What are the stages of Congestive Heart Failure??

[bke64]

I help my mother take care of my 94 year old grandmother, she has been diagnosed with CHF and also has High Blood Pressure.  She has had 2 mini-strokes within the last 6 months, since her first TIA (November 09) her left foot and ankle began swelling with the swelling moving up her leg, now her right foot and ankle are swollen and she has numbness in her right hand and arm.  She is coughing more and more everyday and is now beginning to have shortness of breath.  Her abdomen is swollen and she is now incontinent.  What is the next stage we need to look for?  She suffers from dementia and paranoia, refuses to see a doctor and take anymore medication including her high blood pressure medicine (Lisinopril).  She believes aspirins are "cure alls" and is sneaking them, we believe she is taken 4-6 adult aspirins per day (350 mg).  She is bleeding internally because we see drops of blood on the floor and where she sits.  How long can a person her age live with CHF and could all of the aspirins she is taking cause a heart attack or stroke?  Any advice would be greatly appreciated.  Thanks!!

[gmachris518]

She may be trying to "get out of everyone's way", but death by aspirins is a horrible way to go....so painful.

A bleeding ulcer almost took my life about 3 years ago, and I wouldn't wish that pain on anyone.  

I was on aspirin therapy and my gut, just at the outlet of the stomach blew open,  I ended up with a heart attack, and 7 pints of blood, and it's been downhill every since.  I'm stage 4 heart failure and stage 5 renal failure and I'm convinced the blood loss  caused it.....and the blood loss was caused by the aspirin.

[GeezLouize75]

I hope you don't wash your hands of your grandmother.  I am a volunteer and visit elderly people that family members have pushed to the curb in their golden years. They are still human, no matter what the age or shape, and they have emotional needs. At 94, if she wants to take aspirin, so be it.  Back when she was a child an aspirin was the "cure all" drug.  Just love her and let her know you are there for her. She might secretly be trying to get out of everyone's way......Sad, so, so sad.

[gmachris518]

If you think your grandmother is retaining a lot of fluid then she needs medication to get it out of her system.  Lasix works well for me, at 120 mg/day.  She may need a breathing treatment to clear her lungs first, though, depending on how much fluid buildup she has.  They can check that with a simple xray of her chest.

I've been rushed to the ER twice with fluid build up in my lungs, the chest xray is no big deal, and the breathing treatment is an easy fix.....as I was in "total whiteout", which meant my lungs were full.

And, by the way, if you can get her to the ER for the breathing problem, while she's there mention the other symptoms, like the blood spots.  She may not like it, but they will check everything once they have ahold of her.  

You said she is supposed to be taking lisinopril.  I don't blame her for not taking it.  At one point I was on it for 3 days and went into stage 5 renal failure....now I'm facing dialysis for the rest of my life.  There is no transplant for a person who has an ailing heart and ailing kidneys, especially if that person is over 50 years of age.  Anyway, I think lisinopril is a bad drug and should be pulled from the market, but I'm just one tiny voice in a sea of people who are using the drug, and I can't seem to make myself heard, but I almost lost my husband to lisinopril about 6 months before I was put on it, so I know it's bad.

In any event, your grandmother has lived a very long life, and her age could have a profound influence on how her body will react to treatment, so you need to keep that in mind.

Anyway, like kenkeith said, get rid of the apirins.  Even a young, healthy person can't stand to take aspirins on a full time basis without adverse effects.

[kenkeith]

The danger of excessive bleeding with anti-platelet mediction is a very serious consideration.  If the internal bleeding is not treated, you are correct there will be   consequences that override the heart issue..  

According to insurance policies and AAC an EF<30% is heart failure range.  There are statistics that have estimated about 26% of heart disorder population have an EF in heart failure range and continue their daily activities,  and do not know they have a heart problem.  If an individual is well compensated against heart failure, the individual can do well at least for a short period of time. Untreated the heart will enlarge and EF will continue to decrease and the outcome is cardiac arrest (arrhythmia). There are stages of heart failure and the final stage is shortness of breath, unstable angina (chest pain without exertion), and may be bedridden with an oxygen supply.

One cannot predict an individuals' longivity.  I was written off 6 years ago, and feel well today.  Hide the aspirin pills!

[bke64]

Thank you so much for the information you provided.  I had no idea that the blood turns black when a person is bleeding internally.  My grandmother is a very difficult, secretive person and will not tell me nor my mother how she is feeling, if she is in pain she would never tell us for the fear of us putting her in a nursing home.  That's her paranoia.  

If I sounded cold or heartless regarding how long she will live with CHF, I certainly didn't mean to.  She refuses medicine and any kind of treatment and I'm about ready to just wash my hands of her like the rest of my family has done.  I can't help her because she won't help herself, so now it's in GOD'S hands.  

Oh...... to be honest with you, she had a sister that lived to be 95, the rest of her family all died fairly young.  Her and her sister are the only ones who made it to their 90's.  

I firmly believe that she will wind up drowning in her own fluid, it's just a matter of time.  

Thanks again!!  It's been a big help.
bke64

[gmachris518]

You have asked a loaded question, but I would like to share the info I've learned about CHF.

The swelling in the lower extremeties is a classic symptom, along with the shortness of breath.  The swelling can manifest itself from the bottom of her feet, up to, and including her lungs.  If left unchecked, or unmedicated, she will become unable to take a breath, and it could kill her.  

As far as stages go, I've been told I'm in stage 4 heart failure, but it doesn't mean I'm in CHF, it means that my EF is 15-20%.  I don't belive there are stages, but I do know the coughing is not a good sign, it could mean her lungs are filling up with fluid, and she'll need transport to the nearest ER soon.

Now, about the aspirins.  She could be bleeding internally, but if she is leaving spots of blood everywhere she goes, then it's probably more like a surface sore, that needs attending, or perhaps a hemroid.  If she were bleeding internally, and not able to hold her bowels, the feces would be dark(black), sticky, and tar-like, and she would be leaving little black spots everywhere, as blood turns black in the intestinal tract.

Now, last but certainly not the least important, you're wanting to know how long she can live with CHF.  She is 94 years old, how long do people in your family live?  CHF won't necessarily kill her, unless it's untreated.  

I hope this helps.