मेरे पिता के दिल की विफलता और ऊर्जा स्तर के लिए आयुर्वेदिक सलाह की तलाश - #49482

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Consulting the AYURVEDIC PHYSICIAN for better examination and priscription

THANK YOU DOCTOR FOR SHARING THE COMPLETE CLINICAL PICTURE OF YOUR FATHER AND THE CARE WITH WHICH YOU ARE OBSERVING EVERY PARAMETER AT THIS AGE AND WITH THIS BACKGROUND THE AYURVEDIC OBJECTIVE SHOULD BE LIMITED TO COMFORT ENERGY CONSERVATION AND MAINTENANCE OF DAILY FUNCTION WITHOUT DISTURBING HIS CARDIAC AND BP STABILITY FROM AN AYURVEDIC VIEW THIS IS A CASE OF VRIDDHA AVASTHA WITH PRANA AND VYANA VATA KSHAYA ASSOCIATED WITH KAPHA AVARODHA AND DHATU KSHAYA HIS LOW ENERGY IS MORE RELATED TO OJOKSHAYA AND RESPIRATORY LIMITATION THAN PURE CARDIAC WEAKNESS THEREFORE STRONG HRIDYA OR USHNA FORMULATIONS ARE NOT IDEAL YOUR OBSERVATION REGARDING PRABHAKAR VATI IS CORRECT AS IT CAN RAISE BP AND AFFECT ELECTROLYTE BALANCE IN ELDERLY PATIENTS WITH LABILE PRESSURE IT IS BETTER AVOIDED FOR REGULAR USE IN SUCH CASES AND ONLY MILD BP NEUTRAL SUPPORT SHOULD BE CONSIDERED ARJUNA CAN BE CONTINUED BUT IN A SOFTER FORM SUCH AS LOW DOSE CHURNA OR MILK BASED PREPARATION AS THIS SUPPORTS CARDIAC FUNCTION WITHOUT STIMULATING PRESSURE GARLIC SHOULD BE LIMITED TO LOW DOSE GIVEN HIS ANTIPLATELET THERAPY AND AGE FOR ENERGY AND ENDURANCE FOCUS SHOULD BE ON GENTLE RASAYANA LIKE GUDUCHI AND YASHTIMADHU IN VERY LOW DOSES AS THEY SUPPORT IMMUNITY FATIGUE AND PRANA WITHOUT INCREASING BP OR HEART LOAD THEY ALSO HELP IN COPD RELATED EXHAUSTION VERY MILD ABHYANGA TO FEET AND CALVES WITH WARM TAILA CAN HELP IN VATA REGULATION SLEEP AND MORNING HYPOTENSION WITHOUT CAUSING STRAIN THIS IS OFTEN MORE BENEFICIAL THAN INTERNAL MEDICINES IN BED BOUND ELDERLY PATIENTS DIET SHOULD REMAIN WARM LIGHT AND EASY TO DIGEST WITH NO FASTING LONG GAPS OR COLD HEAVY FOODS THE AIM SHOULD BE STABILITY NOT AGGRESSIVE REJUVENATION EVEN SMALL IMPROVEMENTS IN ALERTNESS BREATH COMFORT AND SITTING TOLERANCE SHOULD BE CONSIDERED A GOOD OUTCOME OVERALL YOUR APPROACH IS VERY APPROPRIATE AND CONSERVATIVE WHICH IS EXACTLY WHAT AYURVEDA REQUIRES IN SUCH A DELICATE STAGE THE FOCUS SHOULD REMAIN ON QUALITY OF LIFE COMFORT AND MAINTAINING WHAT IS ALREADY STABLE RATHER THAN CHASING STRENGTH GAINS

🌿 Ayurvedic Supportive Measures (Adjunctive, Not Replacement) 1. Safe Herbal Options - Arjuna (Terminalia arjuna): Continue, but keep dose low (250–500 mg once daily) — it supports cardiac tone and circulation. - Garlic: Good for lipid and circulation support, but monitor BP closely as it can potentiate hypotension. - Avoid Prabhakar Vati in his case — as you observed, it can raise BP and affect potassium. - Brahmi / Shankhpushpi: Gentle nervine tonics, useful for calming anxiety, improving sleep, and reducing fatigue. - Punarnava (Boerhavia diffusa): Mild diuretic and Rasayana, but since he is already on Torsemide + Eplerenone + Dapagliflozin, use only under supervision to avoid electrolyte imbalance. 2. Rasayana (Rejuvenative) Support - Chyawanprash (sugar-free variant): ½ tsp daily with warm milk, if digestion permits. - Ashwagandha (low dose, 250 mg at night): For strength and endurance, but monitor BP and avoid if fluid retention worsens. - Draksha (raisins soaked overnight): Gentle energy booster, safe for cardiac patients. 3. Dietary Guidance - Light, balanced meals: Khichdi, vegetable soups, stewed apples/pears. - Avoid: Excess salt, fried/oily foods, heavy dairy, red meat. - Favor: Warm, easily digestible foods with mild spices (cumin, coriander, fennel). - Hydration: Small, frequent sips of lukewarm water; avoid large volumes at once. 4. Lifestyle & Gentle Practices - Breathing exercises: Simple Anulom-Vilom (without breath retention) for COPD and relaxation. - Positioning: Semi-reclined posture to ease breathing and circulation. - Massage: Gentle warm sesame oil massage on feet and calves for circulation and comfort. - Sunlight exposure: 10–15 minutes daily for mood and vitamin D support. ADV.- Visit a nearby Ayurvedic physician for better management. WARM REGARDS DR. ANJALI SEHRAWAT

At this age with long standing heart disease COPD pacemaker and multiple cardiac medicines the objective should be stability comfort and preservation of quality of life rather than attempting to increase physical performance Low energy reduced endurance and bed dependence are expected in such patients and aggressive stimulation can worsen blood pressure breathing and electrolyte balance The pattern suggests long term tissue depletion with heaviness breathlessness and variability in circulation therefore any intervention must be mild consistent and non stressing Arjuna and garlic may be continued in low steady doses preferably once daily in the morning Intermittent use or dose escalation should be avoided Prabhakar vati should be discontinued as the observed rise in blood pressure and potassium sensitivity indicate poor suitability in this case For supportive care mild strength promoting medicines in very low doses may be considered such as ashwagandha tablet at night if anxiety sleep disturbance or generalized weakness are present or shatavari tablet if digestion and appetite are adequate These should be introduced one at a time with close observation of blood pressure breathing and electrolyte status Daily routine plays a major role Oil application with warm sesame oil over legs back and chest once daily can improve circulation stiffness sleep and breathing tolerance Gentle assisted sitting breathing exercises and very short indoor movements as tolerated help prevent further deconditioning without cardiac strain Diet should be warm soft freshly prepared slightly unctuous and easy to digest with soups cooked vegetables and stews while avoiding cold raw heavy and gas producing foods Fluid intake should be in small frequent quantities Emotional reassurance regular routine exposure to mild morning sunlight and avoiding frequent changes in medicines are essential supportive measures In such advanced cardiac and pulmonary conditions traditional medicine should remain purely supportive and complementary The aim is reduction in fatigue improved sleep mental calm and day to day comfort while maintaining cardiovascular stability rather than attempting measurable gains in stamina

Hello Dr. Sandeep, Thanks for the clear and thoughtful background info. You’re already doing a great job for your dad, especially considering his age and health issues. Focusing on his quality of life and energy, instead of trying to cure everything, is definitely the right way to go. Let me give you my honest take, using what I know about Ayurveda and keeping things safe for someone older. YOUR DAD’S HEALTH SITUATION: –Age: 83 –Heart: -HFpEF (EF 53%, stable) -Pacemaker -CHF managed with meds -Blood pressure that goes up and down (high at night, low in the morning) – Other stuff: -COPD -On Valproate for 16 years -Mostly bedridden - Low energy, gets tired easily From an Ayurvedic point of view, it looks like age is catching up with him, and his energy is getting blocked. WHAT’S GOING ON (AYURVEDIC VIEW): It’s not just a simple heart problem. It’s more like: Age has made his heart and lungs weaker – Fluids are building up, making it harder for his lungs and heart to work together. – His cells don’t have enough energy That’s why: – Arjuna is helpful for structure – But Prabhakar vati raises his blood pressure – Garlic helps with circulation but can mess with his blood pressure if he takes it all the time You’re spot on with your observations. IMPORTANT SAFETY NOTE: With your dad, we need to be careful to: – NOT over stimulate his heart – NOT raise his blood pressure – NOT increase metabolic heat We just need to: – Help his cells make more energy, – Help him use oxygen better – Improve his muscle tone without changing his blood pressure too much. WHAT COULD ACTUALLY HELP: 1. Stop the Prabhakar Vati for good It has ingredients that can be risky for someone his age with a pacemaker and up-and-down blood pressure. 2. Keep giving Arjuna, but in a different form. Try: Arjuna Ksheerapaka Boil 10 g of Arjuna bark in 200 ml of milk + 200 ml of water until it’s down to 200 ml. Give him 100 ml in the morning. This will: – Nourish his heart muscle – Not spike his blood pressure – It’s better than tablets 3. Add what’s missing – something to boost his cell energy He doesn’t need heart tonics as much as he needs energy support for his cells. Give him: Ashwagandha capsule 1 at night with warm milk This will: – Make his muscles stronger – Help him use oxygen better – Support his nerves – It’s super safe for older folks. 4. For his COPD and low energy: Add: Vasavaleha1 tsp in the morning This will: – Make his lungs more flexible – Help him get more oxygen – Help him be more active 5. If his chest feels blocked: Give: Punarnavadi Mandura 1 tablet in the morning This will: – Reduce fluid buildup from CHF – Support his kidneys – Improve his appetite and blood count – It’s safer than Prabhakar. WHAT TO STAY AWAY FROM: No: – Prabhakar vati – Shilajit –Guggulu – High doses of garlic –Pippali rasayana (These can all mess with his blood pressure or kidneys) WHAT YOU CAN EXPECT: With this plan: Weeks 2-3: –Less shortness of breath –More alert Weeks 4-6: – Can sit up longer – Better appetite – Less tired – No blood pressure spikes – No problems with electrolytes FOOD TIP (SUPER IMPORTANT): At his age, protein is like medicine. Give him: * Moong dal * Milk * Ghee * Rice * Vegetable soups Try to avoid heavy meals at night. TO SUM IT UP: Your dad doesn’t need stronger heart medicine. He needs: – Support for his energy – Support for his cells – Support for his lungs and heart to work together This plan takes into account: – His pacemaker – His unstable blood pressure – His kidney function – His Valproate medication – His CHF Warm Regards Dr. Snehal Vidhate

HELLO, Your father is 83 years old with stage 3 heart failure. His ejection fraction (EF) is 53%, which means his heart pumps blood reasonably well, but his symptoms- low energy , fatigue, and breathlessness- reflect the body’s reduced endurance He also has -hypertenson with evening surges and morning drops -COPD chronic lung issues -A pacemaker and longterm anti seizure medication Currently, he is mostly bed bound, which reduces muscle strength and stamina AYURVEDIC VIEW -At this age, Vata dosha dominates, causing weakness, fatigue, and drynes -kapha involvement contributes to congestion and heaviness in lungs and heart -There is Ojas depletion, the subtle energy that maintains vitality, immunity, and endurance -Prana (life force) is weak, Leading to low stamina TREATMENT GOALS The aim of ayurvedic therapy here is supportive and palliative not to replace modern medicines -Increase energy and stamina (strengthen vata and Ojas) -support heart function safely (without raising Bp or potassium) -improve breathing addling efficiency -enhance digestion and nutrition -reduce fatigue and improve quality of life -prevent further complication like falls, infections, or fluid overload INTERNAL MEDICATIONS A) HEART SUPPORT 1) ARJUNA CAPSULES= 1 cap once daily in morning =strengthen heart muscles, improves circulation, protects heart cells B) ENERGY AND OJAS ENHANCERS 1) ASHWAGANDHA GHRITA= 1/2 tsp ghrita with warm milk at bedtime for 3 months =increases stamina , reduces fatigue, improves immunity 2) DRAKSHA AVALEHA= 1 tsp daily after breakfast for 2 months =improves digestion, gives natural sugars for energy, strengthens rasa dhatu (blood and plasma) C) LUNG AND PRANA SUPPORT 1) SITOPALADI CHURNA= 1gm with honey twice daily after meals =reduces congestion, strengthens respiratory system 2) BRAHMI GHRITA= 1 tsp with warm milk at bedtime =improves mental alertness, prana and overall vitality EXTERNAL THERAPIES 1) OIL MASSAGE= BALA TAILA -lower legs, feet, lower back for 10-15 min , 3-4 times/week =Reduces Vata, improves circulation, supports joints and muscles LIFESTYLE AND DAILY PRACTICES -Gentle activity= sit-in gupriht, assisted short walks, mild stretching -Sunlight exposure= 10-15 min daily PRANAYAM -Anulom vilom= słów and gentle -Bhramari= for calming, mind and improving oxygenation -avoid forced, long sessions due to heart and lung status -SLEEP= short naps, avoid excessive daytime sleeping -POSTURE= keep chest elevated during rest to ease breathing DIET -warm, easily digestible and nourishing -rice, moong dal, prodigy, stewed fruits -milk, ghee, small amounts of nuts -light soups, herbal teas AVOID -Cold/raw foods, heavy pulses, fermented foods -excess salt or fried foods -overeating HOME REMEDIES -warm milk with a pinch of turmeric and ashwagandha ghrita -stewed grapes or pomegranate for natural energy -ginger, cumin, or black pepper in warm water for digestion GENERAL NOTES AND PRECAUTIONS -avoid combining multiple strong formulations simulataneously -stop any formulation if Bp rises, palpitations, or nausea occurs -continue prescribed modern medicines, Ayurevda Is supportive not substitutive -Monitor weigh for fluid retention The approach here is gradual, gentle and supportive focusing on -restoring vitality (Ojas and prana) -supporting heart and lung function -improving quality of life With careful supervision and combination of diet, lifestyle, medications and gentle therapies your father can regain energy, alertness, and better endurance while remaining stable on modern heart failure treatment DO FOLLOW HOPE THIS MIGHT BE HELPFUL THANK YOU DR. MAITRI ACHARYA

✓Medicines Arjunarishta – 10 ml + 30 ml warm water twice daily after food (safest cardiac tonic – strengthens heart muscle, mild diuretic action, no significant BP rise in low dose) Punarnavadi Mandoor – 125 mg (¼–½ tablet) twice daily after food (reduces mild edema, supports energy, very gentle on elderly heart/kidney) Shatavari Kalpa – 5 gm night with warm water or milk (nourishing, reduces Vata fatigue, safe in heart failure) Brahmi Vati (plain) – 125–250 mg night (calms mind, improves quality of life, no cardiac risk) ✓External Therapy (Daily ) Gentle warm sesame oil (Tila taila) abhyanga – full body light massage 10–15 min morning (focus on chest, back, legs) - avoid if very weak Warm Dashmool kwath sitz bath or foot soak 15 min daily (improves peripheral circulation & energy) ✓Diet & Lifestyle Keep balanced diet – continue current, add small amounts of ghee (½–1 tsp/meal) + pomegranate juice 50–100 ml daily Small frequent meals, no heavy dinner Legs elevated 20 min 2–3×/day (reduces venous pooling) Gentle passive movements / breathing exercises (Anulom-Vilom 5–10 min) – no forceful pranayama Sleep 10 PM – 6 AM strictly Important Warnings Do NOT use heating herbs (Ashwagandha, Shilajit, Trikatu, Guggulu, Prabhakar Vati again – BP rise risk high) Monitor BP twice daily + K+ weekly (Eplerenone + torsemide already on board) No forceful exercise or heavy massage If BP drops below 100/60, dizziness, or worsening breathlessness , stop new herbs immediately & inform cardiologist Regards Dr Gursimran Jeet Singh MD Panchakarma