Heart Failure

Health Around the Holidays
Staying healthy around the holidays is hard for most people but then adding the layer of chronic medical conditions and health regimens makes it even harder. It can be very difficult, daunting and frustrating trying to navigate and stay on track through the holiday months. We hope you enjoy this edition of healthy tips and recipes so you can truly enjoy this time of year with your loved ones.

Activity
Living in Minnesota in the winter is not easy, especially for anyone who has a health condition like heart failure. Staying active does not mean hours of grueling exercise. It can be as simple as walking around in your house three times a day for 10 minutes or finding a low-impact chair yoga routine you enjoy for 20 minutes a day. Note the use of the word activity versus exercise. Your heart is a muscle that needs to be used like the other muscles in your body. There are many things you can do wherever your heart health is at today to stay active. Aerobic activities like walking or swimming increase hearth strength and your circulatory system. Muscular strength training like body resistance bands or free weights helps increase muscular strength, reduces fat and creates lean muscle mass. It is important to note that activity can be fun, enjoyable and individualized. See some tips below from our Cardiac Rehabilitation team.

General Exercise Considerations with Heart Failure
  • Start slowly and gradually increase.
  • Choose an activity you enjoy.
  • Create a consistent routine.
  • Consult your doctor before lifting weights and ask about medications that may affect exercise tolerance.
  • Elevated heart rate and mild shortness of breath is expected when exercising. Talk to your doctor if symptoms do not subside after 15 minutes of rest or if you're experiencing any dizziness, chest discomfort or weakness.
Winter Considerations When Your Activity Choice is Outside
  • Warm up: muscles may take longer to warm up due to the cold.
  • Dress in layers to avoid hypothermia and frostbite.
  • Be mindful of the terrain and slippery conditions to reduce your fall risk.
  • Avoid going outside in extreme weather conditions.
Benefits of Staying Active
  • Reduces heart failure risk factors
  • Strengthens your heart and vascular system
  • Improves circulation of blood and oxygen
  • Increases energy levels and exercise capacity
  • Improves muscle tone and strength
  • Improves balance and joint flexibility
  • Improves mood and helps lessen stress and anxiety
Emotional Health
How to manage the holidays when you aren’t feeling merry and bright. (This was in last year’s edition, but it is worth sending out again!)
“It’s the most wonderful time of the year” …except for when it isn’t. While holiday celebrations can be sources of comfort and joy for many people, they can also be challenging, particularly for those managing physical and psychological health concerns, for those who have lost loved ones, and for those dealing with loneliness and isolation.

If your holiday spirit is in short supply, consider the following:
  • Recognize that you don’t need to force yourself to be happy. It’s good to acknowledge all feelings — even the ones that aren’t joyful. You are not alone in feeling this way. 
    • Avoid numbing or avoiding feelings by using alcohol or other substances, which worsen anxiety and depression.
    • You may choose not to celebrate at all — instead of spending the holidays the way you think you should, you might opt for an activity you feel like doing.
    • No matter how you decide to spend the holidays, consider communicating your intentions to friends and family early in the holiday season so everyone knows what to expect.
  • Set a gifting budget and stick to the amount. 
    • Consider having a gift exchange to reduce the number of items everyone needs to buy. 
    • You can also choose to let people know you are unable to give gifts this year.
    • Consider giving the gift of help — whether to a neighbor, a friend, a family member or a stranger. It’s the act of giving that is more important than a present. Our generosity can be a gift to ourselves, because when we focus on others and less on ourselves, we tend to reduce our anxiety.
  • Don’t forget about self-care. 
    • A balanced diet, moderate exercise and plenty of sleep are essential for wellbeing, but the distractions and stressors this time of year can keep us from these basics. 
    • Try and schedule outdoor exercise in the middle of the day when the sun is brightest. 
    • If you can, work near a window throughout the day. Even outfitting your home with warm, bright lighting — such as the candles or twinkling lights associated with this time of year — can help improve your mood. 
  • Remind yourself of the people, places and things that make you feel happy. 
    • Consider scheduling a regular call or video chat with friends on a weekly or biweekly basis so you don’t have to think twice about making the effort.
    • Take advantage of other ways to connect including sending out holiday cards and communicating with family and friends by phone, text, email and social media.
Should I Talk to a Doctor?
Talk to your heart failure team or to your primary care physician if you have been feeling anxious or depressed for more than two weeks or if the holidays are long gone and you are still feeling stressed, anxious or depressed. Integrated Behavioral Health (IBH) providers are on staff both at CentraCare Heart & Vascular Center and throughout CentraCare.
 
Holiday Recipes
Heart-Healthy Recipe: Herb-Rubbed Turkey
Recipe courtesy of Taste of Home
Ingredients
  • 6 garlic cloves, minced
  • 2 Tbsp. plus 2 teaspoons rubbed sage 
  • 1 Tbsp. minced fresh thyme or 1 tsp. dried thyme
  • 2 tsp. pepper
  • ½ tsp. each ground allspice, ginger and mustard
  • ¼ tsp. cayenne pepper
  • 1 Tbsp. all-purpose flour
  • 1 turkey-sized oven roasting bag
  • 2 celery ribs, chopped
  • 2 small carrots, chopped
  • 1 small onion, chopped
  • 1 small potato, sliced
  • 1 turkey (14 lbs.)
  • 1 Tbsp. cornstarch
  • 2 Tbsp. cold water
Directions
  1. Preheat oven to 350˚. In a small bowl, mix garlic, herbs and spices until blended. Sprinkle flour into oven bag; shake to coat. Place bag in a roasting pan; add vegetables and sprinkle with 5 tsp. herb mixture.
  2. Pat turkey dry. With fingers, carefully loosen skin from turkey breast; rub half of the remaining herb mixture under the skin. Secure skin to underside of the breast with toothpicks. Rub remaining herb mixture over inside of the turkey. Tuck wings under turkey; tie drumsticks together.
  3. Place turkey in a bag over vegetables, breast side up; close bag with nylon tie. Cut six ½-inch slits in top of bag; close with tie provided. Bake 2 to 2½ hours or until a thermometer inserted in the thickest part of the thigh reads 170-175˚.
  4. Transfer turkey from oven bag to a serving platter; tent with foil. Let stand 20 minutes before carving. Strain contents of oven bag into a small saucepan, discarding vegetables; skim fat from cooking juices. In a small bowl, mix cornstarch and water until smooth; gradually whisk into cooking juices. Bring to a boil; cook and stir 2 minutes until thickened. Serve with turkey.
Nutritional Information: Serving size 4 oz. without skin, yields 28 servings
Calories: 198, Fat: 6 g (2 g sat. fat), Cholesterol: 86 mg, Sodium: 80 mg, Carbohydrate: 1 g (0 sugars, 0 fiber), Protein: 33 g. Diabetic Exchanges: 4 lean meat.

Heart-Healthy Recipe: Low-Sodium Turkey Stuffing
Recipe courtesy of American Association of Heart Failure Nurses
Ingredients
  • 6 cups cubed bread (no salt – toasted) (about 8 slices)
  • ½ cup unsalted butter
  • 2 cups chopped onion
  • 2 cups chopped celery
  • 2 cups chopped mushroom
  • 2 cups chopped apple
  • ½ cup chopped pecans 
  • 1 Tbsp. savory
  • ½ Tbsp. sage
  • ½ tsp. thyme
  • ½ tsp. pepper 
  • 2 tsp. garlic powder
  • 1 cup apple juice
Directions 
  1. Sauté the cubed bread, butter, onion, celery, mushroom, apple and pecans.
  2. Add the savory, sage, thyme, pepper, garlic powder and apple juice.
  3. Bake in a pan at 350˚ for 20-30 minutes.
Nutritional Information
Calories: 276, Fat: 18 g, Saturated Fat: 8 g, Cholesterol: 31 mg, Sodium: 33 mg, Carbohydrates: 27 g, Protein: 4 g, Potassium: 320 mg

Heart-Healthy Recipe: Low-Sodium Turkey Gravy
Recipe courtesy of Northeast Georgia Medical Center Executive Chef, Byron Harrel
Ingredients
  • 4 cups (32 oz.) unsalted turkey stock, divided
  • 2 Tbsp. fresh sage, remove from stem and finely chop
  • 2 Tbsp. fresh thyme, remove from stem and finely chop
  • 1 cup (8 oz.) skim milk
  • ¼ cup cornstarch
Directions
  1. After you roast the turkey, place the roasting pan on the stovetop over medium heat.
  2. Add 2 cups of turkey stock to the pan and stir about 5 minutes or until the drippings and browned bits from bottom dissolve.
  3. Place a strainer over a fat separator cup.
  4. Pour pan drippings through a strainer.
  5. Add enough stock to the drippings to make 4 cups total. If you don’t have a fat separator cup, you can remove fat from drippings by adding several ice cubes to the liquid and placing it in the freezer for 10 minutes.
  6. Remove hardened fat with a spoon and place stock into a saucepan. You should still have about 4 cups of liquid.
  7. Place the saucepan on the stovetop over medium heat and bring to a simmer.
  8. Add sage and thyme to the simmering stock.
  9. Continue to simmer until the stock is reduced by ¼, or until about 3 cups of stock remain.
  10. Pour milk into a small bowl.
  11. Add cornstarch and stir to mix evenly. Slowly pour milk mixture into the simmering stock, stirring slowly.
  12. Bring sauce to a boil and continue to stir until stock thickens and has a nice shine, about 3 to 5 minutes.
Nutritional Information: Serving size ½ cup, yields 8 servings
Calories 25, Protein 1 g, Trans fat 0 g, Cholesterol 1 mg, Total carbohydrate 5 g, Trace Sodium 14 mg, Added sugars 0 g
 
My Heart Group
My Heart Support Group provides information to people, as well as their loved ones, who have heart conditions, specifically heart failure. At the meeting, you will find resources to take home, such as low-sodium food charts, recipes and other educational materials. The event also includes low-sodium snacks, drinks and drawings for door prizes. A speaker presents for most meetings with a focus on anything related to the diagnosis of heart failure. Any speaker who presents in St. Cloud will be broadcast to the My Heart Group at Melrose via the web. A facilitator at CentraCare – Melrose will lead table-top discussions on the subjects presented, serve low-sodium snacks and hold a door prize drawing. The meeting usually lasts around 1-1½ hours.

The group meets at 3 p.m. on the third Tuesday of each month at CentraCare South Point, 3001 Clearwater Rd, St. Cloud, and CentraCare - Melrose, 525 W Main St. You may also join the meeting online. Video conferencing will allow Melrose and online participants to watch the speaker presentation in St. Cloud through Microsoft Teams.

Guest Speaker
  • Dec. 16: Courtney Littler, CentraCare - St. Cloud Sleep Center
Please note: My Heart Support Group is on a winter break until April 21.
 
To RSVP, email HFSupportGroup@centracare.com or leave a message at 320-470-0760. Include which location and how many people will be attending.
 
get DETAILS