austin heart's congestive heart failure brochure

20
Heart Austin Setting the Standard in Cardiac & Vascular Care CONGESTIVE HEART FAILURE CENTER | PATIENT EDUCATION PACKET

Upload: callie-simpson

Post on 16-Mar-2016

224 views

Category:

Documents


0 download

DESCRIPTION

A redesign of Austin Heart's Congestive Heart Failure Brochure.

TRANSCRIPT

Page 1: Austin Heart's Congestive Heart Failure Brochure

HeartAustinSetting the Standard in Cardiac & Vascular Care

CONGESTIVE HEART FAILURE CENTER | PATIENT EDUCATION PACKET

Page 2: Austin Heart's Congestive Heart Failure Brochure

Welcome to the Congestive Heart Failure Center at AUSTIN HEART. We are committed to providing each of our patients with individualized, comprehensive, and holistic care. We believe that through our outpatient clinic we can maximize your quality of life and minimize your trips to the hospital.

Heart failure is a complex condition that can be optimally managed by a specialized healthcare team. Our specialist team will provide high-quality patient and family care in managing your heart failure. Additionally, we offer each patient our expertise on lifestyle changes, options, answers to your questions, and treatment plans.

CHF Center hours are Monday through Friday, 8am-5pm; call 512-206-3676. At night and on weekends, reach us through our operator line at 512-206-3600. Please call us if you have any questions or problems.

Page 3: Austin Heart's Congestive Heart Failure Brochure

HEART FAILUREGeneral Information ............................................................................................. 2Symptoms of Heart Failure ................................................................................... 2How is Heart Failure Treated? ............................................................................... 3How to Take Care of Your Heart Failure at Home ................................................ 4

WHAT IS CONSIDERED AN EMERGENCY? ......................................................... 5

NSAIDs .................................................................................................................... 6

SODIUMSodium Restriction ............................................................................................... 7Sodium Restriction Do’s and Don’ts ...................................................................... 7Identifying Sources of Sodium .............................................................................. 8Fast Food Sodium Guideline ................................................................................. 8High Sodium Foods –What NOT to Buy ............................................................ 9Low Sodium Foods –What to Buy ....................................................................... 9

FLUID RESTRICTIONHow Much is Too Much? ................................................................................... 10What About Alcohol? ......................................................................................... 10

POTASSIUMHigh-Potassium Foods ........................................................................................ 11What if My Potassium is Too Low? ...................................................................... 11

MAGNESIUM ........................................................................................................ 12

QUITTING SMOKINGThe Twelve Commandments for “Smokers Who Want to Quit” ......................... 13Local Smoking Cessation Groups........................................................................ 13

EXERCISEDo What You Can Do ........................................................................................ 14Overcoming Barriers of Exercise ......................................................................... 15

REDUCING STRESSWhat is Stress and How Do I Cope? ................................................................... 16

HEALTHY HEART NUTRITION GUIDELINESEat Better to Reduce Risk ................................................................................... 17

Table of Contents

Page 4: Austin Heart's Congestive Heart Failure Brochure

2 AUSTIN HEART 512.206.3676 AFTER HOURS 512.206.3600 AUSTINHEART.COM

WHAT DOES THE HEALTHY HEART DO?A healthy heart pumps blood throughout your body. The right side of the heart pumps blood into the lungs, where it picks up oxygen. The left side of the heart pumps oxygen-rich blood through your body, feeding your organs and tissues.

WHAT IS HEART FAILURE?Heart failure is when your heart cannot effectively pump blood to your organs and tissues. Because of this, organs and tissues do not receive enough oxygen and nutrition to meet their metabolic needs.

WHAT CAUSED MY HEART FAILURE?There are several different causes of heart failure:

• Narrowing or clogging of the arteries (coronary artery disease)

• Past heart attack (myocardial infarction)

• Enlarged, weakened heart muscles (cardiomyopathy)

• High blood pressure (hypertension)

• Heart valve disease

• Congenital heart disease

• Infection of the heart muscle (myocarditis) or heart valves (endocarditis)

• Severe anemia

• Heart rhythm problems (arrhythmias)

All of these problems can cause your heart to react in several ways:

• The heart becomes larger

• The heart increases in muscle mass

• The heart muscle is stimulated to work harder

This reaction is helpful at first, but the heart cannot maintain this heightened reaction for an extended period of time. Eventually, the heart’s chambers will be overfilled or underfilled and the strength of the heart muscle contraction will be reduced.

Heart Failure

SYMPTOMS OF HEART FAILURE• Difficulty breathing, especially upon exertion or

when lying in bed

• Waking up breathless at night or frequently waking up to urinate at night

• Frequent dry, hacking cough

• Sudden, unexpected weight gain, defined as 3-5 pounds within 3-5 days

• Swelling in the lower extremities

• Unexplained fatigue, dizziness, weakness, or fainting

• Nausea and/or a lack of appetite with abdominal swelling, pain, or tenderness

Not all symptoms may be present–they will vary depending on the severity of your heart failure. Heart failure is classified as mild, moderate, or severe based on these symptoms.

2 AUSTIN HEART 512.206.3676 AFTER HOURS 512.206.3600 AUSTINHEART.COM

When the heart doesn’t pump as hard, the body receives less blood. This can cause:BREATHING PROBLEMS TIREDNESS SWELLING or WEIGHT GAIN

Page 5: Austin Heart's Congestive Heart Failure Brochure

3AUSTIN HEART 512.206.3676 AFTER HOURS 512.206.3600 AUSTINHEART.COM

Heart Failure

3AUSTIN HEART 512.206.3676 AFTER HOURS 512.206.3600 AUSTINHEART.COM

BOTTOM LINEThe heart is not pumping as effectively as it should, and blood is backing up into the lungs and body. Additionally, the kidneys are also affected in heart failure and they cannot eliminate salt and water from your body very efficiently.

When blood is not being effectively delivered to your tissues, you feel tired and short of breath.

When waste and fluids are not being carried away and eliminated, your tissues will fill with fluid and swell–common places for this are in your lungs, feet, ankles, legs, and abdomen.

HOW IS HEART FAILURE TREATED?The treatment of heart failure can vary from one person to the next– treatments are individualized to be the most effective for each patient that we see. However, there are some general principles of treatment:

• Drug therapy–may include digoxin, vasodilators such as ACE inhibitors, diuretics, and certain beta blockers. Intravenous inotropes may be needed if your congestive heart failure is severe

• Exercise alternating with periods of rest

• Sodium restriction

• Fluid restriction

• Diet modification and supplementation

Each individual mode of therapy will be discussed and supplemented with written material when prescribed.

Page 6: Austin Heart's Congestive Heart Failure Brochure

4 AUSTIN HEART 512.206.3676 AFTER HOURS 512.206.3600 AUSTINHEART.COM

HOW TO TAKE CARE OF YOUR HEART FAILURE AT HOME ...and hopefully stay out of the hospital.

WEIGH YOURSELF DAILY at the same time, in the same place, with the same amount of clothes on. Use the same scale each time. The optimal time to weigh yourself is in the morning, after urination but before breakfast. Call the Center if you see a weight gain of 3-5 pounds in 3-5 days.

CHECK YOUR VITAL SIGNS TWICE A DAY We recommend that you take your blood pressure and pulse once in the morning and once in the afternoon. This helps you monitor your own progress, as well as helping us see how you are doing at home. We have forms that you can easily record your numbers on, and we can help you get a home blood pressure monitor if you cannot afford one.

MONITOR YOUR SALT INTAKE Learn which foods are low in salt and avoid foods that are high in sodium. Read all food labels and be aware of all hidden sources of salt. Be sure that anyone that you are living with understands your diet and the importance of salt restriction.

LEARN WHAT ALL OF YOUR MEDICINES ARE AND WHAT THEY DO Take all your prescribed medicines as directed. We will give you medication cards to assist you with this. You may also call us if you have any questions about your medications. Your medicines work together to help improve the way your heart pumps, help rid the body of excess fluid, and generally make you feel better.

LOSE WEIGHT IF YOU ARE OVERWEIGHT When you are overweight, your heart has to work harder. Losing weight may also help you to lower your blood pressure and if you are a diabetic, it can help you to keep your blood sugar under control.

QUIT SMOKING Nicotine constricts your arteries, causes your heart to beat faster and harder, and deprives your body further of needed oxygen.

MANAGE YOUR STRESS This education packet will give you some ideas on stress management (page 16). You may also talk to the nurse about other stress management options.

Heart Failure

EXERCISE Exercise helps you improve or keep your current state of health. Exercise can also assist you with weight, blood pressure, diabetes, and stress control. Be sure to obtain enough rest, as well.

KEEP YOUR FAMILY AND FRIENDS INVOLVED WITH YOUR CARE The more support you have, the better. Stay in contact with the CHF Center and try to keep all appointments. Remember to bring all of your medicines, medicine card, and your daily vital sign/weight logs.

LEARN THE WARNING SIGNS OF WORSENING HEART FAILURE

Page 7: Austin Heart's Congestive Heart Failure Brochure

5AUSTIN HEART 512.206.3676 AFTER HOURS 512.206.3600 AUSTINHEART.COM

WHEN TO CALL THE CHF CENTER OR DOCTOR

• Worsening difficulty breathing or increasing shortness of breath

• Increased coughing

• Sudden, unexplained weight gain: 2-5 pounds in 2-4 days

• Increased swelling in the legs, ankles, or abdomen

• Unexplained or increased fatigue, dizziness, weakness, or fainting

• New onset of unrelenting nausea, vomiting, or diarrhea with abdominal swelling, pain, or tenderness

• Inability to sleep at night due to increased shortness of breath and/or cough

• Unaccustomed heart palpitations or irregularities

• Sudden inability to lie flat in bed at night or sudden need to increase amount of pillows needed for restful sleep

• Severe leg cramps

• Any other symptoms that seem unusual or sudden

• Call the CHF Center if you notice any sudden changes or if you feel like you are coming down with the flu or a cold.

What is Considered an Emergency?

HOW TO CALL THE CHF CENTER OR DOCTORIf calling during business hours (8am-5pm, Monday through Friday): Call direct at 512-206-3676.

If calling after business hours: Call 512-206-3600 and listen to the instructions on how to call Medical Exchange. Then, call Medical Exchange and ask for the doctor on call for Austin Heart.

IF YOU EXPERIENCE SUDDEN SEVERE CHEST PAIN OR SHORTNESS OF BREATH, YOU NEED TO CALL 911 OR HAVE SOMEONE TAKE YOU TO THE EMERGENCY ROOM

Page 8: Austin Heart's Congestive Heart Failure Brochure

6 AUSTIN HEART 512.206.3676 AFTER HOURS 512.206.3600 AUSTINHEART.COM

WHAT ARE NSAIDs?NSAIDs stand for Non-Steroidal Anti-Inflammatory Drugs. You can find many of these drugs at any drugstore and can buy them without a prescription. The most common examples of these are aspirin and ibuprofen.

Aspirin is commonly used for arthritis and for some circulation problems. Please note that aspirin used in small doses for problems such as these may be used safely.

NSAIDs

WHY DO I NEED TO BE CAREFUL?NSAIDs can be harmful to your heart condition. However, there are many situations when you may need to take them. You need to consult your doctor or the CHF Center nurse before taking any of the following drugs listed or before taking any medications indicated for pain, fever, or swelling.

Specific brand names to avoid unless otherwise directed are:

• Advil • Aleve • Anacin • Bayer • Cramp End

• Haltran • Ibuprofen • Nuprin • Motrin

Other NSAIDs to be careful with include:

• Anaprox • Ansaid • Arthrotec • Cataflam • Celebrex

• Clinoril • Daypro • Disalcid • Dolobid • Easprin

• Feldine • Indocin • Lodine • Nalfon

• Naprelan • Naprosyn

• Orudis • Oruvail

• Relafen • Tolectin

• Toradol • Trilisate

• Vioxx • Voltaren

Page 9: Austin Heart's Congestive Heart Failure Brochure

7AUSTIN HEART 512.206.3676 AFTER HOURS 512.206.3600 AUSTINHEART.COM

SODIUM RESTRICTIONPeople who have heart failure usually need to be on a salt/sodium restricted diet.

MODERATE SODIUM RESTRICTIONS: 2000 MG/DAY

• Remove table salt from the table and do not add salt while cooking

• Avoid salty foods such as pretzels, pickles, etc.

• Avoid processed food and dairy products, such as canned food and cheese

• If a food item has less than 200 mg of sodium per serving, it is a low-sodium food

The easiest way to implement a sodium restriction is to get into the habit of eating a low-sodium diet. Some general rules are:

Sodium

DO• Take the salt shaker off the table

• Cut salt in cooking gradually– start by cutting by half and increase from there

• Use low-sodium seasonings such as herbs, allspice, chili powder, curry, dill, lemon, onion, pepper, wine, and vinegar

• Get into the habit of reading food labels to check for sodium content and select low-sodium foods

• Substitute fresh veggies and other low-sodium foods for frozen, canned, and processed foods

• Discuss the use of sodium substitutes with your physician or nurse, as many alternatives contain extra potassium which may or may not be appropriate for your diet

• When dining out, avoid high-sodium choices and make special requests as needed (i.e. “Could you please prepare that with no added salt?”)

DON’T• Use seasonings that taste salty, such as soy sauce

• Eat foods or snacks with salt on or in them, such as potato chips or pretzels

• Take medications for headaches or heartburn that contain sodium bicarbonate or sodium carbonate

Page 10: Austin Heart's Congestive Heart Failure Brochure

8 AUSTIN HEART 512.206.3676 AFTER HOURS 512.206.3600 AUSTINHEART.COM

Sodium

IDENTIFYING SOURCES OF SODIUMTo minimize the amount of sodium in your diet, you need to know where the highest levels reside.

SALT Most common source of sodium

SEASONING SALTS garlic, onion, and celery salts

SAUCES Soy, worcestershire, steak, ketchup

PROCESSED FOODS Canned soups, bouillon, gravies, TV dinners

DELICATESSEN FOODS Cheeses, cured meats, sausages

FAST FOODS Pizza, burgers, fried foods

SNACKS Salted peanuts, potato chips, crackers, pretzels

PROCESSED OR PICKLED FOODS Processed chicken, pickled herring, pickles

MISCELLANEOUS Licorice, tomato juice, baking soda, organ meats

INGREDIENTS WITH THE WORD “SODIUM” ON THEM MSG, sodium nitrate

FOOD SODIUM SUBSTITUTE SODIUM

KFC 3pc. Fried Chicken 2020 KFC Hot Wings 1230

Arby’s Chicken Cordon Bleu 1824 Arby’s Light Roast Beef Deluxe 826

Taco Bell® Beef Burrito 1303 Taco Bell® Light Chicken Burrito 900

Burger King® Whopper 1300 BK® Broiler 480

Domino’s Pizza® (2 slices) 1403 Domino’s® Cheese Pizza, Hand-Tossed 900

Hardee’s® Loaded Omelet Biscuit 1330 Hardee’s® Cinnamon ‘n Raisin Biscuit 350

Wendy’s® Bacon and Cheese Baked Potato

1430 Wendy’s® Plain Baked Potato 25

Danish Roll 818 Large Bagel 425

Chicken Pot Pie 999 Healthy Choice Chicken Dinner 469

FAST FOOD SODIUM GUIDE

FOOD LABELSFood labels can be very misleading. Here is how to break their codes:

SODIUM FREE Less than 5 mg per serving

VERY LOW SODIUM Less than 35 mg per serving

LOW SODIUM Less than 140 mg per serving

REDUCED SODIUM 75% reduction from original product

UNSALTED, NO SALT ADDED, WITHOUT ADDED SALT No salt added during processing; food may still be high in sodium

Page 11: Austin Heart's Congestive Heart Failure Brochure

9AUSTIN HEART 512.206.3676 AFTER HOURS 512.206.3600 AUSTINHEART.COM

HIGH SODIUM FOODS– WHAT NOT TO BUYWhenever possible, avoid the following:

BREADS, CEREALS, GRAINS, STARCHES• Self-rising flour and corn meal

• Prepared mixes (waffle, pancake, muffin, cornbread)

• Instant cooked cereals

DAIRY PRODUCTS• Buttermilk (store-bought)

• Canned milk (unless diluted)

• Egg substitute (limit to 1/2 cup/day)

• Eggnog (store-bought)

• Salted butter and margarine

SOUPS• Bouillon (all kinds)

• Canned broth

• Dry soup mixes

• Canned soups

MEATS AND MEAT SUBSTITUTES• Canned meats

• Canned fish (sardines, unrinsed tuna and salmon)

• Cured meats (dried venison, bacon, corned beef, etc.)

• All types of sausage (beef, pork, chicken, turkey, Polish sausage, hotdogs, knockwurst, etc.)

• Sandwich meats (bologna, ham, salami, olive loaf, etc.)

• Peanut butter

• Salted nuts

Sodium

LOW SODIUM FOODS– WHAT TO BUYWise food choices include:

FRUITS• Fresh, canned, or frozen

VEGETABLES• Fresh or frozen (no sauce or plastic pouches)

• Canned (unsalted)

DRINKS• Fruit juices, fresh, or frozen

• Canned low-sodium or no salt added tomato & vegetable juice

• Instant breakfast (all flavors but eggnog) – limit to 1 cup/day

• Lemonade (frozen concentrate or fresh)

DAIRY CHOICES• Dry milk or liquid (skim or 1%)

• Homemade buttermilk (limit to 2-3 cups per day)

• Dry curd, cottage cheese (low-sodium)

• Ricotta (made from skim milk or low-fat)

• Neufchatel, farmer cheese, part-skim mozzarella

• Swiss

OILS, FATS• Olive, corn, canola, cottonseed, peanut

• Safflower, soybean and sunflower oil

• Mayonnaise or salad dressing (low-sodium)

• Margarine

MEAT SUBSTITUTES• Tofu (soybean curd)

• Peas, dried beans, lentils (not canned)

• Nuts or seeds (unsalted, dry roasted), sunflower seeds, almonds, walnuts, peanuts

• Unsalted peanut butter

Page 12: Austin Heart's Congestive Heart Failure Brochure

10 AUSTIN HEART 512.206.3676 AFTER HOURS 512.206.3600 AUSTINHEART.COM

HOW MUCH IS TOO MUCH?Most patients need to restrict fluid intake to 2000 ml (2000 cc) per day. That is about 2 quarts per day.

WHY?Excess fluid can increase the workload on the heart and aggravate symptoms of heart failure, such as shortness of breath and leg swelling.

HOW?There are several approaches to restricting fluids successfully:

• Count all liquids, including tea, coffee, yogurt, juices in fruits (1 orange or ½ grapefruit counts as 4 oz. fluid), pudding, ice cream, soup, juice, soda, JELL-O®, ice, popsicles, milk, etc.

• Measure all liquids in an 8 oz. cup or glass

• Keep a written record to track your intake

• Weigh yourself daily

• Monitor for symptoms of fluid overload (shortness of breath or leg swelling)

• Report to the CHF Center any questions or problems you are having

Another easy suggestion is to fill a 2-quart container with water and whenever you drink fluid, empty the same amount of water from the container into the sink. Once the container is empty, you have met your maximum fluid intake for the day.

Fluid Restriction

TO EASE DRY MOUTH:• Chew gum

• Suck on ice cubes or chips (remember to count as fluids)

• Suck on hard candy

• Eat popsicles (remember to count as fluids)

• Take small sips of water

• Brush teeth frequently

WHAT ABOUT ALCOHOL?Alcohol is to be counted as a fluid if you drink it. We strongly suggest that you abstain completely from alcohol, as it may be toxic to your heart.

MEASURING CONSTANTS

1 cup = 8 oz = 240 cc

4 cups = 32 oz = 1 quart = 1000 cc = 1 liter

8 cups = 64 oz = 2 quarts = 2000 cc = 2 liters

1 ml = 1 cc 8 oz = 30 cc

Page 13: Austin Heart's Congestive Heart Failure Brochure

11AUSTIN HEART 512.206.3676 AFTER HOURS 512.206.3600 AUSTINHEART.COM

HIGH POTASSIUM FOODSPotassium is a very important element in the body that helps to keep your heart beating at a regular and normal rate. Many diuretics cause your body to lose potassium. Patients can also lose potassium from vomiting, diarrhea, and taking laxatives or steroids.

WHAT IF MY POTASSIUM IS TOO LOW?If your potassium is too low, you will probably need to take a potassium supplement, which will be prescribed. These supplements come in pill, powder, and liquid form.

If your potassium levels are not terribly low, you may only need to eat more potassium-rich foods.

Potassium

DRIED FRUITS Raisins, prunes, apricots, dates, figs, prunesFRESH FRUITS Bananas, strawberries, watermelon, cantaloupe, oranges, apricots,

honeydew melon, pears, prunes, peachesFRESH VEGETABLES Avocados, potatoes, beets, greens, spinach, peas, tomatoes, broccoli,

brussel sprouts, mushrooms, celeryDRIED VEGETABLES Beans, peasFRESH MEATS Turkey, beef, some fish (such as halibut and flounder)FRESH JUICE Orange, grapefruitCANNED JUICE Grapefruit, prune, apricot

SALT SUBSTITUTES (contain high levels of potassium)

NOTE Check with your doctor before using salt substitutes. In some people, too much potassium can be dangerous. In some cases where diuretics are used, food alone cannot give the amount of potassium needed. Do what your doctor tells you to keep your potassium normal.

GOOD DIETARY SOURCES OF POTASSIUM

Page 14: Austin Heart's Congestive Heart Failure Brochure

12 AUSTIN HEART 512.206.3676 AFTER HOURS 512.206.3600 AUSTINHEART.COM

HIGH MAGNESIUM FOODSMagnesium is an important element in any healthy cardiac diet. You may need to increase your magnesium intake, especially if you are on diuretics. Foods that are high in magnesium include:

• Beans

• Nuts

• Poultry

• Fish

• Green vegetables

• Grains

• Citrus fruits

Magnesium

Page 15: Austin Heart's Congestive Heart Failure Brochure

13AUSTIN HEART 512.206.3676 AFTER HOURS 512.206.3600 AUSTINHEART.COM

THE TWELVE COMMANDMENTS FOR “SMOKERS WHO WANT TO QUIT”

• Do not push yourself to quit before you feel ready.

• Put your best efforts into getting ready.

• Become intensely conscious of every detail of smoking in your life.

• Learn the difference between an “urge” cigarette and a “habit” cigarette.

• Talk to other ex-smokers about how they quit.

• Recruit and train friends and family members to help you quit.

• Develop your own unique quitting plan.

• Pick a dozen stop-smoking tools you will use to accomplish your plan.

• Consider using nicotine gum or patches as one of your tools.

• Focus on one tool at a time, until you feel you have mastered it.

• You may need to master most of your dozen self-selected tools or techniques before you will feel ready to quit.

• Form or join a stop-smoking support group, or read No-Nag, No Guilt, Do-It-Your-Own-Way Guide to Quitting Smoking, a support group in book form.

Quitting Smoking

LOCAL SMOKING CESSATION GROUPSCall the free Quitline: 1-877-YES-QUIT (1-877-937-7848) sponsored by the American Cancer Society. The service is 24 hours a day, every day of the year.

You can talk to a trained cessation counselor and find out which medication can help you quit. You can also enroll in a “quit smoking” program and find out about other programs in your community.

NICOTINE ANONYMOUSOffers group support and recovery using the 12 Steps as adapted from Alcoholics Anonymous to achieve abstinence from nicotine. Call 877-879-6422.

Page 16: Austin Heart's Congestive Heart Failure Brochure

14 AUSTIN HEART 512.206.3676 AFTER HOURS 512.206.3600 AUSTINHEART.COM

DO WHAT YOU CAN DOExercise can be a problem for patients with heart failure, causing them to feel tired and out of breath. However, some types of exercise will actually make you feel stronger and less tired if performed on a regular basis. Here are some exercise tips for people with heart failure:

• Low-impact exercise like walking, swimming, and biking are best.

• Avoid exercises where you find yourself holding your breath for a long period of time or bearing down. Also avoid any activity where you need sudden bursts of energy.

• No lifting, competitive, or contact sports. If any activity causes shortness of breath, rapid pulse, leg pain or cramping, palpitations, excessive sweating, loss of color, chest pain, or light-headedness, STOP immediately and avoid this exercise in the future.

• Do not exercise after eating, drinking alcohol, or when it is very hot and humid outside. Do not exercise if you do not feel good.

Exercise

RESTRest is a very important component of your health. You need to balance exercise and rest so that you have optimum health and energy. Some tips for patients with heart failure are:

• Rest 30-60 minutes after each meal before exercising.

• Give yourself extra time to rest if you are feeling extra stress or after an illness, especially if you had a fever.

• Many patients need extra pillows to rest well – go ahead and use as many as you need!

Page 17: Austin Heart's Congestive Heart Failure Brochure

15AUSTIN HEART 512.206.3676 AFTER HOURS 512.206.3600 AUSTINHEART.COM

OVERCOMING BARRIERS TO EXERCISE

Exercise

BARRIER SUGGESTED RESPONSE

EXERCISE IS HARD WORK Pick an activity that you enjoy and is easy for you.DO NOT HAVE THE TIME We are only talking about 3-4, 20-minute sessions per week. Could you do

without 3-4 TV shows each week, or exercise while you watch?I AM USUALLY TOO TIRED FOR EXERCISE Tell yourself “This activity will give me more energy.”I HATE TO FAIL, SO I WILL NOT START Physical activity is not a test. You will not fail if you choose an activity you

like, but start off slow.I DO NOT HAVE ANYONE TO WORK OUT WITH ME

Maybe you have not asked. A neighbor or a coworker may be a willing partner. Or you can choose an activity that you enjoy doing by yourself.

THERE IS NOT A CONVENIENT PLACE Pick an activity you can do at a convenient place. Walk around the neighborhood or exercise with a TV show or a videotape at home.

I AM AFRAID OF BEING INJURED Walking is very safe and is an excellent exercise. Choose a safe, well-lit area.THE WEATHER IS TOO BAD There are many activities that you can do in your home, in any weather.EXERCISE IS BORING Listening to music during your activity keeps your mind occupied.

Walking or biking can take you past lots of interesting things.I AM TOO OVERWEIGHT You can benefit regardless of your weight. Pick an activity that you

are comfortable with, like walking.I AM TOO OLD It is never too late to start. People of any age, including older people,

can benefit from physical exercise.

Page 18: Austin Heart's Congestive Heart Failure Brochure

16 AUSTIN HEART 512.206.3676 AFTER HOURS 512.206.3600 AUSTINHEART.COM

WHAT IS STRESS AND HOW DO I COPE?Stress is defined as feeling tense on the inside due to pressures from the outside. Most of us have many of these pressures, and some handle them better than others. Since stress makes the heart work harder, try to find ways to relieve the pressure you feel when stressed. Research findings have shown that people can actually control their physical and mental response to stress using stress management techniques. There are six basic strategies that you can use to beat stress:

RELAXATION TECHNIQUES• Imagery

• Biofeedback

• Meditation

• Muscle tension exercise/stretching

• Deep breathing

Why don’t you take 15-20 minutes a day to sit quietly, breathe deeply, and think of a peaceful place or situation?

Reducing Stress

HOLD A POSITIVE MENTAL OUTLOOK• Use positive self-talk, “zap” negative thoughts

• Rehearse what you are going to say before entering a stressful conversation

• Develop an action plan to accomplish a task

• Enlist support from your family, friends, or a local support group

• Rediscover your sense of humor– forgive yourself!

Why don’t you try to learn to accept things that you cannot change? Remember, you do not have to solve all of life’s problems. Talk about your problems and try to see the positive side of the situation.

Why don’t you try to anticipate things that may be upsetting? You may be able to avert some problematic situations. For example, plan ahead to avoid driving in horrible traffic or talking to people you do not like.

ACQUIRE POSITIVE HEALTH HABITS• Get healthy eating habits

• Exercise regularly

• Obtain adequate sleep

Why don’t you take a walk or ride a bicycle?

MAINTAIN SOME TYPE OF CONSISTENCY WHEN YOUR DAILY ROUTINE CHANGES ABRUPTLYWhen traveling, why don’t you still take your daily walks in a new environment?

AVOID CHEMICAL STRESSORS, SUCH AS ALCOHOL, SMOKING, AND CAFFEINEWhy don’t you try to limit your caffeine intake?

SEEK PROFESSIONAL HELP IF A SENSE OF HELPLESSNESS PERSISTSPlease let the CHF Center nurse know if you need assistance in learning or participating in any of these techniques.

One way of coping with stress is to DEAL WITH YOUR FEELINGS. You may feel depressed, angry or anxious because you have heart failure. These feelings are normal.

It may help to talk about how you feel with your family and friends. When you accept that you have heart failure, you can put your efforts into living a productive, good life with it.

Page 19: Austin Heart's Congestive Heart Failure Brochure

17AUSTIN HEART 512.206.3676 AFTER HOURS 512.206.3600 AUSTINHEART.COM

EAT BETTER TO REDUCE RISKReducing your chances of a cardiac event, like a heart attack, angioplasty, or open heart surgery means making lifestyle changes, which include what you eat. We cannot give you a “diet,” but we can give you dietary guidelines.

Basically, a low-fat, low-cholesterol healthy heart diet indicates you should:

• Eat fewer high-fat foods, such as fried foods, and fat from animal sources.

• Keep fat intake to less than 30% of your calories in a week (balance it out).

• Reduce your saturated fat intake to less than 7-8% of your daily caloric intake (>20-25 grams a day; careful with butter, bacon, cheese, and milk).

• Lower your cholesterol intake to less than 200mg/day (patients who have a history of heart failure) or to less than 300mg/day (everyone else).

• Read food labels! They educate you about amounts of fat, calories, cholesterol, and sodium.

• Lose excess weight. Slowly, about 2 pounds a week. This will help reduce triglycerides.

• Limit serving sizes. A serving of meat is about 3 ounces, and ½ cup for other foods.

• Slowly increase your intake of fiber (bulk) to 25-30g/day (reduces cholesterol level, blood pressure, chances of colon cancer and stabilizes diabetes). Great sources are beans and oats.

• Eat more beans. They are a great source of fiber and are low in fat. Try to eat one serving a day. Use Beano® or a similar product if you are worried about gas.

• Eat low-sugar, high-fiber cereals for breakfast and eat whole grain breads and pastas.

• Eat at least 5 servings of fresh or frozen fruits/vegetables a day. They are a good source of vitamins, minerals, and fiber.

• Reduce intake of sugar and sweets. Limit sodas to one per day.

Healthy Heart Nutrition Guidelines

• Choose canola or olive oil.

• Eat fish 2-3 times/week, especially “fatty” fish such as tuna (packed in water), salmon, sardines (packed in olive oil, fish oil, or water), herring, mackerel, anchovies, cod, and halibut. The Omega 3 fatty acids reduce triglycerides and may reduce cardiac events.

• You can take a multi-vitamin daily. Unless your doctor has indicated that you are anemic, try to avoid iron in the vitamin.

Page 20: Austin Heart's Congestive Heart Failure Brochure

WWW.AUSTINHEART.COM

HEART HOSPITAL OFFICE 3801 N. Lamar, Suite 300Austin, TX 78756 (512) 206-3600 fax (512) 206-3604

MEDICAL PARK TOWER 1301 W. 38th St., Suite 500Austin, TX 78705 (512) 458-1006 fax (512) 458-6492

SOUTH AUSTIN 2559 Western Trails Blvd. Suite 200Austin, TX 78745(512) 899-2028 fax (512) 899-0311

NORTHWEST AUSTIN 11149 Research Blvd, Suite 125Austin, TX 78759 (512) 338-0492 fax (512) 338-0265

CEDAR PARK 500 W. Whitestone Blvd. Suite 250Cedar Park, TX 78613 (512) 249-7190 fax (512) 249-0348

FREDERICKSBURG 205 W. Windcrest St. Suite 230Fredericksburg, TX 78624 (830) 990-9994 fax (830) 990-9763

GEORGETOWN 1900 Scenic Drive, Suite 3308Georgetown, TX 78626 (512) 869-2566 fax (512) 869-7434

1

2

3

4

5

6

7

HeartAustinSetting the Standard in Cardiac & Vascular Care

KILLEEN 2207 S. Clear Creek Rd. # 304Killeen, TX 76549 (254) 526-2085 fax (254) 526-9569

ROUND ROCK 2410 Round Rock Ave, Suite 110Round Rock, TX 78681 (512) 341-0889 fax (512) 341-7147

SAN MARCOS 1330 Wonder World Drive, Suite B108San Marcos, TX 78666 (512) 396-5603 fax (512) 396-5623

MARBLE FALLS 1800 Mormon Mill Rd, Bldg. BMarble Falls, TX 78654 (830) 798-2082 fax (830) 693-0040

LA GRANGE 2 St. Mark’s Place, Suite 160La Grange, TX 78945 (979) 242-5677 fax (979) 242-5680

OUTREACH LOCATIONSBlanco, Brady, Columbus, Giddings, Kyle, Lakeway, Lampasas, Llano, Lockhart, Mason, Taylor, Weimar, Wimberley

11

12

8

10

9

NN

4

3

8

7

10

9

12

11

2 16

5