Oedema

[allenlondon]

Mrs A has congestive heart failure, and has swollen ankles, legs, thighs, and abdomen. Weight up 11kg in 6 months.

The two diuretics a day don’t seem to have much effect.

The surgery doesn’t seem very interested in an elderly woman not suffering from covid. Very casual, very vague.

What can we do? Both of us are becoming desperate.

A

[LadyCG]

She should lower her sodium, refined sugar and starch intake and start by cutting out all processed food, drink more water and eat bananas. Bananas are great for shedding water retention.

[allenlondon]

Thanks. She has almost no salt, little starch, few processed foods, but she does drink a lot of water. I’ll try the bananas.

[rowanwitch]

Try writing to the practice manager expressing your concerns, copy to the senior partner of the practice and the PALs service asking them
Treatment options may be limited and short term, for example hospital admissions for stronger diuretic doses with electrolyte monitoring may get the extra fluid off for a while but it will come back. Sometimes it is not disinterest but just not having much left to offer.
I would think there would be benefits from a referral to a specialist if only to see what treatment options are available if any, and to get the support of specialist nurses and others from the multidisciplinary team to help with quality of life issues.I

Sqad may be more helpful.

[Sqad]

I agree with rowan BUT when one has congestive cardiac failure with symptoms that you have described, then despite expert management,one has to accept that the" end" is in sight.
That isthe bottom line here.

[ummmm]

She must be very uncomfortable :-(

Can I ask how old she is?

[anneasquith]

Keep pushing her go practice for at least an appointment, she must be incredible unwell. Surely diuretics can be adjusted/ increased ?

[Sqad]

congestive cardiac failure is not just about diuretics,it is always secondary to something else...coronary heart disease,highblood pressure,diabetes which also need consideration.
I bet my ottom dollar that Mrs London has been seen by Consultants.

[anneasquith]

I hope your correct re a consultation sqad. I hope it was recent .

[rowanwitch]

when we love someone we need to know we have tried everything before we can try to accept the inevitable. It's hard when your heart says there must be something that can be done. One more trial etc, I feel for you.

[allenlondon]

72 mamya. No consultants - everyone seems too busy with covid.

Other suggestions taken on board, thanks.

[anneasquith]

This issue is one of my concerns with , covid’ . I wonder how many sick ( especially chronic) people are being overlooked , everyone seems to be concentrating on covid. My advice remains for Allen, keep trying go for assistance .

[anneasquith]

** GP .

[rowanwitch]

If as you have said elsewhere money is not an issue a private referral might get you to see someone, even if all you hear is "there isn't any more to offer" , at least you will know you have tried. You can still opt to wait for NHS treatment if anything can be done but you would have more information. I still think it's not unreasonable if you haven't seen a consultant to insist on a second opinion. As I said above, it can be a case of knowing you have tried everything for your own peace of mind.

[anneasquith]

Totally agree with Rowan re second opinion. Poor lady sounds to be quite miserable .

[allenlondon]

Rowan, anne, thanks.

She’s just had some scans (private, the NHS wAit was too long), mainly to (hopefully) confirm oedema rather than cancers, so next step if GP remains unhelpful is the top guy (Nigel Stephens) locally. Mrs A has seen him before for heart problems and he’s helpful.

We know we’re dying, but it’s the manner of it that’s so distressing. Oh for that quiet death in your sleep; or for the kind vet and his syringe filled with gentle oblivion.

[rowanwitch]

Definitely referral to community services, and the cardiac specialist nurses for as much help with comfort care as possible.

[Apc2604]

Allen. I am so sorry about Mrs A. With more medical care and concern,she could possibly be helped. I had a neighbour in his late eighties that had the same condition and surprised us by living a good few years longer than expected. That was with superb medical care and many visits to the surgery and his cheerful attitude helped. This is such a bad time to be elderly and need medical help. Everything is about Covid. Fortunately, my medical practice is still doing its best with providing a very efficient service and in addition has employed further staff members to deal with the increased amount of mental health problems. I am elderly and being treated very well with a number of issues. I wouldn't hesitate to go privately in your situation with an unhelpful doctor.

And I am in firm agreement with your last sentence.

Best wishes to both of you.

[allenlondon]

Thank you Apc.

They’re not so much unhelpful as uninterested, although it amounts to the same thing.

Private scan results in, although couched in medical lingo, and thus hard to decipher. Mrs A’s GP phoning her first thing tomorrow to talk and discuss scans.

Allen

[anneasquith]

Pleased Mrs. A having a telephone call tomorrow. Remember to ask any questions you may have .even jot the questions on a piece of paper ( remember no question is silly ) . Good luck .

[allenlondon]

Thanks anne.