Work with the health professionals who are treating your heart failure
Because heart failure is a lifelong condition, you will have dozens—or even hundreds—of appointments with various health professionals during your experience with the disease.
Creating ongoing and lasting relationships with these professionals can have two benefits:
- Better control of your heart failure symptoms and disease process
- Treatment tailored to your own needs
Your health care team
Rest assured that you will not be left alone with the task of managing your disease. You will see several doctors, specialists, and nurses who each will offer you specific suggestions and guidance that are needed to control your heart failure. The number of health professionals you see will probably continue to grow over time. Your health care team can include doctors, nurses, cardiac surgeons, physical and occupational therapists, dietitians, social workers, and pharmacists.
Because of this growing number of health professionals, it may be easy to forget that you must also play an active role in the management of heart failure. In fact, you are the most important member of your treatment team. Without your active participation and cooperation in managing your condition, no amount of effort by your doctors and nurses will successfully improve your health.
Although each member of your medical team plays an important role in heart failure treatment, doctors and nurses help guide you in making the best treatment decisions for you.
Your primary care doctor will act as the coach of your health care team. Your coach may be a family doctor or a cardiologist. Your doctor will be responsible for creating and correcting your drug treatment plan, regularly checking in on signs and symptoms of your disease, and coordinating your care with other health professionals. Your doctor will also help you to understand your overall prognosis and the specifics of how your drugs should be taken.
How often you see your doctor will usually depend on how far your heart failure has progressed. If you have class I or II heart failure, you may see your doctor 2 or 3 times a year to assess your overall health and ask you important questions about your lifestyle. If you have more advanced (class III or IV) heart failure, you will probably see your doctor more often, usually every month or two.
The nurses involved in your care have four main roles, which are to:
- Help assess your symptoms and how they affect your lifestyle. They may also be able to give you suggestions to help you control your disease and make your treatment plan easier.
- Respond quickly to any changes in your health or concerns you may have about your heart failure.
- Help educate you about your heart failure. Much of the continual education that you receive over the months and years of your heart failure will come from your nurses. Nurses also will work hard to encourage your active participation in treatment. They will almost always be available to answer any of your questions about heart failure.
- Act as a link between you and your doctor. When you are having a problem that requires your doctor's attention, your nurse will be able to decide which information is important to tell your doctor.
Communicating with your health professionals
You cannot effectively follow any of your health care team's orders unless you take the time to understand them fully. Open, two-way communication between you and the members of your health care team is the key to a successful relationship. It is important to listen to everything they have to say. However, they will also be listening to you about how you have been feeling between visits and about any concerns you have about your health.
Remember that you should feel comfortable discussing any aspect of your health or life with your health professionals. No question is inappropriate, especially if it is something that concerns you. Do not be intimidated by their level of education or by how busy they are. Focus on taking an active role in your visits with the health care team members.
It may be difficult to remember exactly who does what. To help you understand the roles of each health professional, the following table outlines the responsibilities of some of the people you may encounter during your experience with heart failure.
Role in your care
|Primary care physician (PCP)||Coordinates the care of your heart failure with other illnesses or conditions that you may also have|
|Cardiologist||A doctor specialized in caring for your heart who is responsible for your heart failure care|
|Heart failure specialist||A cardiologist specialized in caring for heart failure who is responsible for your heart failure care if you have severe or very complicated heart failure or are seeking an experimental treatment|
|Cardiac surgeon||A doctor trained to operate on the heart who performs surgeries, such as coronary artery bypass graft (CABG) surgeries and heart transplants|
|Nurse||Educates and cares for you during your illness and answers many of your questions|
|Nurse practitioner||Educates and cares for you during your illness and answers many of your questions|
|Physical therapist||A health professional specially trained in recovery who helps you improve your strength and endurance after surgery or a heart attack|
|Registered dietitian||Teaches you about nutrition and develops diets to promote your health|
|Occupational therapist||A health professional specially trained in helping in your physical recovery so you can return to your previous job or train for a new type of job|
|Social worker||Offers advice about the financial, legal, and emotional aspects of your treatment|
|Pharmacist||Answers questions about how often to take your drugs and the side effects they might cause|
Making the most of appointments
- Keep a notebook about any changes you have experienced. The more precise your observations are, the more helpful they'll be.
- Prepare a list of questions in advance.
- Take notes of key information during your visits so that you can review it later, or ask if you can tape-record your discussions.
- If needed, slow down the pace to help you understand or when you're feeling overwhelmed.
- Never withhold information about whether you are following the recommendations of your health professional.
- Share information about all of your current drugs, including nonprescription drugs, dietary supplements, and alternative medicines.
- Don't leave the office until you understand all your instructions, have them written down, and have asked questions about anything you did not understand.
- Bring along a family member or friend to help with note-taking, listen to instructions, and offer moral support during your appointments.
- Don't hesitate to call the office if you still have questions after your visit.
A note on drug treatment
Sometimes finding an appropriate drug regimen takes a long time and requires significant trade-offs. For example, if you are particularly sensitive to the side effects of angiotensin-converting enzyme (ACE) inhibitors, your doctor may not be able to prescribe this type of medicine in as high a dose as usual, which means that you may not be able to benefit as much from the medicine. Your health may not improve with the drugs as much as you or your doctor had hoped.
It is important to remember that even the most experienced heart failure doctors cannot always find an ideal regimen for every person. If your doctor continues to adjust your drugs several months or even years into your treatment, it suggests that your particular case of heart failure is difficult to treat with the usual drug treatments. In general, treatment for heart failure can be frustrating. Although you should expect to feel better on your drugs than you did before you started taking them, it is not always possible to make you feel great or to enable you to return to your former active lifestyle.
Proper management of heart failure requires you to keep in constant contact with your health care team. Small adjustments to your drug regimen that may be needed over the course of your disease are possible only if your health professionals have a working knowledge of how you are feeling from day to day. In fact, simple signs such as weight gain or ankle swelling may be indicators that you should be put on different dosages of certain drugs.