Cronichally Dehydrated Grandma was prescribed Diuretics

[murphyslabrat]

First off, I think it's funny that I'm posting this in a forum where most people are talking about working out. Like, two of the last three threads I was reading where about Crossfit.

I just moved in with my grandmother to provide transportation and company, in exchange for school money (Wisconsin to Florida, and my family didn't qualify for the pell grant for tax reasons). My grandmother is now 90, pushing 91, and currently doesn't drink an ounce of water that isn't mixed with coffee. Lately, she's been having trouble breathing at night, so we went to the doctor. After going over the medications that she's taking, her temperature being taken, and an EKG, mister M.D. prescribed a Lasex generic for water retention. Apparently, Grandma has water built up around her heart, and is being given the Lasex to help her pass the water.

I'm thinking that this guy should be prescribing normal amounts of water, at least in addition to the RX, if not in exclusion, as water retention is a symptom of dehydration.

Now, for more situational stuff: Grandma has been on this stuff before, and it "turns her into a human water faucet", so she really doesn't like it. This morning I was up at about 8 reading, and she's like, "You should call your mother, I'm sure she'd have something to say about this" (My mom, her daughter, is a DIY nutritionist), but it's ungodly early, so I stall by doing some research on our own, basically to prepare her for what mom is going to say (shut up and take it, eat less salt, and drink water too) when her primary concern is having to constantly pee.

So, the question is: is it healthy for an EXTREMELY dehydrated person to be taking a pharmaceutical diuretic?

 

[SociallyChallenged]

No, it's not healthy. However, this is the right clinical move for someone who has congestive heart failure or cardiac tamponade. The problem is she should be drinking more water. You can talk to her about the risks and, if she still doesn't want to drink more water, find another solution. Some solutions are getting her to drink flavored water (crystal light) or - my favorite - tricking her into ingesting her water. How do you do that? Make her eat foods like grapes, cucumbers, spinach, pastas, rice, etc. You get a large proportion of your water from food (typically most of it). Any food that has water added or has a high water content (frequently fruits and veggies) will make the situation better. Also, keep in mind that the "drink 8 cups of water a day" is a terrible saying. Everybody's water requirement varies greatly. For an inactive, elderly woman, she might need as little as 2-3 cups of water a day, while someone who works construction in Texas might need over 2 gallons. My grandmother has congestive heart failure and she has been on diuretics for a while. The thing that worked for me was ice cream. I can get her to eat a cup of ice cream easily and that's a significant part of her water intake. If your grandmother has insulin-related problems, then that's probably a bad idea, but you get the idea. Best of luck.

 

[Capt Caveman]

If you don't feel comfortable with the doctor's prescription, don't take advice here and bring the test results to another doctor for a second opinion.

 

[Kipper]

Hang on a second, was the dehydration diagnosed by the MD or is this something you're coming up with on your own? Fluid retention can occur for a ton of different reasons, including dehydration, but the buildup of fluid around the heart in congestive heart failure isn't necessarily because of dehydration, but from the heart's inability to properly supply the rest of the body. It pumps weakly, blood flow into the heart is reduced, and blood accumulates "behind" the heart - in this case around the heart near the lungs, which explains the shortness of breath.

If she's a habitual coffee drinker, she may be drinking enough - several cups a day can easily add up in addition to food. As SC mentioned diuretics are first-line therapy, along with dietary modifications that strictly limit the amount of salt that's taken in (Google "DASH diet").

Edit: forgot to mention that lasix is potassium-depleting. If you go back to the doctor, may be worthwhile mentioning. Because old people are usually on a bunch of meds this usually isn't a problem, since other medications can be potassium-sparing - and usually food intake is enough to compensate. The reduced-sodium diets used with CHF generally stress high fruit/vegetable content (unless of course, the person is on coumadin or some other 'blood thinner.') so potassium is generally a non-issue.