Fluid retention in the elderly may be a sign of a more serious condition

Many will face this situation themselves or in a loved one:

An 87-year-old man developed shortness of breath that worsened. He goes to the hospital, where they say he has heart failure. A needle is put in his back and lung to extract liters of fluid, and he is given oral diuretics, but his lungs are still filling with fluid and his legs are very swollen.

This problem is very serious and can not wait for treatment. This man has a very severe episode of acute decompensated heart failure, which causes his heart to not pump very well. This causes your body can not pump enough blood through the kidneys to allow the kidneys to make enough urine. This leads to a large amount of fluid retention, which continues to accumulate in the blood vessels until it starts to come out of the vessels and enter the lungs and ankles.

Having all that fluid in the lungs makes it difficult to get oxygen to the blood and spreads the heart out of its form, making it harder for the heart of the pump. In addition, people with severe ankle edema from heart failure also have swelling of their intestines and this makes it difficult to absorb the oral Lasix, a diuretic. Therefore, fluid retention worsens with each passing day until you are hospitalized.

You can not use a single diuretic and hope to remove more than one liter of fluid a day as it can cause low blood pressure. Therefore, you will probably need to have the needle reinserted into your lungs and have the fluid in your lungs removed again and then hopefully an intravenous diuretic will help prevent it from coming back. Lasix intravenously does not need to be absorbed, goes straight into the veins and is not affected by intestinal swelling.

Not everyone responds well to the diuretic alone and in those people who add other therapy as a drug or device to make it easier for the heart to pump or make the heart pump more difficult to test. They work well in some people, but they cause side effects in others, so doctors will have to try some things until they find something that works. Regardless of how well the doctor treats the patient, the damage is sometimes too severe and there is nothing that can be done.

For everyone with heart failure or a loved one with heart failure, you need to weigh yourself every day. If you notice a rapid weight gain of more than two pounds in a day or five pounds in a week, you should call your doctor immediately. It is much easier to treat at this early stage. If you are not weighing yourself every day and notice a slight shortness of breath, weigh yourself and report an unexpected weight gain to your doctor right away. If your shortness of breath gets worse, report it again immediately. Waiting until shortness of breath is severe before seeking help makes it very difficult to treat.

Dr. Michael White of the UConn School of Pharmacy