Is hospitalization or a clinic better for lymphedema treatment?

A fellow caregiver asked...

My father has congestive heart failure and has gained over 30 lbs. of fluid. His cardiologist has adjusted his medication but with little results. Now they have referred him to a lymphedema clinic to help take off the fluid. I would like to know if he might benefit more from being hospitalized to help take off the fluid. I'm concerned that he will not get the fluid off fast enough with the current recommendations for treatment. Thank you.

Expert Answer

James Frank is Assistant Professor of Medicine and Director of the Medical Intensive Care Unit at the V.A. Medical Center in San Francisco.

Heart failure triggers the body to hold onto fluid, which can leak out into the extravascular spaces, usually in the legs and around the hips. This fluid retention, or edema, is usually treated with diuretics and medications to help the failing heart. If your father's being treated appropriately but still has a lot of edema in his legs, the problem may not be his heart failure. It could be a lot of things, too many possibilities to even speculate, so he defintely needs to be evaluated by his doctor.

Patients taking diuretics often need close monitoring and electrolyte replacement. So perhaps this clinic does all that monitoring for the doctors, and if that's what that means, it seems like it's the right thing for your father.