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CHF - Is My Mum Dying

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  • Monica Zilko — 12/11/2007 12:53:15 — Permalink

    I was wondering if you could help me understand more about my mums CHF condition – which is causing all sorts of other medical problems. Her kidneys are having problems, she has PVD and is in extreme pain, she takes regular doses of morphine, has lupas, and other problems not so bad.She has had 2 operation, the 1st one was a triple heart bypass (sept 06) then 6 months later had another major heart surgery for an anyerysm (sp) that op failed and has left her with severe CHF. The specialists are all amazed that she is still alive, but she has no quality of life. She is so sick and has been admitted to hospital numerous times since – now she refuses to go back in hospital and says she wants to die at home – how can we make her comfortable and happy, is there any hope that she may get a little better.
    please talk to me
    Moncia


  • Sarah Goodlin — 12/12/2007 13:51:51 — Permalink

    Dear Monica. Please accept my condolences regarding your mother’s many problems.
    I can offer you a bit of advice, but I do not know the resources in Australia well. Please contact Dr. Trish Davidson, an expert heart failure nurse researcher (P.Davidson@curtin.edu.au) and ask her advice about care resources.
    A few notes:1. depression is common in persons with heart failure- you might ask physicians to be certain that has been addressed or a treatment tried.
    2. Morphine is metabolized (broken down) by the kidneys into 2 or more substances that can have adverse effects if they build up. In kidney dysfunction the preferred opioid is fentanyl. Hydromorphone is another choice, though it may also have adverse breakdown products. Methadone may also be a good solution, though it is complicated to dose, so it should be prescribed by someone familiar with its use.
    3. Not going back in the hospital may be a very reasonable choice, and with luck you’ll find help providing good care and improving your mother’s quality of life for awhile.
    Please contact me directly (just click on my name on the website) If I can try further to help.
    Regards,
    Sarah Goodlin MD


  • Sarah Goodlin — 12/12/2007 16:34:47 — Permalink

    one more name

    Hi. I allowed you into the clinician group. You may find some of the panagement documents helpful.
    Also you could click on the name of Susan Mannion. I don’t remember where she is, but she is working on a project- I think near Melborne regarding palliative care for heart failure patients.
    SG