Brief Answer: proper clinical review, Cardiac, kidney function. Detailed Answer: Hi and thanks for the query, Generalized fluid retention deserves a special attention, identifying the main origin of the retention and guided management. Diuretics are generally used to manage fluid retention problems. However, it is important to know the cause of the retention, the choice and dosage of the diuretic and being able to manage complications that could arise from use of diuretics. Commonest causes of generalized fluid retention are from kidney disease, heart disease, venous insufficiency (poor venous return to the heart). A history of kidney disease, diabetes, heart disease is to be noted. It would be interesting to do a chest X ray and cardiac ultrasound to exclude heart disease, considering the history of hypotension you describe. Measuring blood urea and creatinine levels would be sufficient to know if its a kidney problem or not. Checking blood electrolytes like blood Calcium, Sodium, Potassium and Magnesium would be important to exclude any ion imbalance that could have arisen from either diuretic use, of fluid overload. This would be informative in guiding treatment. A proper clinical examination of the lower limbs would help in telling if its due ti venous insufficiency or some other things. This should be managed urgently for sure. Life style changes like avoiding Salt, could and excess fluid intake could temporally be useful. Diuretics under these circumstance would be appropriate if given through the parenteral routes (intravenous/intramuscular injections) for a quicker action. Raising the head of the bed slightly could improve breathing difficulties. I suggest you consult your doctor for a proper clinical review. A chest X ray, cardiac ultrasound, abdominal ultrasound, kidney function tests, avoiding salt, reducing water intake, guided use of diuretics with injections, checking for any electrolyte / ionic problems could be sufficient for a start. Thanks and kind regards as I suggest you obtain and urgent review by your family physician. Wishing you the best of XXXXXXX Dr Bain

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