Diuretics

[Juan P. Negret]

After surgery 16 days ago, my doctor prescribed a double dosis (compared with pre-surgery 12.5 mg) of Espironolactone, a diuretic. Is this common? I am peeing a lot, specially at night. In the mornings I feel dehidrated or less energetic and have to drink more liquids. Are diuretics prescribed to get rid of anesthetics from surgery or to keep blood pressure in the normal but low side? Am I loosing too much potassium and sodium? Should I compensate with diet?

Thanks for replies. Juan

 

[Nancy]

Diuretics are used to rid the body of excess fluid which can accumulate after heart surgery. Your doctor may have noticed signs of fluid buildup and is taking precautions. When your heart heals more and is in better working mode, it is possible you will no longer have the need for diuretics. But all that has to be determined by your doctor.

They cause you to pee a lot, of course. Spironolactone is a potassium sparing diuretic which means you will not lose potassium with it like you would with Lasix.

 

[ALCapshaw2]

For some reason, Cardiologists in the USA seem to prefer Lasix (or it's generic form - Furosemide) which does cause Potassium loss.

Fruit Juices often have Potassium supplements in them and can compensate for the potassium loss with Low Doses of Lasix. Bananas are also a good source of Potassium. You may want to ask to have your blood tested for Potassium levels every 3 months or so.

Have you noticed any swelling of your lower leg, ankle, or foot? The usual test is to press your shin bone and watch to see how fast the 'bump' disappears. The Deeper the 'bump' and/or the longer it stays after pressing, the more excess fluid you are retaining.

Another test is to weigh yourself every morning (no clotes, or just underwear). If you have gained 3 lbs in one day or 5 lbs in a week, that is also considered to be a sign that you are retaining too much fluid.

If you mouth feels 'dry' or you feel dehydrated, you probably need to drink more water. Another sign that you need more water is if your urine is a darker shade of yellow or gold. Urologists prefer that your urine be clear or nearly clear. You may need to find a balance between clear urine and excess fluid retention.

Hope this helps.

'AL Capshaw'

 

[opticman]

You should ask your Dr. why he has prescribed a diuretic for you. The only reason I can think of is because someone has excess fluid retention. That was the case for me after my mitral valve repair. A week and a half after surgery I was so filled with fluid from my belly button down to my toes I literally could not bend my legs and did not even recognize myself in the mirror. My Dr. put me on lasix and after 10 days I was fine. Of course with lasix you need a potassium supplement. I'm not familiar with espiromolactone, but you should definitely ask your Dr. I wish you the best possible recovery. Remember to be good, but if you can't-HAVE FUN !!

 

[Nancy]

You do not ordinarily need a Potassium supplement with spironolatone. It is considered a Potassium sparing diuretic. It differs from lasix in that way along with the way to acts on your kidneys.

 

[john79t]

I am on lasix right now 8 days post op. Also He put me on potassium. My understanding is this is to get rird of the post op fluids and it has worked well. He also gave me a BP pill and another for heart rate. My BP is running 100/60 without the BP pill so I stopped it a couple of days ago.

 

[ALCapshaw2]

You do not ordinarily need a Potassium supplement with spironolatone. It is considered a Potassium sparing diuretic. It differs from lasix in that way along with the way to acts on your kidneys.

So why do Cardiologists seem to prefer using Lasix?

Is it just because that is what they learned to use Years ago in their training and they tend to just 'stick with what they know', or is there some reason that they do not like the Postassium Sparing Diuretics?

(My Cardio is a Lasix man.... hasn't really explained why)

 

[Nancy]

There were times when Joe was on both spironolactone and Lasix. They both work differently on the kidneys, and together the effect is increased and it works particularly well with ascites CHF. It is not as dramatic as Lasix and Zaroxolyn combined, and it helps with Potassium loss.

Here are some links

http://en.wikipedia.org/wiki/Spironolactone

http://en.wikipedia.org/wiki/Diuretic

 

[Nancy]

I should also say that most of the time, Joe was on Lasix or a combination of Lasix and Zaroxolyn. But there were times, particularly at one large hospital where they really delved into all of his issues, kidney and otherwise, with heavy testing, where he was put on spironolactone, in addition, and even Bumex from time to time.

As you can see from the Wikipedia article on Diuretics, where they compare them, they work differently within the kidneys.

 

[Ross]

Lordy I'm on just about all of them. HCT, Lasix, Spironolactone, Zaroxolyn......Just got my CMP bloodwork tests and well, I'm messed up. Going to have to ramp up the potassium too. Borderline 3.5 on it.

GOUT CITY!

Somehow, I think my kidneys are going to kill me before my heart or lungs do.

 

[zipper2]

Yup i'm on these lasix and spironolactone,and they monitor my
pottassium closely,this is the only thing they havent come up
with a good home monitoring as inr's.Still gotta go to the vampire
house for checks.
I was off these after 2nd surgery but cus of problems with my
1st mech aortic valve now and chf im sure i'll be on these a long
part of my life yet , So i will run to bathroom for a long time yet
to come as annoying as it is....It works for now.
I just hate the darn lab so much

 

[Braveheart]

I ended up with 40mg. of lasix and a postassium pill, which was what I had been taking for many years anyhow. My surgery consisted of an AVR and a single bypass. They took the saphenous vein for the bypass.As a result, the leg where they took the vein is quite swollen. The other one had some edema, but that seems to be improving daily.

I think that I will just double up on the lasix/potassium regimen for a day or two, and see what happens. I have done this in the past, to good advantage. If that does not help. I will see my PCP.

 

[Glenda]

I too am on both spironolactone and lasix. I haven't been taking potassium but I really think I should. I've been having terrible leg cramgs that wake me up every night. I have to get up and walk around for about ten minutes until they go away and then I'll just get back to sleep and wham, here it goes again. I was up three times last night and it seems to be getting worse. My oncologist put me on vitamin D but it hasn't seem to help. I asked the pharmacist today about taking a vitamin potassium pill and he gave me one of those. It's not as strong ar the prescribed one so he told me to double up on it. If this doesn't work I'll call the doctor and get a prescription.

Gotta run it's time to go to work.

 

[ALCapshaw2]

There were times when Joe was on both spironolactone and Lasix. They both work differently on the kidneys, and together the effect is increased and it works particularly well with ascites CHF. It is not as dramatic as Lasix and Zaroxolyn combined, and it helps with Potassium loss.

Here are some links

http://en.wikipedia.org/wiki/Spironolactone

http://en.wikipedia.org/wiki/Diuretic

AARGH!

A whole new world requiring a new vocabulary....

I've got a headache... can I take an Aspirin ?

More questions for my Nurse Practioneer friends...
Doc's don't seem to want to "waste their time" educating patients, just tell them what to do...

 

[Nancy]

When Joe was in the hospital for his intial treatments for PH, his fluid overload was horrible. They tried everything and nothing was working. They came in and told us that they were going to use Dopamine if things didn't turn around. And they inserted a catheter because the fluid excretion would be dramatic. And it was. I think that one has to be administered in hospital.

His doctors finally got his fluid under control.

This was a teaching hospital and they were able and willing to take big bold steps to get people over whatever hump they were stuck on. I was just in awe of the care there, at least in the Cardiac Intensive Care Unit.

They were even doing heart transplants at that time.

 

[Juan P. Negret]

Thank you all for the comments. Today I visited my cardiologist. He told me to cut down on the spironolactone, and I'll start tomorrow morning. I did have a little bit of fluid retention in the hospital, but I don't seem to have any now. He said that my BP was in the normal but low side (around 115/65). I expect it to rise a little after cutting on the spironolactone (initially I'll try 3/4 and later 1/2 the dose). I also hope that this will help me with my energy in the mornings.

Juan

 

[john79t]

Hopefully my lasix and Pot. is just for post surger since I had no fluid or BP problesms before and both are doing well now at 2 weeks post op. The pot. pills the dr gave me are huge. Something like what we wou;d use a hose to get one don the throat of a horse. I usually can take a handfull of pills at once but we are going to split these puppies next time I take them.