[00:00:00] Speaker A: From Riverside health system. This is the Healthy you podcast, where we talk about a range of health related topics focused on improving your physical and mental health. We chat with our providers, team members, patients, and caregivers to learn more about how to maintain a healthy lifestyle and improve overall physical and mental health. So let's dive in to learn more about becoming a healthier you.
[00:00:26] Speaker B: All right? I am really excited to have Kim Slayden in the healthy you studio with me.
Kim is a registered nurse and a congestive heart failure navigator at Riverside. Hi, Kim.
[00:00:42] Speaker C: Hello. Thanks for having me today.
[00:00:44] Speaker B: It's awesome to have you as well. So this episode, we're going to be talking about heart matters and understanding congestive heart failure, which is a topic very near and dear to my heart.
According to the Centers for Disease Control, more than 6 million adults in the United States have heart failure. We are joined today by Kim, and we're going to delve into that a little bit more to learn about congestive heart failure and what oftentimes is referred to as CHF.
So, Kim, tell me a little bit about how and why you decided to go into this particular field.
[00:01:20] Speaker C: Yeah. So I graduated from Radford University with my BSN. I started my career in transplant in Boston, Massachusetts, moved to Virginia, and joined the Riverside family.
I started in the ICU, worked there for about five years, transitioned to the cath lab, which I loved, and then became the heart failure navigator. And it's a lot of patient education, which is just something I love doing.
[00:01:49] Speaker D: Okay.
[00:01:50] Speaker B: So when you think about a navigator, we think about, like, a car. Like, you use your navigator to get from one location to another. So for our viewers who may not have that medical background, talk to them a little bit more about how you specifically support, educate in that navigator role, specifically around CHF and what that looks like.
[00:02:12] Speaker C: Yeah. So when patients come into the hospital with a new diagnosis of heart failure or an existing diagnosis, I'll see them at the bedside and review symptoms when they should call their doctor, when they should call 911, help them make follow up appointments with their primary care doctor. And in our heart failure clinic, that's at regional.
[00:02:35] Speaker D: Okay. Very good.
[00:02:37] Speaker B: So you keep a long standing relationship, because while you can treat symptoms, congestive heart failure, or CHF, is a chronic condition. Would I be correct in saying that? Yes, it is. And so it's something that doesn't go away, but you're able to manage. Right. And have good quality of life. I hope I'm saying that.
[00:03:00] Speaker C: Right. Yeah. So it's a progressive disease that can't be cured, but it can be managed. And so we go over all the things that you can do to manage your heart failure, to live a pretty healthy life with heart failure.
[00:03:14] Speaker D: Okay.
[00:03:15] Speaker B: Is there an association with past family history?
Are there certain things that make individuals more prone to heart failure? Is it more predominantly in women or men? So talk to me a little bit about that from a presentation perspective.
[00:03:34] Speaker C: Yeah. So your family history and genetics are the one thing that you can't change. So if you do have a family history, you're more at risk to have heart failure. People who have had a heart attack or coronary artery disease, high blood pressure, hypertension, are more at risk.
Any valve issues.
[00:03:55] Speaker D: Okay.
[00:03:57] Speaker C: Also, inflammation of your heart, myocarditis, irregular heart rhythms, which we call arrhythmias. So those are some of the people that are more at risk for heart failure risk.
[00:04:11] Speaker D: Okay.
[00:04:12] Speaker B: So what are some of the symptoms that you would look for that should really cue you in to maybe dig a little deeper or connect with your physician and seek medical evaluation?
[00:04:28] Speaker C: Yeah, that's a great question. So, some symptoms that patients experience, a shortness of breath, a cough that won't go away, swelling in your feet, ankles, legs, or belly. Any weight gain that can't be explained. Hard to breathe when laying flat. If you wake up in the night because you feel like you can't breathe, feeling tired or like you have no energy, and increased urination at night are things that patients with congestive heart failure really notice.
[00:05:01] Speaker D: Okay, that's great information.
[00:05:04] Speaker B: Is there association with diet? So, when I think about foods, processed foods, foods high in sodium, and how sometimes we're moving at fast pace and we get the most convenient meals sometimes, and they really have a lot of sodium intake. Is there an association with that and the stress on your heart that leads to heart failure?
[00:05:28] Speaker C: Yeah. So increased sodium intake makes you hold on to fluid. So being cautious about how much sodium you're intaking is really important. So some heart healthy eating, you want to avoid those processed and convenience foods. Some things that are high in sodium we really don't think about are salad dressings, canned vegetables and meats. You want to try to stay away from those.
And, of course, chips and snacking foods.
[00:06:01] Speaker B: That's my weakness.
[00:06:02] Speaker C: I know.
[00:06:04] Speaker B: Okay.
[00:06:04] Speaker C: It's hard to do. So when I meet with patients, we go over a lot of diet education and things that can be done, and that's the biggest thing now you have to make a lifestyle change.
But we say we still like you to be able to eat the things you enjoy. It's just a moderation.
[00:06:26] Speaker B: Right. So our role is to seek to educate. So what is the daily level of sodium intake that would be appropriate, especially for our viewers if they want to begin to look at labels and understand serving size and portion size to start making those changes.
[00:06:49] Speaker C: Yeah. So with heart failure, we recommend about 1500 milligrams of sodium in a day. And you think, okay, that's a lot. Right? While one teaspoon of table salt has 2300 milligrams of sodium in it. And everyone is shocked when I tell them that, oh, my goodness. Because you think just a dash of salt, but it can make a difference. So looking at those nutrition labels and looking at how many servings are in that package that you're eating, is there.
[00:07:21] Speaker B: A salt that's better, like pink salt, blue salt, sea salt? I do add.
When you think about wanting to taste your food, we also could talk about what are other ways to add that that probably have less sodium. But I know that people who are real foodies really get into making the food taste really good, which means adding a lot of seasonings.
[00:07:47] Speaker C: Right.
So that pink himalayan sea salt has the same amount of sodium in it.
[00:07:54] Speaker B: Okay.
[00:07:58] Speaker C: But I know it's sad, isn't it?
On paper that I give out to patients when I see them is herbs and spices to use instead of salt. And it goes through what meats and things they pair with. Okay, so everyday seasonings that you have at your house, most people have. And it'll tell you what foods they're going to go to because you still want your food to taste good.
[00:08:19] Speaker B: Right.
[00:08:20] Speaker C: That's important.
[00:08:21] Speaker B: Yeah, I know. For me, we've had a lot of conversation about MSG, but I like accent, and I realized that that is also high in sodium. So you do have to be cognizant of that.
[00:08:33] Speaker C: Yeah. Your mixtures of spices, the McCormicks things that are premixed together, usually have salt in them.
[00:08:42] Speaker D: Wow.
[00:08:42] Speaker B: So heart failure can be life threatening, and people may experience severe symptoms. And we've talked a little bit about that. When we think about it getting to that end stage, what are things that precipitate that? Is it due to mismanagement?
I'm sure everybody's different, but what determines that outcome? What are some of the things that lead to that?
[00:09:14] Speaker C: Yeah.
So your symptom management is very important. Taking all your medications as prescribed by your doctor.
Very important thing to do. And then I would say early intervention with palliative care to come up with a plan on the things that you want done. How to live your life is important and people find very helpful.
[00:09:41] Speaker D: Okay.
[00:09:41] Speaker B: And early identification, because I would think that the more damage over time. Right. And I know there's tests that can be done. Talk a little bit about that to determine what your degree or severity is. Is that correct?
[00:09:59] Speaker C: Yeah. So echocardiogram.
[00:10:02] Speaker D: Okay.
[00:10:02] Speaker C: And that's going to give you the ratio of the amount of blood pumped out and what's left in the heart with each beat. And that's your ejection fraction.
[00:10:12] Speaker D: Okay.
[00:10:13] Speaker C: So in the start of heart failure, we see an ejection fraction, 40% to 50%.
It can go as low as 10%. And that's going to be your severe heart failure.
[00:10:26] Speaker B: Severe heart failure. Wow, that's great information.
Now that we have talked about all of those things, what symptoms? And you talked a little bit about that in the previous question I just asked would necessitate, like, a 911 or an emergency response for someone experiencing congestive heart failure.
[00:10:50] Speaker C: Yeah. So if you have shortness of breath to the point where you're unable to talk, that's flash pulmonary edema and your lungs fill up with fluid that warrants a 911 call. Any chest pain that's not relieved, you want to call 911, call in your PCP with any of the symptoms. Getting worse is also important. You want to be proactive, not reactive. So catching things early.
[00:11:16] Speaker D: Okay.
[00:11:17] Speaker B: Very good, Kim. So when we talk about lifestyle changes, it is a chronic disease, unfortunately, and how you manage it is so important and really impacts your quality of life.
What are some lifestyle changes that can help with that or would compound and make the disease process worse?
[00:11:41] Speaker C: Yes. So reducing your stress is important.
Taking all your medications as prescribed. Some people will skip medications because they make them have to go to the bathroom frequently. With heart failure, you see that those dietary modifications, those are some of the lifestyle changes you want to have. Quitting smoking, if you smoke, that's very important. Eliminating alcohol intake.
[00:12:12] Speaker B: Red wine. You hear sometimes that if you're going to do things, red wine is better for the heart. Is that a misconception?
[00:12:20] Speaker C: Depends on who you ask.
[00:12:21] Speaker B: Okay.
[00:12:22] Speaker C: But limiting in moderation. That's what we like to say.
[00:12:27] Speaker B: Okay, got you.
And then obviously, weight loss, is there a certain bmI, is there a target as it relates to that?
[00:12:40] Speaker C: So you want to be your healthiest weight.
[00:12:42] Speaker D: Okay.
[00:12:43] Speaker C: That's something.
It's individualized per patient. So exercise, we say about 30 minutes a day most days of the week.
[00:12:51] Speaker D: Okay.
[00:12:51] Speaker C: Just to be active. Weight loss, changing your diet and that sort of thing.
[00:12:57] Speaker B: And it's mostly brisk walking. I know, like getting your heart rate. I see people leisurely walking. So if you're going to do it, it has to be impactful. So you want to get the heart rate up? You want to be winded?
[00:13:08] Speaker C: Yes.
Getting that heart rate up is important, but you don't want to exercise to the point where you can't breathe.
[00:13:15] Speaker D: Okay.
[00:13:16] Speaker C: So doing as much as you can.
[00:13:18] Speaker D: Okay.
[00:13:19] Speaker B: Really good.
So are there support groups embedded within riverside for individuals experiencing congestive heart failure? So we have the navigation piece or the navigator, which is that support to walk you through the disease process and be there. What a great resource. But are there other things embedded within our system to support individuals experiencing this disease?
[00:13:48] Speaker C: Yes. So we do offer a support group.
We meet the fourth Thursday of every month from three to four in the annex building. And we have a dietitian that can come. We've done cooking demonstrations where we've made heart healthy food. And people have tried things they didn't know they liked and they tasted good.
[00:14:07] Speaker B: Right.
[00:14:08] Speaker C: We also have pharmacy that can come, go over medications, answer any questions patients have about their medicines. And we offer this to patients and their families so the family can come to know how to support their loved one.
[00:14:24] Speaker D: Okay, very good.
[00:14:27] Speaker B: Is there anything else you would like to share with our viewers? It's just been just a wealth of knowledge. Anything that you feel like would be beneficial or instrumental for our viewers to understand as it relates to this disease.
[00:14:40] Speaker C: Just know that there's other patients out there that are experiencing the same thing. And connecting with them and sharing ideas in ways that you manage your heart failure is really helpful. To know that you're not alone. You're not the only person experiencing this. And that's one of the great things about our support group.
[00:14:59] Speaker B: Very good. You also hear about cardiac rehab.
Is that something that can be utilized to help manage symptoms or support.
[00:15:12] Speaker C: So the cardiac rehab is going to be ordered by your physician.
And we do see heart failure patients that come from cardiac rehab. Okay, so Riverside does offer cardiac rehab, and that's going to be prescribed by your doctor?
[00:15:26] Speaker B: By your doctor. But there are other ways to support them. Depending on where they are in the level of disease, to get their activity level up and help them build their strength would be within that program. So that's really great to have. And that just speaks to us, having all of those all encompassing services to support patients experiencing this. So if somebody wants to reach out and they want more information or want to talk directly with you, can you.
[00:15:57] Speaker D: Tell them how they can reach you?
[00:15:58] Speaker C: Yeah. So we have a flyer that's on our website, and it's the heart failure support group flyer, and it has my contact information. But if you would like to, it's Kimberly
[email protected]. And you can just email me for the information. And we also do a Zoom link for patients who are unable to come for the support group.
[00:16:26] Speaker D: Okay.
[00:16:27] Speaker B: All right. Well, Kim, thank you so much for joining us. You can always come back at any time. Thank you for sharing your expertise.
And thank you to our listeners for joining in.
[00:16:39] Speaker C: Yeah, it was so great to be here. Yes.
[00:16:42] Speaker B: Great to have you. Thank you.
[00:16:43] Speaker C: Thank you.
[00:16:46] Speaker A: Thank you for listening to this episode of Healthy Youth. We're so glad you were able to join us today and learn more about this topic. If you would like to explore more, go to riversideonline.com.
