Brief Answer:
Maybe lifelong, but with careful titration

Detailed Answer:
Hello , I am Dr. Mody and hi would be answering your concern.
Firstly let's get some insight into your mother s problem .
Now she suffered from what many doctors ischaemia dilated cardiomyopathy. Here because the heart pumping has gone down the kidney gets less blood, so it would activate a process falsely sensing it as decreases blood volume , resulting in more retention of water leading to swelling all over the body. The about might sound a little confusing so forth I will be precise in my recommendation.
1)the weakness is due to the loss of electrolytes along with water, and the culprit drug here is dytor. However she needs the same as of now she has a tendency To retain extra fluid, maybe the weakness is significant as your doctor was a little aggressive in removing the fluid in short time, and at your mother's age it can cause significant weakness.
So here I suggest give 1 tab dytor 5 mg in morning and 1/2 tab dytor 5 mg in afternoon. After sometime depending on the volume status you may decrease it further
2) as such cardace and razo d would not cause any problems
3) again cardivas 3.125 can be taken twice and we may wait till we increase it further, as the effective dose is 6.25, it's just we are breaking in 2 parts
I strongly believe that in old ppl we should go slow, as they don't really tolerate all the meds as a normal person would.
Also maintain total liquid intake less than 1200-1500 in the initial part, maintain Daily weight to a static level. Coconut water wou help the potassium loss because of dytor.
As the extra fluid in the liver also is removed, her appetite will slowly improve.
Do not exert at present, and allow the body system to slowly adopt again.
She should be all fine in sometime. Don't worry for the same.
In most probability all the drugs are life long, however by careful titration she would be great to go.
Do upload details report, maybe I could help you better post review
Regards Dr Priyank Mody

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Brief Answer:
Respected sir the reports don't seem to be uploaded on my screen

Detailed Answer:
Hello Sir, there are no uploaded report s as per my screen. Plz do look into the same.
Now as I said generally we as cardiologist prefer starting with 3.125 twice a day. Many times on follow up patient would want one to decrease the number of pills, it helps them feel better that the health is improving and so they need less medication, it's a great psychological booster.
So cardivas cr, is a long acting preparation so only once daily dosing required.
My take :
1) as you loving mother is more than 80 years, I would prefer going slow and maybe continue the same dosage if she is tolerating it good and as you said I have achieved good results (swelling completely gone), and symptoms improving.
2)it is prudent to understand that some weakness apart from all mentioned yesterday is due to the heart problem itself, as low pumping heart many times is unable to supply enough blood to the muscles leading to easy fatigue on minimal exertion, which should improve with time. Cardiac rehabilitation had an important role here.

As I said the weakness is mostly due me to dytor and decreasing it to minimum needed dose as the same time increasing cardivas to maximum tolerated dose should be our strategy, however as I said just because of her age, better to go slow.
Regards Dr. Mody

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Brief Answer:
All reports grossly looks to cause no trouble

Detailed Answer:
Thank you for re uploading .
the blood investigation for liver , kidney and blood indices are normal , also x ray chest looks fine for her age .
ECG and echo finding co relate with each other and mostly the pumping is not really bad that she would require very aggressive treatment and as i discussed it still makes sense that we go slow .
Now why i told to decrease the dytor , because as i suspected in one of the reports the sodium went till 131 , though rpt sample had it corrected , however the sodium touching less than 130 in above 80 ppl cause dis orientation , weakness , decreased concentration and other fine neurological deficit .
so do continue with the medication and she should be all good in a week or two.
also i suggest you to do atleast once a month creatinine and electrolytes as part of monitoring
For any further assistance i am just on the other side .
hoping i could help
regards , Dr Priyank Mody , XXXXXXX
Do rate the conversation for other people reference

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Brief Answer:
Happy I could help :)

Detailed Answer:
Thank you Sir :)
Any further reference you can access me at
Http://doctor.healthcaremagic.com/doctors/dr-priyank-mody/70273

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