Saturday, February 26, 2011

Snow, Power Outage and Congestive Heart Failure

This weekend was very busy for me. There was a break in the weather for a few days. Then the snow returned on Friday. We received another 15 inches of snow. The heavy snowfall led to a power outage and no internet. With no internet or power I wasn't able to finish my post for Frugal Friday Tips.

During the outage I helped my son with homework, until I received a call about my 91 year old friend. She fainted at the assisted living facility where she lives. She lost her pulse for a few seconds and the staff had to perform CPR on her. They called an ambulance and rushed her to the local emergency room.

My son and I went to the hospital to be with her. She was sleeping peacefully when we arrived. Her pulse was regular but her blood pressure was very low. The staff took a chest x-ray and drew several vials of blood. When the doctor came back in, he gave us the diagnosis of Congestive Heart Failure. He wanted to admit her to the hospital but she didn't want to stay. He called her family doctor and they all decided to send her home with a heart monitor and new medicines.

After they applied the monitor, I drove with her to my house to pick up what I needed for staying with her for the night. I brought my personal items and clothes, and of course I had to have an animal with me. My male dog Max was the chosen one. (Max is the mildest of all my animals and he knows my friend well. She was delighted he came with.)

Mild Max
It was a long night. I was able to rest but not sleep. My friend kept getting up to go the bathroom and almost fell twice. Max every few hours would jump in bed with her to make sure she was ok. Then he would come to me, then back to his spot on the couch for a few hours, then would repeat the same routine.

This morning I took her to the pharmacy to pick up her prescriptions of Lasix and Potassium. I didn't want to leave her for fear something would happen or she would take off the heart monitor.

She was doing well by mid-morning, so I decided to make arrangements with the staff at the facility for her care and went home to sleep for a few hours. I went back to check on her this evening and she was doing fine.

Most of my career as a Registered Nurse has been in home health and hospice. I have taken care of many patients with Congestive Heart Failure (CHF). I used to do education on the disease process, signs and symptoms, management and medications.

The disease process is caused by the heart not being able to pump the blood as it should. Several reasons can cause this: heart attack, congenital heart deformities and even smoking. When the heart can't do its job, the blood can overflow into the lungs. This leads to the patient being short of breathe, white frothy or foamy sputum possibly blood tinged, swelling of the ankles and feet, because of the poor circulation.

General standard management of the disease at home (not in an emergency situation or acute exacerbation) includes: decreasing salt (salt can increase fluid retention and make symptoms worse), frequent rest periods, alternating rest periods with activity, possible fluid restriction (this would be prescribed by the doctor), elevating feet to help circulate fluid back to the heart where it can be pumped and then be excreted by the kidneys.

Medications can vary widely depending on the patient's health, medications that are already prescribed and other factors that need to be determined by a doctor. Because of various factors, medications will not be reviewed in this post. I recommend for medication education to talk to your pharmacist or physician.

These are very general tips usually applied to the disease. If at any time you have symptoms of CHF you should be seen immediately by a physician. This post is not intended to replace doctor's orders or a doctor's exam but only to provide very general information of the disease. Each patient is an individual and care needs to be individualized for each person who has been diagnosed with CHF. Doctor's orders should strictly be followed to better health, prolong life and decrease chances of complications.

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