The week before Christmas, I had my last session of the year with a therapist I see who helps me deal with the reality of heart failure, how it has changed my life, and how I can manage the challenges. We discussed goals for my life for next year. I identified some goals during our session, and have added to that list since we met.
I must admit that I have always been a fan of setting goals and making lists. My friends and family frequently comment that I am an organized person. In fact, some would add that I am more than organized, I’m obsessive. Well, they can say whatever you want. But I know what makes Melanie operate at peak efficiency. Whenever I makes lists and plans, I tend to get things done. When I try to be more spontaneous and unrehearsed, that is when I tend to I would drop balls and make errors.
Now that I have heart failure, I think it is especially important for people who have chronic illnesses to set goals in the New Year. We need to find projects that we can invest time in and that will attract positive energy to our life. It seems to me that any good results I have had in my heart failure treatment are in part due to the fact that I had things to positive things to look forward to and focus on. Those things gave me a reason to exist and hope, and made me commit more strongly to my treatment plan.
I must also admit that I have always been a little confused as to whether a goal is the same thing as a resolution. After putting this query into the Google search field on the web, I did not come up with a definite answer. I have to admit that I have a bad taste in my mouth when I hear the term “New Year’s resolution”. I think this stems from the fact that people have come to treat a resolution as something they make but have no intention of keeping.
So for this reason, I am calling my plan for next year a commitment to intentional goals. I am going to create a document to remind me of my commitment. It will include as the most important part, an accurate statement of the goal. But then I will explain why this goal is important to my life. Finally, I will set forth some steps that I must perform to move me towards the completion of the goal. I think that the exercise of putting this all down on paper will serve the purpose of making the goal realistic, and will also serve as a contract with the visionary Melanie and the worker bee Melanie to actually get the jobs done. My heart may fail, but if I can remain focused on each goal, I don’t see how I can fail!
As I began to put the goals on paper, I remember a very simple rule: Keep your goals simple and attainable. I think you will agree that none of these goals is difficult, and if I follow the steps, I can easily achieve them.
Well, of course the most important goal for me is to just keep this heart in good shape. This goal is important to my life because frankly, I have been shocked by how very crappy heart failure can make me feel. I have always been a person who likes to be vital, who likes to move and who likes to be learning new things all the time. This has been difficult because the shortness of breath, the dizziness, and bouts of fatigue make it impossible at times to be vital. So simply put, if it gets any worse, it will drag down my ability to be Melanie.
In terms of my treatment plan, I think I have an excellent reputation for doing exactly what I am told. I think what also makes me a good patient is that I try to ask good questions about each element of my treatment plan: what can I learn about the pills I am taking; what are the reasons for the fluid and sodium restrictions; how can I best comply with these restrictions; is the exercise routine I am following ambitious but not harmful? I ask these questions because I want to understand as much as I can about my limitations as well as my abilities. Knowing the answers helps to ensure that I will not undermine all the good things that my medical team is doing.
One thing I learned the hard way just a month or two ago is that I have to be brutally candid about when I am not feeling up to par. This does not mean that I need to call or e-mail someone on my medical team when I have an occasional bad day. But I do need to send up a flare when I have a series of days or even weeks when symptoms seem to have escalated. During the month of November, I failed to send up a flare when I just felt so fatigued that I had to structure my day so I was never active for more than an hour or two at a time. It should have occurred to me that this was not normal. I guess I did not realize how the days of fatigue were piling up and becoming a long stretch of days with unusual fatigue.
After consulting with my team in early December, we changed the level and type of beta blocker that I am taking, and so far that seems to have made a difference. Since results on some of the latest tests that I had performed had improved, it made sense to look at things like my low blood pressure and find a medication that might not impact it as much. But I learned the error of just sucking up how I felt and remaining silent. In this case, it appears we just needed to tweak treatment. But when you have a significant cardiomyopathy, you can’t take it for granted that it is always just a tweak that is needed. A change in how you feel, or symptoms that worsen, or new symptoms that appear may well mean that the cardiomyopathy/heart failure is deteriorating. So what I need to do is keep a periodic tally of how I feel, what has changed, etc. and check in when something, even the most innocent thing, seems off.
I need to do a better job getting rid of clutter in my condo. Trust me, when I say clutter, I do not mean that I am a hoarder. I have done very well over the years to go through my possessions periodically and take things to Goodwill that I am no longer using. But I seem to be overcome by paper. I need to go through my files more often and shred paperwork that has become obsolete. When I see reams of paper to go through, I feel overwhelmed. The last thing someone with a chronic illness needs is to be overwhelmed.
This goal has such an easy fix. All I need to do is devote an hour every few weeks to going through files and selecting documents that I can shred, and then I can do this while listening to music or watching tv. All painless. I might even learn something depending on what I watch!
In order to meet the overarching goal of keeping my heart in good shape, I need to maintain work that I find rewarding and thought provoking. So I will continue to write this blog. But I will also resume some work I had started on a novel. I will keep up the projects I am working on at my church. I will also reach out to my network of friends to see if there are other small, projects that I can work on to keep me . I promise I will not take on anything that is overwhelming. But if I find work that fulfills my heart and my spirit, I think that may be some of the best therapy I can find.
Wish me luck!
Melanie discovered that she had heart failure in 2013. Since that time, she has been learning how to live with the condition, and how to achieve balance and personal growth.