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Is there a time period for these stages? My 86 yr old father was diagnosed with congestive heart failure about 5 years ago . We are not sure what stage he is in or what to expect. Can anyone give me some information on this or tell me where to find some. I have checked online, but I didn't see anything about stages or a timelilne.
He also has dementia, so sometimes getting a straight answer from him about how he is feeling or if something is wrong, is tricky.
Can anyone give any info??
Thank you.

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I really don't think congestive heart failure has stages. It is a condition that can be treated and if not well taken care of can get worse. Other medications for other problems can also make the chf worse like some diabetic meds. The dementia on the other hand dose have stages, this also can play on the chf. The best thing you can do is sit down with his doctor or your own and discuss this with them. This way you will get better answers to your question. I hope this helps a little, I know its hard when you care for someone.
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That is a very good question. I too would like to hear what others have experienced.

My father-in-law has not been "officially" diagnosed with CHF. He has had four different by-pass surgeries and three angioplasties. When he was at Cleveland Clinic for a new heart valve, they asked if anyone had diagnosed him with CHF, but didn’t confirm it there either. That was over five years ago and he is still going. Other physicians have asked the same question, but none has said it definitively. If he doesn’t take a mountain of medications swells up like a balloon. Also has beginning stages of dementia. Due to incontinence issues created by the medications, he is often not too pleasant to be around. He can't smell it and gets testy if we tell him he needs to go change. Refuses to wear protection no matter how it is presented to him. We never refer to them as adult diapers, although, that is how everyone perceives them. What is it with old people? I would think they want to preserve some semblance of dignity, but maybe the mind just doesn’t care any longer. However, my mother was 95 with severe dementia when she died and through the fog she ALWAYS wanted to be clean. I deeply appreciated and respected that about her, even if it wasn’t always easy.

My father-in-law lives with us. He can't go too far without being out of breath. He basically does sitting activities and, sadly, since the death of his wife, they include drinking. Breaks your heart. Along with being very frustrating on numerous levels, especially when the doctors don’t back us when we try to discourage its use with the medications. I too have wondered how much longer he can keep going. He is 86 and out lived his wife who died from dementia three years ago and my mother died last December at 95.........all have lived with us. We are becoming very knowledgeable in areas we never wanted to experience.

I hope someone out there can shed light on the CHF timeline. I know each person is an individual, but am finding there is a pattern to most of the illnesses.

Thank you in advance for you input and thanks for reading. This is a fantastic site and deeply appreciated by all of us who go through the trials and love while caring for loved ones.
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My father died at 84,just this past March. He had just about every heart problem imagineable. He died of congestive heart failure. He suffered a severe heart attack at 62 and lost the back portion of his heart. At the time, he was put on several heart medications and monitored. As time went on , he had to have a mitral valve replacement.He was sent to Cleveland Clinic, but the doctor tried the new band-aid fix, and in so doing, my dad suffered a stroke. This led to 6 weeks at the Clinic and therapy once he came back home. He was put on Coumadin as well as lasix to his heart regimen. There were a few strokes after this and then a V-fib attack. More pills and more therapies along with an ICD implant. Dementia set in,but he still could feed himself and groom himself,etc with some assistence. He was mobile and my mom made sure he had good quality of life. And then, in Dec. of 2011, my Dad heart beat began racing and he was hospitalized and put on the last best type of medication to control it. The medicine gave him jerky tremors and he lost the ability to walk. He was no longer able to be cared for at home, and went to a nursing home, where he spent the next 21/2 months. He began filling up with fluid so much so that his heart and ICD began to be affected. His lungs filled up with fluid, his breathing became difficult and he literally drowned in a fluid around his heart and lungs. Doctor was wonderful and kept him comfortable and out of pain. I watched my Dad die. If you ask me what was the worst part of this ordeal, I would tell you that the last medication , amioderone, was the end for him. His life from that moment on had no quality. Make sure your doctor is honest with you about what to expect and what he will do for your loved one when the time comes. We learned only from this unbearable experienceIf there is no quality to your life, there is NO LIFE AT ALL!
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there is no cure for CHF, but if managed well patients can live a long time. My father is suffering from CHF and COPD. He has been living with CHF for awhile. The stages do involve progressive weakening of the body, fluid build up, circulatory problems, etc. Oxygen helps. My father gets tired easily and is weak. It is heart breaking because one day I know he may not wake up. From what I understand from my research, it is a peaceful way to go. However, my godmother's mother was gasping for air. I think with proper medication and oversight from your doctor you can live fairly comfortably.
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Oh yea, atrial fib, cardioversion 4 times and because it no longer holds they won't do it anymore. Coumadin needs weekly monitoring. Dad was put on Amiodarone too but it is only for controlling fibrillation and since he was no longer a candidate we had him taken off. That was a while ago, but I do remember there were nasty side effects and that is why we asked to have him removed from that medication. Once you start Coumadin, you, more than likely, will be on it for life. And when there is fibrillation, especially atrial, you will be put on Coumadin to prevent clotting.

I am sorry you had such a terrible experience with Cleveland Clinic, Purple. The doctor we had was the top in the world and after extensive research, that is why we elected to go there for Dad’s mitral valve. We were extremely happy with the doctor and his team. However, I have to admit, the nursing care after the surgery was deplorable. I am a nurse and have never seen such shoddy quality of patient (lack of) care. When being transferred his chest tube separated because they were not watching and it wrapped around the wheel of the wheelchair. When he started complaining because it was pulling and hurt, I saw the problem and told them to STOP!! What really corked my cookies was they just reconnected it without cleaning the ends of the tubing that had been dragging on the floor and wrapped in the wheel. We were expected to bathe him as no one ever came in to help. And when they did, they were grumpy and never smiled. It was unreal! Those were just a few incidents, there were numerous others. But, he recovered and is doing fine, so I guess..... We had taken my sister-in-law to Mayo's for 13 surgeries battling ovarian cancer and they were FANTASTIC!! Truly cared about the patients and families comfort. Everyone smiled and had a kind word, not just a number like we were at Cleveland. Think I would choose Mayo over Cleveland. Sorry Cleveland.

I am not sticking to the “timeline” information, but it all is part of the care. IMHO. And interesting to hear what others have experienced as they travel down the road.
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Momsdaughter2,

My mother is a-fib and I know it is a hard thing to handle seeing a loved one suffer.

Wishing you the best.
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My Mom is 88 with CHF. She was first diagnoised 8 years ago. She had a pace maker installed and lives on a ton of meds that sometimes have to be changed now and then to keep up with the problem. (and she is on coumadin, which I hate because of the constant monitoring) . After the implant of the pace maker, the hospital provided us a book to take home called, "Living with Heart Failure". My moms doctor just recently told me in one of her visits that she is worsening. If she lifts anything strenuous , which is not a lot, it causes bleeding out of the valve of the heart. They don't want to operate on her because of her age. Even though she has been told many times about how the condition, and how it can effect you, she continually will say she doesn't understand and continues to do chores around the house. She loves to do house cleaning and is her only hobby she enjoys doing. All I can say, is that I have read up on it on many websites. Never really found anything on a timeline. Its just that the heart is working hard all the time, and can be managed by different medications. However, no one can live forever, so I guess you can only imagine that the heart will keep beating the best it can, till it can no longer. I just keep up with the Doctor and always tell him what is going on as to how she feels. If you are a caregiver, you have to monitor alot of things to keep things on track to help the person with the bad heart. I feel it is only buying them time. I only know that someday it will give out, but the best advice is to always ask the Doctor. If you don't like the Doctor, keep searching to find one that you feel confident with.
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My dad is 86 and was diagnosed with congestive heart failure in 1995 or so. He has had some ok years, some very, very bad years and some fair years. 4 years ago he had respiratory failure from the CHF and ended up on a ventilator for 2 weeks. Noone thought he would survive but did and ended up having his aortic valve replaced a year and a half ago in an effort to better control his failure with medications. He had about 3 fairly good months and then we were right back into the cycle of gradual decline into failure, hospitalization, medication adjustments, etc, etc, etc. This year he was in the hospital for his CHF in Feb, March, April and May. After the valve replacement his heart function improved some but we found in May that it has gotten worse and he is now classified as end stage heart failure. What does that mean as far as a timeline? Who knows. He may go for several months without having any problems or he may go into failure next week. He is always in a state of heart failure, it's just how acute are his symptoms at any given time. Anymore, he goes downhill very fast. He doesn't want to go to the hospital anymore so we admitted him to hospice, knowing that we WILL reach a point of no return with his failure without hospital intervention and this gives us the ability to maintain his comfort at that point. There are stages and you can find the description of them on various websites when you look up congestive heart failure. His stage is Class IV and is determined by his symptoms, his other health issues, etc. It's a long road and very difficult to witness when they are at their worst. Thankfully, there has been more research into this disease process and they are finding better methods to control the symptoms. Ask your doctor if there is a heart failure clinic nearby that you could go to. These are overseen by cardiologists who specialize in CHF and usually run by nurse practitioners. It gives another level of care and their primary focus is managing the failure in an outpatient setting with frequent adjustment of medications based on patient symptoms, lab testing, etc. Dad was in one for about a year and I really did feel it reduced the number of times he could have been hospitalized. Hope this helps.
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Try WebMD for medical questions and answere.
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My uncle Ben is 89 and has CHF and renal insufficiency.His refraction rate is only 35%.He is also incontinent,and taking lasix four times a week doesn't help.There are four stages to CHF,and he is in stage 2B,which means he can walk several blocks before he gets out of breath and has to sit down.He went into vfib several years ago and was declared clinically dead.He has a midway aortic aneurysm,and his lad is 90% blocked.He has an implanted ICD which both shocks his heart and also paces.He is now on both Coreg and Amiodorone,but fluid build up is still a problem,because he likes his TV dinners.Last year,he received 19 shocks in a row and we had to rush him to the hospital.He was put on 400mg of amiodorone which lowered his blood pressure to 70/40,and he couldn't function.I fought to have it lowered to 200,and at least he can get out of bed and take walks.
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@ manybelessings..do you mean just for you they wont do cardioversion more? or is there a limit? my husband is 61 and suffering from diabetes, has dialysis 3x a week, had afib twice in two weeks, both times cardioversion helped. was on warfarin but after 3 weeks refused it any longer. the cardiologist didnt complain. he is also on Amiodarone and 6 other drugs. currently we cant keep his oxygen level over 85% at resting. he uses oxygen all day, and cpap at night. he also cannot walk half a block with out being winded. today he managed to go to breakfast with a friend and has been up one hour of the last 8 hrs. he cants stay awake anymore.
the cardiologist suggested he try having the dialysis take off another kilo, which they did today. i dont know what to expect of his situation.
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Hi prwhite55, hope all is going well for you today and you have some sunshine in your world. It sounds like you have your hands full and I am sure often a heavy heart.

Your situation is much different than ours so I can’t tell you much that may be of help to you and what you are dealing with or suggest viable options. When I said they wouldn't do further cardioversions on my FIL it was because they were not holding and he would just keep going back into atrialfib, so no point in doing it over and over. He is on 17 different pills every day, including Bumex, Amniodarone, Coumadin, and a ton more. His feet and ankles look like watermelons from fluid retention caused by poor circulation after using leg veins for by-pass surgeries. He is in mid-stage dementia and getting him to do what he is supposed to is an exercise in futility. We try to curtail his salt and fluid intake and get him to keep his feet elevated, but he drinks fluids all day and gets up in the middle of the night to get more ginger ale. We have salt substitute and he loads that on his food to the point of snow-covered mountaintops. We put his feet up and two seconds later, he has them down. This is our fourth series of wound clinic sessions because he won't do what he is told or wear the pressure stockings, so his legs split from the fluid pressure. We keep thinking he has CHF, but no official diagnosis and after all the angioplasties, by-pass surgeries and new heart valve, they tell us his heart is fine. Could have fooled me, but hey.

Your husband is young and it sounds like he is mentally acute, so his medical plan will be much different and more aggressive that that of my FIL. I take it your husband has other problems than just the diabetes. Is he also suffering from CHF and possibly COPD?

I wish I could be more help, but I don’t know the care plan or complete medical picture you are dealing with. I am sorry, but that is about all I have to offer relating to the cardioversion and why we aren’t having it done anymore. Seems like in the deep recesses of my mind, the doctor said he could do it 5 times, but I have heard there is no limit. However, after the second, they usually suggest and look to alternative treatments.

I wish you and your husband hope and health in all you are going through. This must be a lot for you to shoulder. I pray that the extra fluid they removed gave him relief and he feels much better. May the doctors find the answers so you will have a long and joyous life together.

Hugs!
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unless you knew him well, you wouldnt even know he was sick. we go to the store normally, take a drive. but the thats all he can do. even then his oxy drops below 85. he refuse to get a portable oxy, cus he 'doesnt want to wear it out in public'..sheeesh.
today he was helping bring in the groceries and his oxy went to 69 and he had blue lips. i told him he needed to be in the hospital and he still refuses.
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Thank you everyone for your input. I appreciate your knowledge on the subject. It is just so hard seeing him struggle everyday just to breath. Last visit with Cardiologist his oxygen level was 97, since then he has been diagnoised with a kidney stone and an aneurysm (sp) in his stomach area, aorta?? Fluid in the lining of his lungs. All of that and he is still calling himself lazy because he can't get out to chop wood or do the yard work. So very sad to see him beat himself up because he can't be the strong worker he once was. Men like him don't come along very often. Thank you all so much!!!
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my dad is being taken care of by my husband and myself and helped tremendously by hospice. He has copd, diabetes, a history of cabg, a quad. by pass, hyperlydemic, hyperthyroid, and severe, severe dementia. When we went to get him in Jan. they didn't think he could even survive the trip to NC, but he not only survived, he actually improved, with reg, medicene, good meals, and most of all love and caring he seemed the best he'd been in 5 yrs. Unfortunately, we are down to the last stages. No food, no fluid, can't swallow and is having a horrible time breathing. I promised him I would not let him die alone in a hospital., and I will keep true to my word. He's had last rights, and I sit and sing with him, I say prayers, and hold his hand. Listening to him breath is agonizing, but I know it is worse for him.His lungs are filling up and there is a foam in his mouth that seems to choke him. We suction this out, and he is burning up with 104 fever. I know that no one can put a time line on a life, I would just like to know how long a person can survive like this, The morphine drops and the atropine drops seem to control the pain, but my heart goes out to him. They say it is only a matter of time, but that can be anything, Please give me some kind of hope that his h*ll will be over soon, My heart is breaking.
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Ive been researching about copd online because my 69 year old grandfather has it and has been diagnosed to ber in the end stage. My brother in laws uncle just recently passed away because of advanced copd. There are four stages and several treatment opitions depending on the persons conditions try looking at these websites and I hope they help.
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I'm 63 years old with possible congestive heart failure. I've had severe, getting worse, swelling in my legs and feet. It started off in the left leg, left foot; but now I have it in both feet and legs--really badly. My skin gets tight and warm. I can't breathe well at all; can't walk up the stairs, breathe heavily; can't sleep well or lying flat. I have a mitral valve prolapse and arrythmia. My father died at 27 years old with congestive heart failure / enlarged heart in the Pittsburgh VA Hospital Jan 20 1950 (he was a Marine in WWII in Pacific, got Malaria as well). Anyway, I have pneumonia in both lungs now (phlegm, pink), but I looked up on Mayo Clinic site and these could be symptoms of CHF as well. I'm a teacher, but I just don't think I can keep up this pace (language arts teacher, papers and more papers). I have difficulty even going down stairs...fire drills. My feet and legs constantly swell; I'm always huffing and puffing. I'm thinking of going on disability and maybe with proper diet, treatment, and exercise, I can beat this. Is this possible?
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My 92 yr old mom has congestive heart failure. It's been years... She has such a tremendous attitude. When she was young she was a nurse on the hospital ship HOPE during WWII, then she became a stewardess. She married my dad and became a good mom. So now, I want to be a good daughter to her. I feel like my life is on hold, because although she lives 45 minutes from me, she wants to live independently and she will call typically early in the morning (which is the time when my dad died) and she gets scared. Everything that was described here, pace maker, coumedin, irregular heart beats, difficulty breathing, swollen ankles, etc, she has... She snuck out and got an intelligence test and driving test after her last hospital stay and they passed her! So she still drives within her neighborhood to a "healthy bones" exercise class and to her local hair dresser to get her hair done once a week. When she doesn't feel well I trust her not to drive. Some days are OK, many days are not so good. She doesn't like to eat anymore. I feel like I'm always struggling to find something good for her to eat. She was always a health nut when she was raising us kids. Now I find out she goes to the frozen foods section and grabs lasagna or something else with very high sodium. I keep trying to get her to stay with clean healthy food, but she loves potato chips (which are not the worst). She goes grocery shopping sometimes. She has someone come in every Friday to clean her house and this woman makes her healthy food. Sometimes she likes it, but mostly she just complains. It is so helpful for me to read the stories on this web site. I don't know if she will live for three months or three years. Right now I'm unable to do almost anything with my own life, because she calls me unexpectedly, often enough to send me into a tailspin. I either stay with her for a week, then we head to the hospital where they adjust her diuretic and other meds, then send her home again to recover. Then she gets better and just as I start to consider going back to work, or start consulting, she begins to fail again. She is very frail, but all I want to do is to be sure that her final days/years are somewhat joyful. I read somewhere that we should not ask what they want but we should be thoughtful and do nice things for them. I don't know what to do, because mom needs to eat, but she complains bitterly because she doesn't like anything that we bring, just because she doesn't like to eat anymore. My understanding from my web search is that the next stage is that she will continue to lose weight and then she won't want to drink. It is so hard to watch her being so frail... Any suggestions on how to be helpful to people who are struggling with their final stages of life would be most appreciated. As with everyone on this question... we just don't know if it will be moments or years... It is hard to know what is best to do. Thank you all for being here with me.
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Sounds like you are doing everything right. What a good daughter you are. She is very lucky to have you as a caregiver. The only thing I would do different is I would let her eat whatever she wants. At 92 she deserves to eat what she wants to eat. Make her happy in her last days. Lays potato chips now has a low sodium chip.They are very good.Good luck to you both.
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Heart failure is often graded on a scale of I to IV based on the patient's ability to function.
1.Class I is patients with a weakened heart but without limitation or symptoms.


2.Class II is only limitation at heavier workloads.


3.Class III is limitation at everyday activity.


4.Class IV is severe symptoms at rest or with any degree of effort.

The prognosis of heart failure patients is very closely associated with the functional class.
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The thing I've experienced with the classes is that my mom has gone in and out of each of those. For example, last January she went from 2 to 4, and after being in the hospital she came home at class 3. After a few months at home she was strong enough to pass a 1 hour driving test and return to her little exercise class at the library. Then in June she fell back to class 4. She is working her way back through 3 and today is again 2. I think the episodes are becoming more frequent, but of course we are very hopeful. I live 45 minutes from her so as a caregiver, some times I leave her at class three and when I speak to her on the phone the next day, she is touring around back in class 2, while I'm worried she will go back to 4. It's extremely stressful for her and for me, but I'm thrilled when she feels better. I think the thing we all have to learn to do is to help them to remain as healthy as possible and to understand that the frequency of reaching 4 will increase over time, but no one seems to know what length of time that is, and it's probably vastly different for different people, so it's hard to plan. As my mom says, " I don't know why this is happening. I'm up and down.... and up ... and down .... and up.... and..." I'm happy she still feels good some times for weeks, hopefully for months...
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I have a friend who is 46 and has CHF the botton of his heart is not working right
he had a defib put in in april and it has gone off 2 times he is very hard headed
and also a diabetic
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Great question I've been wondering about myself. My dad has CHF, aortic aneurysm, vascular disease. He's been told he is a candidate for a stroke for many years. CHF landed him in the hospital a couple years ago and it didn't look as if he'd make it but that got the fluid out and he did. He takes a ton if medicationbut doesn't want to talk about it. My mom died a few years ago and now he spends his time traveling. He paces himself and he can't walk much without needing to stop then he comes home and spends weeks resting. I figure if he's happy I am. Although I often wonder when the call will come from some official saying my dad has died in some far away hotel. We know he's on borrowed time and he seems to too.
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Ecranos, It is so nice to hear your story. It seems each person with CHF lives a slightly different life. I think it's great that your dad can get out and about and enjoys traveling. That most likely stimulates his mind and seems to me like he is living his life fully. As you say, if he's happy then you are... I feel the same with my mom. As long as she is happy, then my mind is at ease. The odd experience for me is that with her CHF, there have been multiple times when she didn't seem like she was going to make it, and yet she did and today is toodling around happily. As for her medications, I do go to the doc with her. I find that some docs are happy to prescribe new meds to her and for example with her recent cold, she got antibiotics, but once she was feeling better the doc allowed us to stop the extra meds early. We are fortunate that she can get the medical help she needs and I also think we are fortunate when she can let up on some of the extra meds some times. Thanks again for sharing your story about your dad. It is helpful to know that he is out and about too.
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If anyone suggests pradaxa instead of coumadine, be sure you understand the trade off. If you do have a blood clot, with coumadine, there are techniques to help bust the clot. If you are taking pradaxa, they can do nothing to stop the clot. I would not take pradaxa unless I was very young with no chance of a blood clot or hemmorage. I speak from experience unfortunately. It is a sad lesson.... Do not allow your loved ones to take pradaxa.
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My father has a defibrillator he also suffers from CHF last year I went to visit him he was very healthy and had a lot of weight. I just went to see him this year and he so skinny stomach is swollen and now hes is wearing a diaper and he said he was in the hospital but left to pick me up from the airport he was on oxygen he went in to get fluid drained off his feet. I am thinking that his conditions has worsen yet him nor his girlfriend will tell me. Please help!
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Quasia, It must be very unsettling to see your father that way. I know for the past few years it was difficult for me to see my mother losing weight, she went into the hospital several times for treatments... feeling terrible for a week before she went in, and then when she got out of the hospital, she recovered quite well. This past April at age 92 she snuck out to the hospital and took an intelligence test and scored at the top of 92 yr olds! She was so proud of it she fessed up and told me that she was scheduled for a driving test and she passed! One hour of driving and they told her she was OK to drive.

So, in my experience there are ups and downs. For my mom it was most important for for her to be able to do as much as possible in between... and to enjoy life. It was also important for her to be able to see and be with family and friends.

Please try not to worry as much as I did. My mom told me not to worry. We had 3-5 good years together and the only thing I struggled with is worry and the unknown. If you can hug your dad and tell him you love him every day, that will work miracles. Be kind and try to be helpful, but also take good care of you. He will want to know that you are OK. No one could tell me what would happen with my mom. She passed away in her sleep a few weeks ago. We had a wonderful evening. She was warm and comfortable and surrounded with love.

I am wishing you comfort and hoping you can be actively involved, but not worried. Also, many people her suggested that hospice would be very helpful and informative to us.
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Thank you so much for the information and words of encouragement I am his only child and I am very close to my father. Don't know what I would do without him! Thanks again~
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My mom 88years old also has congestive heart failure and takes Lasix twice a day to control fluid build up or she will have difficulty breathing. the Lasix has been increased over the year. I Watch her diet, her fluid in take, and adjust the Lasix if I see she is getting into trouble. it is a constant balancing act.
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hello all
have been diagnosed with congestive heart failure coronary artery disease chronic obstructive pulmonary disease type2 diabetes along with high blood pressure.had a consultation with the cardiologist a few weeks ago.i asked what happens now a bypass operation.her reply was for me it is to late,and I will remain on meds until they fail to work.then palliative care.fine.but what is my prognosis anser because I have so many problems she is unable to give me a prognosis.i said that is strange as heart failure goes hand in hand with my other problems so surely you must have an idea her reply was no.i am a 60 year old male.diagnosed approx. 1 year ago but now I have continuous fatigue muscle wastage and general pain to muscle areas in my arms and legs.chest pain and breathing difficulties .all this while I am at rest.i reall y need an approx. prognosis as we live abroad and I really need to put things in order for my family etc.but still falls on deaf ears with doc and cardiologist.can anyone help
rgds rob
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