiovascular disease. So, get off the couch and get moving today!

A healthy diet and lifestyle are your best defense against cardiovascular disease. It’s easy to become overwhelmed in thinking there’s no way to change the eating habits you’ve grown accustomed to for years. However, there are some simple nutrition tips you can include in your daily life that will benefit your long-term health and your heart.
Eat and drink only what you know you can burn off

• Start by knowing how many calories you should be eating and drinking to maintain your weight. You can talk to your doctor about you daily calorie in take and what you need to do to either maintain or lose weight.
• Increase the amount and intensity of your physical activity to match the number of calories you take in.
• Aim for at least 30 minutes of moderate physical activity on most days of the week or — best of all — at least 30 minutes every day.

Regular physical activity can help you maintain your weight, keep off weight that you lose and help you reach physical and cardiovascular fitness. If you can’t do at least 30 minutes at one time, you can add up 10-minute sessions throughout the day.
If you need to lower your blood pressure or cholesterol, the American Heart Association recommends 40 minutes of aerobic exercise of moderate to vigorous intensity three to four times a week.
Eat a variety of nutritious foods from all the food groups:
You may be eating plenty of food, but your body may not be getting the nutrients it needs to be healthy. Nutrient-rich foods have vitamins, minerals, fiber and other nutrients but are lower in calories. Eating a variety of fruits and vegetables may help you control your weight, cholesterol and your blood pressure.
Get the nutrients you need by eating

• fruits,
• vegetables,
• whole grains,
• low-fat dairy products,
• poultry, fish and nuts,
• and limiting red meat and sugary foods and beverages.

Eat less of the nutrient-poor foods
The right number of calories to eat each day is based on your age and physical activity level and whether you’re trying to gain, lose or maintain your weight. You could use your daily allotment of calories on a few high-calorie foods and beverages, but you probably wouldn’t get the nutrients your body needs to be healthy. Limit foods and beverages high in calories but low in nutrients. Also limit the amount of saturated fat, trans fat and sodium you eat. The Nutrition Facts panel on foods and beverages tells you the amount of healthy and unhealthy nutrients, so read the label and educate yourself so you can monitor your intake.
As you make daily food choices, base your eating pattern on these recommendations:

• Choose lean meats and poultry without skin and prepare them without added saturated and trans fat.
• Eat fish at least twice a week. Recent research shows that eating oily fish containing omega-3 fatty acids (for example, salmon, trout and herring) may help lower your risk of death from coronary artery disease.
• Select fat-free, 1% fat and low-fat dairy products.
• Cut back on foods containing partially hydrogenated vegetable oils to reduce trans fat in your diet.
• To lower cholesterol, reduce saturated fat to no more than 5 to 6 percent of total calories. For someone eating 2,000 calories a day, that’s about 13 grams of saturated fat.
• Cut back on beverages and foods with added sugars.
• Choose and prepare foods with little or no salt. To lower blood pressure, aim to eat no more than 2,400 milligrams of sodium per day. Reducing daily intake to 1,500 mg is desirable because it can lower blood pressure even further.
• If you drink alcohol, drink in moderation. That means one drink per day if you’re a woman and two drinks per day if you’re a man.
• Follow the American Heart Association recommendations when you eat out, and keep an eye on your portion sizes.

Source: American Heart Association

February is American Heart Month and we’ll be focusing on educating you on various conditions of the heart, how to keep a healthy heart, and tips for caregivers.
The normal heart is a strong, muscular pump a little larger than a fist. It pumps blood continuously through the circulatory system. Each day the average heart beats 100,000 times and pumps about 2,000 gallons of blood. In a 70-year lifetime, an average human heart beats more than 2.5 billion times.
Cardiovascular disease is expected to kill about 23 million people a year globally by 2030. Yet 80% of all heart and stroke events are preventable. Our goal is to help educate you in hopes of preventing heart disease.
Heart disease is a basic term used to describe several problems with the heart including:
Arrhythmia
Arrhythmias are abnormal beats. The term “arrhythmia” refers to any change from the normal sequence of electrical impulses, causing abnormal heart rhythms. Arrhythmias may be completely harmless or life-threatening.
Some arrhythmias are so brief (for example, a temporary pause or premature beat) that the overall heart rate or rhythm isn’t greatly affected. But if arrhythmias last longer, they may cause the heart rate to be too slow or too fast or the heart rhythm to be erratic – so the heart pumps less effectively.
A fast heart rate (in adults, more than 100 beats per minute) is called tachycardia.
A slow heart rate (less than 60 beats per minute) is referred to as bradycardia.
An arrhythmia occurs when:
The heart’s natural pacemaker develops an abnormal rate or rhythm.
The normal conduction pathway is interrupted.
Another part of the heart takes over as pacemaker.
Cardiac Arrest
Cardiac arrest is the abrupt loss of heart function in a person who may or may not have diagnosed heart disease. The time and mode of death are unexpected. It occurs instantly or shortly after symptoms appear.
Each year, more than 420,000 emergency medical services-assessed out-of-hospital cardiac arrests occur in the United States.
The term “heart attack” is often mistakenly used to describe cardiac arrest. While a heart attack may cause cardiac arrest and sudden death, the terms don’t mean the same thing. Heart attacks are caused by a blockage that stops blood flow to the heart. A heart attack (or myocardial infarction) refers to death of heart muscle tissue due to the loss of blood supply, not necessarily resulting in the death of the heart attack victim.
Cardiac arrest is caused when the heart’s electrical system malfunctions. In cardiac arrest death results when the heart suddenly stops working properly. This may be caused by abnormal, or irregular, heart rhythms.
A common arrhythmia in cardiac arrest is ventricular fibrillation. This is when the heart’s lower chambers suddenly start beating chaotically and don’t pump blood. Death occurs within minutes after the heart stops. Cardiac arrest may be reversed if CPR (cardiopulmonary resuscitation) is performed and a defibrillator is used to shock the heart and restore a normal heart rhythm within a few minutes.
Heart Attack
Your heart muscle needs oxygen to survive. A heart attack occurs when the blood flow that brings oxygen to the heart muscle is severely reduced or cut off completely. This happens because coronary arteries that supply the heart muscle with blood flow can slowly become narrrow from a buildup of fat, cholesterol and other substances that together are called plaque. When a plaque in a heart artery breaks, a blood clot forms around the plaque. This blood clot can block the blood flow through the heart muscle.
When the heart muscle is starved for oxygen and nutrients, it is called ischemia. When damage or death of part of the heart muscle occurs as a result of ischemia, it is called a heart attack or myocardial infarction. About every 34 seconds, someone in the United States has a heart attack.
Cardiomyopathy
Cardiomyopathy refers to diseases of the heart muscle. These diseases have many causes, signs and symptoms, and treatments. In cardiomyopathy, the heart muscle becomes enlarged, thick or rigid. In rare cases, the muscle tissue in the heart is replaced with scar tissue. As cardiomyopathy worsens, the heart becomes weaker. It’s less able to pump blood through the body and maintain a normal electrical rhythm. This can lead to heart failure or irregular heartbeats called arrhythmias. In turn, heart failure can cause fluid to build up in the lungs, ankles, feet, legs, or abdomen.
Cardiomyopathy can be acquired or inherited. “Acquired” means you develop it due to another disease, condition or factor. “Inherited” means your parents passed the gene for the disease on to you. Many times, the cause of cardiomyopathy isn’t known.
Heart Failure
Heart failure is a chronic, progressive condition in which the heart muscle is unable to pump enough blood through to meet the body’s needs for blood and oxygen. Basically, the heart can’t keep up with its workload.
At first the heart tries to make up for this by:
– Enlarging. When the heart chamber enlarges, it stretches more and can contract more strongly, so it pumps more blood.
– Developing more muscle mass. The increase in muscle mass occurs because the contracting cells of the heart get bigger. This lets the heart pump more strongly, at least initially.
– Pumping faster. This helps to increase the heart’s output.
The body also tries to compensate in other ways:
– The blood vessels narrow to keep blood pressure up, trying to make up for the heart’s loss of power.
– The body diverts blood away from less important tissues and organs to maintain flow to the most vital organs, the heart and brain.
These temporary measures mask the problem of heart failure, but they don’t solve it. Heart failure continues and worsens until these substitute processes no longer work. Eventually the heart and body just can’t keep up, and the person experiences the fatigue, breathing problems or other symptoms that usually prompt a trip to the doctor.
The body’s compensation mechanisms help explain why some people may not become aware of their condition until years after their heart begins its decline. It’s also a good reason to have a regular checkup with your doctor.
Heart failure can involve the heart’s left side, right side or both sides. However, it usually affects the left side first.
Source: American Heart Association