I am worried about my husband

My husband is 41, 255lbs. In Oct 2010 he was diagnoised with CHF with an ejection fraction of 30to35%. In Jan 2011 he was diagnosed by a cardiologist with left ventricular ejection fraction of 48% and in Dec 2011 he was diagnoised with end stage cardiac disease and may need a heart transpplant eventually. He is a alcoholic and has abused alcohol from the age of 16. He drinks 211 beer and wine everyday. When he does not have anything to drink, he can't sleep.  As of today, June25,2012, he is having symptoms of shortness of breath, his stomach is big as two basketballs, and vomits mucus from time to time. My questions are is he dying? How long can he live? will his heart just stop without any type of warning? He will not tell me the truth about his health and he will not allow his doctors to tell me. I am really worried about him. Can anyone help me with these questions please?

[jrbon]

I am sorry that your husband is in that situation.

As you already know, no one can answer your questions.

As per if his hearth will stop, this is what all the people that suffer HF are hopping it will happen, unfortunately it is not always the case.

Is he rejecting to go to Emergency ?? This is where he should be.

Jesus

[ideorsan]

Yes, he is rejecting to go to the emergency, and no, I do not already know that no one can answer my questions. I realize that everybody situation is different, however, there has to be some simularity as far as life expectancy for CHF.  I don't understand what the equasions mean, i.e., 30-35%- is that severe, mild? cardiologist with left ventricular ejection fraction of 48%?? and end stage cardiac disease?? Does this mean that he is at the end stage of the disease and there is nothing else to do? what does all this mean? Stage III chronic renal insufficiency? I want to help him but I don't know what to do. I don't understand.

[jrbon]

What I mean is that in your particular case, when your husband seems to be suffering an acute exacerbation of HF, there is no way to know, from the distance, what his prognosis could be.

I know people that are living 20+ years with HF and others that only last for a couple of years... If there is no complications 10+ years are easy to achieve ..

You mention, end stage... but you also said that your husband does not allow you to know what the situation is and that you have no access to the dr. so Have you read any medical report? Does it describe further the problems? Do you know what medication he is on?

In a more cooperative environment, I would advise to stick to the treatment and look for a second opinion. But in your case it seems that your husband has not follow any indication (continue drinking) and most probably it is not following the medication.

I personally, do not trust a dr. that says there is nothing else to do. But of course if the patient does not cooperate.. there is little to do.

As per how severe is the 30% of EF, it depends on how do you feel.. for instance I have 23% and now I am fairly OK. Others with 40% are much worse.

None of the ones that you mention, 30-48%, justify the need for a transplant, either it has fallen very much (to the 5-12%) range or there is another complication.

Short of breath and fluid retention, are normal in HF.. not necessarily implies a near end. But of course the patient need to cooperate.

What can you do to help... if he does not cooperate nothing.... if he cooperate: call doctor, check on a possible increase of diuretics, make him to take all his medication, stop salt intake, stop smoke and alcohol, reduce fluid intake, keep him on a mild temperature (not too cold, not to hot) make him to sleep with several pillows. And make him to go to a Dr.

Jesus

[ideorsan]

Thank you for taking the time to explain. I understand now. Thank You very much :)

[jules6669]

I know what you are feeling right now.  My husband has had 4 heart attacks(first one at age 40), 2 bypass surgeries, multiple caths done.  He had an AICD put in about 8 yrs ago.  History of diabetes, htn,high lipids, chf, acute kidney failure to end-stage failure on dialysis,too many others to mention.

It was a difficult road, many hospitalizations, surgeries, tests, many meds etc,.,,,,my point though is that at the age of 45 the doctors told him that he'd belucky to make it to age 50....well through technlology, great doctors/nursing and most  of all love he did live another16 yrs since that day.  We did have many great years together.  But, he did quit smoking, tried managing his diabetes, didn't drink alcohol, took all his meds, went to all the appointments and so on.  trust me, he was a very difficult patient, who drove the docs and nurses crazy,....he would swear, yell, walk out of hosp against medical advice, chase them out of his room refuse them to put IV's in, refused procedures oh so many things....in the end he usually would relent and let then do what was needed.  like I said they were so great with him, understood that he was afraid, he was mad....from what many of the md's said, "john was not the "typical" patient...everything was different with him...they were amazed at his will to live.  There were 5-6 imes when I was told he wouldn't make it this time and to get things in order but til the end he fought
I would suggest a good support group or a good friend that can offer you support. Remember to take care of yourself, I can't stress that enough. tho I don't regret taking care of my husband, the doctors would see how it affected me that they used to always tell me to take care of self before I ended up like him...and here I am at age of 53 with diabetes, htn,high cholesterol. but i did quit smoking, been 18 months now, and I'm working on diet...wish i listened back then but I did what i felt i had to do..If you need to talk I am willing to listen.  I will pray for you and your family.
Michelle

[ideorsan]

OMG Michelle. thank You so much for these words. I am in tears as I read them. And I am so glad to hear that maybe he can live 10-15 years more. He is a fighter, however, he won't stop drinking. He smokes sometimes, not a lot. He is only 41 years young. He takes his medication sometimes, not everyday like he should. He has had little heart attack episodes where his heart would not stop but he would have shortness of breath and then be hospitalized for a few days to get the fluid off his lungs. He will only go to the hosiptal if it gets really, really bad. He is not on dialysis yet, but I think that is the next thing. It sounds like your John and my Dell are two peas in a pod. So simular. Thank You so Much Michelle. I am 51 years old and I do take care of me to the best of my ability. I know the road ahead is going to get tuff. I really would like to stay in touch with you so I will be checking here I guess. I don't want to put my email up here... cause you never know who else is watching.

[maybebaby29]

I would be more concerned about his liver failing. While it does seem HF is an issue, liver failure can also have the same outcome.

I'm sorry you have to witness this but don't be an enabler to his disease. He is making a choice on how to live, which will kill him. I think if anything, sit down with him (maybe with other family) and let him know that his actions are severely affecting you--mentally, emotionally, and health wise.

He's 41 years old and old enough to be responsible with his life and care enough about you to stop what he's doing. I"m so sorry you're going through this.

[ideorsan]

Why should I be more concerned about his liver failing? How do you not be an enabler to someone that you love? I realize that it's his choice to take his medications and do what he can to stay healthy and I am not making excuses for his behavior or what he has put himself in. I believe he is remorseful and regretful for what he has done to himself and I think that he is scared. He has a lifetime of other factors that have affected his life and brought him to this point. I have resigned to try to just be there if and when he needs me. I do understand that you can lead the horse to the water but you can't make him drink it.
Thanks for your concern.

[patti4981]

I have been diagnosed with Congestive Heart Failure at age 58. I am now 62 yrs old and I go to the Heart Failure Clinic at my local hospital once a month where they weigh me and monitor my medications. I also go to the Coumadin Clinic where they make sure I have enough blood thinner to stop a heart attack or a stroke. It is now 4 years since I got this disease and I sometimes eat foods I am not supposed to have. I feel guilty afterwards. My abdomen always looks like I am going to have a baby but sometimes the water pill just will not work. If I gain any weight, my doctor puts me in the hospital and injects me with water pills in an IV. I don't mind this. It really doesn't hurt. I do understand what the doctor said that there is really no cure for congestive heart failure. The only real cure is a heart transplant. Tell your husband he is not the only one suffering from congestive heart failure and that I have been living with it for four years and I am surviving.

[patti4981]

Tell your husband he will be ok if he takes his medications and stops drinking alcohol. An ejection factor of 35 percent isn't too bad. Blood thinners will prevent him from having a heart attack or a stroke. He is only 41 which is really young. I am 62 and I have CHF and I have never touched alcohol or cigarettes. My doctor said I got CHF from an irregular heartbeat which I didn't even know I had. I find a drug called Lopressor helps with an irregular heartbeat. I know I overdid it at times. What I mean is, I lived alone and I had no one to help with the household chores and cutting 2 acres of grass by myself. In fact, I overworked my heart. Sometimes you can overwork your heart and if you are overweight, your heart can not stand the strain. I know so many people who died around the age of 65 of a heart attack. I think the American diet has a lot to do with it, too. Thank you for listening.

[jrbon]

How is your husband doing?

Jesus

[ideorsan]

Thanks for asking. Honestly, I don't know because he has been out of town visiting his mother for two weeks now. We talk and he tells me he's okay. I can tell he is still drinking. I'm not sure if he is taking his meds or not. I have just resigned to "it's his body, his life" and all I can do is give him support. That old saying is true "You can lead the horse to the water but you can't make him drink". Well, my horse will not drink.

[patti4981]

I am sorry to hear your husband is still drinking. I know he will not go to an Alcoholic treatment center where they make you stop drinking. He is really young at 41. Maybe you can have some people over your house from AA and they can talk to him. It seems like he doesn't care if he lives or dies. He should think about the people that he will leave behind. I am sorry he is not taking his Medicines but they say even if you don't take your medication for CHF, you still will live at least a other five years. I take my CHF medications every day but still I eat sugar. I just can't stop it. I am 62 and I am scheduled to go to the heart failure clinic on Wednesday where they will be upset that I haven't lost weight. What can I do except go to Weight Watchers?

[ideorsan]

Well Patti, he definitely will not go to a aa clinic or anything like that. I think he does not realize how serious his problems is. he has not had anything happen to him--"the smoking gun"-- that would make him see or realize that he has a serious problem. As long as he drinks without anything serious/life-threating happening, he will continue to do it. He can deal with the fluid build-up, the coughing, and the vomiting, the sweating, the sleepless nights, etc. as long as he doesn't have to go to the hospital. I think that if something happens to him like an attack or if he can't take deep breaths and he himself says "take me to the hospital", then that might be a "wake-up call" for him. It has to be "Life-Threatening" other than that, he is going to drink and smoke his pot and maybe take his medications.

[ideorsan]

Thanks Patti for your comments. It has really given me a different perspective on dealing with this disease with my husband. He is very stubborn and self-destructive, but he is my sweetheart and I love him to life.

[Rich38]

I have read the above posts and can certainly understand your concerns and frustrations. It sounds as though you are doing all you can to influence him in the right direction.  

In my opinion your husband is in denial and depression. His continued drinking and smoking are a way for him to escape reality. Ideally he would seek help with both his adiction (addiction) and his depression, but it sounds as if that is not going to happen. Ultimately, when confronted with the facts, the decision of accepting his condition and the necessary treatment and behavior modifcations are up to him. If he continues as you describe he will reach a point where his condition will make these changes for him weather he likes it or not. Sticking his head in the sand will not make it go away.

I had a heart attack at age 62 resulting with an EF of 18-19%. I was given a pretty dicouraging prognosis. In my case, I decided that I was not ready to accept my condition or futher decline without a fight. I requested aggressive treatment from cardiologist, followed his instructions, put myself on a self imposed diet and lost 30 pounds, exercised, stopped drinking, etc. I am now 74, my EF has increased to 45% and I do just about everything I wish. I still take my meds, several of which didn't exist when I was first diagnosed, I exercise, and even have a drink from time to time. This morning I cleaned the garage and mowed the lawn with a hand mower. Life is Good!

My point is this: your husbands future is pretty much up to him, he can choose to try for improvement or give up. You can love him and be supportive but the ultimate decision is his.

Good luck to you both.
Rich38

[shersmith]

what you have posted is my story my husband is older but has the same problems. he takes meds but drinks from the second he wakes up till he goes to bed. we have been married for 28 years i dont know what i will do without him. if he sleeps 2 long i am afraid to check on him i know one day i will open the bedroom door and he will be dead i pray for him 20 or more times a day. i know that this is the hardest thing i will ever have to do but i am glad to know i am not alone

[ideorsan]

all you can do is love and support. Since I posted about my husband in June 2012, he has had a stroke and he is only 41 years young.  He has survived the stroke, Praise God, however, he still drinks and I like you I feel that one day, he just won't wake up.  But I think now I am prepared.  All you can do is love him and support him.  Keep doing what you do for him.  It's his choice.