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several questions
have your Drs tried you on Ranolazine?
Have you been considered for a biventricular pacemaker
why were you turned down for heart transplant
which part of the country do you live in?
can yo list your meds for me to take a look at
Nic
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I am 57 years old, diagnosed with stage 4 CHF & stage 4 CAD stage 4 angina, as per the canadian and NYHA charts.
I have has 2 open heart surgeries, 32 stent implants, breachy therapy, a TMR, a pacer/defibulator implant, on oxygen 24/7 confined to bed or wheel chair.when I stand my feet turn purple/black my stools are dark brown but mostly black mud
I have angina 24/7 on a scale of 1-10 even at rest I have almost a consistant 5, with any activity the pain level rises. I am unable to walk without increased pain and ability to beath is seavearly decreased with activity.
My ejection fraction is 43-55 it ranges from test to test, my heart is extremely large, and ischemic. I do not have the usual signs of edema( my stomach is enlarged about 4 times the normal size, it feels like it is full of water, and I have a hydra seal in my testicles. ( I assume that is where the fluid retention is ). I take lasix 80 mls each day, I am alergic to nitro,When I stand my feet turn purple/black I was recently turned down for heart transplan and stem cell reasearch( they claim I am unable to undergo any invasive proceedures unless it is life threatening. I have taken all the prescription medications available and the cardiologists say there is nothing more that can be done for me.
here is the question and presenting problem, I was admitted to hospice in Nov of 07, when admitted I met the criteria . Now they are threatening me with discharge for the following reasons
1. I did not die yet
2. My ejection fraction rate is to high
3 I have not lost weight
4 I do not show the normal signs of edema
5 i have not shown a rapid decline.
My understanding is Ejection fraction is not a good indicator
the amount of fluid retained in my groin and stomach would account for the way my fluid is been retained ( not the normal legs, feet ankles arms ect. ) I do break out in swets and water pours out of my body like a faucet. when standing my feet turn purple/black
is it possable that with the above mentioned, I am not a stge 4 and should not get end of life care or is hospice just playing games. What kind of rapid decline are they expecting ? I am in bed and in pain 24/7 and in need of oxygen constant not on demand.
How do you determine when and if a stage 4 CHF patient is hospice appropriate and how do you decide how long a patient has to live ?