Swelling

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Dad and I were so focused on highlighting his back pain to the PCU doctors that we forgot to tell them that his feet were still swollen. Since then, the swelling had slowly crept up to his knees @@

Meanwhile, thankfully the combination of Norgesic/Anarex (1 tab 3 times a day) + 2-4 tabs of paracetamol could manage his back pain. After taking diazepam for 5 consecutive nights, dad took it only when he couldn't sleep. He was given only 10 tablets whereas there were 14 days to the next appointment. Since then, he took twice and had 3 tabs leftover.

During the next appointment with the PCU specialist (yes, the same one who didn't care we wanted to protect the remaining kidney), we highlighted the following symptoms:
  • Swelling on feet, calves and knees
  • Back pain but manageable
  • Stomach pain
  • Worsening constipation: no bowel movement for just over 3 days
  • Shortness of breath (twice a week)
We also highlighted the frequency of adhoc painkillers:
  • Norgesic/Anarex 3 times daily
  • Paracetamol 1-2 times daily, 2 tabs each time
  • Diazepam twice a week
  • Oxynorm 2-3 times daily
" Heart failure is a chronic, progressive condition in which the heart muscle is unable to pump enough blood to meet the body’s needs for blood and oxygen. Basically, the heart can’t keep up with its workload. "

" People with Heart Failure May Experience......swelling in the feet, ankles, legs or abdomen or weight gain. You may find that your shoes feel tight. 
(Buildup of excess fluid in body tissues (edema) "

The above was obtained from American Heart Association website.

The specialist attributed the swelling to heart failure. After discussing a couple of options, the course of action is to first take frusemide so that my dad can pee out lots of this retained fluid. Failing that, add reduction of fluid intake too. Didn't work on first two days @@

As for dad's constipation, the specialist prescribed metoclopramide to be taken on top of all other anti-constipation medicine if he hasn't pooed for a day i.e. target daily bowel movement. This stumped the pharmacist as this medicine is commonly used for nausea (which the doctor did tell us) and vomiting but not constipation. I walked back to the clinic (with the giant cache of medicine haha) and obtained assurance from the specialist that this was the correct medicine. Well, guess what? He is correct: a few health websites, including research papers, confirmed that this medicine is also used "to help with emptying of the stomach in people with delayed stomach emptying". I am surprised that the doctor knows better than the pharmacist.

Probably a combination of metoclopramide, prune juice and dragon fruit (fruit taken the night before), my dad finally managed to empty out 3 days worth of waste 😬

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