Congestive Heart Failure

For Nyel, these hospital stays are all about balancing the numbers – a grand and complicated game of managing his body’s reaction to the various medications prescribed to control his congestive heart failure (CHF).  First and foremost: get rid of the excess fluids.  Equally important: don’t stress the kidneys or add any further burdens to his heart.

That’s the oversimplified explanation for what we think we understand.  With each visit we learn more.  More about all the kinds of heart failure there are.  More about the types of heart failure that pertain to Nyel.  More about his particular symptoms and how they can or cannot be treated.  Although Nyel has several sorts of heart failure, for the past year, it’s the CHF that has caused his frequent stays here at Emanuel Hospital.

Syringe

The biggest problem for him is the fluid retention which causes extreme shortness of breath and dizziness.  Here at the hospital, they give him diuretics by IV, keep track of his urine output and measure his daily weight. So far, in the eight days he’s been here he’s averaged about two liters of net output of fluid a day and he has lost twenty-one pounds.  Wowie!  Zowie!  This morning he weighed 179 pounds – the least in the forty years I’ve known him!

Every morning (and sometimes later in the day), the “lab lady” comes and draws blood.  Whatever tests they do to the contents of those precious vials provide information about how all that fluid loss is affecting his other organs (especially his kidneys) and whether his electrolyte levels (and probably other stuff) are staying within acceptable ranges.  It’s a magic formula of numbers that tell the story.

Yesterday, he was switched from the IV diuretic to a new combination of oral medications that, presumably, will keep him properly balanced at home.  This trip, we are being held here to see if what they send him back to Oysterville with will actually work on a continuing basis.  It’s always the intent, of course, but it has yet to work as planned.  We all (doctors, patient, and wife) hope against hope that this time Nyel can resume a more normal lifestyle and stay out of the hospital for a while.  A long while.

IV Stand

Today, his potassium was too low, despite extra oral doses yesterday.  So… no oral diuretic and no something-else-that-I-don’t-remember-but-deals-with heart-beating-function until noon when the “lab lady” will be back to check again.  Also, potassium is now being delivered by an IV drip system for the next four hours to get more into him quickly.

Meanwhile, the physical therapist (with the amazing first name of Phuk – pronounced with a long u; Vietnamese for ‘luck’) came in, walked the halls with Nyel and pronounced him “good to go!”  Breathing good.  No dizziness.  Fairly good balance. Able to walk unassisted well enough to go home.  Physical therapy recommended to improve strength and endurance!!!  Yay!

So… maybe Thursday I’ll be taking the new slimline version of Nyel home.  We hope so!  Depends on those pesky numbers.