Heart Failure: Working With Your Medical Team

Heart failure is a lifelong condition. So you will have dozens-or even hundreds-of appointments with various health professionals while you have the disease.

Creating ongoing and lasting relationships with these professionals can give you:

• Better control of your heart failure symptoms and the disease.
• Treatment tailored to your own needs.

Your health care team

You will not be left alone with the task of managing your disease. You will see several doctors, specialists, and nurses. Each will offer you specific suggestions and guidance that can help you to control your heart failure. The number of health professionals you see will probably grow over time. Your health care team can include doctors, nurses, cardiac surgeons, physical and occupational therapists, dietitians, social workers, and pharmacists.

With such a large care team, you might forget that you must also play an active role in managing your heart failure. In fact, you are the most important member of your treatment team. If you don't take part and cooperate in managing your condition, no amount of effort by your doctors and nurses will improve your health.

Each member of your medical team plays an important role in heart failure treatment. But your doctors and nurses help guide you in making the best treatment decisions for you.

Your doctors

Your primary care doctor will act as the coach of your health care team. Your coach may be a family doctor or a cardiologist. He or she will create and correct your drug treatment plan, regularly check in on the symptoms of your disease, and coordinate your care with other members of your care team. Your doctor will also help you to understand your overall prognosis and the specifics of how your drugs should be taken.

How often you see your doctor will usually depend on how far your heart failure has progressed. If you have class I or II heart failure, you may see your doctor 2 or 3 times a year. At those visits, your doctor will check your overall health and ask you important questions about your lifestyle. If you have more advanced (class III or IV) heart failure, you might see your doctor more often.

Your nurses

The nurses involved in your care have four main roles. They:

• Help assess your symptoms and how they affect your lifestyle. They may also be able to give you tips to help you control your disease and make your treatment plan easier.
• Respond quickly to any changes in your health or concerns you may have about your heart failure.
• Help educate you about your heart failure. Much of the education that you receive over the months and years of your heart failure will come from your nurses. Nurses also will work hard to encourage your active participation in treatment. They will almost always be available to answer any of your questions about heart failure.
• Act as a link between you and your doctor. When you have a problem that requires your doctor's attention, your nurse can decide which information is important to tell your doctor.

Communicating with your care team

You can't follow your health care team's orders unless you take the time to understand them fully. Open, two-way communication between you and the members of your health care team is the key to a successful relationship. Make sure to listen to everything they have to say. But they will also be listening to you. Tell them about how you have been feeling between visits and about any concerns you have about your health.

Remember that you should feel comfortable discussing any aspect of your health or life with your health professionals. There are no wrong questions, especially if it is something that concerns you. Do not be intimidated by their level of education or by how busy they are. Focus on taking an active role in your visits with the health care team members.

It may be hard to remember exactly who does what. The following table may help you understand the roles of each person on your care team.

Your health care team

Team member	Role in your care
Primary care physician (PCP)	Your PCP coordinates the care of your heart failure with other illnesses or conditions that you may also have.
Cardiologist	This is a doctor specialized in caring for your heart. He or she is responsible for your heart failure care.
Heart failure specialist	This is a cardiologist specialized in caring for heart failure. He or she is responsible for your heart failure care if you have severe or very complicated heart failure or are seeking an experimental treatment.
Cardiac surgeon	This doctor is trained to operate on the heart. He or she performs surgeries, such as coronary artery bypass graft (CABG) surgeries and heart transplants.
Nurse	A nurse educates and cares for you during your illness and answers many of your questions.
Nurse practitioner	A nurse practitioner also educates and cares for you during your illness and answers many of your questions.
Physical therapist	This health professional is specially trained in recovery. He or she helps you improve your strength and endurance after surgery or a heart attack.
Registered dietitian	A dietitian teaches you about nutrition and develops diets to promote your health.
Occupational therapist	This health professional is specially trained to help in your physical recovery so you can return to your previous job or train for a new type of job.
Social worker	He or she offers advice about the financial, legal, and emotional aspects of your treatment.
Pharmacist	A pharmacist answers questions about how often to take your drugs and the side effects they might cause.

Making the most of appointments

Work closely with your medical team to take an active role in your health care.

• Keep a notebook about any changes you have experienced. The more detailed you are, the more helpful they'll be.
• Prepare a list of questions in advance.
• Take notes of key information during your visits so that you can review it later. Or ask if you can record your discussions.
• If needed, slow down the pace to help you understand or when you're feeling overwhelmed.
• Never hold back information about whether you are following the advice of your health professional.
• Share information about all of your current drugs. Include nonprescription drugs, dietary supplements, and alternative medicines.
• Don't leave the office until you understand all your instructions, have them written down, and have asked questions about anything you did not understand.
• Bring along a family member or friend. He or she can help with note-taking, listen to instructions, and offer moral support during your appointments.
• Don't hesitate to call the office if you still have questions after your visit.