Family Emergency

A couple of weeks ago, my dad’s face, legs, feet, and hands started swelling. Concerned, our caregiver called us and told us about his condition. When we took him into his primary doctor, we learned that Dad had developed Congestive Heart Failure. He prescribed him diuretics to reduce the swelling and also a prednisone based inhaler. He also instructed us to put him on a regimen of Advair and his Albuterol given by a nebulizer. For the next 2 weeks, neither was having a dramatic effect on him. So, we took him to his doctor and addressed our concerns on his follow-up visit on Wednesday. However, during his visit his doctor was concerned that his breathing was too strained and felt it was serious enough to get our dad to the emergency room.

On Pins and Needles

Wednesday night, Josie called me from the ER upset. I did not go with her because I had my little girl to tend to. So, I went home after the ambulance picked Dad up from his doctor’s office.  In that moment in time, they had Dad on a ventilator and he was having a really hard time breathing. He had bouts of anxiety where he would start yanking the mask and tubes out of his mouth and Josie had to wrestle him to keep them in. The attending physician had told her that it was a touch and go situation and had a grim look on his face. He told her that Dad not only was showing signs of CHF, but also COPD- Chronic Obstructive Pulmonary Disorder. Given the changes in Dad the past few weeks this was news that we were dreading: not just one eventually fatal condition, but another one as well. I was so upset and scared that we were going to lose him that night because of the way they were talking. I wasn’t able to visit him until yesterday.

Cautious Optimism

Later Wednesday night, Josie called me back and had a little good news: Dad was breathing better. The doctor came back to tell her that Dad didn’t have COPD. That was welcome news. The only thing we had left was to see the results of his echocardiogram.  Well, that didn’t happen until today. Apparently, there’s more good news, that they couldn’t really find anything abnormal.  However, she forgot to ask (given the chaos) the doctor about the CHF again. So, we will be waiting to find out again tomorrow when he visits with Dad again. According to one of the nurses, he does have it, from what she learned but she cautioned that we find out from the doctor directly.

I want to know what stage he is at and what course of treatment they are going to offer him to slow down the process. I’ve been reading more on the condition since I last wrote about it in November’s article on Congestive Heart Failure. (Hope that wasn’t an omen) and I believe it’s true that you must be a patient advocate. Healthcare staff are so overworked and tending to so many patients that sometimes it’s hard for them to be “detail-oriented” about every patient’s condition. So it’s important that you know what questions to ask and not be satisfied until they give you an answer you are satisfied with. So, just waiting again. But I am glad hearing periodic reports from Josie that he is getting better.  I will be making the trek to the hospital later today.

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Congestive Heart Failure

Congestive Heart Failure occurs when the heart is not pumping effectively , and not delivery enough oxygen to the blood.

What Causes It?

  • Weakened or damaged heart muscle as a result of a heart attack or coronary artery disease.
  • Prolonged high blood pressure
  • Damaged heart valves
  • Long term alcohol abuse
  • Chronic lung disease such as emphysema
  • Some viral infections

Symptoms to Look For

  • Fatigue
  • Shortness of breath after exercise or severe shortness of breath after any activity
  • Difficult breathing laying in bed or waking up at night with shortness of breath
  • Swollen ankles and feet along with weight gain because of too much body fluid

Diagnosis and Tests

Your doctor may diagnose by using any of the following tests:

  • Physical exam
  • Chest X-RAY
  • ECG (Electrocardiogram)
  • Ultrasound (Echocardiogram)
  • Special type of catheter inserted into the heart or through arteries

Treatment

  • Increase efficiency of the heart’s pumping action: ACE inhibitor drugs are given to treat congestive heart failure. They dilate or open up the arteries. The heart has less work to do as a result and can pump blood more effectively.
  • Digoxin may also be prescribed to increase the heart’s pumping efficiency.
  • Eliminate excessive water: Diuretics are given to remove water build up in your body as a result of CHF. Potassium supplements are also given to replace potassium losses caused by diuretics.
  • Lots of rest: Each day of complete rest saves your heart approximately 25,000 beats. Alternating rest periods with activities helps.
  • Reduce Stress and Anxiety which increases blood pressure and heart rate.
  • If none of the above work, heart surgery may be needed. More serious cases may need heart transplants or implant or an artificial heart.

If left untreated, CHF can be life threatening. If you follow the doctor’s directions on diet, rest and medications, you will probably enjoy many years of almost normal living.

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