CHF Patient with Anasarca?
My mother has CHF with anasarca. How can you get the swelling under control? Can anararca be controlled? She is on the following medications:
Any help would be appreciated. I am her daughter trying my hardest to help her. Thank you for taking the time to read this.
Anasarca is simply extra fluid, which all CHF patients battle, that accumulates in the abdomen. Diuretics help (metolazone and lasix) by helping the kidneys excrete fluid. The heart medications metoprolol, coreg and digoxin all help the heart work more efficiently. (Side note– metoprolol and coreg are the same class of medication, so check with your doctor that your mother is supposed to be on both of thesse at the same time. Sometimes people are on both.) An important number to know in CHF is your EF, or ejection fraction. It is an indicator of the power the "pumping" part of your heart has. A patient with an EF less than 40% generally should also be on an ACE-Inhibitor (Lisinopril, Enalapril, etc.) or an ARB (valsartan, irbesartan), unless contraindicated (ask your doctor.)
To minimize fluid retention, there are several things you can do. Limit salt and fluid intake as directed by your physician. Exercise. Eat nutritious meals and get plenty of protein. Elevate your legs when at rest. Some doctors have their patients use compression stockings on their legs.
When these measures fail to keep fluid retention under control, patients with severe anasarca will sometimes undergo paracentesis, which is using a large needle to drain fluid from the abdomen. Patients can hold liters and liters of fluid in their abdomen– just last week we took 17 liters off of a very sick patient!
Maintain a good relationship with your physician. Monitor daily weights and call as soon as a weight gain of 2 pounds overnight or 5 pounds in one week is noted, or as directed by your physician.