Observations - Severe Edema & Albumin Replacement Effectiveness

Update - I went back to the hospital this past week.  I went in on Tuesday August 30, and came home Friday 3 days later.  I went in  with a wet weight of 189 pounds and left weighting a dry weight of 178 pounds.

My albumin level was 1.7     and my total serum protein was 3.2.  


These levels are pretty good for me, and I suspected they would be according to where my edema was most pronounced.


Edema characteristics are different depending on what the Albumin level is.  For example, when my albumin level is less than one, the edema uncomfortably manifestos  on the dorsal (top) surfaces of my feet; painfully stretching the skin almost bubble-like.  This  situation is in addition to severe generalized edema known as Anasarca.  


When the albumin level is less than 1,  the edema commonly  manifested in my scrotum, penis, as well as beneath  my chin.  


These areas are all known as ‘dependant surfaces’ because they are areas that water (edema) will dam up or collect simply because it can go no farther.  Even my belly at the belt line (my abdominal tissue) would collect fluid and hang outward  looking alot like a water bag!

In addition to severe edema affecting dependant areas, the edema at the less-than- one-level seems to manifest in my intestinal walls as well.


Furthermore, it has been my experience that I eat smaller meal portions  when the level is less than one because there is not as much room in my abdominal cavity for my enflamed intestines, my diaphragm and large portions of food.  I would feel full quickly, and would have difficulty breathing deeply (not enough room for diaphragm motion).


Prior to the severity of my edema progressing to this degree, I’ve noticed that my oral Lasix gradually lose their effectiveness.  As they do, my edema gradually increases culminating into the severe symptoms described above.


Treatment I receive for this is simple:  Albumin (human) 25%, USP  In a Single Use 50MIL vial (every 8 hours), and 60 to 80ml Lasix 30 minutes following each Albumin infusion.

Blood pressure monitoring as well as electrolyte level monitoring are a must.


I have made some observations concerning this albumin replacement therapy.  


First observation when my albumin level is so low, it takes about 36 hours before I really start urinating a lot and see a significant weight (edema) loss.  Also, salty snacks can hamper this therapy’s diuresis effects.

Another observation of mine is that body movement helps the process of diuresis. (Diuresis is the medical term for eliminating edema via urination through the use of pharmaceuticals.  Diuretics pull fluid into the bladder to be eliminated).  


I have found that taking regular walks seems to help the diuresis process.  I believe that this is due to the increasing circulatory activity.


A third observation pertains to how the edema decreases.  The first place I notice it decrease is my intestines.  Very quickly I begin to feel less bloated.  Next, my arms, then my lower legs lose their edema.  After that, I lose it in my dependant areas last.

One thing to know is that you have to use your weight to accurately assess fluid loss.  This is because you can be fooled when in bed (supine) for a number of days, your edema will have a new dependant surface:  your back.


If your back is your dependant surface, your shins (lower extremities) will be skinny though you’re edema hasn’t actually decreased.  So, use your weight.


When being weighed by hospital staff, you should ensure the scale is accurate.  If your weight when checking into the hospital  wildly differs from what you know your weight should be, you should confirm the weight by weighing on another scale.  


After you are confident the weight is accurate, you should use the same scale for every daily weight.  Additionally, you should be weighed at roughly the same time each day. 


Also, refer to your weights in terms of dry or wet weights.  I have gone in the hospital with a wet weight of 200 pounds, and  7 days later  discharged with a dry weight of  170 pounds.




Well, I’m going to leave it here.  I hope this information is useful to you in some way.