congestive heart failure/kidney failure

[Deesknee]

I am wondering if anyone has history of aging parents, or I suppose spouse/friend etc., with Congestive heart failure due to aging. My Dad is 88. He has had several stents put in & bypass surgery in the past. He was diagnosed with congestive heart failure a few years back, and more recently kidney failure. We took him to the doctors a couple days ago as he was complaining of excessive difficulty breathing. He was released after IV/meds for his swelling. Sent home with a RX and advised to be better about his salt intake. He moved up here from FLA (to an asst. living community) in March. I've been thinking some of his symptoms were allergy/seasonal. Now, I am very concerned he is worse than I thought. His breathing has become much more strained within the past week, and his nose is constantly running. Also, he is not sleeping well, & is complaining he is tired. Here is part of my concern. We (my brother and I) have been encouraging him to ride the stationary bike, in the gym where he lives. BUT, now I am worried that may increase his heart issue, increasing his difficulty breathing. Does anyone have any knowledge in this area. He has an appt. with a cardio doctor in 2 weeks. I intend to ask him, along with a few other questions, but for now I would like to be able to suggest to my dad that perhaps he should lay off the 2 mile bike excersise if it could worsen his condition, but if it is helping (like we were thinking) I don't want him to stop. Any advise? BTW, he is 88 and in addition to riding the 2 miles a day on the stationary bike he uses weights (about 50lbs) 2x a week to strengthen his arms.
The only experience I have with CHF is my Mom who passed away in Nov. She also had COPD. I know she started coughing to the point of not being able to breathe, and it wasn't long after that that she passed. Am I to expect the same thing with my Dad? He is just recently starting the coughing. Thank you for any advise. And of course prayers.

 

[mommasita]

I don't have any advice or experience. I do offer my thoughts and prayers. Please let us know how it is all going.

 

[Deesknee]

I don't have any advice or experience. I do offer my thoughts and prayers. Please let us know how it is all going.

thank you mommasita.

 

[Disney Enabler]

I don't know about congestive heart failure. I do have Pulmonary Hypertension which effects the heart and lungs. What you are describing sounds like excessive fluid that is impacting the heart and lungs. I would contact his doctor either by phone or email instead of waiting for his appointment in two weeks. Salt intake is really important to watch in addition to how much water intake your Dad takes.

Good Luck. Sending good thoughts and pixie dust.

Carol
It's a great day to be alive!!!

 

[Deesknee]

I don't know about congestive heart failure. I do have Pulmonary Hypertension which effects the heart and lungs. What you are describing sounds like excessive fluid that is impacting the heart and lungs. I would contact his doctor either by phone or email instead of waiting for his appointment in two weeks. Salt intake is really important to watch in addition to how much water intake your Dad takes.

Good Luck. Sending good thoughts and pixie dust.

Carol
It's a great day to be alive!!!

Thank you. He is being excellent about TRYING to watch his salt intake.
I have a question for you, when you say watch his water intake, do you mean make sure he is drinking enough, or not too much? I was pushing the water, but then I began to think, if his kidneys aren't functioning properly, maybe he should LIMIT his water intake. My brother has called Dads cardiologist. Problem is, since Dad just moved back to MA in March this was going to be his first visit with this dr. So, I'm sure they have established patients who are taking precedence.


Dad is doing much better. He was over yesterday, and was breathing MUCH easier, with zero coughing in the 2 hours he was here. Of course the temps being in the high 90's and up today with incredible humidity. probably won't be too good for him. I hope he stays home where he has a/c.

 

[Pea-n-Me]

I hope your dad is still doing ok. Sorry to be late responding.

He is being excellent about TRYING to watch his salt intake.
I have a question for you, when you say watch his water intake, do you mean make sure he is drinking enough, or not too much? I was pushing the water, but then I began to think, if his kidneys aren't functioning properly, maybe he should LIMIT his water intake.

I'm sure by now you have gotten direct recommendations re: your father's dietary and fluid intake from his medical team. But I'll comment in general.

The salt and fluid connection is really important with heart failure. He HAS to be cautious about sodium intake and he has to limit his fluids. General recommendations are not more than 2Gm (2000mg) of sodium and or 2 Liters per day of fluid (24 hrs). Reading labels and watching serving sizes is imperative. (I see he is in assisted living, be sure they are following recommended guidleines!) Sodium holds fluid in the body tissues so that a failing heart cannot pump or perfuse efficiently, and fluid builds up in the lungs and other tissues (often the abdomen and extremities) and organs can start to fail, etc.

Many people underestimate how much fluid they are drinking. Two liters is only about 8 smallish cups in 24 hrs - really not much, especially for men, who usually drink more than women. Hospitalizations aren't uncommon for fluid build up, even when people are "trying to watch" - it has to be quite strict and it's tough to do with the world we live in, unfortunately. Often just going to a party or a restaurant can start the [snow]ball rolling.

Once the fluid comes off with diuretics, it's important to try to keep it off using the above guidelines or whatever tailored recommendations are given specific to him. He should weigh himself daily to make sure his weight is not creeping up, which would be an indication of fluid build up.

I would not imagine he'd be able to do the bike unless he was feeling really great, in optimal health given his condition. HTH.

 

[Deesknee]

I hope your dad is still doing ok. Sorry to be late responding.


I'm sure by now you have gotten direct recommendations re: your father's dietary and fluid intake from his medical team. But I'll comment in general.

The salt and fluid connection is really important with heart failure. He HAS to be cautious about sodium intake and he has to limit his fluids. General recommendations are not more than 2Gm (2000mg) of sodium and or 2 Liters per day of fluid (24 hrs). Reading labels and watching serving sizes is imperative. (I see he is in assisted living, be sure they are following recommended guidleines!) Sodium holds fluid in the body tissues so that a failing heart cannot pump or perfuse efficiently, and fluid builds up in the lungs and other tissues (often the abdomen and extremities) and organs can start to fail, etc.

Many people underestimate how much fluid they are drinking. Two liters is only about 8 smallish cups in 24 hrs - really not much, especially for men, who usually drink more than women. Hospitalizations aren't uncommon for fluid build up, even when people are "trying to watch" - it has to be quite strict and it's tough to do with the world we live in, unfortunately. Often just going to a party or a restaurant can start the [snow]ball rolling.

Once the fluid comes off with diuretics, it's important to try to keep it off using the above guidelines or whatever tailored recommendations are given specific to him. He should weigh himself daily to make sure his weight is not creeping up, which would be an indication of fluid build up.

I would not imagine he'd be able to do the bike unless he was feeling really great, in optimal health given his condition. HTH.

Thank you so much. That is very helpful. He did speak to a couple different specialists who did give us a low down. I am somewhat dissappointed with the assisted living residence food services' helpfullness. They simply told my brother they do their best to cook & shop healthily. I wish they could give us more details than that. Dad actually got readmitted to the hospital Saturday got out Monday and ended up back in tonight. He has pneumonia. They said he is already doing much better, but they are going to keep him in ICU overnight to monitor him. In the meantime, my DFIL passed away Monday night. (after a lengthy battle with Alzheimers)
Again, thank you for ALL you do for these boards. I appreciate the help.

 

[Pea-n-Me]

I'm sorry to hear that, on both counts.

I would ask for a "family meeting" with all involved parties to make sure that everyone's on the same page at the ALF about his dietary needs since they are so important to his health and well-being. You would want to have the dietician, the nursing supervisor, the social worker and an administrator present. You and your brother should go together if possible, too. His needs should be written out in his daily plan of care. I would ask how they are managing his low sodium diet, two liter a day fluid restriction, and whether he's being weighed daily and what plan is in place if his weigh increases. Double check with his cardiologist exact recommendations prior to the meeting. (There could have been some confusion before, but going forward it should be clear.)

 

[Deesknee]

Thank you. My Dad has been moved to a regular room and doing much better. I didn't get to see him yesterday as we had DFIL's funeral. But my brother said he looks better than he has in a long time, & the doctors are happy with his progress. DB & I are going to get together and figure out what is the best plan of action for Dad. Although he is living in an asst. living residence, HE is actually on an independant living floor. I think perhaps he needs to be on an actuall asst. living floor. DB & I will meet, talk options over, then meet with the facility, then DB & I will sit with our Dad. He is still VERY MUCH in charge of his own medical decisions, as his mind (thank God) is still very much in tact.
My thought is the asst. living may be more willing to help with a low salt diet. But, knowing he is unable to live "independantly" may do more damage to him mentally than it will help physically.

 

[Deesknee]

Just thought I'd update. My Dad has been in and out of the VA hospital in Boston. They let him out 2 days ago. He slept 1 night in his apartment, had a regular scheduled appt. with his primary care physician the next a.m. At which time his blood pressure was so low they sent him to the local ER. Where he has been re-evaluated by there doctors who say he is not as bad as the VA said he was. They believe he has been extremely dehydrated. My brother and I are going to get a 3rd opinion regarding Dad's heart & kidneys. In the meantime my Dad says he will stay in this hospital until they get to the bottom of it. He has no desire to spend his remaining years in and out of hospital rooms.
He has spoken with a nutritionalist and understands better the foods he should avoid.

Now it is a matter of stabilizing his bowels, as he has had a bit of a problem with incontinence while at the different hospitals. I honestly think it is his nerves, but obviously I want it checked out.

Now, if you don't mind, I would like to share a heart warming story regarding my recently deceased FIL. Last Friday we buried my FIL. He was a fun loving, kind hearted, sensitive man, whom was loved dearly. He was a founding member of the local (small town) youth football league. So, the family decided to have the local youth football as one of the organizations to have donations send to in lieu of flowers. (the other was Alzheimers). Well, as the funeral procession approached the church from the funeral home, we noticed young children in blue shirts. As the church has a school affiliated as well, we thought the children from the school were having some type of gathering. Imagine our surprise when we realized it was a dozen or so youth football players in game jerseys with helmets in hand lining the path the family and ultimately my FIL's casket would pass. As the casket passed each little guy raised his helmet in honor of my FIL! My FIL had full military honors, but nothing touched our hearts the way those little football players did. My FIL would have shed a tear or two himself with that sentiment. Someone took the time to arrange that. Some of the players stayed for the funeral. People truly are good. Thank you for listening...ah... reading along.

 

[Pea-n-Me]

Touching football story.

Believe it or not, it is not uncommon for there to be conflicting or mis-diagnoses when it comes to heart failure. I agree with a third opinion. Seek out the best specialist in heart failure you can find, and go from there. Be prepared to have his old records sent to this person as well. It can be figured out. Good luck.

 

[Deesknee]

Touching football story.

Believe it or not, it is not uncommon for there to be conflicting or mis-diagnoses when it comes to heart failure. I agree with a third opinion. Seek out the best specialist in heart failure you can find, and go from there. Be prepared to have his old records sent to this person as well. It can be figured out. Good luck.

thank you. That is the way he wants to go as well. ...as least today it is. We'll see once he is out.