I suffer severe edema from CHF - perhaps an MD or another sufferer explain to me.?

Question

I've taken Zaroxylyn & torsemide for a few months. Strangely, the water packed and sitting in the tissue spaces has never subsided, and diuretics produce ony a minor urination. But this trapped water from edema of CHF, what or how can drain or pull it out of the spaces in the thighs, feet, ankles, calves, & abdomen where it sits with bursting pressure.? I am told by Mds that it traversed the capillaries within the tissues and filled those spaces. But once this hAPPENS, really how can diuretics bring it out in urination.? Someone please explain. I developed CHF post MASSIVE MI - my ejection fraction is 50% - I have global hypokinesis and severely reduced left ventricular systolic function. I live in extreme torments from liver swollen with fluid and thighs to feet, under extreme water pressure from within. IF God would take me tonite , it would be an act of mercy and my fondest desire. CHF also makes nausea for drink & food, can't recline & sleep. slight exertion gives gasping.

BAUER- thanks for a clear, carefully written answer. I begin to grasp the elusive facts. I am on aCE-inhibitors, not beta-blockers. I may try to undergo ultrafiltration by machine to siphon of liters of water from my blood. If they accept me. WAs OK till Nov.06 then sudden edema started.
Thanks for your clarity & thoughtful reply. You will be a great doctor.

Answer 1

The fluids that are in the tissue spaces is called, "3rd spacing" the diuretics are of little value to directly effect that. What they will do is remove the excess fluid in your circulatory system and that will cause the 3rd paced fluids to be drawn back across the cell membrain. A very slow process. You may want to prop up your feet and this may help some. You have to remember that fluids will find the lowest point. Also sitting decreases the circulation in the legs. So no prolonged sitting and try to keep your feet elevated. Lay on the sofa with a pillow under your feet and under your head so your butt is the lowest point.

Answer 2

I sure hope they have you on Lasik. That is the diuretic of choice for CHF.

Diuretics cause you to lose the water filtered by your kidneys from your blood. Water from your tissues leaves to replace the water lost by your blood. This water is then also lost by filtration through the kidneys.

Water leaves the tissues to join the blood because the blood has "oncotic pressures". The proteins that aren't filtered by the kidneys act as molecular magnets for water. The main blood protein is called albumin. Make sure that you have enough. It is made by the liver, and since your liver is damaged by your ascites (fluid retention) it may not be producing enough which would explain the lack of effect of the diuretcs.

By the way, an ejection fraction of 50% is really not bad, normal is 60%. People can live with 20%, though severely compromised.

I'm sure you are are not sleeping well. Make sure you are sleeping on a few pillows to prevent fluid buildup in your lungs when you are horizontal.

Exertion leaves you gasping because you are most likely on a beta blocker (metoprolol, toprol, lopressor are all names fo the same thing). These prevent your heart from having the ability to work harder. It leaves you gasping, but your heart is "on vacation".

Answer 3

seems you have a pretty good knowledge about your problem if you know your ejection fraction, unless your doctor told you without explanation. your heart can't get the blood out to the body do to abnormal functioning of the heart. the blood gets backed up in your venous system. the blood is then pulled down by gravity toward your feet through the inferior vena cava. Laying down is a problem because the head down position will force fluid to areas other then your feet. There is no cure for this. Once the damage has occurred to the heart tissue from the MI the heart tissue is dead. Your heart builds up more heart tissue to compensate for the damaged areas. the increased muscle mass will build up on the inside of the heart and outside. This deceases the space for blood in the ventricles of the heart, making the heart have to pump faster to get out the same amount of blood per minute. The result is eventually the heart will be unable to meet the bodies demands resulting in cardiac failure/ death. If you have CHF, then you know when you do any activity that you become short of breath easier then before the MI.
To decrease the rate of failure, you can control your diet, lose weight, quit smoking, and talk with your doctor about blood pressure medications and water pills. 50% ejection fraction, means your heart is pumping only half of the blood it should pre unit of time. Resulting in less oxygen to the muscles.

Answer 4

Very tough problem. I doubt you can get much help from this web site, although I don't blame your for trying. Be very careful about taking advice from here. For example, one of the previous "experts" stated you should be on Lasik (probably means Lasix), so he clearly does not know that Zaroxylyn does the same thing (diuretic). You need to ask your cardiologist these questions, and make sure he/she understands how miserable you feel. I know this wasn't too helpful a post, but I hope and pray that you will feel better.

Answer 5

I do have to agree with Jeffery, here is not the place to get help with your problem, a couple of the answers are entirely incorrect and is best answered by you Dr.. Don't be afraid to call your Dr. and complain, thy are their to help you and will , but if thy don't know in between your visits what is going on thy can't help you. its hard to remember everything you are going thu so keep a diary and bring it with you to your Dr. and also any questions you may have

Answer 6

you definetely might desire to work out yet another heart expert and doubtless even commute to a distinctive scientific institution for therapy,such because of the fact the cleveland medical institution or perhaps the mayo medical institution..there is not any reason to be suffering this way...has any scientific expert suggested a surgical operation to shrink the dimensions of the left ventricle