My Dad (81) had paracentesis on 9/23; 6 litres withdrawn. Lost 14 pounds of fluid. Furosemide and Spirolactone then seemed to start working well. Edema disappeared. He lost 16 additional pounds as of 10/13. Blood work on 10/13 showed that the kidneys were being affected. Both diruectics cut to 1/2 of former dosage. On 10/17, we could not really wake him up fully. Taken to hospital and diagnosed w/ dehyrdration; ammonia level at 40. Propanolol and both diruectics stopped. BP is very low so diruectics and propanolol cannot be resumed. Fluid retention is returning. If BP will increase and stabilize, doctors plan to reinstate diruectics at a lower dosage. Mental status has greatly improved since being hydrated. He will go to rehab to build up strength as soon as BP stabilizes at an acceptable level. If BP does not improve, meds will not be reinstated; fluid will return; more problems seem to surface when ascites and edema is bad. Just a Catch 22 situation. I just hope he will be able to resume his quality of life prior to last week.
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