Unfortunately, without adequately diagnosing him, it makes treating him very difficult. I would stress to your brother-in-law that going to his doctor is suboptimal. His doctor is just putting a bandage on this situation probably because by ordering test and the likes would be too costly especially if your BIL is self-pay. Try to convince him to go to the ER and get himself admitted. Once he is in the hospital the social workers and discharge planners will help him apply for Medi-care. Remind your BIL that Medi-care is not charity because he paid into it. You might also check if he has any veteran benefits which definitely will defray all cost. While in the hospital, all the necessary test can be done and treat properly instituted. By just treating CHF with lasix is substandard care. I m not clear why he is vomitting blood. Does he drink?