Heart-to-heart talks help heart failure
Poor communication between people with failing hearts and their doctors
and nurses complicates -- sometimes even counteracts -- heart failure
Advances in our understanding of heart failure and the development of
new drugs and treatments are helping people with this condition live
longer and better than they did 20 years ago. That said, heart failure
kills a quarter of a million Americans a year. It's also the No. 1 reason
why older people end up in the hospital.
Despite its ominous name, heart failure doesn't mean a heart teetering
on the brink of stopping forever. Instead, it describes a heart that's
failing to pump enough blood to meet the body's needs. In spite of this,
many people continue to function somewhat normally. But there are people
who wait too long to get advice or treatment for escalating symptoms.
In fact, this is one of the top reasons people with heart failure end
up in the hospital.
The more serious your heart failure, the more important it is to take
stock of what you want for your immediate situation and your future.
Clarifying these preferences can help you and your doctors map a strategy
that will give you what you need and what you want.
"Some people will do everything in their power to hang on another six
months to see a grandchild born or finish an important project," says
cardiologist Lynne Warner Stevenson, director of the heart failure program
at Harvard-affiliated Brigham and Women's Hospital. "Others want to focus
on feeling better today." Thinking through questions like these can help
you talk with your doctor or nurse about the direction of your treatment:
- How do I feel?
- What bothers me most? (This may not be heart failure but some other
- How do I want to feel?
- If I could fix just one thing right now, what would it be?
- What is the one thing I would like to do or achieve but feel I can't?
- Am I having trouble with my medications?
Open communication that includes hopes, fears, and needs isn't easy.
Doctors and nurses don't always have the time, or take the time, to pursue
or continue such conversations. And many people don't want to "bother" their
care providers with personal issues, or feel that discussions like this
aren't appropriate. Quite the contrary -- they're not only appropriate,
The more you and your doctor personalize the way you manage your heart
failure, the better the chances that you'll control it rather than the
other way around.
January 2004 Update
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