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Stroke & Congestive Heart Failure
An_245912 posted:
My brother was diagnosed with congective heart failure about 6 years ago and underwent surgery and had a defibulator put in. Two weeks ago he was admitted into the hospital with water retention that went through his chest into his legs. At the time his heart capacity was around 20%. They discharged him and allowed him to go back to work. He had just went in on Sunday when he had a stroke ( later determined at the hospital). He was in ICU until today when they sent him to another floor. He can eat a little now but hasn't been able to talk since Sunday. I know that he is not a candidate for surgery again because of his overall poor health. What else can be done to help, if anything? I just want to get an idea of what are the possible long term affects. I've read a lot of articles but none of them address both stroke with congestive heart failure at 30% capacity. Any bits of advice is much appreciated.

Thanks, Ginger
Richard C Senelick, MD responded:
It always hard to answer specific questions without all the details, like your brothers age and all his other medical issues. In general, his congestive heart failure and poor heart function put him at a much higher risk for a stroke and make it more difficult for him to recover from this stroke.

At our rehabilitation hospital we find that people with a low ejection fraction ( heart function) have a more difficult time participating in rehabilitation. When faced with two debilitating situations it is always good to dividewhat is going on into strengths and weaknesses. It is probably obvious what your brother cannot do, what you and the therapists need to do is identify those things he can do and build on his strengths. He may have to lead a much more sedentary life and the job is how to bring quality into that life.

Do you know if he will be able to return home? Are there people to care for him ar home? Will his home need to be modified? It is never too early to start planning. Ask to speak with the Case Manager at the hsopital.

Finally, be sure people do not give up on him and give him every opportunity to improve. Ask about whether he will go to a rehabilitation hospital. I wrote a series of blogs on WebMD under Chronic Conditions on How to Pick a Rehabilitation Hospital.

Good Luck
After your stroke you may be experiencing a new normal, but remember what George Eliot said- It is never too late to be what you might have been. You still can achieve new goals.
An_245912 replied to Richard C Senelick, MD's response:
Thank you. He changed his lifestyle after the first surgery but went back to his old ways (unhealthy eating habits and smoking). He knows better but lives alone in Atlanta while me and our parents are in Fort Lauderdale. He doesn't have anyone to care for him locally but we are preparing to spend time with him after he is released. I feel it is best for him to go into a rehab facility where we can all learn together what to do and how to continue quality of life. He is stubborn and does not react well to help. As of today he is able to talk a little but nothing else has changed.

He was very mean and resentful to my parents the last time this happened. That hurt them more than anything. So far it has been diffcult to get much information since he has not been able to sign the HIPPA release form. I didn't realize that this applies per incident and cannot be continued from hospitalization a week or so ago. Of course, that is making things more difficult.

Thank you for listening.
itmatsb replied to An_245912's response:
My mother had severe congestive heart failure and was told by the top cardiologist at a major university 2 years before she had her hemorraghic stroke that she would have died by then. She had the major stroke at age 86. I was then told by the doctor that she had about 4 days to live. And she looked like it. Was on oxygen, not talking, barely there. Then she gradually got better. Went into rehab and was able to walk a lot and talk fine. Her wits were totally with her. She kept having small strokes when I kept thinking that we were losing her, but always bounced back. Finally TWO YEARS LATER, she got down to about 75 lbs and died.

So anything is possible, BUT, she had me visiting her almost every day. We had love between us unlike your brother who it sounds like you probably wish wouldn't last much longer after the way you describe him. But then again, I had plenty of problems with my mother before she had the major stroke. Love could maybe conquer a lot in your brother. I wouldn't pressure him or fault him for his diet. Just accept him the way he is.

Good luck in your very difficult situation.


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