Pumping Marvellous

Revolutionary Treatment for Heart Failure

This is a truly amazing breakthrough in removing fluid from patients – this is maybe one of the most revolutionary breakthroughs in HF treatment – You need to listen to this http://soundcloud.com/pumping-marvellous/bbc

The seasonings aisle at the supermarket can be overwhelming, especially if  you’re trying to find a healthy alternative to salt. There are many seasoning  products on the market and the ways the food industry promotes them can make it  difficult to find a healthy choice.  Sea salt has long been touted as a  healthy alterative to table salt and it’s no surprise that 61% of respondents in  a survey conducted by the American Heart Association believed sea salt to be  low-sodium alternative to table salt. Sea Salt is no better for you than normal table salt.

There are many other products  that are marketed as being healthy alternatives to salt. Commercial “salt  substitutes” are one such product.  Most salt substitutes contain potassium  chloride in place of sodium chloride.  By replacing sodium with potassium  in the chemical structure of salt, food scientists have developed a variety of “salt substitutes” that taste similar to table salt and that can help reduce  overall sodium intake when used in place of table salt.

You might be using a potassium based salt substitute  without realising it. It would be wise to go through your cupboard and  check ingredient labels — if you see potassium chloride listed, the seasoning is  a potassium based salt substitute.

There is a lot of talk in the media and medical websites about Salt and it’s effects and that maybe it isn’t a bad thing after all? We would just like to say to you that you always have to keep an open mind to everything however salt is bad for Heart Failure patients in another way which is what we talk about. This is about salts ability to allow you to retain fluid in your body which means that the Heart works harder. This is a cause of Oedemas and is the reason why you take water tablets / diuretics like furosemide.

Always follow the guidelines outlined by your Doctor or Nurse. take the HYPE with a pinch of salt!

Peter Pepper talks about Fluid management for #HeartFailure

Fluids management for Heart Failure patients

Peter talks to Heart Failure Patients about managing their fluids

This is an interesting post based around intelligent pills and Heart Failure patients.

A new era of “intelligent medicines” is heralded today with the disclosure that the NHS is about to begin trials of pills that contain a microchip, reminding patients when to take them.

When the pills are swallowed the “edible” microchips react with the acid in the stomach sending a message to a sticking plaster containing a sensor strapped to the shoulder. If the patient has forgotten a dose, the sensor delivers a text message to the patient’s phone reminding them to take their pills.

In addition, the sticking-plaster sensor monitors the patient’s bodily functions such as heart rate and can recommend adjustments to the dose accordingly, which can also be delivered to the patient via text message. The sensor can also send messages via the internet to carers and, if wanted, other family members, updating them on the patient’s condition.

If successful, the system could improve patients’ well-being while reducing costs by avoiding unnecessary hospital admissions.

The technology, developed by the US company Proteus in California, is being tested initially on 40 NHS patients with heart failure at Imperial College Healthcare Trust in London and the Royal Berkshire Trust in Reading. If successful, the four-month trial will be followed by a larger year-long trial starting in 2011 to measure the effect of the system on reducing hospital admissions.

Patients in the NHS trial will be given versions of two standard heart drugs – bisoprolol, a beta blocker that slows the heart beat, and furosemide, a diuretic that reduces fluid in the tissues – with the microchips incorporated in them.

The sticking-plaster sensor will measure heart rate, physical activity and whether the patients remain lying down while sleeping. If they are frequently forced to sit up, that is a sign of increasing fluid on the lungs, a common and potentially serious side effect of heart failure which requires urgent adjustment of the dose.

Research suggests that between a third and a half of patients do not take their medicines as instructed, leading to worse health, more hospital admissions and wasting $290bn (£186bn) a year in the US, according to a report by the New England Healthcare Institute published last year.

Unpleasant side effects, confusion over instructions, forgetfulness, language barriers and feeling “too well” to need medicine are among the reasons cited for non-compliance. People with chronic conditions such as diabetes and high blood pressure are least likely to stick to the regime prescribed by their doctor.

Nicholas Peters, professor of cardiology at Imperial College and a consultant to Proteus, said: “The whole idea of this technology is to inform patients about their own well-being, to encourage them to take the tablets and to take responsibility for their own health. It can help them stay stable and prevent them getting on to the slippery slope that leads to hospitalisation.”

“People may say, ‘Why do you need technology to detect a missed dose? If I feel ill I can adjust the dose.’ But, in heart failure, once symptoms worsen it is often already too late. There is a narrow window. The patient can become fluid over-loaded and hospitalisation is the inevitable next step.”

The microchip could be placed in almost any medicine. The technology has already been trialled in the US for psychiatric disorders where compliance is a particular problem.

Mobile-phone networks have already developed applications to remind patients to take their medicines, but the Proteus system, called Raisin, takes it a stage further. Networks could offer the application at a discount as an inducement to customers to join.

Dr Jerry Gurwitz, a geriatrician at the University of Massachusetts Medical School and expert on drug errors, said persuading patients to take the drugs they need is a challenging problem, especially among older people who live alone. “I think any person who is practising medicine is going to say it’s one of the biggest challenges and frustrations of providing care to patients right now,” he said.

The Proteus system has received the EU’s consumer and health stamp of approval and the company is expected to seek regulatory approval for widespread use in the EU next year.

Interesting post on Alcohol

I was in Lloyds Pharmacy this afternoon picking up my bucket load of drugs and I picked up a really useful device and instantly thought of Pumping Marvellous readers.

I am sure Lloyds will love me for this but it is a little invention produced by the East Lancs PCT, now I am sure this has been out for a long time but I was really impressed with it.

Now I don’t really drink alcohol so I am probably not the best person to comment on this but here goes.

It is a black wheel looking thing which tells you the units per drink and the calories per drink. There are a set of measures so if you can’t get your hands on one of these then here goes –

Regular Cider 5%ABV – 1 pint (568ml) – 2.8 units and 250 calories
Strong Cider 7.5%ABV – 275ml bottle – 2.1 units and 99 calories
Guinness 4.1%ABV – 1 pint (568ml) – 2.4 units and 210 calories
Port 20%ABV – 50ml glass – 1 unit and 78 calories
Sherry 17.5%ABV – 50ml glass – 0.9 units an 77 calories
Alcopop/Ready to Drink 5%ABV- 275ml bottle – 1.4 units and 200 calories
Standard Beer/Bitter 3.6%ABV – 1 pint (568ml) – 2 units and 182 calories
Standard Lager 4%ABV – 1 pint (568ml) – 2.3 units and 200 calories
Premium Beer / Lager 5%ABV – 330ml bottle – 1.7 units and 142 calories
Premium Beer / Lager 5%ABV – 1 pint (568ml) – 2.8 units and 244 calories
Super Strength Lager 9%ABV – 440ml can – 4 units and 250 calories
Whiskey/Bourbon/Brandy 40%ABV – 35ml measure – 1.4 units and 78 calories
Gin/Vodka/Rum 37.5%ABV – 35ml measure – 1.3 units and 72 calories
Wine/Champagne 12%ABV – 750ml bottle – 9 units and 555 calories
Wine/Champagne 12%ABV – 125ml glass – 2.1 units and 133 calories

Hopefully this will make you think twice about consuming alcohol.

Your Daily Allowance

In the UK the department of health recommends that an adult man does not drink more than 3-4 units of alcohol and an adult woman 2-3 units of alcohol as a maximum in any one day.

Managing Heart Failure in extreme Heat

I am currently going through my first summer after being diagnosed with Heart Failure in January 2010. Writing this I am thinking maybe I should write this next year when I am an expert but the subject is always at the top of my mind so nothing like the present but I thought I would need some help so the following is an excerpt from the British Heart Foundations website.

“Extremely hot weather can cause dehydration and heat exhaustion. Heat and humidity can
interfere with the body’s natural cooling process. If you have a heart problem, extreme
heat may place an extra burden on your heart and circulation.

Excessive sweating in hot weather increases the loss of fluid from your body. This reduces
the total blood volume. This will increase the workload of your heart and the demand for
oxygen, which can lead to angina if you have coronary heart disease. Losing too much
body fluid will also increase your internal body temperature, which could be life-threatening if left untreated.

If you are in hot and humid weather, it is very important to wear light, comfortable clothing. Managing your fluids is a very difficult process as you are trying to balance excess perspiration as well as the diuretic action of your drugs. If you feel as though you need to increase your fluids have a chat with your clinician. However if you need to take more fluid on board then sip the fluid or have a look at some of my tips, sweets, frozen grapes and water spray. Try to avoid caffeine-based drinks because these act as a
diuretic. (That means that they increase the amount of fluid you get rid of through your kidneys.)

Symptoms of heat exhaustion include heavy sweating, cold clammy skin, dizziness,
muscle cramps, shallow or fast breathing, nausea and vomiting. If you have any of these
symptoms, get medical attention immediately.

It’s a good idea to consult your doctor if you have any concerns about extremes of
temperature or have plans to travel to a country with either a hot or cold climate.

Health spas, saunas, jacuzzis and steam rooms

If you have a heart condition or have high blood pressure, it is generally advisable not to
use spa facilities – including baths, saunas, jacuzzis or steam rooms. In particular, don’t
use facilities that involve a sudden change of temperature – for example, having a hot
sauna and then plunging into a cold bath. If you particularly want to use any of these
facilities, ask your doctor about it first. Depending on what heart condition you have, your
doctor can give you advice on which types of facilities you should avoid.

Binge drinking and your Heart health

“Some people think it’s natural to have a bottle of wine a night. For far too many it seems respectable because you’re drinking with food and it’s not associated with any drunken behaviour or even feeling drunk.
“But if it happens regularly, you may have problems later on”

“You may not be an alcoholic, but if the overall amount of alcohol you drink regularly exceeds recommended limits, it may still cause serious harm.”

For most people, a glass of wine or a pint of normal-strength beer a day does no harm (and may even do some good) but drinking above that level increases blood pressure, which can lead to heart failure.
Alcohol is measured in units a pint of typical strength beer (about 4% alcohol) contains two to three units, and a glass of wine can contain anything from 1.5 to more than three units, depending on the strength of the wine and size of the glass. Men who regularly drink more than three to four units of alcohol a day, and women who regularly drink more than two to three units a day are likely to be damaging their heart health. Heavy drinking over a number of years can damage heart muscle, and lead directly to heart failure, as well as having many other harmful effects on your health. It also causes weight gain because of the calories in alcohol.

Binge drinking is particularly likely to increase blood pressure and increase the risk of heart failure. The alcohol intake that amounts to binge drinking may well be lower than you think, and reflects the levels of heavy drinking in a single night that start to seriously affect health. For a man, binge drinking is more than eight units in a night (about three pints of beer with 5% alcohol), while for a woman, it is about six units in a night (three standard or two large glasses of wine).

Unseen damage

For a woman, simply having a large glass (250ml) of 12% wine (3 units) every day, or a man drinking two pints of 4% lager (4.6 units), can push you above the recommended limits.

Men who regularly drink more than 2 pints of strong (5.2%) lager, which is more than 6 units, every day are more than three times more likely to get mouth cancer and could be three times more likely to have a stroke.

Women who regularly drink two large glasses of 13% wine (6.5 units) or more a day are twice as likely to have high blood pressure and are 50% more likely to get breast cancer.

If you have Heart Failure binge drinking will have a more profound effect – not only a big challenge in managing your fluid levels.

OK so how do I know if I am doing myself damage? for self-assessment see below

Drinking self assessment
Alcohol Tracker
Unit converter

Diuretics

Diuretics used to be known as water pills because they stop fluid collecting in your body and make you urinate more often. These are one of the most common treatments in heart disease. However, there have been only a few large studies into how effective they are in heart failure.

Researchers have combined the findings from smaller studies and concluded that diuretics extend life and improve symptoms of heart failure. Clinicians recommend them for people with heart failure who have signs of fluid retention, such as swollen ankles or breathlessness due to fluid in the lungs. Doctors will vary the dose of diuretic depending on your symptoms.

There are many different types of diuretic, but some of the most widely used for heart failure are bendroflumethiazide, chlorthalidone and furosemide.

Cut your salt intake

Ok will all like a bit of salt but too much salt can raise your blood pressure, and this can lead to heart failure or a worsening of the condition.

Suggested recommended limit: 2,000 milligrams per day (less than one teaspoon per day).

Limiting sodium is one of the most important things that people with heart failure can do.

Sodium makes the body hold on to fluid. To pump the added fluid, the heart has to work harder. People with heart failure shouldn’t put this extra strain on their hearts.
Excess fluid can also cause weight gain. Your heart has to work harder when you put on extra weight.
Too much sodium in the diet can worsen symptoms like swelling and shortness of breath. If those symptoms become severe, the person may need to be admitted to the hospital.
Sodium increases blood pressure. High blood pressure constricts the arterioles, making them resistant to blood flow. This makes the heart work progressively harder to pump enough blood to the body’s tissues and organs.

Cut down on table salt now!

Take the salt shaker off the table.
Discuss using salt substitutes with your doctor.
Limit salt in cooking
Avoid any seasonings that taste salty, including:

stock cubes (make your own stock it’s vastly superior)
cooking sherry or cooking wine
chilli sauce
meat tenderizer
seasoning salts
soy sauce
steak sauce
worcestershire sauce

Try substituting salt-free seasonings with lemon juice, vinegar and herbs.

Drain and rinse canned foods before preparing them to remove some of the salt. Tuna can now be purchased in fresh water – avoid the brine.

If you can use fresh fruits and vegetables over canned or frozen versions with added salt.

Shop for canned or frozen foods with no salt added.

Avoid packaged foods such as soups or rice dishes that come with a packet of powdered seasoning.

Avoid all processed convenience foods

Most of us take in more sodium through packaged convenience foods and snacks than by using table salt.

Look for “low-salt” or “low-sodium” labels on cans and packages. This label means the food has 140 milligrams or less sodium per serving. “Very low sodium” means it has 35 mg or less per serving.

“Reduced-salt” or “reduced-sodium” simply means that the product has at least 25 percent less sodium than the original version of the same product.

These foods may still have more sodium than you’re allowed.

Canned soups and dry soup mixes
Canned meats and fish
Ham, bacon and sausage
Salted nuts and peanut butter
Instant cooked cereals
Salted butter and margarine
Processed meats, such as deli items and hot dogs
Prepared baking mixes (pancake, muffin, cornbread, etc.)
Prepackaged frozen dinners (look for options where one serving has less than 400 mg of sodium)
Preseasoned mixes
Snack foods (crisps, snacks, olives, pickles)
Cheese
Tomatoes
Salad dressings
Fast food
Pay attention to your serving sizes.
A 2.5-serving can of soup with 200 mg of sodium per serving actually gives you 500 mg of sodium if you eat the whole thing. That’s a real dent in your 2,000 mg-per-day allowance.

Watch for other forms of sodium.
Read the ingredients. Many foods contain more than one form of sodium, such as

sodium alginate
sodium sulfite
sodium caseinate
disodium phosphate
sodium benzoate
sodium hydroxide
monosodium glutamate or MSG
sodium citrate.
Know what’s in your medicines.

Some medicines are high in sodium, too – always read the sodium content and warnings before taking an over-the-counter medication. Don’t take headache or heartburn medicines that contain sodium carbonate or bicarbonate.

Also be very careful that if you use lo-salt products that are based on “potassium sulphate” this will effect your INR warfarin levels.