If you’re one of the roughly 5.7 million Americans diagnosed with heart failure–like I am–the Holidays can be especially rough. In fact, a study suggests that while hospitalizations for heart failure decline on the holidays themselves, they spike after major holidays such as Christmas. There are a number of reasons for this, according to the study. One is that people may be less likely to seek treatment on the holidays themselves because they don’t think their doctor is working, or they don’t want to “ruin” everybody else’s holiday. Waiting to seek treatment when you’re feeling symptoms can cause them to get worse, which could be another reason that hospitalizations spike in the days immediately following a holiday. With the stress of traveling, eating lots of high-salt foods, and the lack of exercise while celebrating can all lead to weight gain and fluid retention, causing heart failure symptoms to get worse, requiring a trip to the hospital.
So what are we to do to make sure we get through the holidays without going into the hospital? I’ve come up with 5 things that are the most important for me.
1. Make Sure You Refill Your Medications
This is the biggest one because if you don’t have your medications, you can’t take them. For me, those medications are:
- Entresto (sacubitril-valsartan) 24-26 mg tablet twice per day
- Carvedilol 12.5 mg tablet twice per day
- Spironolactone 25 mg tablet once per day
- Furosemide 40 mg tablet once per day
Sometime before December 15, at the latest, I look at mine and make sure I have enough to get me through the first week of the year. I will also double check my pharmacy’s hours during the holidays. Most importantly, I make sure that there are actually refills left on the prescription, because if there aren’t any, it can be hard to get a hold of your doctor to call the pharmacy and let them know to refill them.
This last part is so important. Calling my doctor’s answering service is typically a nightmare. Once I discovered I was out of furosemide on a Sunday morning, which is the day I set up all of my pills for the week in my AM/PM pill case. I called the answering service and got a woman who sounded like she smoked three packs of day and tortured kittens in her day job.
“Yes, I’m a patient of Dr. ____ and I need a refill on one of prescriptions.”
I said it again.
I spelled it.
“I don’t have that doctor, sir.”
“Is this [name of clinic] Heart?”
“Well, who is on call? I just need someone to call me to get my prescription refilled.”
“I’m asking you! Whichever cardiologist is on call is fine. I just need to speak with them about a refill.”
“FOR MY HEART. I NEED HEART MEDICATION BECAUSE I HAVE HEART FAILURE…” and I may have cursed but I was seeing red.
“Sir I don’t appreciate your language sir.”
I had to pull it together because clearly my blood pressure was going up and that’s the last thing I wanted, I only wanted to talk to the on-call cardiologist to get a refill.
“Can you just read me the list of doctors?”
This went on and I yelled at her to just have someone call me and she made me say my phone number 18 times. Someone finally did call, and I got my meds, but please, take it from me, you don’t want to deal with this ever, but especially during the Holidays.
Which brings me to my next item.
2. Avoid Stress (and De-stress as Much as Possible)
Here’s a non-exhaustive list of things that cause stress during the holidays:
- Hosting family
- Making sure everyone has got presents
- Worrying about paying for presents
- Cooking for a large group of people
- Making the house look full of holiday cheer
- Terrible holiday songs
- People trying to discuss politics
- Being someone who doesn’t celebrate
- Office Holiday parties
- Year-end work deadlines
- Bad weather
- Ungrateful children
- Rude guests
- Finding a seat in church on Christmas Day
As I said this list is not exhaustive. You may have things on your list of stressors that I left off of mine. The point is, this time of year is extremely stressful. The American Psychological Association has some great resources on managing difficult family conversations, dealing with financial stress and the pressure of gift giving.
Some of the things I like to do are to first, I’m not afraid to let people know that, “Hey, I have heart failure, and so I may be a little limited in what I can do;” and second, I like to sneak away and do a five minute guided meditation using an app on my iPhone. There are a bunch out there and I highly recommend it. I also have a therapist to help me manage my mental health, which is something I struggled with even before I developed heart failure.
3. Eat Well
One of the things that make the holidays special is the food. Christmas cookies, holiday feasts, hams, pies, cake. Some of these can be full of fat and salt, which I try to minimize as much as possible. So I try (and let’s be real, I don’t always succeed at this) to make sure I’m sticking to my prescribed diet. This can be tricky if you have catered office parties, or if you’re not hosting your own event because you’re not in control of what is being cooked and served. So do you’re best here, and don’t over-do it as best you can.
4. Holiday Parties
One of the big changes I made after I was diagnosed is that I quit drinking alcohol. While I wasn’t an alcoholic, I did enjoy a good party now and again. One of the things that can be awkward, is your at a holiday party and someone asks you, “Hey, do you want to a cocktail/beer/glass of wine?” and then you say “No thanks, how about just a diet soda?” and then they’re all like, “Wait you don’t drink? How come?” And then you have to decide how much information you want to disclose about your illness, etc, or be awkward and say like, “It’s none of your business pal!”
So what I do is make sure I’m always holding a beverage with bubbles in it. Ginger ale, Diet Coke, La Croix. People really do see you holding a drink and they don’t question what is or isn’t in it. It can help you avoid awkward conversations.
Between this and watching what you eat the holiday party, you’ll be in good shape.
5. Know Your Limits
We have heart failure. When it comes right down to it, our job is to take care of ourselves and stay out of the hospital. We have limits on what we can and shouldn’t eat, how much weight we can lift, what kind of exercise we should or shouldn’t do. Own that and don’t be afraid to speak up. If you feel guilty about not being able to do as much, try speaking to someone about it, and try not to let it ruin your holiday.
But just about the worst idea I can think of is spending Christmas or the first few days of the new year in a hospital bed. So let’s try to stay out of one this year.
- Holiday Healthy Eating Guide – American Heart Association
- Holiday Stress Resource Center – American Psychological Association
- Hospitalizations for heart failure spike after major holidays – New York Post