Abstract
The referral letter was brief and to the point: ‘This 81-year-old lady's heart failure is getting worse, with increasing peripheral oedema, despite maximal doses of a wide range of medications, listed below. Please advise.’ The problem turned out to be very simple, as her daughter explained when she brought her to the clinic. ‘She won't take the water tablets, doctor,’ she told me. Her mother liked to take a stroll outside in the mornings and stay indoors in the afternoons to watch her favourite television programmes. The morning diuresis made that impossible. And since her heart failure had become worse the daily strolls had become more difficult as well. I suggested that she take the furosemide in the afternoons instead.
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