Congestive Heart Failure

[bczach]

My 84 year-old mother had diabetes mellitus and has had 3 strokes, one of them massive within a 5- year period about 4 years ago, 3 heart attacks after that within the past year which left her with congestive heart failure. In January of this year her primary care doctor sent her home with hospice care saying that she could last 1, 2 or as long as 6 months because of the congestive heart failure. As the days go by, she gets weaker and weaker, now not able to even stand with assistance. About two weeks ago she started to have episodes of sweating and nausea and a week later she started what appears to be seizure activity, 3 of these within one week, two in one day within less than two hours time. Right now she is on Ativan drops every four hours, which helps with what the hospice nurse feels is seizures. She has lost a considerable amount of weight since the middle of January. For my own sanity, because it is hard seeing Mother go through like this, I need to know how long she can last like this. I am her only care giver. Her heart was weak also. Please help me to understand what is going on and why seizures. At one point her nurse diagnosed the sweating and nausea as TIAs. Please help!
  

[bczach]

Thank you so very much for replying to my questions. Unfortunately, my mother continued to have the TIAs and stopped eating and drinking on Friday, March 6th. She passed away at 4:01 p.m. on Monday, March 9th. I was standing at her bedside. I cared for her for the past five years in my home, and came home to care for her 24/7 as of January 20th this year. I have not grieved over her death. When I think of her at her worse state, I just block it out of my mind so that I don't hurt. This is so hard. At times, I feel as if I am losing my mind. I want to cry over my mother's death. I have lots of beautiful memories from childhood to adulthood, but I do feel the need to cry but just cannot.

[Dr J Singh]

Hi,

I can very well understand the agony you and your mother are going through. I know it’s extremely painful seeing your near and dear one worsening day by day and you’re helpless. Actually, in your mother’s case, the poor ejection of the blood supply from the heart results in poor supply to the brain also and this can result not only in something known as ischemic encepaholopathy (pathology of the brain due to poor blood supply) and can also result in repeated TIA’s as well as death of portions of brain (called as microinfarcts). The answer to all these problems is improved ejection of the blood supply from the heart. I don’t know whether your mother is on digitalis, as it’s known to improve the ejection of blood supply from the heart. Please check with your doctor.

If her BP is also low, then dopamine/dobutamine infusion may also help.

I hope that helps. Pl do keep me posted. Kind Rgds.