Congestive Heart Failure questions

[PMSha]

My 65 year old father was diagnosed with CHF approx 2 1/2 years ago when he had to have a kidney removed and was found to have had a silent heart attack at some point in time.  He has problems with edema sometimes and becomes exhausted after walking very short distances, but he is able to do certain activities provided he can rest every so often.  What are the "stages" of CHF?  I read about Stage 4 here in your forum and would like to know the others.  Is the amount of liquid consumed per day usually limited?  His cardiologist has set no limit and he drinks quite a bit (water and fruit juice).  Other than taking his daily dose of Demidex (sp.) is there any thing he can do to keep the water off of his legs?  Keeping them elevated or ?  Lastly, have there been any recent developments that he might discuss with his cardiologist that might be beneficial to him?  Thank you so much for your time and thank you for this forum!

[Lugee]

I am a 51 year old woman who has ideopathic cardiomyopoghy, probably caused by a viral infection.  I was misdiagnosed in the emergency room of a local hospital (obese 51 year old woman agitated because she has a cough) before finally landing at Strong Hospital in Rochester.  I am on coreg, lasix, vestril and lipitor and have a cholestrol level of 151, clear veins and arteries and do water aerobics, work and pretty much lead a normal life with my 1/3 heart function except I tire easily at night.  I am told I may go on like this indefinitely if I remain healthy, but only a heart transplant will help if I worsen.  People keep asking me if I am on a "list"--I am not.  My own internist asked me where I would go.....as I was originally diagnoses in Rochester, am I bound to have them do the transplant if needed?   Can anyone go to the Cleveland Clinic, even for a second opinion....my internist said go to the place with the highest success rate..someplace that does many many trasplants a year, not a few.   This is an awkward situation for me....I respect my cardiologist, but I also want the best.  Also, for the last 9 months I have had a numbness /hotness take over my right foot after walking 25 minutes or so.   The foot doctor said he found a decrease in the circulation, but when an ultrasound was done, they found nothing wrong...don't know what causes it, but it limits the one activity I love, walking.   Makes it impossible.  The foot doctor said the test was not run correctly as they did not do the ultrasound when the foot became numb after walking,....had me sit in a chair and shake my foot awhile.  Never got the same feeling.   I feel up against a wall.  First in the throws of CHF being told to drive myself to the Cleveland Clinic as they didn't know why so many things were wrong with me, and now this .  Any suggestions?   Are these just things to live with?   I know I looke pretty good for a person with my condition and can't help but think that I got "blown off".   Thank you in advance.

[Squeaky]

My 58 year old sister has just been told by her cardiologist that she has CHF and she has only 1/3 use of her heart.  He said her heart became this severely damaged within 2.5 months.  Besides being in shock, how can this happen to such a strong, resilient human organ?  Thank you so much for any information.  Squeaky.

[CCF-M.D.-CRC]

Dear PMSha,
Heart failure symptoms are classified in 4 catergories.  Individuals with class I heart failure are able to do all normal activites without symptoms.  People with class 4 heart failure have symtpoms just lying in bed and class 2 and 3 are between those two extremes. Your father would probably be considered class 2 or 3 depending on how short the distances are that he can walk without symptoms.  In general individuals with heart failure  are on sodium and fluid restrictions and the severity of these will depend on the degree of heart failure.  A typical  restricted schedule would be less than 2 gm of sodium and less than 1500cc of fluid a day.  Diuretic like demadex help keep fluid off but to be most effective they should be combined with salt and fluid restrictions. Keeping the legs elevated does reduce swelling in the legs but increases swelling in the thighs and buttocks.  There are many new developments daily in heart failure treatment.  If he would like an evaluation at the Cleveland Clinic we can review all his therapies and make recommendations to his doctors on the latest advances.  To make an appointment call the number below and ask for an appointment in the "Heart Failure Clinic".