Exercise and heart failure Heart failure not only affects your heart, it also affects your muscles and how the blood is pumped around your body. You may be getting cramp or feeling tired. Exercise will reduce these feelings and help your body work more efficiently. If you are exercising, you need to take it slowly at the beginning and then work up your time and speed as you feel better. These are some guidelines for you to follow.

Frequency

You should aim to exercise five days of the week. Try not to take your two days off together, as it will be harder to return to exercise on day 3.

Intensity

It is important that you are able to talk at the same time as you are exercising or doing any activity. This means your body is able to cope with the activity.  The need for an operation are not able to talk it means your body is not working efficiently and your heart has to work a lot harder. Of course if you are out for a stroll you will be able to talk at the same time but you won’t get all of the benefits. The correct level is that you are able to talk but not able to sing. Remember that the exercise will be harder if it is hot, cold or windy. You will need to slow down your activity to cope with this.

Type

A combination of aerobic exercise and gentle weight training is best. This includes walking, swimming and cycling. It is important that you speak to you doctor about weight training, he or she will tell you what is best for you.

Time

Ideally you should exercise for 30 minutes continuously. Start with just 5 or 10 minutes and gradually increase up to 30 minutes in about six to eight weeks. Start off slowly to allow your body to adapt to the new activity and gradually increase the pace. You should start to slow down gradually for the last 10 minutes. Avoid exercising after heavy meals when your heart has to use energy to help your body digest food.

Points to remember

People with heart failure will benefit from regular physical activity and regular rest.

You should remember the following.

• You should avoid sudden bursts of activity.

• Try to find something physical activity you enjoy, as it will be much easier for you to do regularly. If you are not sure about exercise, you should talk to your doctor or nurse who will advise you what level is good for you.

• Do not feel that you have to exercise when you are tired.

• Avoid exercise for 11/2 hours after a meal. This allows your body time to digest your food and you will gain more benefit from the exercise.

• Combine rest periods during the day with periods of activity. To make sure you get a good night’s rest, do not take diuretics (water tablets) at night, do not use pillows to prop yourself up if you tend to have breathing difficulties at night and do not eat a heavy meal just before bedtime.

• Your doctor and nurse specialist will give you advice about the activities that are suitable for you to do.

Sexual activity

Heart failure may alter some aspects of your sex life. Your desire for sexual activity may be reduced, especially during periods when you are not feeling well. Also, some of the medication prescribed for people with heart failure may reduce sexual drive and cause impotence. If you experience any of these symptoms, you should discuss them with your doctor or nurse specialist.

Healthy eating

A balanced healthy eating plan is one of the important lifestyle factors for people with heart failure.

It is important to eat a wide variety of foods and to reduce the salt in your diet. You need to follow a low-salt eating plan because the more salt you eat, the more likely it is that fluid will build up in your body. Any build-up of fluid in your body will make your condition worse and make you feel unwell.

You should get dietary advice specific to your needs from a dietitian or a nurse specialist.

Helpful tips for a healthy low-salt eating plan

• Choose a wide variety of foods.

• Try to follow any specific advice that you have been given.

• Reduce the amount of salt you use in cooking and at the table.

• Flavour your food with pepper, herbs, spices, garlic or lemon juice instead of adding salt.

• Include plenty of fruit and vegetables – aim for five or more servings everyday.

• find that you have to stop because you are ‘gasping’ this may mean that there is some congestion. Remember, treating early congestion is usually quick and easy and prevents more serious symptoms developing.

Alternatively, if you are not able to climb the stairs, you can measure your breathing while you are dressing. If you notice you have to stop and rest while you are getting dressed in the morning, this may mean that fluid is building up.

Try not to eat too many ready-meals, canned, tinned and processed foods.

• Eat oily fish (such as salmon, mackerel, trout or herrings) once or twice a week.

• Avoid foods that are high in salt – salty meats, tinned or packet soups, salted snacks such as crisps, ketchups and processed sauces.

• Use low-fat foods as much as possible.

• Always check before using ‘salt substitutes’ as they can have side effects. Try to use other flavourings instead.

• Check labels on foods to see how much salt or sodium they contain and choose food that has less salt in it.

• Try to eat as much fresh food as possible.

Heart failure can sometimes cause a reduction in appetite. If you lose weight without meaning to, or if you notice that your appetite is not as good as usual, it is important that you ask the nurse specialist at the clinic to arrange an appointment with the dietitian for you. You will then get specific dietary advice.

Monitoring your symptoms It is important that you monitor your heart failure symptoms every day and take action when you notice any deterioration. Your nurse will teach you the important symptoms to look out for and they are described in this book to help remind you. You can monitor your condition easily by taking note of everyday activities. Here are some helpful tips to do this.

Recording your weight

Keep your weight book next to the weighing scales in the bathroom. When you wake up each morning, after going to the toilet stand on your scales and write your weight in your booklet. You should weigh yourself at the same time of day with the same amount of clothing. Take a look back at the previous recordings to check if you have put on weight. Sudden weight gain (two kilograms or four pounds over two days) are an early sign of congestion and should be reported to your nurse or doctor. Treating early congestion is usually quick and easy and prevents more serious symptoms developing.

Checking for Swollen Ankles

As you are putting on your socks or tights in the morning, check your ankles as your nurse has shown you (press your legs with your thumb – if it leaves an imprint or a hole there may be fluid). Swollen ankles may mean that fluid has built up.

Measuring your breathing

An easy way to measure your breathing is taking note while climbing the stairs. If you can normally get to the top of the stairs without having to stop to catch your breath, use this as your measurement. If you

You can also measure your breathing in bed. If you find that you have to place an extra pillow behind you at night to make your breathing easier it may be a sign that fluid is building up in your lungs.

It is more serious if your breathing causes you to wake during the night ‘gasping’. You should always contact your nurse or doctor the next morning if this happens.