Pills my mother is taking and side affects

  My mom age 78, has congestive heart failure and has a pace maker. The Doctors  have her on Coumadin, Lisinopil, Digoxin, Coreg and Darvacet for pain. She is feeling lousy, diaherria, pain uner her rib cage, shortness of breath, burping or tring to burb constantly,  extreme tirediness too weary even to talk some times, to name a few. She has a problem seeing lately and when she sits down she can't catchi her breath.
  She is in sever pain under the rib cage and has it bullds she panics and just makes it worse. She keeps saying she aches and hurts all over.  The doctors just keep giving her more pills. I think the combination she is on could be causing some of the problems. If it is what can we do?
  I would like her to get out of her present HMO and see some other doctor but I don't know where to start. What kind of doctor???

[CCF Cardio MD - MTR]

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Dear Elaine, thank you for your question.  Some of the symptoms your mother is
experiencing could be related to the congestive heart failure (CHF) like the
shortness of breath, fatigue, and general malaise.  CHF is caused by coronary
artery disease and by unknown processes that cause the heart to dilate and lose
pumping function.  With coronary artery disease, the CHF is termed ischemic
cardiomyopathy and sometimes responds to revascularization with angioplasty
or bypass surgery.  Most patients with ischemic cardiomyopathy have had a prior
heart attack which damages the heart muscle.  The unknown causes of heart failure
are termed dilated cardiomyopathy and include chronic, severe hypertension,
valvular heart disease, viral infections of the heart, and immune system disorders
like lupus.  If your mother does have coronary artery disease, then the rib cage
pain she is complaining of could be angina and should be investigated as such.
If she has had a cardiac catheterization during her work-up for CHF, then coronary
disease could have been identified or excluded.  If she never had coronary
disease excluded as a diagnosis, her current pain could be angina but I can't make
that diagnosis in this forum without seeing her as a patient.  The medications
she's on (Coreg - a beta blocker, Lisinopril - an ACE inhibitor, Digoxin - a
medication that increases the pumping power of the heart, and Coumadin - a blood
thinner to prevent clots from forming in the heart) to treat CHF are all appropriate
and should be continued.  The Darvocet is mild pain reliever, but when too many
Darvocet pills are taken, symptoms similar to your mother's could develop. Perhaps
Tylenol would help with her pain and would not cause many side effects. The diarrhea
could be caused by one of her medications, but the other symptoms would be uncommon
side effects from any of those medications. Your mother certainly should see a
cardiologist to resolve the many cardiac issues that she has.  If you plan to
see a physician outside of your HMO, then you may have to pay out-of-pocket
so I would check with her HMO first - they may have a cardiologist affiliated
with their organization.  In the meantime, it would be unwise to stop any of her
medications without confering with her physicians.  If you live near Cleveland,
we have many cardiologists who are experienced with taking care of patients with
CHF.  You could call 1-800-CCF-CARE and ask for an appointment in the Heart Failure
clinic.  I hope you find this information useful.
Information provided in the heart forum is for general purposes only.  Specific
diagnoses and therapies can only be provided by your physician.