DEAR DOCTOR: My 80-year-old mother has been diagnosed with congestive heart failure. Is there anything she can do to keep it from getting worse?
DEAR READER: In congestive heart failure, the heart is no longer able to pump blood efficiently. Although heart failure can't be cured, it can be managed with medication and lifestyle changes. Maintain a healthy weight, get daily exercise and keep blood pressure under control.
In addition:
- Be vigilant about medication. Your mother's cardiologist will have prescribed one or more drugs to manage the effects of her declining heart function. These may include a diuretic to deal with excess fluid, a beta-blocker to manage arrhythmias, an anticoagulant, statins to control cholesterol and medication to control heart rate. Learn the purpose of each drug that she takes. Post a detailed list of her daily drug regimen in a visible spot.
- Eat a heart-friendly diet. Go for fresh fruit and vegetables, whole grains, beans and legumes. Protein should come from lean meats and fatty fish like salmon. Stick to healthy fats like olive oil. Limit or quit caffeine, and steer clear of sugar and sugary drinks.
- Be aware of salt. Sodium makes you retain fluid, so limit intake to 2,000 milligrams per day.
- Watch the fluids. We need to take in enough fluids to stay hydrated, but for people with heart failure, too much can make it harder for the heart to pump. Your mother's cardiologist will have given her a target amount. It's important that she stick to it. And don't forget that juice and soup count as liquids.
- Get on the scale every day. A sudden weight gain of 2 pounds or more can indicate a serious problem. If that should happen, your mother should call her doctor immediately.
- Look for other warning signs. Dizziness, fainting, sudden shortness of breath, heart palpitations, increasing exhaustion and abrupt swelling in the feet, legs or ankles should be reported to her doctor right away. Even a change in her physical abilities - a walk that had been easy and has now become laborious - can indicate problems.
Elizabeth Ko, M.D., is an internist and primary care physician at UCLA Health.
Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o Media Relations, UCLA Health, 924 Westwood Blvd., Suite 350, Los Angeles, CA 90095.