Medication for CHF patient

My mother, age 91, has CHF, probably stage 4.  Still ambulatory in her own home with day care help.  She had been on furosemide, lanoxin, zestril, and 10mg heart patches and nitro tabs as needed.  She weighs about 85 lbs, with no obvious signs of edema (how can a layman tell?); blood pressure 50/100. She stopped taking meds about two months ago, except for the patches, and is convinced that she has fewer "attacks" without it. It does appear to be true. She's a strong willed and intelligent lady that is not enamoured with Doctors. I'm mainly concerned about possible edema as that seems to be a killer. Is there any way I can tell?  Should I urge her to resume the furosemide?

Thank you for yor help.  Ted.

[CCF-M.D.-CRC]

Dear Ted,
I suppose at age 91 she is entitled to do what she pleases with her medications.  Edema is not actually the killer in heart failure but is a symptom of the underlying cause - that is decreased heart function.  However, you are correct that she in not taking her medications she may develop some edema.  One way to handle this may be to take the furosemide (water pill) on an as needed basis.  When she has some swelling in her feet or is feeling a bit short on breath she could take a pill.  She should also watch her weight carefully and if it is increasing this is a sign of edema.  Of course she should discuss this with her doctor first.