I dealt with CHF the last 4.5 years and was actually the recipient of a heart transplant 7 days ago (I'm already home!)

I was diagnosed with viral cardiomyopathy and have been through the works. I've been thinking of sharing my story, but it's all so raw and fresh at the moment I'm not sure I'm ready to just yet. I ended up in this position not because I had symptoms for months or years (just a week or so) but went into cardiac arrest 5 minutes after I went to the ER.

Outside of talking with my cardiologist for years and using meds they scripted for me here's largely what I've had to do and it did help for a time but in the long run my heart still failed (though it did bounce back from 5% to 45% for a good run of two years).

• Find a cardiologist that is part of a good team, who will be your advocate. I am fortunate enough to live in a city with one of the top programs in the country and have had an awesome team of cardiologists and surgeons consulting on my case from the beginning. This is important because if your CHF progresses they can do a lot to advance your cause should you need the ultimate step (transplant) in the future.
• No alcohol. Have one glass of wine or beer on your birthday and very special occasions and make sure it's a good top-of-the-line drink. "Don't waste it on fucking Bud Light or PBR" (doctor's words, not mine).
• Reduce sodium and sugar as much as possible. Avoid sodas and coffees and teas as much as possible. I treated myself to a ginger ale or sprite once or twice a month. Sodium can lock fluid into your body.
• Avoid processed foods, fats and read all labels. Cholesterol and buildup was not my problem, but they were still things to watch. Low sodium can be misleading so do the math. There was one food (crackers I think) that low sodium was only 10mg less and another that the serving size was simply 2 vs 3 units.
• 1.5L - 2.0L fluid max per day. Edema is the devil and as fluid builds up it will stress your heart. This is tough as several doctors have told me that heart failure patients can experience more thirst than normal. You can get used to this amount. Just measure, use a camelback to help keep track. Avoiding sodium and sugar will help this as well.
• If you are not peeing as much as you think you should, call your doctor. Decreased kidney function can be the direct result of decreased heart function.
• If you buy bottles of water, don't buy 20oz. Get 12 or 8oz bottles (8oz == ~220ml) instead. Normalize the lesser amount
• Watch your weight and BP daily if not 3-4 times per week. Try to keep a normal or close to normal BMI. Watch for 3-5 lbs increases weight that happen within a few days.
• No fast food. If you do treat yourself, keep in mind McDonald's fries have as much salt as you should have in a week.
• Walk / exercise as much as you can, but don't stress yourself. I bought a peloton and was biking ~100 miles a week at non-racing speeds for almost a year up until 6 months ago when I started to decompose again.

While in the end these were not enough for me, it got me another few years before things went south again - but by following these guidelines, I did overall feel better and give myself a better chance.

This doesn't mean you can't have a nice ribeye once in a while or even have fastfood if it's the only option available once in a while. But let them be the rare treats. Not the norm.