a self-help guide for patients with heart failure
TRANSCRIPT
A Self-help Guide for Patients with Heart Failure
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.ardiomyopathy
.ptimization
.ehabilitation
.ducation
CORECL IN IC
When should I call my health care provider?
Call your health care provider if:
• Yougainmorethan2poundsinonedayor5poundsinoneweek.
• Youhaveincreasedswellinginyourlegs,anklesorabdomen(belly).
• Youhavetroublebreathing,whetheryouareactiveorresting.
• Youhavetroublesleeping,wakeupshortofbreath orcan’tsleeplyingdown.
• Youfeelpaininyourchest.
• Youloseyourappetite(havenodesiretoeat).
• Youfeeltired,weakorconfused.
• Youfeeldizzy.
• Youhavebadlegcramps.
How do I call my health care provider’s office?
Contact:________________________________
Phonenumber:___________________________
What if I need to call when the office is not open?
Contact:________________________________
Phonenumber:___________________________
Emergency room visits
Ourgoalistoimproveyourqualityoflifeandhelpyouavoid avisittotheemergencyroomorhospital.Ifweworktogether, wecanachievethisgoal.
But,ifyoufeelyouneedtocall911orgototheemergency room,pleasedoso.Ifyougototheemergencyroom,pleasebring yourlistofmedicinesandyourdailyweightchartwithyou.
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CONTENTS
Section 1: the heart
Introduction............................................................................ 5 Normalheartfunction............................................................ 5 Heart failure............................................................................ 6
Section 2: MedicineS
Medicinesandwhattheydo.................................................... 8 Tipsontakingyourmedicines................................................. 9
Section 3: Low-SodiuM diet
Whyfollowalow-sodiumdiet?............................................. 10 Tipstohelplowerthesodiuminyourdiet............................ 12 Guidetosodiuminfood....................................................... 13
Section 4: LifeStyLe changeS CanIexercise?....................................................................... 15 Whataboutsex?..................................................................... 15 WhatelseshouldIdo?........................................................... 15 CanIdrinkalcohol?............................................................... 15 Isitnormaltofeelsadordepressed?....................................... 15
Section 5: reSourceS CommunityReferral.............................................................. 16 CardiacRehabilitation............................................................ 16 CardiacHomeCare............................................................... 16 DiabetesEducation................................................................ 17 Nutritional Support............................................................... 17 FinancialAssistance................................................................ 18 Transportation........................................................................ 19 HandicapParkingCertificatesandPlates............................... 19 FairviewLifeline..................................................................... 19 HealthCareDirectives........................................................... 20 Otherresources...................................................................... 20
weight chartS .................................................................... 21
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SECTION 1: The Heart
Introduction
Ifyouhavebeentoldthatyouhaveheartfailureoraweakheart,thisbookletisforyou.
Youmayfeelfrightenedorangry.Thisisnormal.Youprobablyhavemanyquestions.
What does it really mean for me?
What can I do to improve my heart function?
Can my heart failure be cured?
Thisbookletwillhelpyouandyourfamilymanageyourheartfailure.Itwillanswer manyofthequestionsandconcernsyoumayhave,including:
• Causesofheartfailure
•Symptomsofheartfailure
•Treatmentofheartfailure.
Understandingyourconditionand followingthetreatmentguidelinescan helpyoumanageyourheartfailureand liveamorefulfillinglife.
Patientswhounderstandtheircondition makebetterdecisions,livealongerlife, stayoutofthehospitalandfeelbetter!
Itisuptoyoutobecomeanactive partnerwithyourhealthcareteam. Wearecommittedtohelpingyou.
Normal heart function
Theheartisamusclethatpumpsthebloodtoallpartsofthebody.
Heart chambers:Therearefourchambersintheheart.Theupperchambersarecalledatria andthelowerchambersarecalledventricles. Theheartmusclepumpsbloodfromchambertochamberandtothebodyandlungs.
Heart valves:Thevalvesactlikeone-waydoors,separatingthechamberssothatthebloodflowsinonlyonedirection.Whenthevalvesareopen,bloodmovesintothenextchamber.Whenthevalvesareclosed,bloodispreventedfrommovingbackwards.
Coronary (heart) arteries:Thesearebloodvesselsontheheart.Theysupplythemusclewithbloodfromthelungs.Thisbloodisfullofoxygen.
Left Atrium
Right Atrium
Right Ventricle
Left Ventricle
The Healthy Heart
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Heart failure
What is heart failure?
Heart failuredoesnotmeanyourhearthasstoppedbeating.Itmeansthatyourheartis notpumpingbloodasitshould.Itcannotsupplyenoughbloodtokeepyourbodyworkingproperly.
What causes heart failure?
• Cloggedarteries(coronary artery disease)
• Pastheartattack
• Highbloodpressure
• Heartvalvedisease
• Infectionoftheheartor heartvalves
• Heartdefectsfrombirth
• Heartmuscledisease(cardiomyopathy). Thisisaweakeningoftheheartmuscle. Itmaybecausedby:– Avirus– Lackofbloodflow– Alcoholordrugabuse– Chemotherapy– Amedicalproblemduringpregnancy– Unknowncauses.
What happens in heart failure?
• Theheartchambersgrowlarger.
• Theheartmusclegrowslarger.
• Theheartbeatsfastertopumpthesameamountofbloodtotherestofthebody.
• Thebodymakesmorestresshormones.
Aweakenedheartcannotpumpenoughbloodtothebody.Totrytopumpmoreblood,theheartgrowslarger.Butovertime,evenanenlargedmusclecannotpumpenoughblood.Whenthishappens,notenoughbloodflows toyourorgans.Thismayaffectthe brain, the lungs and the kidneys.
Right Atrium
Left Atrium
Right Ventricle
Left Ventricle
The Weakened Heart
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What are the signs and symptoms of heart failure?
• Fatigue(tiredness)orweakness
• Shortnessofbreath
• Swellingintheankles,feet,legs, handsorabdomen(belly)
• Increasedheartrate
• Rapidweightgain
• Increasedneedtourinate(emptybladder) atnight
• Lackofappetite(nodesiretoeat); upsetstomach
• Confusionorlackoffocus
• Problemsbreathingwhenlyingflat; wakingupshortofbreath
• Aracingheartbeat
• Dizzinessorfainting.
How is heart failure treated?
Heartfailureistreatedwithmedicines,dietandexercise.Supportfromfamilyandfriendsisalsoimportant.
How is my heart tested?
Wemayruntestsonyourhearttodecide onthebestplanoftreatmentforyou.Thesemayinclude:
Echocardiogram. Thistestusessoundwavestolookatyourheart.Itshowsthesizeofyourheartandvalves.Italsomeasureshowmuch
bloodyourheartispumpingeachtimeitbeats.Thisiscalledtheejection fraction (EF).
• AnormalEFistypicallyfrom 55to65percent.
• Inaweakenedheart,EFisoften lessthan40percent.
Stress test. A stress test is used to see how well yourheartcanstandphysicalactivityandhowwellbloodisflowinginandaroundyourheart.
Wedothistestbyhavingyouwalkonatreadmill.Weinjectmedicineintoyourarmtoincreasetheflowofbloodtoyourarteriesaroundyourheart.
Tomeasuretheelectricalactivityofyourheartduringthestresstest,weuseanelectrocardiograph (EKG).(Seebelow.)Wemayalso use an echocardiogram or nuclear imaging.
Laboratory blood work. Labtestsmeasure:
• Thyroidfunction • Kidneyfunction
• Cholesterol • Liverfunction
• Electrolytes • BNP(ahormone (includingpotassium) releasedwhenthe heartmuscleis
stretched).
Angiogram. Thistestchecksthearteriesofthehearttoseeiftheyareblocked.Itcanalsochecktheheartvalves.
Electrocardiogram (EKG). Thistestrecordstheelectricalactivityoftheheart.
Chest X-ray. Thistestcanshowifthereistoomuchfluidinthelungs.
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SECTION 2: Medicines
Medicines and what they do
Beta blockers
Sloworreverseheartfailure.Theyhelppatientslivelongerbyblockingtheharmfuleffectsofadrenalineontheheartandbloodvessels.
Common side effects:fatigue,slowheartbeat,sexualdysfunction
Examples:carvedilol(Coreg),metoprololsuccinate(ToprolXL)
ACE inhibitors and ARB
Improvetheflowofbloodtothebody,whichreducesstressontheheart.Theyalsoblocktheharmfuleffectsofangiotensinandaldosterone.Thisslowstheadvanceofheartfailure.
Common side effects:feelingdizzyorlight-headed,drycough
Examples:lisinopril(Prinivil),ramipril(Altace),valsartan(Diovan),losartan(Cozaar),olmesartan(Benicar)
Diuretics (“water pills”)
Reducestressontheheartandhelpitworkbetterbyremovingexcessfluidfromthebody.Youmayurinatemoreoftenwhentakingadiuretic.Thisisnormal.
Common side effects:musclecramps,gout
Examples:furosemide(Lasix),torsemide(Demadex),HCTZ
Spironolactone (generic)
Blockstheharmfuleffectsofaldosteroneontheheart.Mayhelpremoveexcessfluidfromthebody.Helpspatientswithaweakheartlivelonger.Unlikeotherdiuretics,itcanincreasethelevelofpotassiuminthebody.
Common side effects:breastenlargementinmen,dizziness,musclecramps
Brand name:Aldactone
Digoxin (generic)
Strengthenstheheart.Ithelpscontroltherateandrhythmoftheheartbeat,sotheheartcanpumpmorebloodtothebody.Abloodleveltesthelpsusmonitoryourdose.Ifthelevelistoohigh,symptomssuchasconfusion,rapidheartrate,blurredvisionoryellowvisioncanoccur.
Brand names:Lanoxin,Digitek
Nitroglycerin
Makesbloodvesselswidertohelptakeexcessfluidawayfromthelungs.Itisalsogiventopatientswhohaveanginaduetoblockedheartarteries.Itopensupthecoronaryarteriessothatmorebloodcangettotheheart.
Example:isosorbide(Imdur)
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Tips on taking your medicines
• Alwayskeepalistofyourmedicineswithyou.Bringittoeachclinicvisit.
• Donotskipmedicines,evenifyouarefeelingbetter.
• Avoidover-the-countermedicines,herbs andsupplementsunlesstheyareadvisedbyyourdoctor.
• Reportanyunusualsideeffectstoyourdoctorornurse.
• Foreachmedicineyoutake,youshouldknow:– Thename(boththebrandnameandthe
genericname)– Theamount(dose).
• Filloutamedicationcardandkeepitin yourwallet.
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SECTION 3: Low-Sodium Diet
Why follow a low-sodium diet?
It is very important for people who have a weak heart muscle to follow a low-sodium diet.
Sodiummakesthebodyholdontofluid,whichcancauseshortnessofbreath,weightgain,andswellingoftheankles,legsorabdomen.Whenthebodyhastoomuchfluid,thehearthastoworkhardertopumpblood.
Mostpeoplewithaweakheartshouldlimitsodiumtoabout2,000milligrams(mg)aday.
Askyourdoctorhowmuchyoushouldlimit yoursodium.
Reading the food label
Mostpeoplecallit“salt,”butthelabel willsay“sodium.”
• Look at the actual serving size. Youmaybesurprisedathowsmallitiscomparedtowhatyouareservingyourself.
• Look at the sodium amount. Remember,thisistheamountper serving.
• Do not follow “% daily value.” Itisbasedonadietthatincludes 2000caloriesperday.
• Remember:Limityourselftoabout2000mg ofsodiumaday.
• Countingmilligramswillhelpyoustaywithinyourlimit.
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Food diary
Writedownallthefoodsyoueatandtheirsodiumcontentfor2days.
DAY 1
Breakfast:
Lunch:
Dinner:
Snacks:
Totalmilligrams(mg)ofsodiumforday1:______________
DAY 2
Breakfast:
Lunch:
Dinner:
Snacks:
Totalmilligrams(mg)ofsodiumforday2:_______________
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Tips to help lower the sodium in your diet
At home
• Avoidusingsaltatthetableandwhencookingorbaking.
• Usefreshorfrozenfruitsandvegetables.Ifyouusesaltedcannedvegetables,drainandrinsethemtoreducetheamountofsodium.
• Useseasoningsotherthansaltinsoups. Forexample:– Beansoup:addapinchofdrymustard.– Vegetablesoup:addallspice,adashof
sugarorasmallamountofvinegar.– Chowder(madewithskimmilk):add
peppercorns.– Peasoup:addbayleaf,parsleyorcurry.
• Ifyourdoctorsaysit’sokay,youmayuseasaltsubstitutesuchasMorton’sSaltSubstituteorNoSaltinsteadofsalt.Butdo not use a salt substitutewithoutyourdoctor’sconsent.
• Replacesaltwithherbblendsthataresodium-freeandpotassium-free.Somecommonsalt-freeseasoningsarelisted intheboxtotheright.
Eating out
• Askforfoodthathasbeenmadewith lesssodium.
Shopping
• Lookformaindishesorfooditemsthathavenomorethan500mgofsodiumperserving.
• Choosepreparedandprocessedfoodscarefully.Theymaycontainlargeamountsofsodium.Examplesincludecannedsoups,stews,gravies,potpies,TVdinners,frozenentrees,pizzasanddrymixesforcasseroles.
• Choose“low-salt”or“low-sodium”versionsofyourfavoritefoods.Whenpossible,makeyourownversionswithnosalt.
Salt-free Seasonings
• Lawry’sSeasonedPepper
• McCormickSalt-Free AllPurposeSeasoning
• McCormickGrillMates Salt-FreeSeasoning
• Mrs.DashSalt-FreeSeasoning
• SpiceIslandsSalt-FreeSeasoning
• VegitAll-PurposeSeasoning
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Guide to sodium in food
Belowisalistoffoodsrangingfromlowtoveryhighsodium.Theamountofsodium inprocessedfoodsvaries,soalwaysreadthefoodlabel.
Meat, fish and nutsfreshbeef,pork,fish,lamborpoultry, 2to3ounces freshshrimp,clams,oystersorlobster, 2ounces salt-free,cannedtuna,3ounces peanutbutter,1tablespoon
Breads and grains flournoodles,riceorgrains(plain) unsaltedpotatochips,1ounce unsaltedsaltinecrackers,6 hotcereals(regularandquick) unsaltedpopcorn
Milk productsmilk,1cup icecream,1cup yogurt,1cup
Fruits and vegetablesfresh,frozenorsalt-freecannedvegetables fresh,frozen,cannedordriedfruit
CondimentsTabascosauce mustard,1to2teaspoons mayonnaise,1tablespoon jam,honeyorsyrup low-sodiumbakingpowder yeast,1package unsalted nuts Worcestershiresauce,1teaspoon
Drinksfruitjuiceorsalt-freetomatojuice,1cup coffee,tea sodapop(dietorregular) Gatorade
Low sodium (140 mg or less per serving)
Meatbacon(porkorturkey),2strips
Breads and grains breakfastcereal,1cup
Milk productsbuttermilk,1cup processedcheese,1ounce regularpuddingfrommix Parmesancheese,2tablespoons
Fruits and vegetablespickledbeets,½cup cannedvegetables,½cup
Condimentsbottledsaladdressing,2tablespoons ketchup(catsup),2tablespoons cookingsherry,¼cup
Drinkscocoa,madewithwater
Moderate sodium (141 to 400 mg per serving)
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Meats, main dishes and soupsfrozendinnersandpotpiesramennoodlesmacaroniandcheesespaghettiandtomatosaucelasagnacannedpastahamburgerortunahelpersfrozenpizzaPolishandViennasausagehamandCanadianbaconsardines SpamcornedbeefCheezWhizbouillion,broth,cannedsoupor driedsoupmix
Vegetablessauerkraut
Breads and grainspreparedbreadcrumbsbuttermilkbiscuit,plainmicrowavepopcornself-risingflourpreparedstuffing
Seasonings and othertable,seaandseasoningsaltsMorton’sLiteSalt(1teaspoon=1,150mg)picklessoysauce(1tablespoon=1,025mg)bakingsodameattenderizer
DrinksV-8orvegetablejuicecocktail
Meatcoldcutsorlunchmeat,2ounces porksausage,1ouncebratwurst,3ounceshotdog,1pepperoni porkandbeans,½cupfrozen,breadedfishsticks
Milk productscottagecheese,½cup instantpudding,½cup
Breads and grains cornbread,frommixbiscuit,frommix,1frozenwafflesandpancakes,2instant(packaged)hotcereal,½cup Shake‘NBakeassortedchips,1ounce
SeasoningsMSG(1teaspoon=500mg)bakingpowder,1teaspoonBBQsauce,2tablespoons
High sodium (400 to 700 mg per serving)
Very high sodium (more than 700 mg per serving)
For other resources on nutrition and low-sodium diet, see page 17.
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SECTION 4: Lifestyle Changes
Can I exercise?
Theheartislikeanyothermuscle.Exercisehelpsitworkbetter.Itisimportanttostayactive,evenwithaweakerheart.Youmayneedtorestmoreoften,butyoucanstillremainactive.Exercisecanhelpyoufeellesstiredandhavefewersymptoms.
• Planregularexerciseintoyourday.
• Ifyouhavebeeninactive,startlowandgoslow.Forexample,walk5minutesadayfor aweek,thenincreaseto6minutesadayfor aweek.
• Listentoyourbody.Stopandrestifyoufeeltiredorshortofbreath.
• Somedaysmaybeharderthenothers.Don’tgetdiscouraged.Anyamountofactivityisgoodforyourheart.
What about sex?
Mostpeoplewithaweakheartcanreturntohavingsexoncethesymptomsareundercontrol.Sex(sexualintercourse)requiresaboutthesameamountofenergyasclimbingonetotwoflightsofstairs.
• Avoidhavingintercourserightaftereatingaheavymeal.
• Ifyoustarttofeeluncomfortableortiredduringintercourse,stopandrest.
• Ifyouarehavingsexualproblems,talkwithyourdoctor.
What else should I do?
• Stop smoking.Smokingdamagesyourbloodvesselsandmakesyourheartbeatfaster.Askaboutoptionsforquittingsmoking.
• Lose excess weight.
• Manage your stress.
Can I drink alcohol?
Alcoholcanweakenyourheartfurther.Youshouldavoidalcoholorlimititsusetospecialtimes,suchasaholidayorbirthday.
Is it normal to feel sad or depressed?
Manypeoplefeelsadordepressedafterbeingtoldtheyhaveheartfailure.Itiseasytofeeloverwhelmedbythechangesinyourlifestyle,medicinesanddiet.Youmayfeelthatyouhavetoomanydetailstoremember.
• Leanonfamilyandfriendsforsupport.
• Joinasupportgroup.
• Takelifeonedayatatime.
• Planactivitiesthatyouenjoy,suchashobbiesandvisitingfriends.
• Ifyouarefeelingsad,depressedorhopeless,askyourdoctorforhelpcopingwithyourdiagnosis.Medicineorcounselingmayhelp.
Rememberthatlifecanbeenjoyabledespiteyourdiagnosisofheartfailure.Byworkingwithustoimproveyoursymptoms,youwillstillbeabletodomanyofthethingsyouliketodo.Stayhopeful,smileoftenandenjoyeachday!
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SECTION 5: Resources
Community Referral
Listedbelowareseveralagenciesthatcanlinkyouwithusefulresourcesinthecommunity.Theywillansweryourquestionsatnocharge.
Fairview On Call 612-672-7272 ProvidesinformationabouteducationalprogramsandsupportgroupsatFairview. Alsohelpspeoplefinddoctorsfortheirspecificmedicalneeds.
United Way 211(formerlyFirstCallforHelp) Dial211or651-291-0211 www.211unitedway.org
Human Services Bloomington:952-563-4953 EdenPrairie:952-294-5950 Edina:952-848-3936
Senior LinkAge 1-800-333-2433 www.mnaging.org
Fairview Home Care Social Worker 612-728-2468,menu#1
DARTS Community Services 651-455-1560 Askfor“InformationandAssistance”tofindavarietyofservicesinDakotaCounty. www.darts1.org
Cardiac Rehabilitation
CallFairviewOutpatientCardiacRehabclinics.
• Fairview Southdale Hospital:952-924-5255
• University of Minnesota Medical Center, Fairview:612-273-5709
• Fairview Ridges Hospital:952-892-2527
• Fairview Northland Medical Center: 763-389-6426
• Fairview Lakes Medical Center: 651-982-7843
Cardiac Home Care
Cardiachomecareisforthosewithspecificcardiacneeds.Acardiachomenursecanvisityourhometohelpyoumanageyourdietandmedicines.Thenursecanalsohelpyoulearn thesignsofheartfailurethatyoushouldreporttoyourdoctor.Thismaypreventatripto thehospital.
Homecaremayalsoprovidephysical,occupationalandspeechtherapyorhomehealthaidesforbathingandpersonalcare.
Medicarepaysforhomecareasprescribedbyyourdoctor.Privateinsurancemayalsocoverneededhomecare.
Talktoyourdoctor,nurseorsocialworkerifyouthinkthathomecaremightbenefityou. OrcallFairview Home Care and Hospice (612-728-2468)todiscusshomecareguidelinesandservices.
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Diabetes Education
Taking Charge of Your DiabetesisavailablethroughgroupandindividualsessionsforthosewithType1,Type2andpre-diabetes.Topicsincludehealthyeating,stayingactive,bloodglucoselevels,medicinesandmore.
Adoctor’sreferralisrequired.CalltheFairviewDiabetesProgramat612-672-6700foranappointmentandlocations.
Nutritional Support
YoumaymeetwithdietitiansatFairviewtodiscussyourdiet.Calloneofthenumbersbelowfordetails.Ifyouhaveawrittenreferralfromyourdoctor,yourinsurancemaycoverthecostofthecounseling.
• Fairview Southdale Hospital: 612-672-7272
• University of Minnesota Medical Center, Fairview: 612-672-7272
• Fairview Ridges Hospital: 612-672-7272
Meals-on-WheelsbringsahotlunchMondaythroughFridaytothosewhofindithardtocookforthemselves.Askforthemealslowestinsodium.Toenroll,call612-623-3363orgotowww.meals-on-wheels.com.
Store-to-Door:Call651-642-1892forgrocerydeliveryservice.Servespeople60andolder.OrderfromCubFoods.Fee($3–$15)basedonage,incomeandnumberofpeopleinhousehold.
Good books on low-sodium diets
• American Heart Association Low-Salt Cookbook,AmericanHeartAssociation
• Fast Food Guide, FairviewHealthServices (toorder,call612-672-4458)
• Fast Food Guide 1-888-232-2737;www.bddiabetes.com Clickon“dietandexercise,”clickon“EducationalLiterature”onthesidebar, thenon“FastFoodGuide”fromthelist.
• The No-Salt Cookbook,DavidC.AndersonandThomasD.Anderson,AdamsMedia
• The No-Salt, Lowest-Sodium Cookbook,DonaldA.Gazzaniga,St.Martin’sPress
Helpful websites for recipes and diet tips
• www.americanheart.org
• www.calorieking.com
• www.fitnessandfreebies.com
• www.healthyheartmarket.com
• www.megaheart.com
• www.recipezaar.com
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Financial Assistance
Ifyourincomeislowandyouareelderlyordisabled,youmayqualifyforMedical Assistance.Thisprogramhelpspayforyourmedicalbillsandmedicines.Formoreinformation,call:
• Dakota County Public Assistance: 651-554-5611
• Hennepin County Aging and Disability Services:612-348-4500
• Mille Lacs County:320-983-8208
• Sherburne County:763-241-2600
Otherresourcestohelppayforprescriptionmedicinesinclude:
Medicare Part D ThisprogramisforpeoplewithMedicare.Ithelpscoverthecostofprescriptiondrugs.Youmaytakepartinthisprogramregardlessofincome,healthorprescriptiondruguse.Fordetails,call1-800-633-4227[1-800-Medicare]orgotowww.medicare.gov.OrcalltheStateHealthInsuranceAssistancePrograminMinnesotaat1-800-333-2433.
Fairview Pharmacy Assistance Program 612-672-7062 Asocialworkerwillhelpyoulearnabouttheprogramsthatoffermedicinesforfreeoratgreatlyreducedrates.Toqualify,youmustbeanolder,low-incomeadultwithnocoverageforprescriptiondrugs.AndyoumustbereceivingmedicalcarefromaFairviewdoctorandusingaFairviewpharmacy.
Minnesota Board on Aging:1-800-333-2433 (Senior LinkAge Line);www.mnaging.org TheMinnesotaBoardonAginghelpspeoplefindthebestoptionsforlow-costmedicines.Thisincludesdiscountcardsandpatientassistanceprogramsofferedbydrugcompanies.
Pharmaceutical Company Patient Assistance Programs:1-888-477-2669;www.pparx.org Offersadirectoryofprogramsthatprovidespecificmedicinesatadiscountorforfree. Whomayqualifywillvarybyprogram.
Pfizer:866-706-2400; www.pfizerhelpfulanswers.com PfizerwillhelpyoufindthePfizerprogramthatisrightforyou.Allprogramsofferadiscountontheirmedicines.
Orange Card:888-825-5249;www.gsk.com Thisprogram,sponsoredbyGlaxoSmithKline,offersfreeGSKmedicinesbasedonincome.
Veterans Administration Hospital Veteranswhoqualifymaybeabletoreceivehelpwiththeirprescriptioncosts.CallyournearestVeteransHospitalfordetails.
• MinneapolisVeteransAdministration 612-725-2242
• VAHealthBenefitsCenter(nationaloffice) 877-222-8387
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Transportation
Thereareanumberofoptionsinthemetroareaforthosewhodonotdriveanddonothaveaccesstoothermeansoftransportation.
Metro Mobility 651-602-1111 www.metrocouncil.org Door-to-doorridesfordisabledpeople.Youmustapplytobecertifiedandpayasmallfee.
VEAP (Volunteers Enlisted to Assist People) 952-888-9616 Ridesforpeoplewithphysicalorfinancialinabilitytouseothertransportation.ServesresidentsofBloomington,Richfield,EdinaandMinneapolissouthof50thStreet.Youneedtoapply,anddonationsareaccepted.
Metro Transit / BE LINE 612-373-3333,option#2 BusservicewithinBloomingtonandEdinathatconnectswithMetroTransit.Busesareequippedwithwheelchairlifts.Feesvaryaccordingtoageandtimeofday.
Metro Transit 612-373-3333 Busservicewithinthemetroareaforanypurpose.Feesvarybyroute,ageandtime.
L J’s Handi-Van:763-389-9440 Medi-Van:1-800-422-0976 Mainlyservesthenorthernmetroarea.Vansareequippedwithwheelchairlifts.Thereisafee,andridersmustcallinadvancetoarrangerides.
Fairview Senior Transportation 612-672-7685 ProvidesridestoanyFairviewmedicalfacilitywithinMinneapolisforanyadultwhoisatleast60yearsoldandliveswithintheMinneapoliscitylimits.
Handicap Parking Certificates and Plates
State Motor Vehicle Division, License Bureau Offices 651-296-6911;www.mndriveinfo.org Forpeoplewhosephysicalconditionlimits theirabilitytowalk.Ifyoudonotdrive,youcangetacertificatetousewhenyouaregivenaride.Toapply,youandyourdoctormustcompleteaform.
Fairview Lifeline
Lifelineisaresponsesystemforemergencies,linkedtoa24-hournumber.Whenyouneedhelp,yousimplypressthePersonalHelpButtonyouweararoundyourneckoronawristband.
“LifelinewithReminders”isaunitthatallowsyouorsomeoneyoutrusttorecorduptosixremindermessages.Theycanbesetuptoplaydaily,weeklyoronlyonce.
FeesforLifeline(2009)areasfollows:• BasicLifelineservices:$39permonth• LifelinewithReminders:$42permonth• One-timefeeiftechnicianinstallstheunit:
$65.Ifself-installed:$35.
Fordetails,call952-885-6185orvisit www.fairview.org/lifeline.Thereareslidingfeesforthosewithqualifyingincomes.
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Health Care Directives
Ahealthcaredirectiveisasetofwritteninstructionsaboutthekindsofhealthcareyouwouldwantifatimecomeswhenyouno longercanorwanttomakeyourownhealthcaredecisions.
Onceyouwriteyourhealthcaredirective,itwillstayineffectuntilyoudecidetochangeit.CallFairview On Call at612-672-7272andaskfora healthcaredirectiveform.
Other Resources
www.fairview.org InformationonFairviewanditsservicesandprograms.
www.umphysicians.org/heart InformationonUniversityofMinnesotaPhysiciansHeartatFairview
www.heart.org Goodwebsiteforinformationoncongestiveheartfailure.
Success with Heart Failure: Help and Hope for Those with Congestive Heart Failure, MarcSilver,MD,PlenumPublishingCorp. Excellentbookwrittenforpatients.
C.O.R.E. Clinic(Cardiomyopathy.Optimization.Rehabilitation.EducationClinic) TheC.O.R.E.ClinicisaspecialityclinicforpatientswithheartfailureatUniversityofMinnesotaPhysiciansHeartatFairview.Patientsarereferredtotheprogrambyacardiologist(heartdoctor)ortheirprimarycarephysician(maindoctor).Theprogramprovidesaccesstocareandeducationtohelppatients:
• Adjusttheirmedicines.
• Avoidgoingbacktothehospital.
• Improvequalityoflife.
• Slowtheprogressofthedisease.
C.O.R.E.CliniclocationsincludeEdina,BurnsvilleandUniversityofMinnesotaMedicalCenter,Fairview
Formoreinformation,call612-365-5000.
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Weight Charts
Weighyourselfeverymorningatthesametime,onthesamescaleandinthesameclothing. Writetheamountontheweightchart.Bringthechartwithyoutoyourclinicvisits.
SUN MON TUES WED THURS FRI SAT
Date Weight
Date Weight
Date Weight
Date Weight
Date Weight
Date Weight
Date Weight
Date Weight
Date Weight
Date Weight
Date Weight
Date Weight
Date Weight
Call your doctor if you:
• Gainmore than2poundsinonedayor 5poundsin oneweek.
• Haveincreasedshortness of breath.
• Wakeupshortofbreathorcannotsleeplyingdown.
• Haveincreasedswellinginyourlegs,anklesorabdomen(belly).
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Weighyourselfeverymorningatthesametime,onthesamescaleandinthesameclothing. Writetheamountontheweightchart.Bringthechartwithyoutoyourclinicvisits.
Call your doctor if you:
• Gainmore than2poundsinonedayor 5poundsin oneweek.
• Haveincreasedshortness of breath.
• Wakeupshortofbreathorcannotsleeplyingdown.
• Haveincreasedswellinginyourlegs,anklesorabdomen(belly).
SUN MON TUES WED THURS FRI SAT
Date Weight
Date Weight
Date Weight
Date Weight
Date Weight
Date Weight
Date Weight
Date Weight
Date Weight
Date Weight
Date Weight
Date Weight
Date Weight
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For informational purposes only. Not to replace the advice of your health care provider. Copyright © 2004 Fairview Health Services. All rights reserved.
www.umphysicians.org/heart
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SMARTworks 520999 – REV 02/24/11.