Advice needed.

[Sunflowers99]

Hi. My lovely father is 91. A brief history-He has heart failure. He had a heart attack in his early 60's. Had pacemaker fitted nearly 11 years ago. Had a echo about 7 months ago and found aortic valve stenosis(not yet had appointment to discuss this). He's on various medication for blood pressure, blood thinners and statins. He was took to A and E Tues. They suspected a small heart attack as his troponin level was slightly raised. He has fluid on the lungs and between the lining and chest wall. No infection. Swollen legs and ankles, was on oxygen but now off it. Have put him on diuretics. They said he's being treated for worsening heart failure. My question is what is his prognosis is? What can I expect in the near and longer future? Any idea of time frame? Need to know what care he will need? He maybe home soon so need to make things as comfortable as possible for him. What questions do I need to be asking medical staff. Thank you.😊x

[Ageingfast]

sorry to hear that Dad is unwell.

The two bits I can comment on are

One. The stenosis will be mild or moderate or severe or Critical.

I went for five years with mild stenosis and it was no bother at all. When it reached moderate I still was ok but only one year on moderate. When it reaches severethen you probably have one year to live. The remedy is a new heart valve but I doubt that will be possible for a ninety years old patient with medical issues.

Two. Questions for the medical people…..I listen rather than talk. The only question is what Can I do to help you doctor.

Please give your Dad my best wishes.

From an elderly patient.

C.

[Sunflowers99 in reply to Ageingfast]

Thank you C. Really appreciate the time you have took to reply. I wish you well as you can be. X Thinking of you.

[Hidden]

I was at a Heart2Heart session where we discussed heart failure. It is a deteriorating condition that steadily gets worse. The cardiac nurse said that with cardiac failure, unlike with cancer, it is very hard for the clinicians to know when someone will die. Her advice was plan for the worst and hope for the best. The sessions were run by Hospice Care and they were clear that Palliative Care is now offered by most hospices (not Macmillian and a couple of others) and can be at home. I would suggest you talk to the team caring for your Dad who may be able to point you to what is available locally. Finding out what they offer will put you in strong position to act if you need to. All his treatment so far sounds the ordinary treatment for heart failure.

[SailorGirlBlues]

Hi there! Do they know what brought on the heart failure? It is my understanding that sometimes it can be reversed depending on what brings it on.

Have they told him what his ejection fraction is?

Getting the water off may help. The diuretics may help with the water on lungs. Has anyone recommended a procedure to take the water off? Depending on where the water is there are procedures that can remove it more quickly than the water pills. If I were you, I would make sure he eats foods with potassium as the diuretics can reduce it in the body. Confirm with his doctor though, of course! Labs should give you an indication of how he is doing.

I wish your father much luck and great health!

[Sunflowers99]

Hi.I think Dad was diagnosed with Heart Failure many years ago I didn't know until the A and E doctor said you know he has heart failure? I just knew he had had a heart attack in past, pacemaker and aortic valve stenosis. When I was in A and E I called my partner and told him they said he had heart failure, my partner was putting his shoes on and heading up straight away to A and E thinking it was the end. Hate the way it's called Heart Failure.

Before we took him to A and E on the Tuesday we took him to A and E about 5 weeks before. That's when they said you know he has heart failure. We took him to A and that time because he was breathless walking down the stairs. He was very pale and was slummed over a bit. He had pain in his legs and his legs could not hold him up. We called for a ambulance and after 6 hours they arrived and his stats seem OK and they warned us of the wait. I said he needs to go as my dad wasn't right. We were 7 hours in the back of the ambulance and 20 hours on a corridor. They said his heamoglobin was 75. He had low sodium and high potassium. He got IV for the sodium and a Iron IV. Went on to another ward and his breathing was crackling. He had a chest infection. They got rid off the infection . Had fluid on his lungs, in legs and in the lining and was put on water and iron tablets. He was transfer to a reablement unit awaiting a care package. He was in the reablement unit when he had to be transferred back to A and E that's when he had a mild heart attack. Dad his home now. The day after he came home he had 2 falls. He was ok. He was breathless using the stair but that's improving. He's under a heart failure nurse in the community she has increased his water tablets but looking to decrease it again in 2 weeks. On restricted fluid. His EF is 43.8. She was talking about his fluid levels and she said it was 6800 in hospital now 2700 but wants to reduce it more but I don't what this level is called sorry. His heamoglobin when up to 92 but down now to 81. He has been referred to Gastro to investigate. Dad sleeps all morning now. Breathing is normal but he's not done much. His legs have gone down and has swelling in the feet. Nurse is coming in another 2 weeks. He's having pain in his knees. He is stubborn and won't get a stair lift. Poor thing hates getting old and relying on others. He's in good spirits otherwise. X