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My father, in his 80's. He has had an atrial fibrillation for the last decade.


He is currently in the hospital for treatment of an infection, which is clearing. They have now said his heart is working at 15%, his blood pressure is low and he has water retention.


The doctors are using a diuretic to clear the water, but if the blood pressure does not increase as a result, they will stop the diuretic treatment.


I wonder if anyone could chime in with any knowledge or experience of where we may be headed, should the diuretic not do it's job.

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Ukpear, that's good news! Any further conversations with his doctors?
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Ukpear, how is dad doing?
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ukpear Jul 2023
Things have improved - the diuretics are helping, but systolic blood pressure is still low at 90. Definitely more positive than last week.
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My unprofessional feeling is that your father has Cunjuctive Heart Failure (CHF). The heart no longer can pump blood thru his body. Because of this, he is not getting enough oxygen either. Because the heart is not pumping correctly there is water retention that needs to be gotten rid of because the lungs will fill up with fluid. The heart muscle is the problem. Hope this info helps in asking the Dr. questions.
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No one is going to give you a straight answer because at a certain age and health condition it is just a guess if one will continue to improve or decline. We understand the desire to know but it is an unknown. That he is critical perhaps is known. Will he recover to go home. Time will tell.
Here is an example.
My mom had CHF. On her last trip to the hospital she also had a UTI and was in ICU for several days. Once the fluid was off, she went to a Rehab in the hospital. They kept a close eye, but she was doing great in rehab. She had just gotten a speech evaluation to check her swallowing. It was recommended that she start using thickener in fluids. The next day she was diagnosed with aspiration pneumonia.
She went from going home to dying in what seemed like a few hours.

If not for the pneumonia she would have been going home and we had already decided on hospice care at home because she was just so tired of the daily struggle with the fluid. Instead she left ICU for a nice Palliative care room in the hospital, family gathered and she died.

At a certain point with the fluid and your dad with the BP issues, the pendulum will swing. The human body is a miracle but does wear out.

It is sometimes not the primary disease that one dies from. We selfishly want them to live but it isn’t always what’s best for the patient. Big hugs.
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My dad had a EF of 16% and went for months. The doc said he didn’t know how my dad was alive. It was from chemo heart damage. One day, months later, my dad died peacefully in his sleep.
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southernwave Jul 2023
He was actually cancer free when he died.
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UKPear, welcome and (((hugs))).

In your shoes, I would contact the cardiologist and say something like "I was too shocked by the bad news to fully take in what you were telling me today.

Could you possibly explain really simply what prognosis we might be looking at if the diuretics don't work? Is there further treatment or should we be thinking about hospice and end of life care?"

I went through this with my elderly mom; her heart rate dropped significantly and she was hospitalized. The attending cardiologist told me something that I didn't really understand.

My brother said to him "Doc, I'm not that bright; what are we looking at here?".

The doctor said "your mother will be dead this evening if we don't put in a temporary pacer and schedule her for a pacemaker in the morning."

You need to let the doctor know that you are willing to hear the hard details.

Wishing you and your family better times.
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I agree that your father’s doctor is your best resource.

My dad had heart issues as well as my brothers. Everyone’s situation is individual.

You may want to consider speaking with the hospital social worker to see what may be needed down the road.

Wishing you peace as you continue on your caregiving journey.
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What did the doctor say? And why don’t you trust what they say?
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ukpear Jul 2023
I do trust them.

They said he's not out of the woods yet.

I guess I'm trying to understand where he could be heading, and what we as a family might expect.

The chat itself was a bit of a shock.
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This is a question for your fathers doctor, but to me it doesn't sound good. Perhaps it's time to bring hospice on board, so your father can be kept comfortable until the Good Lord takes him home.
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