Normally, our bodies eliminate extra fluid by excreting it as urine. People with heart failure can lose the ability to expel extra fluid.
The heart must then work harder to pump the excess fluid around the body and may not be able to keep up. Extra fluid can accumulate and seep out of blood vessels into tissues, leading to swelling in the lower legs and ankles. Fluid may also accumulate in the lungs, making it difficult to breathe, particularly when lying flat.
Monitoring Your Water Weight
Usually, if your weight increases by a few pounds over the course of several days, it is not because you have gained fat or muscle. Noticeable changes in weight over a few days typically relate to accumulation of water, or water weight. This may be the first sign of fluid buildup due to heart failure.
Monitoring your weight is an important way to manage your heart failure. You should:
- Weigh yourself every morning the same way:
- Go to the washroom and empty your bladder
- Wear the same thing every morning
- Don’t eat before weighing yourself
- Use the same scale every day
- Record your weight on a calendar. You can use a tracking log to record your weight and notice any changes.
If your weight has increased, ask yourself:
- Have I consumed more salt/sodium than usual in the last few days?
- Have I been drinking more fluid than recommended?
- Has there been a change in the amount of urine I’m producing?
If you have gained more than two pounds (0.9 kg) in one day, or five pounds (2.2 kg) in a one week, this may be a sign that you are retaining fluid. You may need to begin taking/take more diuretics and should contact your health care provider.
Fluid restriction is key to treating heart failure symptoms. Remember:
- Ask your health care provider how much fluid you should limit yourself to each day. For patients with heart failure, this is usually 1.5 to 2 L per day, or about 6-8 cups.
- You are not just restricting the water you drink. You should also be including coffee, tea, juice, soup, JELL-O, ice cream, and even some fruit (especially melons like watermelon) in your restriction.
- Your health care provider may prescribe a diuretic, or “water pill,” to help expel extra fluid that has accumulated in your body. These water pills may make you feel thirsty, but this does not mean that your body needs more fluid. It is important to not compensate for the fluid you are losing by drinking more.
Tips for controlling your fluid intake
- Plan ahead to spread out the fluid you drink over the day.
- At first, use a 1.5 or 2L bottle to keep track of the fluid you are drinking. For example, when you have a cup of coffee, measure out the same amount of water and pour it into the bottle. When you have filled the bottle, you have reached your fluid allowance for the day. You can also keep track by recording and adding up fluid amounts on a piece of paper that you keep nearby.
- With a measuring cup, measure the amount of fluid held by your drinking glasses, coffee cup, and soup bowl. Knowing how much fluid they hold will help you to plan the amount of fluid you can drink for the day.
- Use small cups and sip slowly.
- Take your pills with apple sauce or soft food such as yogurt.
- Drain excess fluid from canned fruit.
- If you are thirsty or have a dry mouth, try sucking on small amounts of hard candy or a lemon or lime wedge. If you have diabetes, make sure the candies are sugar-free.
- Some people find that brushing their teeth often or rinsing their mouth with chilled mouth wash helps manage their thirst.
- Use a humidifier to moisten the air in a room.