He’s Knocking on My Door

Tag: Home Monitoring

  • Daily Journal #9: A Small Victory

    Some days your body simply tells you it’s had enough.

    Yesterday was one of those days.

    After only getting a few hours of sleep the night before because of my ongoing battle with insomnia, I was completely exhausted. Around 6:30 in the evening, I laid down in bed to watch a little television.

    The next thing I knew, I had slept for more than eight hours.

    I honestly can’t remember the last time I slept that long.

    Lately, a “good night’s sleep” has felt like something other people get to enjoy. Eight uninterrupted hours has become so rare that waking up this morning actually felt different. I felt refreshed. It’s amazing how something most people take for granted can feel like such a gift when you’ve been struggling with insomnia.

    My morning health check was encouraging. Everything looked good, and that’s always a reassuring way to start the day.

    Unfortunately, my right hip continues to remind me that not everything is moving in the right direction.

    The pain has been intense since yesterday afternoon. While medication would probably take the edge off, it comes with another problem—constipation. Like so many things that come with chronic illness, it often feels like solving one problem creates another. For now, I’m going to try and manage the pain without taking anything.

    At least today I can get comfortable in my recliner. Yesterday, even that seemed impossible.

    Living with chronic illness has taught me that progress isn’t always measured in big milestones.

    Sometimes it’s measured by a good night’s sleep.

    Sometimes it’s simply finding a comfortable place to sit.

    And sometimes, it’s waking up feeling just a little more refreshed than you did the day before.

    Today wasn’t perfect.

    But today was better.

    I’ll gladly take that as a small victory.

  • Daily Journal #8: Goods and Bads

    This morning started on a positive note. My daily health checks all looked good, and by later this morning I was down a few more ounces. It’s not a huge change, but every ounce is another step toward my weight-loss goal, and I’ll take every victory I can get.

    Unfortunately, the rest of the day has been much more difficult.

    Since yesterday afternoon, I’ve been dealing with severe pain in my right hip. The pain shoots all the way down my right thigh, making it nearly impossible to get comfortable. Even my recliner—usually the one place where I can find some relief—hasn’t helped. No matter how I sit or shift, the pain just won’t let up.

    I finally gave up and went to bed early last night, hoping sleep would help. Instead, I woke up at 12:30 a.m. and never made it back to sleep. Another night of insomnia.

    The combination of chronic pain and sleepless nights is exhausting. When your body hurts and your mind won’t let you rest, it wears on you physically and emotionally. You begin to wonder how much longer you can keep going like this.

    I’m hoping this stretch of insomnia ends soon because it’s becoming just as draining as the health issues themselves. For now, I’ll focus on the one positive from today—the scale moved in the right direction. Sometimes that’s enough to remind me that even when everything else feels like it’s working against me, there is still progress being made.

  • My Morning Health Check: The Numbers I Track Every Day

    My Morning Health Check: The Numbers I Track Every Day

    Living with heart failure and kidney disease means that every morning begins with a small collection of measurements. The process can be tedious, but it has become an important part of understanding what my body is doing and recognizing changes before they become larger problems.

    This is the routine developed for me with guidance from my medical team. It is not medical advice or a monitoring plan for everyone. Your doctors should determine which measurements and warning signs matter for you.

    Starting with a Consistent Weigh-In

    My routine begins after I use the bathroom and before I eat or drink anything. I try to wear approximately the same amount of clothing each time and always use the same scale in the same location.

    These details may sound overly particular, but consistency makes it easier to tell whether a change on the scale is likely real or simply caused by different clothing, food, fluids, or the time of day.

    The American Heart Association recommends weighing yourself each morning after urinating, before breakfast, without shoes, and while wearing the same type of clothing.

    I record my weight and compare it with both the previous day and the preceding week. The general warning levels I watch for are:

    • A gain of approximately 2–3 pounds in one day
    • A gain of 5 pounds or more in one week
    • Any different threshold my medical team has instructed me to follow

    A sudden increase does not automatically prove that I am retaining fluid, but it is a reason to look more closely at my other numbers and symptoms. The American Heart Association explains that rapid weight gain can be an early sign of fluid retention in people with heart failure.

    Tracking Body-Water Percentage

    My scale also estimates my body-water percentage. I convert that percentage into pounds using this formula:

    Body weight × body-water percentage = estimated pounds of body water

    For example, if someone weighs 200 pounds and the scale reports 50% body water:

    200 × 0.50 = 100 pounds of estimated body water

    I do not treat this number as a precise measurement or as proof that I am retaining fluid. Consumer body-composition scales can be affected by hydration, food, skin contact, time of day, and other factors. I use it as another trend to compare with my previous readings.

    If my weight and estimated body water rise together—especially if I also notice swelling, shortness of breath, or other changes—that gives me more information to discuss with my medical team.

    An Important Scale-Safety Warning

    Body-composition scales use bioelectrical impedance analysis, or BIA. They send a very small electrical signal through the body to estimate measurements such as body fat, muscle mass, and body water.

    People with pacemakers or certain other implanted electronic medical devices should not use impedance-based features unless the device manufacturer and their medical team have confirmed that it is safe. Some compatible scales provide a weight-only or pacemaker-safety mode that disables these features.

    I have a loop recorder and an artificial heart valve rather than a pacemaker. Even so, I checked with my cardiologist before using this type of scale. Anyone with an implanted medical device should check the instructions for the exact scale and speak with a qualified medical professional before using its body-composition functions. Withings explains how BIA and its weight-only safety mode work here.

    Blood Pressure and Heart Rate

    Next, I record my blood pressure and heart rate.

    For me, a higher-than-usual blood pressure reading can be one clue that my heart is working harder or that something has changed. A lower-than-usual reading—especially when accompanied by dizziness, weakness, or lightheadedness—can raise questions about dehydration, medication effects, or whether too much fluid has been removed.

    A single reading does not tell the complete story. I look at the measurement alongside my weight, symptoms, medication use, and recent trends. I do not change my diuretics or other medications based only on my spreadsheet unless my medical team has given me specific instructions to do so.

    Glucose

    I also record my glucose. Tracking it alongside my other measurements gives me a more complete daily picture and helps me notice patterns that might otherwise be missed.

    Blood glucose can be affected by food, medication, illness, stress, activity, and sleep, so the context surrounding the number matters. As with my other readings, I follow the targets and reporting instructions given to me by my health care team.

    Recording Everything in One Place

    I currently track all these measurements in an Excel workbook:

    • Weight
    • Daily and weekly weight changes
    • Body-water percentage
    • Estimated pounds of body water
    • Blood pressure
    • Heart rate
    • Glucose
    • Symptoms and other notes

    Google Sheets would work well for the same purpose. The most important part is keeping the information organized and easy to review over time.

    My cardiologist and nephrologist review these records regularly. Having the information collected in one place makes it easier for them to see patterns and understand what has been happening between appointments.

    What I Want to Build Next

    My next goal is to create a dashboard within the spreadsheet. I would like it to use green, yellow, and red indicators:

    • Green: Measurements are within my usual range
    • Yellow: I am approaching a threshold and should pay closer attention
    • Red: A measurement has reached a limit established by my medical team and may require action

    The thresholds will need to be personalized. A number that is normal for one person may not be normal for someone else, particularly when heart disease, kidney disease, diabetes, and medications are involved.

    Eventually, I would like to turn this system into an app that makes daily tracking easier. When I finish the spreadsheet dashboard—and if I develop the app—I will share what I learn.

    Tedious, but Worth Doing

    I will be honest: completing this routine every morning can feel repetitive. There are days when I would rather step off the scale, forget the numbers, and get on with my morning.

    However, these measurements give me a clearer picture of my health. One isolated number may not mean very much, but changes across several days can reveal a trend worth paying attention to.

    This is what I personally do to monitor my health each day. It does not replace professional medical care, and I follow the thresholds and instructions established by my cardiologist and nephrologist. Anyone who wants to begin a similar routine should first ask their medical team what to measure, how often to measure it, and which changes should prompt a phone call or urgent care.

  • Daily Journal #7: A New Weight-Loss Goal

    A New Weight-Loss Goal

    I woke up and completed my daily health checks. Everything looked good, and my weight was down slightly compared with the past few days.

    My weight loss seems to have reached a plateau, so I’ve set a new goal: 225 pounds by April 1, 2027. I weighed 255.7 pounds this morning, which leaves me 30.7 pounds to go. Breaking through this plateau may be difficult, but I believe the goal is achievable.

    When I had my stroke in 2020, I weighed a little over 400 pounds and was in the worst physical condition of my life. The stroke was a frightening wake-up call.

    When I compare where I was then with where I am today, the progress is incredible. I still have work ahead of me, but I’m proud of how far I’ve come—and I’m going to keep moving forward, one pound and one day at a time.

  • What Is HFpEF?

    What Is HFpEF?

    How Can I Have Heart Failure If My Heart Is Pumping Normally?

    That was one of my first questions after learning that I had heart failure with preserved ejection fraction, commonly called HFpEF.

    My echocardiogram showed that my ejection fraction was in the normal range. If my heart was still pumping normally, how could I possibly have heart failure?

    The answer is that ejection fraction tells only part of the story. HFpEF is not primarily a problem with how forcefully the heart squeezes. It is a problem with how well the heart relaxes and fills between beats.

    It is also important to distinguish a normal ejection fraction from a normal heartbeat. A person can have a preserved ejection fraction while also having an abnormal rhythm, valve disease, conduction problems, or other cardiac conditions, like me.

    What Does “Preserved Ejection Fraction” Mean?

    Ejection fraction measures the percentage of blood that the left ventricle pumps out with each contraction. In HFpEF, that percentage is generally 50% or higher.

    However, a normal percentage does not necessarily mean that the heart is moving a normal total amount of blood.

    Imagine a flexible balloon that expands easily and fills completely. Now imagine a thick, stiff balloon that can hold only a smaller amount. Both balloons might empty the same percentage of their contents, but the stiff balloon starts with less inside it.

    Something similar can happen with HFpEF. The heart may eject a normal percentage of the blood inside the ventricle, but because the ventricle cannot relax and fill properly, the total amount of blood pumped may still be insufficient—especially during physical activity.

    The National Heart, Lung, and Blood Institute describes HFpEF as a condition in which the left side of the heart becomes too stiff to relax fully between beats. That stiffness prevents it from filling with enough blood to meet the body’s needs efficiently.

    What Is a “Stiff Heart”?

    The heart works in two main phases:

    • During systole, the heart contracts and pushes blood forward.
    • During diastole, the heart relaxes so its chambers can refill.

    With HFpEF, the squeezing phase may remain relatively strong, but the relaxation phase is impaired. The left ventricle does not expand as easily as it should. More pressure is therefore required to push blood into it.

    This is why HFpEF was once commonly called diastolic heart failure.

    The problem may become more noticeable during exercise or other activity. The body needs more oxygen-rich blood, the heart rate increases, and the ventricle has less time to fill. A stiff heart may not be able to increase its output enough to meet that demand.

    This can contribute to symptoms such as mine:

    • Fatigue
    • Shortness of breath
    • Reduced exercise tolerance
    • Lightheadedness
    • Swelling
    • Rapid weight gain
    • Difficulty breathing while lying flat

    How Does Pressure Build Up?

    When the left ventricle cannot fill easily, pressure begins to rise inside it. That increased pressure can travel backward into the left atrium and then into the blood vessels in the lungs.

    As pressure rises in those vessels, fluid can move out of the bloodstream and into surrounding tissue. In the lungs, this congestion can cause shortness of breath, coughing, reduced oxygen levels, and difficulty breathing while lying down.

    Congestion can also affect the right side of the heart and the veins returning blood from the rest of the body. Fluid may then collect in several places, including:

    • Feet and ankles
    • Lower legs
    • Abdomen
    • Lungs
    • Tissues around internal organs

    Some people first notice tighter shoes, sock marks, swollen ankles, abdominal fullness, or an unexplained increase in weight. Others experience worsening shortness of breath before obvious swelling appears.

    How Is Excess Fluid Removed at Home?

    For many people with heart failure, fluid management begins at home. The exact plan should be developed with a cardiologist or other healthcare professional and may include:

    • Limiting sodium, mine is around 1200mg a day
    • Following a prescribed fluid limit, mine is 1.5 liters a day
    • Taking an oral diuretic, sometimes called a water pill
    • Monitoring weight, blood pressure, symptoms, and swelling daily
    • Contacting the healthcare team when warning signs appear

    Diuretics help the kidneys remove extra sodium and water through urination. This can reduce congestion and make it easier for the heart to work. It also make you having to use the washroom much more frequently.

    A person should not begin taking extra diuretic medication or change the dose unless their clinician has provided specific instructions for doing so. Too much diuretic can cause dehydration, low blood pressure, electrolyte abnormalities, or worsening kidney function. I’ve been in the hospital for this.

    What Happens If Home Treatment Does Not Work?

    If oral medication is not removing enough fluid—or symptoms are becoming severe—hospital treatment may be necessary.

    In the hospital, clinicians can give diuretics intravenously. IV medication enters the bloodstream directly and may work more quickly and reliably than oral medication.

    The healthcare team may also:

    • Measure urine output
    • Monitor daily weight
    • Check kidney function
    • Check sodium, potassium, and other electrolytes
    • Monitor blood pressure and oxygen levels
    • Adjust heart failure medications
    • Treat the condition that triggered the worsening congestion

    In uncommon, severe cases where medications are not effective, a specialized filtration procedure may be considered to remove excess fluid. Most episodes, however, are treated with carefully monitored IV diuretics.

    Why Daily Monitoring Matters

    Fluid can accumulate before it becomes obvious in the feet or ankles. For that reason, daily weight is one of the most useful early-warning tools for someone living with heart failure.

    Weight should generally be checked:

    • Every morning
    • After using the bathroom
    • Before eating or drinking
    • On the same scale
    • In similar clothing

    The American Heart Association advises contacting the healthcare team about a sudden gain of approximately 2–3 pounds in one day or 5 pounds in one week, because it may indicate fluid retention. These are general guidelines; each person should follow the limits established by their own healthcare team. These are the thresholds I have also established with my doctors.

    Blood pressure should also be recorded regularly, but there is no single blood-pressure threshold that applies to everyone with HFpEF. Both high and low blood pressure can create problems. The appropriate range depends on medications, kidney function, symptoms, and other medical conditions.

    A useful daily record can include:

    • Weight
    • Blood pressure
    • Heart rate
    • Swelling in the feet or legs
    • Shortness of breath
    • Ability to lie flat comfortably
    • Fatigue or lightheadedness
    • Diuretic use
    • Sodium and fluid intake, when directed

    The trend often matters more than a single number. A gradual weight increase, falling blood pressure accompanied by dizziness, or steadily worsening breathing deserves attention even when no individual reading appears extreme. I track these daily in an Excel spreadsheet. I will make a post and explain how and what I track.

    A Normal Ejection Fraction Does Not Mean a Normal Heart

    HFpEF can be confusing because the heart may still appear to squeeze normally on an echocardiogram. But the heart must do more than squeeze—it must also relax, fill, and respond when the body requires additional blood flow.

    A stiff ventricle cannot perform those jobs efficiently. Pressure rises, blood backs up, fluid accumulates, and symptoms develop. That is genuine heart failure, even when the ejection fraction remains preserved.

    Living with HFpEF means learning to notice small changes before they become emergencies. Daily monitoring, medication, sodium awareness, and communication with the healthcare team all play important roles in keeping fluid and symptoms under control.

    This article is based on personal experience and general educational information. It is not medical advice. Medication doses, fluid limits, sodium goals, and warning thresholds should be established with a qualified healthcare professional.

  • Equate 8000 Blood Pressure Monitor Review: What I Use Every Day

    Equate 8000 Blood Pressure Monitor Review: What I Use Every Day

    A reliable blood pressure monitor is an essential part of my daily routine. Every morning, I check my blood pressure along with my weight and other health measurements. These readings help me notice changes and provide useful information to share with my doctors.

    Because I live with heart failure and other chronic health conditions, I pay close attention to possible signs of fluid retention. Blood pressure alone cannot determine whether fluid is building up, but I use it as one part of the overall picture—along with changes in my weight, swelling, symptoms, and the care plan provided by my medical team.

    The monitor I use is the Equate 8000 Series Premium Upper Arm Blood Pressure Monitor. I purchased it at Walmart and have found it dependable and easy to incorporate into my morning routine.

    What I Like About It

    One of its most useful features is Bluetooth connectivity. My readings can be synchronized with Apple Health, which helps keep my health information together and makes it easier to review changes over time.

    The monitor supports two users, so two people can maintain separate reading histories on the same device. It also alerts me when it detects a potentially irregular heartbeat during a measurement. Since I live with persistent atrial fibrillation, I do not use that notification to diagnose anything, but it is still useful information to notice and discuss with my healthcare team when necessary.

    It offers two different measurement modes:

    • A standard mode that takes one blood pressure reading
    • A multi-reading mode that takes three readings and calculates an average

    I especially like the three-reading option because blood pressure can vary from one measurement to the next. Having the monitor calculate an average gives me a more consistent number without requiring me to record and calculate three separate readings myself.

    The monitor is also extremely quiet while operating. That makes it convenient to use early in the morning without disturbing anyone else.

    It runs on four AA batteries, so it does not need to remain plugged into an outlet.

    What I Don’t Like

    My only significant complaint is its size. It is larger than some blood pressure monitors, so it is not the most convenient choice for travel or for someone with limited storage space. For regular use at home, however, the size has not prevented it from becoming a valuable part of my routine.

    My Overall Opinion

    This monitor has worked well for my needs. I like its Bluetooth syncing, support for two users, quiet operation, irregular-heartbeat detection, and the option to average three readings.

    It is not the smallest monitor available, but for daily home use, I have found it convenient and dependable. Most importantly, it helps me consistently track information that I can review over time and share with my healthcare providers.

    View the Equate 8000 Series Blood Pressure Monitor at Walmart

    This is my personal experience with a product I purchased and use. It is not medical advice, and a home blood pressure monitor is not a substitute for evaluation or treatment by a qualified healthcare professional.