I'm hoping to hear from those who actually HAVE CHF & much edema?

Question

Please answer only if you are a MD or if you YOURSELF have severe CHF &*edema.after an MI. I developed massive MI after car struck me, my ejection fraction today is 50%. Recently my body is swelling badly with ascites, leg & ankle swelling to point of severe pain from pressure inside tissues. I have severe left ventricular dysfunction & severe global hypokinesis. short of a heart transplant, I understand my condition is chronic, progressive & due to damaged heart pump unable to circulate blood well, so that return blood backs up into tissues & organs. I tried many diuretics, Hydrochlorothiazide worked poorly, inducing urination far less than a cup of coffee. Lasix & loop diuretics worked not at all. Cardiologists have no magic wand to cure my dilemna. They rely on Diuretics so much to expel edema. but cause is cardiac damage. I restrict fluids now & sodium, with little effect. I am nauseous & am bloated horribly in my tissues. My bloodwork is normal. Observations??

Answer 1

First, you really do need to get that fluid off, and diuretics are pretty much your only option. The extra fluid increases your blood volume, making your heart work harder and thereby slowly causing more damage. It's very unusual for lasix not to work at all so either they're not giving you enough to get to the 'threshold' that makes you pee or there's something wrong with your kidneys. Once the threshold is reached, your prescriber should increase the frequency with which they're giving it to you instead of the dose.

After they've taken all the excess fluid off of you, other medications are used to ease the work on your heart. Spironolactone and ACE inhibitors such as lisinopril are medications that help prevent further damage to your heart. Beta blockers such as metoprolol and atenolol are used after everything else is stable, i.e. the excess fluid is removed, to decrease the strain on your heart. But most important right now is the fluid issue.

If you're seeing a cardiologist, they already know everything I'm telling you and are struggling to manage your body's lack of response. As I mentioned before, it could be that your kidneys aren't working properly. Or it could be that you're taking medications that cause your body to hold onto fluid. Anti-inflammitories such as ibuprofen (Advil) and naproxen (Naprosyn) can do this as well as cause damage to the kidneys. Also, if you have ascites, you may have damage to your liver. When the liver gets damaged it can produce less protein called albumin, and then fluid leaks out into the abdominal cavity and other tissues causing edema and ascites. If you've ever had hepatitis or a history of heavy drinking, those could be causes for liver damage.

Blood tests you may want to ask about include LFTs (liver function tests), CMP (complete metabolic panel), creatinine clearance, and fractional excretion of sodium. However, if you have good doctors, these have probably been done already.

Answer 2

Hi Danny, I'm not a MD or CHF patient but I suffer from exess fluid issues, I have lymphedema. I'm not sure if something like Manual Lymph Drainage might be helpful in your case, it would help the legs and ankles and improve circulation but with your heart condition I'm not sure if it would be a good thing, you might want to ask your doctor about it though, just thought I would suggest it as a possibility. My mother had very severe diabetes and chronic angina problems for many years. She wound up with ascites and pain and they never did anything to help her at all, no diuretics or anything. I wish I had known more at the time to help her. My MLD therapist does see and treat heart patients so that's why I suggested the MLD. It could be that in the accident some of your lymph nodes were damaged too when they did the breathing aparatus and the surgery for your leg too.

Answer 3

I am unable to help with how to get rid of the fluid, but I can assure you that you need the best sleep you can get. It is important to elevate your legs at night and elevate your torso when sleeping. Elevating your torso will reduce pressure on your lungs and heart while you are sleeping or just resting. By elevating your legs, fluid will seek a lower level and hopefully be eliminated through your bladder. I bought a Craftmatic Adjustable Bed and it has helped my CHF more than all the meds combined. Good luck.