Fluid Retention

[Kevin]

I am scheduled for my 3rd AVR on Nov 26th. I was very fortunate in past situations to have very minor symptoms. Not so this time.

Biggest bother right now is fluids. My calves and legs are loaded up and my belly is very bloated also. They took Xrays yesterday and confirmed there is no evidence of pulmonary edema, so that was really good news.

A couple of weeks ago, after my angiogram, my cardiologist put me on 20mg of Lasix, which I know is a low dose. It hasn't had any real effect as far as I can tell. (I have been weighing myself daily).

In addition to the swelling, things are pressing on my stomach and I tend to vomit a lot. I now eat about 600-800 calories a day because I can't take much more than that wihtout vomitings. Also can't really eat after early afternoon without it sitting in there and coming up in evening.

I've been on this low intake of food for more than a month and I am the heaviest I've ever been due to fluids.

Yesterday my doctor doubled the dose to 40mg per day of Lasix. I hope this helps because I really would prefer to go into my surgery without all this fluid.

I have one question.....

Are there any natural remedies for getting rid of fluids that I might employ to help things along? I do not mean pills or herbals or anything like that - Iam thinking more about foods that could help or any other ideas anyone may have.

Thanks in advance for your help.
Kev

 

[Lynlw]

not for the fluid, but the food intake problem, have you tried eating small amounts of food thru out the day, kind of like for hypoglycemic diets where you have small meals every 2 or so hours and eat 6-8 toimes a day instead of the usual 3 big meals?

Also for the fluid, have you cut down/out salt? there are some good posts (by Nancy) about low/no salt diets for CHF in the recipe section

 

[njean]

I hate to tell you this, but you are in full-blown CHF(congestive heart failure)!

The way you describe yourself is exactly the way I was when I was waiting for my 2nd OHS. Every inch of me was swollen with fluid retention. Towards the last two weeks of my wait, I would vomit everything that I ate & everything that I drank. The drs. said that I was literally drowning in my own fluids. And in order to be able to get any sleep at all, I would have to sleep sitting up completely or else I felt like I would drown if I tried laying down. When I was flown by emergency to Houston, I had gained 30+ lbs. of just fluids.

If the 40mg is not helping you much, then perhaps your cardio can increase it some more before your surgery. The added fluid will not make a difference in your surgery. They will still operate on you & you will lose the fluid almost immediately. I did.

Best of luck to you & hang in there. You don't have too much of a wait but I know you feel like it's an eternity.

I'll be praying for you!

 

[njean]

I hate to tell you this, but you are in full-blown CHF(congestive heart failure)!

The way you describe yourself is exactly the way I was when I was waiting for my 2nd OHS. Every inch of me was swollen with fluid retention. Towards the last two weeks of my wait, I would vomit everything that I ate & everything that I drank. The drs. said that I was literally drowning in my own fluids. And in order to be able to get any sleep at all, I would have to sleep sitting up completely or else I felt like I would drown if I tried laying down. When I was flown by emergency to Houston, I had gain 30+ lbs. of just fluids.

If the 40mg is not helping you much, then perhaps your cardio can increase it some more before your surgery. The added fluid will not make a difference in your surgery. They will still operate on you & you will lose the fluid almost immediately. I did.

Best of luck to you & hang in there. You don't have too much of a wait but I know you feel like it's an eternity.

I'll be praying for you!

I forgot to mention one important thing.....if you're taking Lasix, you need to be taking potassium as well because you will be losing potassium with the increased urination.

 

[Nancy]

I helped my husband with fluid retention (CHF) for many, many years. He had a very difficult time with it. Here are some things I learned.

Fluid accumulates in the extremities, but it can also accumulate in the abdominal area (ascites). When this happens, it can press on the liver, stomach and in Joe's case sometimes his spleen. It can also get into these organs.

Once ascites sets up shop in your abdomen, you can lose your appetite, and you can also get nauseous. And of course, your stomach area will blow up and make you very uncomfortable. Another thing that happens with ascites is that the pill form of Lasix doesn't always work sufficiently well. I think that is because your digestive system organs become compromised, and they are necessary to get Lasix into your system.

When this happened to Joe, his doctors tried the addition of Zaroxolyn 1/2 hour prior to the Lasix dose. That boosts the effect of Lasix and can give great relief. If this doesn't work, then a trip to the ER is probably what would work. They will put you on IV Lasix, bypassing your compromised digestive system and get Lasix into your bloodstream where it can work on your kidneys better.

If your doctor does any of these things, you have to get lab work done to check your Potassium and other electrolyte levels. Plus you should have a full metabolic profile done to check your liver function, kidney function and general blood values. You should be on Potassium supplements anyway with Lasix.

Joe also had to stay on a diet that was extremely low in salt and sodium, just barely enough to keep him healthy. It was hard, but he did it.

Don't fool around with CHF. It has to be taken seriously. Make sure your doctor is keeping a good eye on it for you. Doesn't sound like it to me, but maybe you have to bug him more.

If your legs are very swollen, you must keep an eye out for cellulitis which is a skin infection that can happen when the skin is stretched too far and causes little breaks in the skin. Your legs can also weep. If your legs get sore and the skin is red with a rash, hot and very touchy, you need to call the doctor asap and get on some antibiotics.

You should also be using medical support stockings to keep that swelling down.

 

[Kevin]

Yikes. This all sounds scary. I very much appreciate the information.

I am on potassium supplements, so that part is good.

This morning was my first dose of Lasix at 40mg. Already, I have noticed much better urine production, so I'm hoping this will help.

I already do eat very little very often. It seems like the only way I can keep it down. I am a pretty low sodium guy already, but will definitely cut this back further as well.

My doctors said it all looked managable and they said if I experience any fast weight gain to take 60mg of Laxis on a temporary basis. They also said if the weight gain is fast and I feel worse - go to the ER.

I was totally unaware of the skin infection possibilities. Thanks for making me aware of this. I will keep a close eye.

I forgot how comforting it can be to share this information with others and be able to use the experience so I can talk to the docs in a more educated manner.

Thank you so much. I will give you an update soon!
Kev

 

[Nancy]

I don't know if this will help to stave off a skin infection, but when Joe's legs got big, I used to rub them with infection control foam that you can get over the counter in the pharmacy.

CHF is manageable, but it takes careful supervision on your part and a willingness to call and bug your doctor. I guess he does sound like he is doing the right things. So, do your own part and keep a very careful eye on your symptoms.

Here are the classifications of CHF, so you can tell where you are.
http://www.abouthf.org/questions_stages.htm

And here is a site maintained by a young man who has CHF. It's VERY informative.
http://www.chfpatients.com/CHF.htm

 

[Kevin]

Well, I have some good news. Since doubling the dose of Lasix to 40mg per day, I have lost about 5 pounds. That's in 3 days or so.

That 5 lbs has made all the difference. Sleep is easier, I haven't vomited since and my legs and belly have reduced in size. Not perfect yet, but a LOT more tolerable.

Thank goodness... honestly, if I had to continue feeling the way I was, I'm not sure how long I could go on without going bonkers.

Hopefully, I can unload another 5lbs of fluid, but if not - I won't be complaining. This level is very tolerable.

Thanks so much for everyones responses so far. I learned a lot and will definitely follow the good suggestions you gave me.
Kev

 

[Nancy]

That's good news. It would be good to also get rid of any extra fluid you think you have gained. Once to get to your bottom line where you think you were normally, then you will have a baseline to compare sudden fluid gain. So try to do that. And when you are at your normal weight, get a girth measurement around your stomach area. That will be helpful too, in case you develop ascites again.

I kept a daily log for Joe with his weight, blood pressure and temp. Did that faithfully every morning when he weighed himself after using the bathroom, before breakfast and w/o clothing. Sort of like in the hospital when the nurse comes along to get your vitals.

One of his doctors said this was an important and valuable thing to do.