The answer: Congestive Heart Failure (which simply means the heart isn’t pumping as it should).  

This is a permanent condition, but doesn’t have to be life threatening – it just means I need to do what is necessary to take care of me and my heart (and my weight needs to be third on the list).  I’m not worried, I know I’ll be fine and will do all I can to get healthier and improve my heart - as the results of Friday’s stress test showed there has already been some improvement over the past two years.  It’s a process not a race and will take time.

About two years ago I had been diagnosed with congestive heart failure, the only thing they told me then was lose weight and go on a very low salt diet, as well as perscribing a blood pressure medicine that included a diuretic.   Since that time I’ve lost over 90 lbs and changed my diet completely to simple low sodium foods.  My focus was getting the weight off but I didn’t really understand how to deal with the congestive heart failure. The past few weeks I saw big increases on the scale for no reason (for example 9 lbs overnight, 19 lbs the following week, for a total of 40 extra pounds since early Dec.) - turns out it is from fluid retention from increasing my water intake and increasing exercise way too much (doing the stairs at work 4 to 5 times a day) because I had hit a plateau and hadn’t lost anything for a long time I was focusing too much on trying to lose weight which ends up I was doing things that were bad for my heart. 

However, what I had been doing right all this time was keeping my food intake very low with veggies, fruit and whole grains (and very little salt, very little processed foods) and adding some herbal supplements : with omega 3 an d 6s, a natural diuretic (that is helping get the water retention down), some very good sources of nutrients, and one to help my arthritis (it turns out regular medicine for arthritis would be bad for my heart so herbal supplements are good option). 

I had put the CHF in the back of mind and hadn’t really thought about it much most of the time. I felt fine and focused on losing weight and improving my health overall. What I didn’t really understand before was that congestive heart failure isn’t something that is curable, it isn’t like having a cold that you can get over. The fact is, I still have it and will have it for the rest of my life, and that losing weight is important but I have to mainly focus on taking care of my heart (unfortunately what I need to do for my heart makes it very difficult to lose weight).

And the added bonus I have rhumatoid arthritis (since age 2), and almost all medication to help with the pain for arthritis causes water retention and should be avoided by someone with congestive heart failure.

Also if I had continued to listen to my primary physican last month and taken her advice to push myself to workout an hour a day to the point of exhaustion I would probably have killed myself (obviously she hadn’t gone through my medical records when I went to her for a flu shot and asked her about how to get over my plateau and start losing weight again). I was no where near doing an hour a day, but I was pushing myself to do more and more, and gaining lots and lots of fluid as a result.

In a nutshell – lesson learned, you really do have to be your own health advocate, do your own research, ask lots of questions, and know your own body and respect it and always check out the advice others and even your doctor gives you against other experts and doctors until you find what is right for you.

And to those who accused me of being anorexic and needing mental health care intervention, and that I was seeing a shaman or herbalist instead of a real doctor, once again let me just say that I appreciate your good intentions and concern – but my REAL cardologisit and her medical staff have confirmed that I am NOT anoerxic, and they all have real medical degrees, and they have approved my food plan and the herbal supplements, and for me diuretics are life saving and for my heart (I am not taking them as a diet aide).

This past Friday I went in for a stress test (in two weeks I have an echo cardigram scheduled, and two weeks after that I meet with the cardioologist).  Last year’s stress test lasted about 3 minutes and the staff was scrambling to get me off as fast as possilbe.  I felt ok, but the monitor was showing my heart was not doing well.  This time I was able to stay on the treadmill for 7 1/2 minutes before reaching target heart rate.  The staff told me I was doing great and had improved a lot.  Plus my blood pressure is going great also (2 years ago it was averaging 190ish/90ish, and now it is 116/68 which is awesome!)

I also spoke with the medical staff while preparing for my stress test about my recent weight gain, especially the 9 lbs over night and then then the 19 lbs gained over the week after that, and in a nutshell what I was doing to lose weight (lots of water and hard exercise) was actually not good my heart.  Once all the tests are done, I’ll be having a sit down with my cardiologist and getting a detail plan for exactly what exercise plan I can follow and will go over my food plan and supplements again (as I always do when ever I see any doctor and cardiologist).

This was the general advice from the medical staff and pamphlets they gave me:

  • Monitor blood pressure and keep taking medication as prescribed.
  • Exercise – Small amount of gentle exercise, avoid excertion – walking, bike (start 15 minutes 3 times a day, very gradually work up to 30 minutes 3 times a week, and maybe eventually after a long time of conditioning work up to every day if possible). No heavy lifting, no pushing, no pulling. Don’t do isometric exercises that require holding your breath, bearing down or sudden bursts of energy. Avoid lifting weights and competitive or contact sports, such as football.
  • Avoid fatigue, get plenty of rest.
  • Diet – Eat foods high in fiber, like fruits and veggies, and whole grain, keep meats lean and small amounts – avoid everything else, especially foods high in fat, cholesterol and sugar. No alcohol or very limited (no more then 1 a day).
  • Limit your consumption of sodium (salt) to less than 2,000 milligrams (2 grams) each day, 1500 would be a good goal, and even less if possible.  Very little or eliminate prepackaged foods, fast foods, canned foods, etc. (they contain way too much sodium).
  • Limit fluid intake to less than 2 liters a day, because the more fluid you carry in your blood vessels, the harder your heart must work to pump excess fluid through your body and strains the heart.
  • Reduce total daily intake of calories to lose weight, since exercise is limited, reducing calories is necessary to get the weight off.  Take vitamins and natural supplements to help get needed nutrients.

Some of this advice is the complete opposite of what is required for losing weight – no heavy exercise, lots of rest, and not a lot of fluids.  This all adds up to making things harder to losing weight and focusing mostly on eating healthy foods and lowering calories, and slowly building up to doing some form of light exercise.

It is probably going to be a long time or perhaps impossible to know what my “dry” weight is (“dry” weight without extra water\fluid). In general the goal is to keep your weight within four pounds of the dry weight.  Best way to weighin to get as “dry” a reading as possible is to step on the scale at the same time each day, preferably in the morning, in similar clothing or nude, after urinating but before eating, and on the same scale (which is what I’ve been doing).

The staff also recommended keeping a record my weight daily, and any rapid increases (i.e. 3 to 5 pounds in one day or 8 to 10 pounds in one week), call the doctor.  A couple weeks after the echocardigram in two weeks, I’ll have my sit with my cardiologist and be sure to go over all the details with her a set out health plan with her based on the all test results.

I’m feeling very positive because a lot of what I have been doing (food plan and supplements) is what I need to keep doing.   And the exercise and too much drinking water that I was doing wrong is very easy to change.  I am feeling really confident that I can keep improving my health and my heart.    

Related Posts:
2/4/08 Some Improvement.
2/2/08 Weighin Week 92.
1/29/08 Preview for Weighin (includes list of herbal supplements).
1/26/08 Weighin Week 91
1/2/08 Medical and Diet History (an overview)
11/6/08 Weighin Week 80 and 81 – info. from appointment with primary physician
Weighin Summary – week 1 to present.

Related Articles:

Currently Diet Pulpit is rarely updated. Lady Rose is now blogging at Blissful Moon, where she is staying healthy and continuing to have adventures, please stop by and visit.

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