Congestive Heart Failure

My father has been diagnosed with CHF.  In the last 4 months he has been hospitalized a total of 30 days.  He currently is back in the hospital because of extreme fatigue and unable to sit up without gasping for air.  His O2 sat before admission was running between 54 to 78 percent.  His EF on his last admission was 25 percent.  He also has emphysema and just aquired diabetes on his last admission. The meds he takes are Levaquin 500mg, Lanoxin .25 mg, Prednisone 10mg 2 every other day, Spironolactone 25mg, Synthroid .125, Frolic Acid 1mg, Isosorb Mono 30mg, Furosemide 50mg, Asprin 1 daily, Glyubride 5 mg, Albuterol 2.5mg as needed, Combivent 2 puffs q 4hrs. Each time he's been in the hospital, the doctors suspected he had pneumonia, which now they think its just his lung disease.  He has a pesistant cough. He now has a problem with low b/p. The doctors can't seem to keep it stable.  Even sitting up in bed causes it to drop very low.  These are the meds he's taking now in the hospital: Levothyroxine 125MCG QD, Folic Acid 1mg QD, Aspirin 81mg QD, Salmeterol Inhaler 6.8 gm BID, Acetaminiphen 325mg Q6H, Humulin, Prednisone 20mg QAM, Glyburide 5mg QD, Ipratropium NEB solin with Albuterol 0.5mg/2.5ml Q6H, Albuterol NEB SOLN (Dilute in_ML NS with Atrovent 2.5mg/0.5ml Q6H, Montelukast 10mg QD, Digoxin 0.25mg QD12, Ceftrixone 2gm pre-mix 2gm/50ml ML/HR Q24H, Guaifenesin AC syrup 5ml Q4H PRN, Dopamine pre-mix(s)400mg/250ml IV PRN, Potassium Protocol PO 10MEQ PRN, Temazepam 15mg PRN, Magnesium Sulf 1gm/2ml PRN, Albuterol NEB 2.5mg/0.5ml Q1h PRN, Ipratropium NEB 0.5mg/2.5ml Q1H PRN.  He was taking Lasix, Spironolactone, Valsartan. I apologize for the long list of meds but my question is:  The doctors have told him that there is nothing more that can be done for him. At this point, is there anything that can be done for him.  He just seems to be taking a lot of drugs and they don't really appear to have any positive affect on him. He is 70 years old.  These past few months he has really gone down hill fast. Thank you in advanced.

[CCF-M.D.-CRC]

Dear springfoot,

It is always a difficult question to answer when we get posts asking if there is anything else that can be done.  Without evaluating the patient and all the data I can't really give you an answer.  It sounds like he is on appropriate therapy for chronic lung disease and heart failure.  These are both very serious conditions and the combination of the two can lead to a very grave status.  In young people a heart and lung transplant is sometimes used but this is not generally an option for older people.  Issues that need to be addressed with his doctors are things that can be done to improve his quality of life and his wishes concerning life-support equipment (e.g ventilator) should he come to that point.  These are tough issues and discussing your feelings and concerns with him and his doctors is important.

[robbo]

Please can you tell me if candida can enter the heart, and is there anyone specifically at risk and what are the symptoms?? Many thanks R.W

[Sheegan]

I've witnessed the deterioration of my moth-in-laws health due to CHF.  She is currently in the hospital on no IV's, O2 @4L & receiving diuretic pushes.  O2 MUST be continuous or her O2 reading will drop to below 62% in minutes without activity.  Chest X-Ray shows Left Lower Lobe Pneumonia and she has cyanosis to the lower extremities & her hands as well as the nose. Stubborn & non compliant when at home - the fact is still that my husband and I are responsible for her & her business.  Each patient is different, but, is this what would be considered the final stages of CHF?  They tell us that removing the fluid from the abdomen and the ankles and offering the O2 is a comfort measure and that is all that can be done, but can one live with this condition for years?

Thank you kindly for any time you give this.