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I have Afib and have fluid around and a little in the lungs.

By Anonymous September 24, 2010 - 7:04pm
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My Dr. limited me to 40 oz. of liquid a day and two Bumix and 1 Aldactone a day thinking that I would begin to lose the water. So far,only one day trying this, I have not urinated any more and I can not tell any difference in my shortness of breath or swelling. He said I'd lose about 5 lbs. in a day but I haven't so far - What do you think?

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Thanks for trying to help. I'll look forward to hearing from you or Cary Tuesday. Hope you are well!!!!!!!!!!!

October 3, 2010 - 8:10pm
(reply to Tod)

Hi Tod

Doctors do sometimes limit fluid intake along with diuretics. They also sometimes do the opposite. It just depends on the situation and your history.

What is the diagnosis related to the fluid? Is it another cardiac issue other than Afib? Do you have other diagnoses that complicate all of this like pulmonary or renal issues? Are you weighing yourself at the same time each day to watch for the fluid change?

Are you walking or doing some other type of movement? This helps mobilize the fluid out of some of your tissues. For instance, if your legs are swollen, walking around helps force the excess fluid out of those tissues and back into the circulatory system where it can then be excreted by your kidneys.

I guess at this point I have more questions than answers. I think I would ask the cardiologist the questions I mentioned before, along with asking what exactly are my diagnoses, what will we do to improve my breathing, why am I not seeing a fluid loss on these meds? How is the fluid restriction going to help since it doesn't seem to be working? What about my kidney function?

If the doc draws blood for lab work as I'm sure is likely, I would ask for copies of the labs and if you don't start feeling better, it's time for a second opinion. Then you can take the most recent labs with you.

Are you also seeing a pulmonologist or is this strictly thought to be cardiac? Often a pulmonologist will have different ideas about treatment than the cardiologist would. The problem is the specialists often think mostly about that one organ that is their specialty, rather than your entire self. That's the good and bad of a specialist. So the cardiologist sees you as a heart and vessels, the pulmonologist sees your lungs and vessels, the nephrologist sees your kidneys, etc. But they sometimes forget all the systems interact and in addition there is an entire person carrying those organs around who feels crummy. Sometimes you have to remind them of that.

If I can help explain anything further, please let me know, and if you want to discuss anything after your appointment, I'll be happy to do so. I looked for a good guide to help explain all of this for you, but there tends to be a lot of medical jargon involved. If I find one that makes sense to a normal person I will link you.

Good luck. I hope you feel better soon.

October 4, 2010 - 6:38am

Hi Anonymous

You don't say if you are having symptoms, which figures into this equation. If your symptoms worsen dramatically or you have sudden difficulty breathing or chest pain, I suggest you seek emergency treatment, and by that I mean call an ambulance.

Did your doctor give you parameters as far as when to check in? For instance, if you don't lose 5 pounds within 24 hours call the office, or if you aren't better by Monday come in, or something along those lines?

This can be a tricky situation for a few reasons. AFib can cause clots, and those clots can enter your lungs causing pulmonary embolism. With fluid in your lungs it might be a little difficult to notice symptoms of a tiny clot. That's why I say if it suddenly worsens, seek help. Another thing is if you are limiting fluids and taking diuretics at the same time, there is only so much fluid you can excrete. Imagine a bucket of fluid. Once you empty it, it's empty. If you don't put any more fluid in, you can turn it upside down but it's still empty.

We do have information on AFib: http://www.empowher.com/condition/atrial-fibrillation/definition.

That does not mean your doctor is incorrect, I'm just explaining that it can be a real balance to limit fluid intake and try to get your kidneys to excrete fluid at the same time. So I suggest that if you don't know exactly when you are supposed to see the doctor again, or what to watch for before you call, you might want to check in and ask.

Questions I would ask: What symptoms are an emergency? What symptoms require a call? When should I return for a checkup? What symptoms should be expected?

If you get some parameters, it will be much easier for you to figure out when you need help and when you can sit tight and wait to see what happens. If you want to discuss this further, please let us know. Good luck and please keep us posted.

September 24, 2010 - 7:20pm
(reply to Cary Cook BSN RN)

My doctor has changed my diuretics twice and I still amnot getting any results but he seemed to say that my kidneys would draw on the water in my body if I didn't put alot more in than I was letting out. I am so confused. He is a cardiolist and is trying to help my breathing which he says I have too much fluid and therefore have short breath. I've read where to drink more but maybe that is just to flush out what is already in the kidneys. Do you have any suggestions.

October 3, 2010 - 12:10pm
(reply to Tod)

Did Cary's information above help answer your question? She provided great information regarding the delicate balance of fluids that you are talking about. Are you able to talk with your doctor about your concerns? Has your doctor suggested that you increase your fluid intake to "flush out" your kidneys?

October 3, 2010 - 7:26pm
(reply to Alison Beaver)

No, He has not suggested increase in fluid bu to decrease fluid to 40oz a day so that the kidneys would draw the other fluid out, is what I understoood. He says if you put the same back in that you put out each day, you can';t make any progress. But it sure isn't working. This is the second diruretic that he'e tried and I can't tell the different in the output nor weight. I go back to him Thursday. What do you think about his reasoning. I always read about flushing out the kidneys but once it gets in the body, I don't Know. I just know I'm awfully discouraged and still short of breath and don't feel good at all. Can't do or go anywhere. Thanks for your concern.

October 3, 2010 - 8:03pm
(reply to Tod)

It's nice to hear back from you.

I will forward your post to Cary, as she has more experience with this topic than I do. I will check back Tuesday to make sure your question is answered!

Hang in there; I'm sorry you are feeling discouraged!

October 3, 2010 - 8:06pm
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