One of the themes that we have heard from almost every clinician is the challenges heart failure patients face when managing their own medications, eating the right foods, and making a variety of other lifestyle changes. It would be easy for doctors, who understand the critical medical value of the treatment plan, and us, who, thus far, have mostly learned about the clinical side of the disease, to become frustrated at the idea of someone not following the roadmap that will lead to one of two paths: good quality of life or poor quality of life. However, most of the physicians we have met appreciate the complexities of breaking down and rebuilding lifestyles that have been solidified by decades and decades of living.
The truth is that the average patient is on about 12 medications, some of which are twice a day, some after certain meals but no later than mid-afternoon (because they will make you urinate and keep you awake), some right before bed (because they might make you tired if taken in the daytime), some need to be taken sequentially with set time intervals in between...all in varying doses that can change from one week to the next. All of the pills look similar and have complex, multi-syllabic, scientific names.
Many patients are unaware of the fact that a McDonald's salad can have 1,390mg of sodium (68% of the daily value of sodium recommended for a heart failure patient), enough to send them over the edge to the emergency room for three days because of excess fluid congesting their lungs. Most patients don't know that drinking green tea (heavy in Vitamin K) negates the role of the blood thinner coumadin, which works by blocking the production of Vitamin K dependent clotting factors.
Stay tuned for how the fellows will delve deeper into this topic.