Any idea how long my husband may have?
On Nov.16 -08 my husband had a massive heart attack. He didn't know what was happening; he thought he had food poisioning. He had no chest pain, only pain in he neck, and vomiting. He waited twelve hours after the symptoms started before going to the hospital. They were able to put in two stents. He is diabetic and had a triple bypass in 1999, and also had three stents put in in July 08, but this was his first heart attack. Since the attack he has been told he has Stage Three congestive heart failure. He has had pleural effusion that required removal, and massive edema that caused his bypass scars to open up and drain fluid. He is not a big man and has lost twenty pounds on the diuretics. He also takes every CHF med that is possible. His blood sugars run between 150 and 200 daily. He has an ejection factor of 25. He seems to be in good spirits but also developed a arryhthmia and they want to put in a defibrulator. I am scared that I will lose him anyday, and he is only 51. His doctor has just told him he is a very sick man, but avoids the "How long do I have?" question What are his survial chances if he has gotten so sick in such a short amount of time?
Expert Answer
Unfortunately, this course of events is not uncommon in people with known heart disease and diabetes. Most importantly, your husband needs to get all of his risk factors very well controlled. These include
blood pressure under 120/80mmHg
LDL (bad cholesterol) under 70mg/dl
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Hemoglobin A1C less than 7%.
If he is carrying a lot of weight in his stomach, losing inches off the waist will help improve his risk factors. Cardiac rehabilitation is another important topic to discuss with your husband's cardiologist. Studies have shown that exercise can improve CHF symptoms and improve quality of life.
Steps you can take to prevent further heart failure hospitalizations include checking your husband's weight daily and notifying the cardiologists of rapid weight gains (over 2 pounds in one day), limiting sodium (salt) intake to less than 2,000mg/day and limiting fluid intake.
Recent studies have shown that cinnamon is helpful in stabilizing blood sugars in diabetic patients. You can add it to oatmeal, coffee, yogurt or apples.
Close medical management is a must.
In addition to the defibrillator, you should discuss a bi-ventricular pacemaker with the cardiologist. A bi-ventricular pacemaker may help to improve CHF symptoms plus may improve the pumping capacity of the heart. The defibrillator/bi-ventricular pacemakers come together in one device and are frequently used in patients with CHF.
By incorporating the above information, you will be doing all you can to prevent heart failure progression. Heart failure mortality has improved over the years with the new medications and treatment that are available. However, even with such treatment, some patients do continue to experience further weakening of the heart muscle. Heart transplantation is always another option for younger, otherwise healthy adults as your husband, if warranted. This may be something to discuss with the cardiologist.
Finally, a support group for patients and families may be a good idea. You can try contacting your local hospital to find out about local support groups.