What Causes Edema In Legs And Hands With History Of Heart Failure?

Posted on Mon, 2 Feb 2015

Question: My husband, 81, has congestive heart failure, lung disease caused by asbestos & asthma as well as inoperable kidney cancer. (Cannot sustain a surgery.). In the past few weeks he has gained 15lbs, the edema is manifest not only in feet but also legs, ankles, hands & arms. He sleeps or rest 20 hrs a day & the only exercise he gets is walking the dog 4x a day. (Approximately 1/8 of mile each walk.). Although he is on many meds,, inhalers etc., I continue to see daily deterioration. Of course there is the depression factor & his choice to not try to do anything further to help himself.
Given these circumstances & the description of his behavior, is there anything that I can do to enhance his quality of life? I honestly believe that he is willfully heading to total demise sooner rather than later!
Thank you.

Answered by Dr. Prakash H Muddegowda (4 hours later)

Brief Answer:
advance directives and living will

Detailed Answer:
Hi,
Thanks for asking.
I am Dr. Prakash HM and I will be answering your query.
Based on your query, my opinion is as follows:
1. Continuing with medication and good nutrition.
2. Family support and involvement in social activities, to improve mood and reduce depression. Mild physical activity is beneficial. This could help in improving quality of life.
3. Most importantly, advance care planning like end of life care, nutritional support during acute or end stage illness is necessary. This advance directives will help in family making supportive meaningful decision.
4. Also living will and health care proxies will be beneficial.

Sorry to know about your husband current condition.

Hope it helps.
Any further queries, here to help again.

Dr. Prakash HM

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Prakash H Muddegowda (7 hours later)

Good morning,

Thank you for your reply & advice.

I know that you cannot possibly predict how much time we are looking at, but, in your opinion, assuming ll meds etc. stay the same what would be your best guess of time left? His children live all around the country and I'm wondering if I should bring them to town soon.

Thanks

Answered by Dr. Prakash H Muddegowda (3 hours later)

Brief Answer:
look for breathlessness

Detailed Answer:
Hi,
Thanks for asking again.

At present, he is active even though he sleeps more.
As he is not breathless or has any infection, I would give home at least 6 months or more.
If he develops any form of breathlessness along with infection, it could become critical and difficult and would be less than a week.

Hope it helps.
Any further queries, here to help again.

If you do not have any further queries, you can close the discussion and rate the answer.

Dr. Prakash HM

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Prakash H Muddegowda (1 hour later)

Many thanks again.

Your response have been helpful & more or less have confirmed my own prognosis.

By the way, there is shortness of breathe, no infection.

Thanks again.

Answered by Dr. Prakash H Muddegowda (1 hour later)

Brief Answer:
With exertion, shortness of breath normal.

Detailed Answer:
Hi,
Thanks for asking again.

If there is shortness of breath, even at rest, then it changes the prognosis. With mild exertion, shortness of breath can be seen due to fluid accumulation.
With this condition, if infection, specifically lower respiratory tract will be serious and all infections needs to be treated early.
Not to worry for now. With limited activity and nutrition, he should be good.

Hope it helps.
Any further queries, here to help again.
If you do not have any further queries, you can close the discussion and rate the answer.

Dr. Prakash HM

Note: For further queries related to coronary artery disease and prevention, click here.

Above answer was peer-reviewed by : Dr. Raju A.T