I ask that either MDs or those who actually HAVE severe ongoing edema of Congestive heart failure reply to me?

Question

since Nov.06 I began to swell with severe edema from ankles up to thighs, liver has severe ascites now. I can no longer walk freely or flex legs to wear pants or climb stairs. I am in severe torment from edema. Torsemide did nothng, Zaraxylyn gave some diuresis but my edema is truly unchanged no matter what drugs I take. Plus, I have toxicity limits due to fevers and nausea & dizziness from drugs.
MY relative faraway, an MD says that .25 mg digoxin daily will clear away this entrenched hard edema. But MY heart attack which started my illness was so MASSIVE - large infarction & scarring in "
EVERY WALL OF the heart. M yEjection fraction is 50%. I have severe reduced both left & right ventricular dysfunction. Seems to me that digoxin might give a boost to a mildly damaged heart, but not one as damaged as mine. I seem also to have poor response to diuretics, since blood perfusion to kidneys is impaired , Do you feel that digoxin can compensate for massive heart damage?

AMY P: thanks for your kind reply. yes, I had thyroid panel & protein checked,, all labs were very normal , liver, creatinine, kidney panel, lipids. etc. Albumin normal. I personally doubt daily digoxin can compensate for my scarred heart. And I thank for your caution about digoxin, Imagine an EKG with every wall showing large MI & scarring? A car hit me, and caused heavy blood loss with cardiac SHOCK. Tauma was massive. I am looking into ULTRAFILTRATION AS ATEMPORARY RELIEF MEASURE. tHEY USE 2 VENO-VENOUS CATHETERS HOOKED TO A PUMP, OVE 8 HRS ,5 LITERS CAN BE SIPHONED OFF OF SERUM AS IT RETURNS TO VEINS.

amy, i HAVE POOR RESPONSE TO ALL DIURETICS, My edema in tissues remains unaffected. Please stay in touch with me and pray for me if you could. God bless you.

Amy: thanks again for your concern. I an now convinced that no matter what diuretics I take, thse drugs simply DO NOT expel & force out the water within my tissues. this fluid, once it exits or leaks from the capillaries, in to the tissue spaces, seems to be sequestered , or unreachable to the drugs.My jugular veins are gross & throb constantly. From my right leg, clear cold water (plasma) drips 24/7.Edema began about Nov. from foot ,then ankle,leg,calves,knees,

Answer 1

Your ejection fraction is considered low normal, and a poor ejection fraction, if this number is accurate, is not the cause for your edema.

The fact that you have ascites and severe edema suggests to me that you have right sided congestive heart, as opposed to left sided CHF. (You might also have another cause for your edema, such as protein in the urine or a thyroid condition. . . has this been checked??)

Digoxin is unlikely to help, unfortunately.

Just want to add a bit more, as I got interrupted when I was answering you previously.

The trauma you suffered explains a lot. I think ultrafiltration would be an option for you, although I have only read about it, and not performed it on any of my CHF patients. Another option might be something called enhanced external counterpulsation or EECP, which is also used in congestive heart failure (as well as intractable angina pectoris).

Do you have cardiac cirrhosis, or damage to the liver from right sided congestive heart failure? This certainly could contribute to your edema.

And yes, I will keep you in my thoughts and prayers. This is a miserable situation. I wish there was more to offer.

Amy

Answer 2

1

Answer 3

An ejection fraction of 50% is not really that bad; Normal ejection fraction is 55-70%. I have seen many people with 20% EF who are walking/talking. You need to focus on treating the symptoms of a low ejection fraction since a low EF is irreversible.

Yes Digoxin will help condition because it helps the heart to contract more vigorously and effectively, and helps to reduce symptoms, such as edema.

You still need a diuretic such as furosemide to relieve the leg swelling.

If your heart rate is greater than 80 and especially if its in 90-100's you should be on a beta-blocker to improve symptoms by slowing the heart’s contraction rate and reducing its pumping action, thus lessening the heart’s workload. Keep in mind that digoxin will slow down your heart rate


Sounds like you may have some liver damage as well if you have ascites. If you are not being treated by a cardiologist then you need to be. A general practitioner is not going to cure what ails you. Good luck.

As for Sumom the person who answered your question, I would call 911 or drive your mom to an Emergency room and get different doctors. To do nothing is unexcusable and her legs need to be treated. If they still do decide not to treat you need a clear and understandable reason why she is not being treated.

Answer 4

My prayers are also with you, not only for relief of your physical pain, but for your emotional anguish as well. Why are you so unhappy with yourself that you will not treat yourself well? Why do you refuse to enter a hospital? Why do you feel you are not worth the care? An ejection fraction of 50% is actually pretty good. You would not qualify for a heart transplant with that. A "normal" EF is 70%. I see people where I work every day with ejection fractions of 15%. While these people do have congestive heart failure, they collaborate with their doctors to optimize their quality of life. I am sad for you, because I believe you are lonely and depressed, and emotional pain makes physical pain even more unbearable. Please do not give up. Keep trying. Please allow someone to help you. You are worth it. Just because diuretics have not helped so far doesn't mean some combination can never work. ....go to the hospital. Let them help you. Lots of people out there really do care.

Answer 5

danny,
i am trying to help my mom who has edema as you do. digixin has helped control it for some months even after congestive heart failure.she spent last week in the hospital without a diuretic. since shes been home the swelling and pain are unbearble. her legs and feet have tripled in size.water is literally pouring out of her skin. a couple spots are so tight that the skin is breaking and ready to bleed. her m.d. doesnt seem alarmed and we
cant get an answer that we understand!we would be truly greatful if you would share any answers that come your way. please email me and i will gladly do the same.you will be in our prayers.thank_you, [e-mail] and mom...

Answer 6

Please read the book, "Miracle Stem Cell Heart Repair For Heart Attacks, Heart Failure & Bypass Patients" by Christian Wilde, Abigon Press, ISBN 1-59975-054-6, published in October 2006. I am presently reading that book for review purpose.

I think you will find hope and I hope you will be accepted for one of the trials that are going on. I am sending Reiki to you for your highest welfare. To know what is Reiki (if you don't know about it), contact me separately.

I hope you don't mind my replying to your question though I am neither a MD nor a patient of CHF.