So, my cardiologist has a foot fetish. Actually, every cardiologist I’ve seen and most of my general practitioners look at my feet. It sounds creepy, especially since I hate feet, but believe it or not, it actually serves a purpose. As heart failure progresses, patients tend to have fluid retention. It commonly presents in swollen feet and ankles, thus the foot fetish.
Fluid is enemy #1 for patients in heart failure. Think for a second about running, walking, or doing jumping jacks in a swimming pool. It is much harder to do those things with the water resisting your efforts. The same goes for your internal organs including your heart. If they are surrounded by water is makes it much more difficult for them to do their jobs.
The fluid retention is a symptom of the decreased cardiac output of my heart. When your heart muscle contracts it pushes out 55%-70% of its total blood volume; mine only expels about 15%. This decreased cardiac output reduces blood flow to the whole body including the renal system or kidneys. With the reduced blood flow to the kidneys, they produce what is called renin. Renin leads to the of production the vasopressor angiotensin. Angiotensin increases the production of the steroid aldosterone by the adrenal glad which causes salt and fluid retention. This fluid retention manifests differently depending on the presence of left or right heart failure. In left heart failure pulmonary edema is more common meaning fluid retention is seen in the lungs and pairs with symptoms such as shortness of breath. Edema is more commonly seen in the ankles and feet in right heart failure.
Would you believe I got a ‘C’ in Anatomy and Physiology in college?!
To help manage fluid, heart failure patients are generally on a low sodium diet. I started managing my sodium intake about six years ago but had to make some major changes within the past year. Imagine laying in bed at night and then suddenly waking up to the feeling that you are drowning. If I consume too much sodium, sit for too long, or don’t get enough sleep this is when pulmonary edema rears its ugly head. You can hear the water in my lungs with every breath I take and I feel like I’m drowning from the inside. Luckily, I have a diuretic that helps make that fluid go away. It takes a few hours but then it’s gone. That fluid still takes its toll. I feel tired and rundown. It almost always occurs in the wee hours of the morning. If this occurs at 0430 and takes three hours to go away, all of a sudden it is 0730 and my kids are up and raring to go!
My cardiac team limits me to 2,000mg of sodium per day. I have learned a few tricks and meet that goal daily. I still occasionally have to take a diuretic to take the fluid off my lungs but I am happy to say I haven’t had to do that in over a month (*knock on wood*).
*comment requests* How much sodium to do you eat in a day? What would be hardest for you to give up?
*challenge* Take the sodium break-up challenge!
Can you reduce your sodium and give your organs a break?
Take the pledge
Courage, dear heart ~ C.S. Lewis