25 tips to manage the crushing fatigue of heart disease | Heart Sisters

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25 tips to manage the crushing fatigue of heart disease by Carolyn Thomas (https://myheartsisters.org/yes-it-s-all-about-me/) ª @HeartSisters (https://twitter.com/HeartSisters) For my whole life BHA (Before Heart Attack), I can hardly remember feeling real fatigue. Oh, sure, I’d feel sore working long hot days on our fruit farm as a teenager. Or sleepy after pulling those all-nighters in college. Or out-of-my-mind exhausted coping with a teething baby and a sleepless toddler. Or tired at the end of a stressful day juggling deadlines in my public relations career. Or maybe even pleasantly pooped after my running group finished a long road race. But generally speaking, on a day-to-day basis, never ever the kind of severe fatigue I experienced AHA. I’ve always been one of those disgustingly perky early risers who leaped cheerfully out of bed the minute one droopy eyelid cracked open to discover the clock showed anything past 4:30 a.m. Once I finished leaping, I’d hit the coffeepot and then the shower, in that order. Then away I’d go, tap dancing 90 mph to meet the day ahead, rarely slowing down until I hit the pillow much, much later that night.

But after I was discharged from hospital following my heart attack, I was gobsmacked to suddenly experience daily bouts of extreme bone-crushing fatigue that I could never have even imagined existed before. I remember, for example, going for a walk one day with my son, Ben, shortly after coming home from hospital. My post-op instructions from the CCU had been to walk outdoors one block a day for the first week, two blocks a day the second week, etc. Ben and I had barely made it to the stop sign at the end of our block when I had to grab his arm to lean on for support all the way home. I couldn’t believe it! I felt like a frail old lady, barely able to shuffle one foot in front of the other. And when we finally returned home (slowest pace in recorded history), I could hardly make it to the couch to recover from the exertion of this simple little walk. What was happening to me?!? It’s hard to describe this kind of relentless fatigue to those who have never experienced it, or to explain fatigue that is not relieved by just resting. And nobody had warned me in hospital that this relatively common reality during cardiac recovery was heading my way. I could find only a handful of research studies confirming what I was experiencing.

A 2008 Swedish study out of the University of Gothenburg, for example, found that about half of all patients who survive a myocardial infarction (heart attack) are still experiencing “onerous fatigue” four months after the infarction.* Dr. Pia Alsén, author of this study, observed: “Many people experienced the fatigue as new and different, not related to physical effort or a lack of rest; it occurred unpredictably and could not be attributed to any definite cause.” The elusive cause of the fatigue might also lie in the damage done by the heart attack itself. When heart muscle is damaged from being deprived of oxygenated blood flow during a heart attack, scar tissue is formed on the damaged heart muscle, decreasing the pumping efficiency in the affected area. The resulting reduction of blood flow can produce fatigue, depending on the size and location of the scar tissue. If you’re a heart patient diagnosed with mitral valve prolapse (MVP – one of the most common conditions that affect our heart valves), your mitral valve is enlarged and unable to close correctly, preventing blood from flowing normally throughout your body. When your organs don’t get an adequate supply of oxygenated blood due to MVP, you can experience extreme fatigue. Some medications that you are taking for heart disease can also cause fatigue. These include the beta blockers (atenolol, metoprolol, etc.) and statin drugs to treat high cholesterol (Lipitor, Zocor, Crestor). And if you also have a sleep disorder (https://myheartsisters.org/2011/02/22/sleep-linked-to-heart-disease/) like sleep apnea (a condition linked to heart disease), you can feel extreme fatigue during the day. Weakness, fatigue, and shortness of breath are to be expected in virtually all those recovering from a heart attack. Heart patients being discharged from hospital should be advised before going home that they may find just getting out of bed, taking a shower, and dressing can feel utterly exhausting, especially in the early days and weeks. See also: Why Taking a Shower Is So Exhausting for Heart Attack Survivors (https://myheartsisters.org/2011/04/23/mets-after-heart-attack/) It’s important to remember that symptoms like crushing fatigue can also be found in thyroid (https://myheartsisters.org/2014/01/27/when-thyroid-problems-masquerade-as-heart-disease/), depression (https://myheartsisters.org/2016/01/24/cardiac-depression-myths-facts/) and other medical conditions. It’s possible to have both heart disease and a second condition that is also contributing your exhaustion. Kelly Young, founder of Rheumatoid Arthritis Warrior (http://rawarrior.com/), describes the kind of fatigue so many patients with chronic illness experience. She wrote: “All of a sudden on Monday afternoon, it felt like it was 2 a.m. and I should be in bed. This is not the same as being tired. It’s more like being sick with the flu. I can remember the ‘good’ feeling of tired after working hard. This is not it – this is being sick. It can come at any time of day or night. “This fatigue is not always the result of physical activity. It can suddenly develop for no apparent reason. This fatigue can last hours or days. It makes movement very difficult. “It is not a psychosomatic condition.” Here’s Kelly’s list of tips in managing severe fatigue common among those living with a chronic illness (shared by her blog readers at RA Warrior (http://www.rawarrior.com): Budget energy wisely. Guard energy. Have a regular schedule. Or go to bed early. Do gentle modified stretching or yoga. Nutritious balanced snacks such as protein bar and fruit. Get the best sleep at night possible. Get the best bed possible. Use heat to fight fatiguing pain. Eat on a regular schedule. Eat enough protein. Take small naps. Relaxation or meditation techniques. Alternate periods of activity and rest. Check for deficiencies such as iron or vitamin B-12. Treat the disease as aggressively as possible. While resting, plan for what you’ll do when you are more able. Fruit juice & sympathy. Check for side effects of medicines. Take them at the best time of day to avoid fatigue. Accept the reality that the list will not be accomplished today. Caffeine. When the body says “No more” – stop. Watch a movie. Take large naps. Delegate and oversee. Blue Kryptonite! * Alsén, P., Brink E. & Persson, L-O. (2008). Living with incomprehensible fatigue after recent myocardial infarction. Journal of Advanced Nursing, 64(5), 459-68. . Q: Have you had to deal with severe fatigue since your heart disease diagnosis? See also: Why taking a shower is so exhausting after a heart attack (https://myheartsisters.org/2011/04/23/mets-after-heart-attack/) Exhaustion: the ‘ (https://myheartsisters.org/2015/09/13/exhaustion-leaky-emotion-chronic-illness/)leaky emotion’ of chronic illness (https://myheartsisters.org/2015/09/13/exhaustionleaky-emotion-chronic-illness/) I need a nap! (https://myheartsisters.org/2017/04/23/i-need-a-nap/) Depressed? Who, me? Myths and facts about depression and heart disease (https://myheartsisters.org/2009/08/31/depression-myths/) . Tags: beta blockers (https://myheartsisters.org/tag/beta-blockers/), exhaustion (https://myheartsisters.org/tag/exhaustion/), fatigue (https://myheartsisters.org/tag/fatigue/), Kelly Young (https://myheartsisters.org/tag/kelly-young/), mitral valve prolapse (https://myheartsisters.org/tag/mitral-valve-prolapse/), Rheumatoid Arthritis Warrior (https://myheartsisters.org/tag/rheumatoid-arthritis-warrior/), statins (https://myheartsisters.org/tag/statins/) COMMENTS 151 Comments CATEGORIES Living with heart disease

151 Responses to “25 tips to manage the crushing fatigue of heart disease” Jill C February 19, 2018 at 9:51 am # Dear Heart Sisters, I have Hypertrophic Cardiomyopathy (HCM) for which I have had open heart surgery twice 4 years ago…. In December I had an ablation for atrial arrhythmias and a stent for a 90% lesion in my Circumflex artery…. Caught BEFORE an MI. In your blog, I finally found a fellow experiencer of this weird, unpredictable, intermittent, seeming without-cause FATIGUE… I have dealt with it for years eliminating statins, balancing thyroid hormones, sleep studies, decreasing meds etc. After my stent I thought I was coming to a normal energy state….. going for walks…. going to the pool … But I was duped again … just spent 3 days in a chair, taking naps and sleeping 10 hrs at night. Is this just the way it will be the rest of my life and I need to accept it? I am an RN and it’s hard for me to embrace things that I can’t explain physiologically. I would appreciate knowing about any ongoing or completed studies in Cardiac Fatigue. Thanks for being there. REPLY Carolyn Thomas February 20, 2018 at 8:09 pm # Hi Jill – I’m so sorry you are experiencing this. It sounds like you’ve done everything possible to solve this fatigue mystery over the years, and then had some relief in the past couple of months until now. There has actually been far more research into cancer-related fatigue than in heart disease-related fatigue. I’m not a physician so cannot comment specifically on your case, but I can tell you generally that there are certain types of cardiac conditions that are in fact linked to significant fatigue (e.g. heart failure, infections like endocarditis, arrhythmias like atrial fibrillation, certain valve conditions, dilated cardiomyopathy, etc). Some episodes are intermittent and fleeting, others are chronic. I thought for sure mine was chronic and progressive in the early weeks/months – but although I still have “those days”, I have learned that carefully pacing myself helps me avoid the worst episodes of fatigue these days, so please do not give up hope. I do think it’s curious that immediately after your stent/ablation, it seems like you were feeling less fatigued (“normal energy state”) which must have made you feel hopeful at last. You are in relatively early days since those two procedures and NO, it does not necessarily mean “this is just the way it will be”. But speak to your physician about these severe fatigue symptoms to see if there might be other clues to the mystery. Best of luck to you… REPLY Jill C February 21, 2018 at 9:32 am # Thank You Carolyn….I am curious that you said that “…you are in the early days” following my ablation and stenting….I guess I felt that since I didn’t have an actual MI, that recovery would be pretty quick … 7 weeks now…. Do you have experience or info on recovering from those procedures? Of course underlying HCM and stacking 2 procedures 2 weeks apart can have an effect too, I would imagine. REPLY Carolyn Thomas February 21, 2018 at 6:52 pm # Jill, I have come to believe that anything up to one year post-procedure (no matter the procedure, or what the cardiac event was) is “early days” relative to coming out the other end one day feeling anything like your ‘real’ self. And I think you are 100% correct: you had two significant cardiac procedures, just two weeks apart, on top of your underlying HCM! No wonder you are feeling so exhausted… There are two distinct areas of recovery, as you know: the physical part that’s simply the body recuperating from any invasive procedure, and of course the psychological part that makes us feel discouraged enough to ask questions like yours: “Is this just the way it will be the rest of my life?” That’s a profoundly surreal question for most of us. I’ve written lots on this both here on my blog and also in my new book. A couple articles you might find relevant include this one on the “loss of selff” after a medical crisis, or this on on feeling like we’ve now entered a “new country” – and don’t know how to get back home. I also wrote about why I believe there is “no such thing as a ‘small’ heart attack” (or any other cardiac procedure, for all those reasons. Crushing fatigue can also be a very common companion to depression. One day at at time, one foot in front of the other at a time… REPLY Sylvia Sinclair January 7, 2018 at 2:48 am # My 77-year-old husband has had 3 heart attacks and 2 stents up to 2008. Then last year they discovered lung cancer but told him that a partial lobectomy would get rid of it so he had that on 29/11/17. His lung collapsed as expected but he was discharged from the hospital with 2 portable drains on 19/12/17. Unfortunately, he then had a heart attack on 23/12/17 and had to go back to the hospital where they renewed a stent that had become blocked. Then on 25/12/17, he suffered a cardiac arrest. He was shocked back immediately and spent more time in the hospital but he hasn’t been able to eat properly for months so he is now 8 stone 10pounds where he once was 11 stone 6 pounds. He came home on 02/01/18 and sleeps a lot, can’t stand as he’s so weak and has a respiratory infection for which he is taking antibiotics. We found your comments about fatigue after a heart attack, very informative, thank you. REPLY Carolyn Thomas January 7, 2018 at 6:08 am # Hello Sylvia – no wonder your husband is feeling so fatigued, considering all his body has gone through in a short time. You too must be exhausted just trying to cope with all of this. Best of luck to you and your husband… REPLY Anonymous August 21, 2017 at 5:13 pm # (This comment has been removed as it was trying to sell you stuff…. ) REPLY Brian August 9, 2017 at 7:50 am # Suffered a heart attack on 9/28/2016 at 53 yrs of age. Will never forget it. Had 2 surgeries to install 3 stents. Afterwards, had issues of passing out (2x) and many incidents of heart palpitations (tachycardia) so the cardiologist implanted a loop recorder after testing the electrical system of my heart. I have read people talking about having rehab. My doctors never said anything about rehab. They told me what they did during the surgeries; prescribed me a diet of pills; told me to stop smoking and to change my diet. Like many others, my life has changed. I get tired easily and must take a nap everyday. The medications I take in the morning and the evening cause me to be tired too. I have no ambition to do much of anything especially in the Arizona heat and most anything physical. Previously, I was very active, had a physically challenging job as a commercial electrician and I worked about 50 hours a week. Now, it seems I can’t do much at all and I limit my outdoor activities and running errands during the summer months- I simply cannot stand the heat. From what I am reading, this is pretty much what many others go through after having a heart attack. At least I am alive and get to enjoy my 4 month old grandson. Sometimes we have to look at the glass being half-full instead of being half-empty. REPLY Carolyn Thomas August 9, 2017 at 4:09 pm # Hi Brian – Arizona in the summer!? No wonder you have no ambition to do much of anything. Heart patients need to be especially careful during hot weather (read more about that here) plus you are still less than one year post-heart attack. It can be a severe shock to those of us who used to be super-active to suddenly not be able to do what was likely considered routine before. See if you can get a treadmill or exercise bike to use indoors, with air-conditioning – it seems like a paradox, but getting a regular cardio workout – just start slow! – can often end up being the most helpful way to get through this fatigue. I know from personal experience that grandbabies are the best medicine ever! Enjoy that precious little one and don’t be too hard on yourself – there’s no award for being the fastest heart patient to bounce back. Just do what you can do, little by little, and take extra special care to do what you can to avoid the heat. REPLY Donnie Harding July 26, 2017 at 3:34 pm # I have been fighting heart disease since 2002 when I was only 36 and in 2010 I had a quad bypass and ever since my surgery I have grown more and more fatigued. In 2013 I had another heart attack as well as pulmonary embolism in my lung, in turn I can no longer work mainly due to fatigue. And now I suffer from severe anxiety and depression which is what my dr claims is the main source of my fatigue in his opinion, which I personally find mind boggling because it seems my 15 years of living with heart disease and surviving a total of 12 of them does not qualify me to have a valid opinion on my prognosis because I didn’t go to medical school. Sorry I digress, I know what my body feels and what I can and can’t do but I feel like maybe I’m crazy because I’m told most of it is in my head. I just want to thank you for sharing this because I realize I’m not alone and I never knew my beta blockers and statins contributed to my symptoms as well, the warning on my bottles only suggest dizziness as possible side effect. But truly thank you and thank you to all who have shared your stories I have found them inspirational. Sincerely, Donnie REPLY Carolyn Thomas July 26, 2017 at 10:09 pm # Hello Donnie and thanks for sharing your very complicated story here. Honestly, my first thought while reading it was, ‘Geez Louise, no wonder Donnie is depressed!’ I like what cardiac psychologist (and heart attack survivor himself) Dr. Stephen Parker once wrote about his own anxiety and depression during cardiac recovery: “There are damned good reasons to feel anxious and depressed. A heart attack is a deeply wounding event, and it is a wound that takes a long time to recover from, whatever the treatment.” I’m not a physician so cannot comment specifically on your situation, but I can tell you generally that we know one of the most important longterm complications of pulmonary embolism is called chronic pulmonary hypertension (which may show up as fatigue, limited exercise tolerance or shortness of breath). Here’s an interesting journal article about that. Nobody can say which came first: did the fatigue cause the depression and anxiety, or did the anxiety and depression cause the fatigue? Fatigue is, unfortunately, the very common companion to a number of chronic diagnoses. Re your depression/anxiety: I really hope that you will make an appointment with a counselor, pastor, therapist or other trained professional to help improve your quality of life. You cannot change the medical diagnoses you’ve had, but you – with some skilled help – might very well be able to make some changes to your mental and emotional state. Best of luck to you… REPLY Bert July 25, 2017 at 9:53 am # You’re the first person that I can relate to. I coded five times, I’m very lucky to be here, my wife saved my life. Thank God she knew CPR, and we don’t think about what she went through also. I think I have come back a different person. I have no interest, I don’t want to work, play, enjoy my summer home. I feel sick most of the time, but no one understands the way you feel. You’re right, once they fix you, it’s over. Luckily, my daughter is an RN and gets me help and support groups, but your heart doctors don’t understand. I’m going to try your suggestions, but it’s been a year and doctors can’t seem to understand what we deal with. I did 14 weeks of cardiac rehab, but not one nurse or doctor ever asked about how I was doing mentally. I think all they think about is physically. I paid no attention to feelings, and it got to me a few months later. Thanks for posting this. There are a lot of us out there wondering when it may pass. I worry everyday if I’ll ever be the same.

REPLY Carolyn Thomas July 25, 2017 at 12:28 pm # Hello Bert – many heart patients are stunned by how long it may actually take to start feeling like our old selves again. Some of the symptoms you describe (e.g. no interest, don’t want to work, play, enjoy things) sound like depression symptoms (very common in heart patients). Read more about that here. You may benefit, as I did, from talking to a professional therapist, pastor, or counselor about what you’ve been going through (it’s a good way to get unstuck and feel less like a different person). Yes, your old self IS still there inside you and your instincts are intact – but maybe just buried a bit by what hit you a year ago. Many of us just need a little help uncovering them while recuperating from something so catastrophic. You’ve been through a lot! Meanwhile, while you’re waiting for your talk therapy appointment, try this little trick that helped me a lot: every single day, go out and do one thing, at least one thing, that makes you happy. Doesn’t have to be a big major event at all, just one small thing (like a walk in nature, or watching the sunset, or an ice cream cone on a sunny day). Try it and let me know how you make out… Best of luck to you… REPLY Kathy Thompson May 8, 2017 at 1:21 pm # Thank you for writing this. I am one year post quadruple bypass age 54 (I have Familial Hypercholesterolemia and HIGH Lipoprotein(a) and am a high energy person. Today is one of those days. I’m exhausted for no reason at all. I normally exercise an hour a day and complete my errands and activities. Today I can barely keep my eyes open. After reading your post, I’m going to surrender to it and plan for tomorrow when I will likely feel good again. REPLY Carolyn Thomas May 8, 2017 at 2:05 pm # Hello Kathy – some days are like this (in the words of Alexander’s mother in one of my kids’ favourite storybooks when they were little – “Alexander and the Terrible Horrible No Good Very Bad Day”). Sometimes, we can figure out why we’re suddenly so exhausted, but other days (like today, for you) it’s a mystery. Hang in there, be extra nice to yourself… REPLY Pat May 8, 2017 at 9:37 am # Since my heart attack, I’m absolutely shattered. REPLY Carolyn Thomas May 8, 2017 at 2:03 pm # Sorry to hear this, Pat. When heart attack survivors use words like “shattered”, that typically means you’re not only talking about physical effects but emotional and psychological ones too. One day at a time, little by little, things WILL feel a bit better. Please make an appointment with a therapist, pastor, counselor or other trained professional to help you get through this. Best of luck to you… REPLY Wayne Sandifer July 25, 2017 at 12:53 pm # It does mess with your head for sure. I worry daily about my tiredness and shortness of breath when doing even small tasks. At times, I have hyperventilation panic attacks but after THOROUGH testing this past May, I do feel lots better except for the fact of the heart failure… coughing and all It is hard to deal with at times for sure… REPLY Carolyn Thomas July 25, 2017 at 4:11 pm # Hi Wayne – for many people, heart failure can have its own list of debilitating symptoms that may be quite different than those experienced by heart attack survivors. But fatigue can feel as awful in both diagnoses. Glad you’re feeling a bit better after your tests. Hang in there… REPLY treecollector52 January 4, 2018 at 10:47 am # hi I’m a 54 year old male..i had train and worked out my whole life my workout consisted of 300. pushups a day and 6 to 8 miles of walking fastpaced 5 days a week… I had a heart attack the week after Christmas…my strength and power was second to not even men half my age. my body fat never exceeded 6 percent my whole life .the cardiologist was shocked at the condtion of my body and sill suffered a heart attack…when I first went to cardio rehab most of the people there thought I was one of the trainers to be only shocked to find out I was not.. needless to say I was devastated mentally Iam slowly gaining strength back a little at time. I have the slightest twinge of pain anywhere heart pops in my head I have two stents now. the one thing that I can tell you from my training experience is any musle even the heart can be made stronger even if its damaged… i guess what I’m saying is a heart attack can happen to anyone anytime anywhere so don’t feel bad if you had that piece of cake or a extra helping or two. enjoy your life tell your kids you love them and the grandkids ….stop and remember the birds are always singing and the sun is still shining behind the rain clouds even in a down pour…..stay strong all… REPLY Carolyn Thomas January 4, 2018 at 3:33 pm # Your story is a reminder that, as you say, a heart attack CAN indeed happen to anyone, anytime, anywhere. When the the super-fit famous runner Jim Fixx dropped dead during a run in 1984, I remember hearing the theory that it had perhaps been his high level of fitness that may have actually postponed his own cardiac event by a decade (he had a broad family history of heart disease). You might be interested in reading the new book “The Haywire Heart” by Dr. John Mandrola about the known links between the elite competitive athlete and heart disease. Best of luck to you…. REPLY Janice Lamb April 28, 2017 at 9:46 am # Before my heart attack I worked 50 to 60 hours a week. Now I can barely manage 20 hours a week sometimes less than that. Housework is difficult and I do only what I can. I have small grandchildren and just taking them to the park wears me out. I am tired all the time. I am depressed just because I can’t do what I used to do. REPLY Carolyn Thomas April 28, 2017 at 3:50 pm # Hello Janice – thanks for sharing your experience here. The ‘before’ and ‘after’ differences (not just in energy level, but in so many other ways, too) can feel absolutely shocking to heart patients. It can sometimes feel like we don’t even recognize this new person we’ve become. Sociologist and chronic illness researcher Dr. Kathy Charmaz calls this experience “the loss of self“. Your last sentence really caught my attention, because often it’s hard to tell which comes first: are we depressed because we’re so tired, or are we tired because we’re depressed? Please make an appointment to talk to a therapist, counselor, or pastor about what you’re going through. Many of us find talk therapy to be a turning point (not that it erases fatigue, but it can help to stop feeling so awful about fatigue). Meanwhile, for the time being try being very kind to yourself, don’t beat yourself up about the housework, and practice p-a-c-i-n-g nice and slow no matter what the activity you’re doing. Best of luck to you… REPLY Donna Rewald April 26, 2017 at 4:50 pm # I had a mild heart attack April 9th, no stent required as where the small blockage is located, it’s too narrow to put one in. Only symptom I had was it felt like someone was sitting on my chest and a couple of dizzy spells when I was out shopping. I’m still in shock, trying to wrap my head around it all. I am soooo tired though!!! I’m on Lipitor and aspirin a day for meds, also on Champix to quit smoking. But I am sooooo tired!! I’ve just started reading your website which I love, and can’t wait for your book to come out. REPLY Carolyn Thomas April 26, 2017 at 6:46 pm # Hello Donna – welcome to the exclusive club that none of us ever wanted to join! You are still in VERY early days, and likely feeling what my heart sister Jodi Jackson calls “postheart attack STUN!” I’m so glad that you’re going to quit smoking – that alone will make a tremendous change in your heart health. I’m also glad you found my site – here are a few other posts that are aimed at the freshly-diagnosed heart patient: – Handling the Homecoming Blues – Six Personality Coping Patterns That Influence How You Handle Heart Disease – How We Adapt After a Heart Attack May Depend on What We Believe this Diagnosis Means I hope your doctor has referred you to a cardiac rehabilitation program (if not, ASK!) Meanwhile, your only job now is to heal and rest up and do just what you’re doing – reading as much as you can to learn all about what the heck has just happened to you! Take it nice and slow… Best of luck to you! C. REPLY Donna Rewald April 27, 2017 at 6:20 am # Oh thank you so much for validating what I’m feeling, so I’m not going crazy, it’s normal to be THIS tired?!! My family dr has referred me to a cardiologist but I don’t have an appt as yet. Things move slowly here in Ontario, Canada I’m afraid!! All my family Dr has told me is to “take it easy” for about a month, no vacuuming (I don’t know why, he didn’t say, I didn’t ask) and see you in 3 weeks! So I’m quite lost to say the least right now!! Thank you for the quick reply and the links I so very much appreciate them and whatever other words of wisdom you can give!! Hugs REPLY Carolyn Thomas April 27, 2017 at 4:51 pm # Hi again Donna – no, you are most definitely NOT going crazy. You are recovering physically right now, but you are also recovering psychologically – which is an aspect of cardiac recovery few docs or nurses warn heart patients about before discharging us from hospital. So you’re not just feeling physically tired, you’re emotionally tired – which is a whole other kind of tired. Here’s another post you might also find useful: After Your Heart Attack: Now What? I can’t stress enough how important it is for you, especially while you’re waiting to see your cardiologist, to learn as much as you can about heart disease. That way, when you do see him/her, you’ll be better prepared to have a good conversation. I spent many years working in hospice palliative care before my heart attack, and we knew that people experiencing grief, bereavement and loss very often feel surprisingly exhausted too. Again, rest as much as you need to (but also get outdoors for a walk every day; your body needs to move just as much as it needs to rest now). Hang in there – one day at a time – and I’m sure you will start noticing that you start feeling a bit better, day by day. REPLY Brian August 9, 2017 at 7:32 am # Donna, you may want to see if the Lipitor you’re taking may have side effects which are causing some of your issues. One of the many prescriptions I was ordered to take was Lipitor. The side effects were over the top. I Googled Lipitor and found that there are many side effects the drug maker failed to disclose. As a result, many have filed class action lawsuits. I simply stopped taking it; informed my cardiologist of the side effects, and he prescribed me a different medication which has far less side effects. REPLY Art April 17, 2017 at 5:05 pm # I have COPD, asthma, afib and was doing ok walking, exercising light. Then after cancer surgery for my kidney I’d get exhausted easily. Then was told I have congestive heart failure. Some days I feel pretty good not too wore out, but other days can’t even walk around the grocery store with my wife. I feel like I just wanna fall down. My wife feels like I’m exaggerating so it seems. REPLY Carolyn Thomas April 18, 2017 at 2:21 pm # Art, you are dealing with not just one diagnosis, but a whole whack of complex conditions. No wonder you feel like you want to fall down! I’m guessing you are also taking a whack of prescribed medications, each one to address a different medical diagnosis. Please make an appointment with your GP and ask for a full medication review to make sure your exhaustion isn’t a side effect of one or more (or a combination) of your meds. Also, look into a cardiac rehabiliation program near you; these have been shown to improve quality of life for heart failure patients. It can sometimes be hard for other people to really understand how this kind of exhaustion really feels if they’ve never experienced it themselves. Best of luck to you… REPLY Wayne April 18, 2017 at 3:13 pm # Know the feeling..as I get anxiety related s.o.b. walking 20 feet at times…so went to cardio Dr yesterday and had bloodwork, EKG and echo done – next week PET scan. my lungs seem to keep fluid which does not help… did get some meds adjusted… REPLY Darrell April 4, 2017 at 6:37 am # I have had pressure or tightness in chest area ever since my heart attack six months ago. It comes and goes, seems to come at the end of the day, cardio doc says nothing wrong with heart, P.F. Put me on anxiety med, felt better but didn’t stop chest tightness from reappearing , now we are getting chest X-ray and pulmonary test, have shortness of breath, always longing for deep breath or attempting to yawn and never completing yawn or getting relief, fatigue in the evening after 12 hr days, go to bed at 8pm, get up at 4am. I am 60 yrs young (ha ha). Discomfort in chest has gotten better with time, it is manageable but makes me tired, when it first started after h.a. It was awful, I called paramedics two times. Hopefully it will heal completely in time, whatever “IT ” is, not sure if there is an answer? REPLY Carolyn Thomas April 4, 2017 at 4:30 pm # Hello Darrell – I’m not a physician so can’t comment specifically on your situation (and it sounds like some of your tests have not been done yet) but generally speaking, it does sound like your chest symptoms have “gotten better with time” which can mean things are moving in the right direction, more slowly than you would like of course (but it means they’re not getting worse!) Meanwhile, please talk to your doctor about a referral to a counselor, therapist or pastor: as Dr. Stephen Parker (a cardiac psychologist but more importantly, a heart attack survivor himself) likes to say: “A heart attack is a deeply wounding event, and it takes a long time to heal.” Try starting a Symptom Journal, keeping track of including date, time, what activities were you doing in the hours leading up the symptom, etc. You might be able to see a pattern emerging to help explain what’s happening to you. Feeling exhausted can also be a symptom of thyroid conditions – talk to your doctor about that. Best of luck to you… REPLY Sarah April 3, 2017 at 5:37 am # It’s been a year since my heart attack and I only returned to work a month ago. I am exhausted by the time I get home every day and usually go to bed by 7. Weekends are spent getting as much sleep as my body wants. When will I feel like exercising? REPLY Carolyn Thomas April 3, 2017 at 8:45 am # Sarah, I feel for you! You’re describing my “normal” routine these days. You may not “feel like exercising”, but getting outdoors and putting one foot in front of the other can be a good start, whether you feel like it or not. In cardiac rehab, I learned that “motivation FOLLOWS action”, not the other way around! The realization I finally came to is that I was going to be exhausted by 7pm anyway, whether I walked or not, so I might as well get a walk in before bedtime. Any time of day that works for you will help to break that routine of not moving, because we know that the more time we spend in bed, the less we’ll feel like moving. In your case, you’re also dealing with your back-to-work adjustment, which would be exhausting even without your diagnosis. Ask your doctor for a meds review (some common cardiac meds list fatigue as a side effect) Hang in there… REPLY Jan Beesley May 11, 2017 at 2:54 am # Hi there I have been reading the advice here and I wonder if anyone has experienced feeling of the stent in your heart area. My treatment was well over a year ago, any help out there? Thankyou. Jan REPLY Carolyn Thomas May 11, 2017 at 5:47 am # Hi Jan – I’m not sure what you mean by “feeling of the stent”. The stent itself is such a tiny thin metal mesh tube that it likely couldn’t be “felt” but if you are having symptoms that seem to be coming from your heart, please talk to your physician. REPLY Alicia Butcher Ehrhardt March 19, 2017 at 7:08 am # If you already life with a chronic illness with a no-energy component (I’ve had Chronic Fatigue Syndrome for 27+ years, and had adapted as well as possible), the additional fatigue from these causes (drugs, depression, heart) feels like the end of the world. I had no margin of safety. I have no normal to ‘go back to’ by being patient. I have hopes that the cardiac rehab – which will be very gentle due to the underlying illness – might improve this fatigue somewhat, but it is really bad right now. REPLY Denyelle March 18, 2017 at 11:53 am # I had a heart attack January 10. I am 42 years old. I keep telling my heart doc I am tired very early in day. I get up about 10:30 am, ready for bed again about four pm. He tries to say it’s not from my heart and my coronary disease but I know myself, been very active all my life. Can someone tell me if this is normal? REPLY Carolyn Thomas March 19, 2017 at 6:49 am # Hello Denyelle and thanks for your comment/question. I’m not a physician, but I can tell you that generally this kind of fatigue is very common, post-heart attack. It doesn’t feel “normal” at all, but it is common, and temporary. You are in very early days still. Your body is slowly adjusting, both physically and emotionally – especially since you are such a young woman. This will take time to get through, but there are things you can try to help you (e.g. follow all the tips in this post – and I’d add one more thing to that list: get outdoors every single day for fresh air and exercise, even if you’re just walking around the neighbourhood). Talk to your GP if you don’t see some sign of improvement in the next few weeks. Best of luck to you… REPLY Wayne April 3, 2017 at 9:19 am # Yeh sounds familiar! I am 66-had a heart attack at 60 and my energy level is way way down, even when I was at the gym. I tire quickly. My main problem nowadays is anxiety about getting tired and out of breath quickly which causes me to slightly start to hyperventilate while even walking around the house! And yes..I have been thoroughly checked with lung CT scans and nuke stress tests…I say to myself..”OK HOW SOON WILL I GET OUT OF BREATH ON THIS VENTURE” It’s a pain REPLY Wayne Sandifer July 25, 2017 at 12:56 pm # I tire easily, specially shortness of breath with heart failure from the attack…ugh… but I live with it. REPLY Sarina Ames February 13, 2017 at 8:35 pm # I would like to know if other women experience bouts of extreme fatigue years after their heart attack. I had an MI in November of 2012 at the age of 42. To this day I still experience occasional episodes of acute illness that seem to have no cause. Sometimes I just “hit a wall”, suddenly feel exhausted, and must go lie down. A nap and a few hours of taking it easy, and I start to feel better again. Other times I have days where I need to sleep for 12-16 hours. None of these episodes seem to have any sort of relationship to my activity levels or routine, just wham! Feel awful. My PCP has run all the tests to see if anything else could be wrong and all came back OK (liver and kidney function, nutritional panel, thryroid, etc.). All my other arteries are clear, according to a CAT scan done last year – no plaque! – my BP and cholesterol are low normal, and I exercise regularly. Could the scar tissue on my heart be causing this, all these years later? REPLY Carolyn Thomas February 14, 2017 at 9:27 am # Hi Sarina – what an exhausting (and maddening!) situation you find yourself in. I’m not a physician so of course cannot comment specifically on your case, but I can tell you generally that, in the absence of other causes (thyroid, etc) it is entirely possible that heart muscle damage might be the culprit behind your fatigue. I’m not sure if you’ve had an echocardiogram done lately to check on your heart function/valves/ejection fraction – that may help solve the mystery. Best of luck to you… REPLY N Carelse February 2, 2017 at 2:33 am # Good Day to all ! I had mild heart attack on 9 January 17 its now 3 February 17 ….I’m really feeling depressed right now . On certain days I feel like I’m getting better then the next day bang !!! shortness of breath, head spinning feel like a “zombie “. i have Google my tablets (atenolol. ,SIMVASTATIN. Clopidegrol75mg.and half aspirin .just want to know from someone out there how long does this feelings last …please reply. …. REPLY Carolyn Thomas February 2, 2017 at 5:03 am # What you’re describing is very common in the early weeks after a heart attack. Many of us experience that up and down recovery (one day feeling better, but next day feeling worse). This will ease up day by day, and you will slowly have more good days than bad. See your doctor if your symptoms get worse, as some side effects of your drugs may be a factor, too. Ask your doctor to refer you to a cardiac rehabilitation program if one is available in your area. If not, start walking outdoors every day, a little farther each day, to help regain your fitness. Meanwhile, start reading this 4-part series on adjusting to your new diagnosis. Best of luck to you… REPLY David Thompson December 18, 2016 at 6:28 pm # Just had 2 Stents put in 4 weeks ago. Beginning to feel tired often. Nap often. Go to bed early. This is helpful information to me. REPLY Carolyn Thomas December 18, 2016 at 6:55 pm # Hello David – you are in VERY early days yet. Napping and going to bed early are wise things to do when you’re feeling this tired, both physically and emotionally. It will get better – but in the meantime, listen to your body. And tell your doctor about this so that all doctors will learn more about what it’s really like post-discharge. Best of luck to you… REPLY Doris December 6, 2016 at 12:06 pm # Hello I am so glad I found this site. A little over a month ago I had two heart attacks and three stents put in. One blockage was the widowmaker 70% blockage, then the other two were 80% and 96%. I had been feeling pain for two weeks before I went to hospital. I thought I had a pinched nerve in my back that was causing the pain. When I did go to hospital, they said if I had not taken four baby aspirins and got to hospital, I probably would have died. Two weeks after all this I started Cardiac Rehab. The thing is I come home from it and within an hour I am taking a nap from being so tired. Also I find just doing simple things like dishes, vacuuming, washing clothes, sweeping or mopping is totally exhausting. I was expecting to be back to my old self by now. This fatigue is driving me crazy. My house is not as clean as it used to be, my dishes are not cleaned as often and so forth. I do have a very sweet and understanding husband. He helps me with all of this. What really upsets me is that I am only 55 yrs old. I just want to pop back and have things the way it used to be. I also have OCD, depression, anxiety and PTSD. I do take meds for all these things with all the Heart meds. Oh yeah I also have arthritis and have to take pain meds at times for that. My question is…. Is my house and stuff going to be back to normal again? I feel like my house is so dirty all the time and I feel like the worst wife ever. I cry to my husband and tell him I am sorry for being such a terrible wife. He says babe you are not. Go relax you are doing good. He is so supportive and understanding. I don’t know what I would do without him. REPLY Carolyn Thomas December 6, 2016 at 3:49 pm # Hello Doris – I think it’s really important to cut yourself some slack, starting now. You are in very early days yet, just a month or so after your heart attack. You may have expected to feel back to normal by now, but that would have been an unrealistic expectation for many heart patients. As my friend Dr. Stephen Parker likes to say “Having a heart attack is a deeply wounding event, and it takes time to heal, both physically and emotionally.” It’s very common to feel extremely tired after cardiac rehab exercise classes – this kind of fatigue tends to improve a lot as your level of fitness improves, so hang in there. You are also dealing with a broad range of challenging health issues – no wonder you are feeling exhausted! Your house will get back to “normal” someday, but perhaps not to your OCD expectations, so that may require seeking help to manage those expectations. And ask that wonderful hubby of yours to get you a copy of the book called “Thriving With Heart Disease” by Dr. Wayne Sotile – I think it might really help you. Best of luck… REPLY Debbie February 23, 2017 at 7:10 am # Carolyn, I had two stents put in mid-November due to a 95% blockage in my “widow-maker” artery, and a 75% blockage of another. I started cardiac rehab about 6 weeks ago, going 3x a week during my lunch break from work, and was doing well, had some fatigue but not this crushing type I’ve experienced the last 2 weeks. I also have a torn rotatorcuff (right shoulder) that causes shoulder pain, and in these last two weeks I have stopped doing any arm-type exercising at rehab. Yesterday after rehab the fatigue was so bad I could hardly sit up at my desk after returning to work, and my shoulder started hurting so bad. I got off work had my hubby rub my shoulder with pain cream, and went to bed putting a heating pad on my shoulder and slept 4 hours. I got up still feeling bad, the crushing fatigue. The pain in my shoulder is worse which usually improves some after a rub down and time on the heating pad. The rotator cuff area (front shoulder) had radiated to my far right chest. I finally had to take a pain pill and go back to bed. Now I’m worried that my stent(s) may be failing. Do you think I’m overreacting? REPLY Carolyn Thomas February 23, 2017 at 4:39 pm # Hi Debbie – I don’t think you’re overreacting; I think you’re in pain! I’m not a physician so cannot comment on your specific symptoms, but I can say generally that living with the kind of pain, inflammation and spasm caused by a torn rotator cuff can be extremely exhausting at the best of times, whether or not you were participating in a cardiac rehab program. Consider making an appointment with a physiotherapist who is experienced in the treatment of rotator cuff injuries, and meanwhile keep avoiding all upper body exercises at cardiac rehab. Focus on lower body workout machines like the stationary bike rather than running on the treadmill. A trained physio may also recommend a shoulder brace, a simple, non-surgical way to stabilize and protect that shoulder joint. You didn’t say why you’re now thinking stent failure is the culprit, but remember that pain that can be massaged away or reduced with a heating pad would not likely be associated with the pain of a blocked coronary artery as happens in stent failure. Best of luck to you… REPLY Dawn November 27, 2016 at 9:01 am # I had the widowmaker heart attack several weeks ago and I get very out of breath and just taking a shower makes me need to lay down and take a nap. I think my husband is getting angry because of the fatigue. Thank you for this post – it reassured me since the hospital did not tell me these things. REPLY Carolyn Thomas November 27, 2016 at 1:50 pm # Hello Dawn – I often wonder why heart patients are NOT routinely warned before hospital discharge about the very common crushing fatigue experience that we so often share in the early days and weeks, post-discharge. Had we been told this in advance, it might not be so shockingly traumatic when we experience what you and I both did once we’re back at home, yes, even just taking a shower. And yes it can be very tough for our family members to really ‘get’ it if they’ve never experienced this themselves. Good luck to you as you continue to recuperate…. REPLY Wayne Scott March 28, 2017 at 1:45 pm # I had a heart attack and stent 5 years ago. I get winded easily..sometimes more than others. I am now 66 and can no longer do lots of things I used to..and yes, tire easily. REPLY Carolyn Thomas March 29, 2017 at 11:08 am # Hi Wayne – it’s hard to pinpoint the reason for your ‘feeling winded’ five years post-heart attack. Sometimes it’s a vicious circle: avoiding exercise for example, because it’s tiring, so being out of shape means you get more winded with exertion, and on and on it goes. Sometimes, sleep issues/smoking are the culprits. Talk to your doctor about possible other contributing factors. REPLY Doris December 6, 2016 at 11:18 am # A little over a month ago I had two heart attacks and three stents put in. I have been in cardiac rehab doing exercise. However I still feel like I can’t do anything any more. My house looks terrible. I find that any cleaning is almost too hard. This is crazy and I totally know how you feel. My husband is very understanding and reassuring to me always. REPLY Tannis Collins November 14, 2016 at 7:25 am # In December of 2006 I had a spontaneous coronary artery dissection (SCAD) heart attack in my LAD artery. I was told that it should have killed me instantly. It started at about 5:30 pm and lasted until around 8:00am the next day, when the took me into open heart surgery and did a triple bypass. I was in the CCU for a month and then moved to the cardiac rehab unit. That was 10 years ago and the damage to my heart was severe. Since then my life has changed dramatically. I am now unable to do and enjoy many things I was more then capable of doing, but the hardest thing to deal with is the extreme fatigue. Sometimes it just comes on all of a sudden. I have learned that having a SCAD heart attack is different from a typical heart attack and that it is very rare and most do not survive it. So I’ve been very blessed and have had awesome Drs the first team at Saint Vincent’s in Billings M, Cleveland Clinic and at the Mayo Clinic where Dr Sharonne Hayes is doing a study on SCAD heart attacks.

I’ve learned a lot but I can’t seem to get my husband to understand the extreme fatigue; he thinks the more I get up and move around and do things I’ll feel better, but sometimes the more I do the worse it gets and stress is a huge danger for me because it was the extreme stress I was under that caused the SCAD. I lost 3 very close family members in the same week, my brother who we did not even know he was ill with AML leukemia and died 9 days after it was diagnosed; the very next day my favorite auntie passed away and then two days later my 1st husband died from brain cancer. I was holding him while he was dying when my LAD dissected. So it was the overwhelming stress that caused it. It has been a real battle just getting the cardiologists to understand that I cannot be treated like a typical heart attack patient. It has taken several years to get just a few to listen but now I need my husband to really listen not just to me but to what the Drs have told him as well. Any suggestions? REPLY Carolyn Thomas November 14, 2016 at 1:11 pm # Hi Tannis – you have really been through the wringer and back again. SCAD is indeed misunderstood by many (I remember being told that many physicians will go through their entire careers without ever seeing a living SCAD patient, although Dr. Hayes at Mayo now says that, while it used to be considered “rare”, she now believes that this condition is just “rarely correctly diagnosed”). So glad you have been treated and seen by the best in the cardiac world so far! Re this fatigue you’re suffering from: it can be almost impossible (especially for people who have never suffered anything like the kind of crushing fatigue we’re discussing here) for healthy people to really ‘get’ what we’re talking about. It’s kind of like talking about depressed people, and insisting that if only depressed folks would just pull up their socks and quit moping around, they’d feel better – without realizing how hard it can be to pull up those socks. I can tall you one interesting thing I’ve personally learned about my own heart-related fatigue. When I’m engaged in something I really love doing (like spending time with my darling grandbaby, for example) I actually can forget all about my fatigue for a short but crucially important time! I encourage you to start making a list of all the small things you most love doing (e.g. being out in nature, or with a favourite book or ? ? ? ) and build those small activities into every single day. Even a short period of time doing what you love can help. Our family members also want and need us to be “fine” (so that they can stop worrying and get on with this shared life that they were hoping for). Get your hands on two books: one by Dr. Wayne Sotile called “Heart Illness and Intimacy“ and one by Rachel Freed called “Heartmates: A Guide for the Partner and Family of the Heart Patient” – I think you and your hubby can both relate to them.

I also hope that you are seeing a professional therapist to help you gain perspective and to manage stress (both this current stress around the fatigue, plus the grief of three serious losses and any unresolved issues surrounding those catastrophic events of 2006). If you’re not, please make an appointment. Best of luck to you… REPLY Jane November 19, 2016 at 2:18 pm # 10 years, especially under those circumstances, is not a long time. I suppose my question is this: do you want to keep this husband? The reason I pose that so bluntly is this: having to think about, respond to, work around other people who do not accept where “you’re at,” regardless of health, is exhausting. And, here we have the horrorday season upon us. No one is at fault when things cannot be understood. It simple “is.” I’m going through the biggest transitional period in my lifetime. My health is ?, but surely some of the gross fatigue I feel is due to that. Oh and the heart disease. (My doctors now practice “shunning,” as a healing technique – seriously). But still. Especially with the horrorday season, and this very seriously bad political climate, (and I don’t even have TV), I could easily dig myself into a big bad hole. I don’t want to go on about it. I just wonder if it might be better if you and your husband at least didn’t live in the same place. Down the block from each other, or across town, for example, if you can manage it. Personally, I am only just now having various awareness(es) of things I no longer have to think about – not even consider. Even while grocery shopping. And, especially, how I fit into the new scheme of things. I’m not good at it, but – and I thank you for reminded me of this because of your comment – I am practicing. It will take practice. Years and years and years… and years of the other, don’t vanish. So. Practicing every day, is something I can only, as yet do, when I am by myself, or with strangers. (Sorry. I brought it back to me again – self-centered woman that I am now). Okay then. Just some things to consider. PS I could use some help in all my stuff, but I would need to win the lottery to be able to find – if one existed – a genuine professional, who didn’t think I just needed to put on a happy face. Depression can get too close, when I forget that there is nothing for me to be concerned about in all this. Nothing. And I want joy. (Although when I was somewhat dancing in a parking lot today, I frightened two separate women). REPLY Carolyn Thomas November 19, 2016 at 3:58 pm # Thanks for this, Jane. I love the image of you “somewhat dancing”…. I do that regularly with my grandbaby (who is charmingly unconcerned about frightening strangers – dancing in public is just what makes her feel good!)

REPLY Guy Merritt November 12, 2016 at 12:46 am # I’m 64-years old and had been very active – I’d been remodeling our house for the last three years, doing a lot of heavy work (drywall, concrete, etc.). About a month ago I went to the local Home Depot and grabbed a couple of bags of wood pellets for our pellet stove (40 pounds each – not much, for me). When I put them in the car, my heart had a weird, fluttering feeling. I figured I was just tired. But it didn’t stop. Long story short – about 9 days later I finally went to the hospital. I’d had a very mild heart attack, according to the hospital – minor damage to my right ventricle and arteries in good condition. My own doctor called it a “sub-clinical” heart attack, it was so minor. Got out of the hospital in 3 days, about two weeks ago. Now, when I get tired – which is often – I feel like I am gonna die…..I mean, it’s indescribable. It’s 3 AM and I am awake because me and the wife were watching some TV and, at about 9 PM, I told her I felt like I was gonna croak if I didn’t sleep. Laid down on the couch and woke up 6 hours later. Is this normal? REPLY Carolyn Thomas November 12, 2016 at 5:01 am # Hello Guy – you have just explained brilliantly why there is, in my opinion, no such thing as a “small” heart attack (unless you’re a doctor who’s never actually had one). I’m not a physician, but I can tell you generally that you are still in very early days yet. As I quoted Kelly Young in this article, “This is not the same as being tired.” It’s way beyond that. And I now believe that this kind of crushing fatigue is even more distressing for formerly-active people. It’s not “normal”, but for now it is “normal” for you. Try not to fight it, or worry yourself sick – that will just make you feel worse. Typically, this won’t last. Nap whenever and however long you need to for the time being, and get out and walk every day in the fresh air as much as you can. Eventually, your body WILL adjust. Do mention this fatigue to your doctor (it helps to educate physicians that this is a real ‘thing’ that’s often underappreciated by the medical profession) and request a medication review to check for drug side effects. Best of luck to you… REPLY Londa Krepps October 22, 2016 at 3:47 am # I wish I could make my significant other understand this debilitating exhaustion. I get tired from just running errands and he does not understand. He’s wonderful but he does not understand this fatigue. REPLY Carolyn Thomas October 22, 2016 at 6:40 am # Londa, show him this article. It’s tough to really understand fatigue like this unless a person has actually experienced it. It’s what’s called “healthy privilege.” Best of luck…. REPLY Lisa October 18, 2016 at 10:28 am # 5 days post massive MI. I’m soo tired and fatigued and also saying so. Hope this passes and gets better. I’m 58 and feel 90. REPLY Carolyn Thomas October 19, 2016 at 1:54 pm # Hello Lisa – you are in very early days yet! As my friend Dr. Stephen Parker (cardiac psychologist and a heart attack patient himself) says: “A heart attack is a deeply wounding event, and it is a wound that takes a long time to recover from.” And he means recovering physically and emotionally and spiritually and in every possible way! See if you can get a copy of the book called “Thriving With Heart Disease” by Dr. Wayne Sotile – I found it so valuable in the early days and weeks following my own heart attack. Meanwhile, you can read some of his essays here. Hang in there but be patient: it does get better…. Honest! REPLY Lisa October 19, 2016 at 2:03 pm # Thank you so much for your inspiring words, they’ve been taken to heart. I will read the book as well. REPLY Mij Woodward October 3, 2016 at 7:35 pm # Thank you so much for this article and the list of suggestions. Just what I needed, especially the blue kryptonite recommendation! REPLY Carolyn Thomas October 3, 2016 at 8:33 pm # Let me know if you track down a source for that blue kryptonite, Mij! REPLY Jeanette September 5, 2016 at 1:32 pm # I was diagnosed with congestive heart failure after a week in the hospital w/ asthma flare-up, bronchitis, severe shortness of breath, & fatigue. My heart is strong, no blockages, no heart attacks! At first I was on oxygen 24 hrs a day for 2 months. Then I got better, off the oxygen! Feeling great! Now all of a sudden, I’m short of breath again, extremely fatigued! I take Lisenopril 10 mg, Toprol 25 mg. I’m so exhausted I can’t do anything. What can I do to get my strength back? I had a flare-up of arthritis, the Dr. put me back on prednisone 10 mg. That’s when I got worse again, only took it 5 days when the trouble started gradually. Fluid build up in my stomach area, I take demadex but it doesn’t seam to help much, fluid comes right back! REPLY Carolyn Thomas September 5, 2016 at 7:31 pm # Jeanette, that’s quite a roller coaster ride you’ve been on! I’d love to see you sit down with your cardiologist for a medication review as soon as possible, and also to review your heart failure diagnosis with you so you are all on the same page. I’m not a physician so cannot comment on your specific symptoms, except to say generally that a person diagnosed with heart failure is rarely able to say “my heart is strong” just because there are no blockages in coronary arteries. By definition, heart failure means your heart is having trouble pumping blood as effectively as it should (hence the classic fatigue, shortness of breath and fluid build-up symptoms). I hope that your cardiologist will have some good suggestions about tweaking meds, etc. to make your life more comfortable. Meanwhile, here are some really useful videos from a British non-profit called Pumping Marvellous you might like. Best of luck to you… REPLY Not Alone September 28, 2016 at 5:35 am # My 64 year old husband had a heart attack Memorial Day weekend. We were grocery shopping and he said he was not feeling well. After a trip to our local hospital and 1 stent later for 100% blockage, life has been very different around our house. I have read that some of the meds he is taking can cause fatigue, but all he does anymore is sleep. He goes to his cardo rehab appointments and then comes home to take yet another nap. I’m so glad I found this website, I thought my husband was just on the wrong meds. I wish the hospital would have told us to expect this extreme fatigue. This is like having a new born baby, eat & sleep, repeat. REPLY Carolyn Thomas September 28, 2016 at 5:48 am # Dear Not Alone – In many ways, the situation you describe IS very much like having a newborn in the house. The person you knew is gone, replaced (temporarily) by this sleepy man. The good news is that, like newborns, we usually ‘grow out of’ this scenario as time goes on. Your hubby is barely four months on. More good news: he’s attending cardiac rehab! That’s fantastic! And it’s predictable that exertion can bring on a big wave of crushing fatigue right afterwards. But it’s very important that your husband’s doctor is aware of his fatigue. It could be aggravated by his meds, or could be linked to depression. Ask for a medication review. Hang in there… REPLY Chris August 17, 2016 at 12:34 pm # I am a 46 year old man that had a widow maker heart attack and died! I am so glad I found this posting because I am always tired and I mean like oops got to go to sleep now…ridiculous. I could work 12 hours in 100 degree heat before and now, although thankful to be alive, suffer from severe fatigue. It has only been 5 weeks since the procedure but man I need to work and just not sure of my limitations. I am glad to hear there is light at the end of this tunnel. Thanks. REPLY Carolyn Thomas August 18, 2016 at 5:21 am # Chris, you are in very early days yet. Severe fatigue like you describe can feel surprising – especially since few people are warned about it before they leave hospital. Hang in there, one day at a time – things will improve, believe it or not, but it can take time. Meanwhile, be very good to yourself whenever you’re home. It may be necessary to lay low and focus on rest instead of thinking you can bounce right back to your formerly busy self. Best of luck to you… REPLY Jane November 19, 2016 at 2:23 pm # Yes. Please do allow yourself time. Not weeks. Not even just a few months. Whatever time it takes. You are alive. I often consider attempting to learn Greek, rather than beat myself up about what I can and cannot do physically, but my eyes are bad – you get the gist. REPLY Jennifer August 11, 2016 at 12:48 am # I Just slept like 18 hrs today and have slept increasingly more this past 2 weeks. I thought it was the weather but now I’m thinking it’s directly connected to my surgery. I wish someone had told me this prior to leaving hospital how crappy I’d feel for a while. It’s been 4 months today and I keep hoping I’ll return to some sort of normalcy. REPLY Carolyn Thomas August 11, 2016 at 12:26 pm # Hi Jennifer – you could be affected by both (the hot weather AND your post-op situation). That sense of being exhausted even after an 18-hour sleep is overwhelming because it makes no sense to us. You WILL return to “normal” one day – you’re at that 4-month stage that the Swedish researchers studied; being this tired at this stage is not uncommon. It’s frustrating, but not uncommon. Meanwhile, talk to your physician about this so your symptoms will be part of your records. REPLY J. July 8, 2016 at 10:57 pm # Note from Carolyn: This comment has been removed because of its distinctly aromatic stench of utterly over-the-top quackery. REPLY Mary DiOrio July 2, 2016 at 9:21 pm # After years of having undiagnosed Graves disease, being told “you’re depressed, nothing else”, then finally a diagnosis from a young intern in an ER, I got Propylthiouracil and in only 2 days I felt reborn. I was sent for thyroid scan and then told I needed Radioactive Iodine or RISK A STROKE (my BP was always normal/low! I’ve been experiencing what I can only call A SLOW INEXORABLE DEATH since, this was 10 yrs ago. Now Graves Eye Disease…. no cure no treatment, and I’ve been unable to get out of bed except to go to the bathroom, pour food for my cat, or get some cereal which is all I can prepare, for the past 9 mos and I get chest pains THAT RADIATE TO MY SHOULDER AND JAW (DX so far) AND MY HEAD. When these pains arrive at my jaw and TOP of head, there’s a moment I’m SURE I’ll die. MY DR (did you know, if you are over 50 and living on poverty SSI alone, your PRIMARY DR IS A NURSE PRACTITIONER??) does nothing but check my T4 alone. MY last blood test was Oct 2015 and now I’m unable to move. I’m unable to do any more research for myself because I can’t retain much anymore AND whatever I find is ignored anyway. I lived and worked and brought up my son in Italy from 1971 until 1992. MY Italian Dr warned me not to return, or, if I did, to return to HIM before allowing anymore damage by an American Doctor (there’d been a lot of UNneeded surgeries etc prior to that and in Italy I regained my health and good looks and happy personality). I’m too sick and poor to return now and I honestly hope this ends soon. I fear nursing homes which are ALL hot beds of ELDERLY ABUSE, and the longer this goes on, the more painful and frightening it gets. Now my hair is gone, along with my teeth. Just sitting up to write this, has me shaking slightly from the effort. I feel for ALL women in this country who have reached this point. The total lack of good doctors, especially specialists of hormones and all glands, thyroid, adrenal and thalamus is deplorable. Perhaps if I had expensive insurance….. sorry, I’m beginning to whine now. The worst thing taken after taking everything else, is my faith. Gone. Nobody can be stripped of SO MUCH and CARED FOR SO LITTLE, except, perhaps, in BOTSWANA? KABUL? I just turned 69 and look 30 yrs … bad years… older. I’M SURE THERE IS SOME HEART OR VALVE PROBLEM, BUT I HONESTLY CANT EVEN TAKE A SHOWER NOW. This is what happens, you complain, insist, even change doctors .. until the time you’re so bad off, all you do is take your pain meds, your thyroid synthetic, and SLEEP. OBAMACARE? I miss the health system of Europe!!!!!! REPLY Carolyn Thomas July 3, 2016 at 5:22 am # Mary, this is a nightmare story. I’m so sorry you are suffering in so many ways. I’m not a physician so of course can’t comment on any of your specific symptoms, except to say that it’s simply shocking that any person could be suffering like this in the world’s richest country. You mentioned your son – why isn’t he advocating for you? There is somebody out there who can assist you. Good luck to you in regaining peace and health. REPLY Megan June 27, 2016 at 6:04 pm # My husband had a mild heart attack and 3 stents placed 6 weeks ago. It kills me to see him so fatigued and exhausted now. I know this is a site for women, but do men experience it also? We were always going places, exercising together and now he can barely walk up the steps without needing a break. I doubt it’s depression with him. He started cardiac rehab 2 weeks ago so hoping that helps some. Any advice for a worried wife? REPLY Carolyn Thomas June 27, 2016 at 6:18 pm # Hi Megan – YES, men certainly can experience the same kind of debilitating fatigue after a cardiac event that women do. It’s an equal-opportunity symptom! You and your hubby are in very early days still, and I too think that attending (and more important, completing) his full cardiac rehab program will make a big difference for both his physical and psychological health. Even though his progress might seem alarmingly different than you’re expecting, try not to rush him or make him feel pressured to do more than he feels comfortable with – he will gradually improve over time. My only other advice: I’d recommend you try to find a copy of the book Heartmates: A Guide for the Partner and Family of the Heart Patient by R. Freed (I believe it’s out of print, but you can try tracking it down online or at a library or used book shop). Best of luck to both of you… REPLY Jules June 22, 2016 at 3:04 am # Five weeks ago today I had a mild heart attack. I’ve been going to cardiac rehab 3 days a week since Week Two, went back to work Week Three, eating right, losing weight and feeling great. Until Monday this week, when I felt so tired I could hardly stay awake at work, went to bed at 7 PM, slept twelve hours then stayed home from work Tuesday to sleep six more hours. What is going on with me? I feel so lazy especially after doing so well. REPLY Carolyn Thomas June 22, 2016 at 6:44 am # Hello Jules – I feel tired just reading what you’ve managed to accomplish in just five weeks! No wonder you are feeling so exhausted – and no wonder you are feeling so shocked by this exhaustion after such a great start! Often, we go into autopilot mode immediately after a cardiac event, as you clearly did: follow doctor’s orders, go to rehab, lose weight, go back to “normal” as soon as possible. But sometimes we are so overwhelmed with what has happened that the actual reality hits like a delayed reaction (in your case, about a five-week delay). There are many emotional and psychological aspects of any heart event that need healing as much as the physical results do. Speak to your doctor about this, and consider making an appointment to talk to a professional therapist/pastor/counselor about what you’re going through. I’ve written a lot about the psychosocial impact of heart disease here, here and here, for example. Meanwhile, please be gentle with yourself – you are NOT being lazy, and you’re not alone. REPLY betsmack June 11, 2016 at 3:55 pm # I’m in early 50s, had a mild heart attack almost a year ago. I have a stent, on beta blocker, statin, blood thinner. Recently had a stress test and blood tests, all came back great. Asked cardiologist, why am I still extremely exhausted after a year? He told me to go off statin for two weeks to see if that helps. Did that, but felt the same, went back on it. I want to sleep all day, weekend, I usually do. I have to force myself to get up and work, I work from home. After I’m done, I take a nap. It’s good to read I’m not the only one who is exhausted. I’m not depressed over the heart attack, in fact I felt I had another chance at life. But, my quality of life has never been so bad. It’s hard to explain to my family. They don’t get why I’m always tired. I’ve lost 30 pounds since the heart attack, eat a lot better. I don’t know if I should force myself to exercise. I was exercising, but I’m bruised all over from the blood thinners, and it hurts. I can go off blood thinners in July, looking forward to that. On top of this I’ve have compressed fractures in my upper back and osteoporosis, so I can only walk a short distance. Thanks for reading. REPLY Carolyn Thomas June 11, 2016 at 4:31 pm # Thanks for sharing your story here. You are definitely not the only one to feel this tired. The good news is that passing the one-year milestone is often a turning point for many of us! The irony of exercise is that the less we do it, the less we feel like doing it. I’m not a physician so cannot advise you specifically, but if I were you I’d check with your family physician about your compressed fractures for a clearer discussion about your ability to exercise, and also about your bruises. Perhaps a referral to a physiotherapist or occupational therapist would also be useful as they are the real experts in functional mobility. Your bruises are actually a good sign – they mean that your meds are working to keep clots from forming inside your stent! I recall feeling puzzled about two perfectly circular bruises below my belly button; I just couldn’t figure out what could have caused these identical symmetrical bruises until later that evening when my cat Lily jumped up onto my lap for her regular lap nap and did her ritual little ‘making biscuits’ kneading on my abdomen before curling up in a sleepy ball on my lap. Just her tiny cat paws could cause those dark bruises because of my anti-platelet meds! REPLY betsmack June 12, 2016 at 2:57 am # Thank you for the reply. I have no one to talk to who has been through this. It’s nice to hear from others and read their stories. I did go to a physical therapist for my back, I chose water aerobics, hoping not to get more injured. I went 3 months and didn’t help. I’ve been researching online for exercises to do for people with back issues. I’m currently using a Tens unit, seems to help. With the weather getting hot now in AZ, planning on starting to swim. It’s giving me something to look forward to instead of sleeping all the time. Sleeping makes me feel like life is passing me by. There’s too much left that I’d like to do in my life. My cats try to do the nesting on my tummy too, I let them for a minute then have to move them. My bruises are all over my legs, trying to figure out what I do while sleeping REPLY Carolyn Thomas June 12, 2016 at 6:19 am # You’re right, Betsmack – sleeping is a way to let life pass you by. Right now, it seems it’s hard to tell how much your fatigue is affected by your back issues, and how much by a heart condition. Good luck with your plans to go swimming! Remember that even if a particular form of exercise doesn’t seem to address your current fatigue, any form of exercise can improve your overall mood and quality of life. REPLY Joanne May 24, 2016 at 1:40 pm # Thank you so much for writing this! I had a heart attack 12 days ago, luckily no damage to my heart, just had a stent placed. I’m exhausted all the time! My kids keep trying to tell me it’s depression but I’m not depressed! I’m very thankful to be alive! I just need to rest a lot, a nap in the afternoon and I go to bed by 9:00pm. When will this stop?!! REPLY Carolyn Thomas May 24, 2016 at 8:54 pm # Hello Joanne – you are still in very early days yet so it’s not surprising you feel exhausted all the time. Every person reacts/recuperates differently, of course, but you will likely begin to feel more like your previous perky self as time goes on. If you start feeling worse over time, see your physician. Crushing fatigue can also be a symptom of depression. Best of luck to you…. REPLY Joanne May 24, 2016 at 9:05 pm # Thanks Carolyn! It’s so nice to hear this is normal. All the nurses at the hospital kept telling me I’d feel so much better after the stent was placed. No one said anything about being exhausted! REPLY Carolyn Thomas May 25, 2016 at 5:37 am # One of my pet peeves: very few heart patients before hospital discharge are warned to expect what all cardiac research shows is predictable! So instead, we often feel alarmed and frightened at home. Read this post for more info, too. REPLY Tonda Hunter May 20, 2016 at 10:39 am # Wow, thank you for this article! I had my second heart attack 2 months ago and I’ve been sleeping ever since! It’s like when I was much younger and at the beginning of both of my pregnancies, all I wanted to do was sleep! But I never had this after my first heart attack. However, after reading this it now makes sense, the first one was mild. This one was much worse! I don’t know how long this will last and I’m sure it will feel like eternity, but at least I won’t think I’ve turned into a frail, old lady who gets exhausted at the drop of a hat! REPLY Carolyn Thomas May 20, 2016 at 11:58 am # Hello Tonda – your comparison with that first trimester fatigue of pregnancy sounds very accurate to me! You haven’t turned into a frail old lady, but it will take time to gradually build up stamina and regain your former level of energy. Best of luck to you… REPLY Doug Kozak May 12, 2016 at 8:00 pm # Been 3 years since surgery for ascending aortic aneurysm and valve replacement, was done at Barnes Jewish. The fatigue did get better somewhat, but no way back to normal, then there’s DEPRESSION. REPLY Carolyn Thomas May 12, 2016 at 8:18 pm # You raise an interesting point, Doug. Depression is very common among heart patients, yet virtually none of us are warned before we leave hospital that it’s common and treatable. ANd that is an important gap in care because people living with depression are far less likely to exercise, take their meds, eat a healthy diet, or follow their doctor’s recommendations to help prevent another cardiac event. I’ve written lots about this preventable gap in our care (here and here for example). REPLY millercanning May 11, 2016 at 7:41 pm # Reblogged this on Heart Matters. REPLY Mary Kay Osborne May 9, 2016 at 6:35 pm # I had my first stent in 2010. Second one in 2013 and have battled fatigue every since. I have not felt good since about 2008. I want to feel good again! REPLY John April 19, 2016 at 2:12 pm # For about two weeks I have been experiencing extreme fatigue after moderate exertion. I am the proud owner of three stents, not new, and am wondering if it’s time for another. For somewhat longer I have had severe low back pain and now some in my neck as well. I suppose these are most likely unrelated to the fatigue. REPLY Theresa Henry April 4, 2016 at 9:44 am # What is Blue kryptonite? Thank you for the article! REPLY Carolyn Thomas April 4, 2016 at 5:41 pm # Hi Theresa – blue kryptonite doesn’t actually exist (unless you’re in a Superman movie!) It’s a imaginary mineral on the planet Krypton that can drastically improve the health of anything organic, including humans. “Continual consumption of blue kryptonite puts humans in a perfect state of health.” Apparently! REPLY Pat Olson March 30, 2016 at 1:42 pm # This so hit the mark. I kept thinking…is it just me? Anything I do exhausts me. Thank you for letting me know I am not crazy. I hope I can find the light at the end of this tunnel soon. REPLY Carolyn Thomas March 30, 2016 at 2:57 pm # Hello Pat – I hope you find that light at the end of the tunnel soon, too! Hang in there – and try reviewing Kelly’s helpful list of tips and see if adapting some of them helps you towards that goal. REPLY Michelle February 22, 2016 at 7:59 pm # Thank you so much for sharing this! I thought I was going crazy. I’ve been trying to explain my feelings of fatigue but couldn’t. This article is me exactly. Now I know I’m not the only one. REPLY Carolyn Thomas February 23, 2016 at 5:23 am # Hello Michelle – glad you found this post! You are definitely not the only one. Best of luck to you… REPLY Lindsey March 5, 2016 at 7:46 pm # Do any of you have a strange, almost icy hot feeling on your chest and shoulders? Aside from fatigue, I have it off and on. Doctor not sure what is causing it. Had a heart attack 3 months ago and had three stents put in. I am 35. Any comments would be appreciated. REPLY Carolyn Thomas March 6, 2016 at 4:22 am # Hi Lindsey – there are a number of reason that patients with stents might experience weird symptoms long after the procedure, such as stretching pain (fairly common, due to vasospasm or coronary artery stretch during the original procedure) or Dressler’s Syndrome (not as common but can start a few weeks afterwards; can also cause pain when taking a deep breath or when twisting the chest). If your symptoms continue, however, see your doctor. Read more about these and other forms of cardiac pain here. REPLY Francine March 8, 2016 at 11:53 am # It is now 16 months after a quadruple bypass and I am so tired. My arms feel like lead. I am not able to walk for more than 10 minutes before I am out of breath and start coughing, and if I don’t stop and rest I usually throw up. My doctors says surgery was a success and it will get better ….. but it is taking so long. Please does anybody have an answer for me? REPLY Carolyn Thomas March 8, 2016 at 12:43 pm # Francine, I’m sorry you’re going through this. I’m sure you anticipated that you’d be feeling much better than this by now. Often the healing process seems like it’s advancing pretty well at the beginning with predictable improvements week by week, so when improvements seem to stall, it can be puzzling and frustrating. I’m not a physician so cannot comment specifically on your case, but I can say in general that a number of my readers have reported a similarly surprising length of time enduring bouts of exhaustion. Some studies suggest that ongoing fatigue is associated with depression, especially among female patients, far longer than for male patients following a cardiac event (although I wonder which comes first: the depression causing the fatigue, or the fatigue causing the depression?) Certain cardiac medications can also worsen feelings of fatigue. Please make an immediate appointment with your cardiologist. This is a quality of life issue. Not being able to walk 10 minutes without coughing, shortness of breath and vomiting is NOT a “normal” outcome, no matter how “successful” the original bypass surgery was, and it may be an early warning sign of further cardiac issues. Best of luck to you… REPLY Ann McDonald March 8, 2016 at 1:16 pm # I am totally weary of the word “depression”. Being sick is enough without the onus of self infliction! This person is very ill and if she feels badly about it, good for her! She isn’t dead yet! She needs help yesterday. REPLY Carolyn Thomas March 8, 2016 at 1:35 pm # Ann, you can be as “totally weary” of the word as you like, but it can’t minimize the very real psychosocial fallout and poorer outcomes associated with cardiac-related depression, nor does the word somehow imply self-infliction. This person is ill, and she needs to see her doctor immediately, which is what I told her, too. REPLY Ann McDonald March 8, 2016 at 1:54 pm # Part of the stigma of mental illness is the idea that it is something that an individual can cure by themselves. I.e. It is self generated. Understanding depression has puzzled more than you or me. Furthermore it is used as a bandaid for almost everything from bunions to brain tumors. Even in this more elucidated age where Dr. Dyer can say “I’m Ok: You’re Ok.” It is convenient to dose out the Celexa rather than find the root cause of this devastating fatigue. Otherwise there wouldn’t be so many of us floundering in a state of enervation trying to get from one nap to the next. REPLY Carolyn Thomas March 9, 2016 at 5:12 am # Ann, I’ve written lots on mental health in cardiovascular disease here for years (including stigma – here, here, here for example) so I’m not disagreeing with what you say, except that it wasn’t Dyer who wrote “I’m Ok: You’re OK” – that was Thomas Anthony Harris. REPLY Doug Kozak January 7, 2016 at 8:49 pm # Had aortic aneurysm and valve replacement 2013, haven’t been the same since. Fatigue is horrible, to the point that I sleep or vomit violently, ya don’t get a vote. Getting better now after 3 years of learning how to deal with it. REPLY Carolyn Thomas January 8, 2016 at 2:28 pm # Thanks for sharing your experience with fatigue, Doug. Any clue about why it’s suddenly improved after three years? REPLY Chris Steinle February 22, 2016 at 6:11 pm # Hi Doug, Had the same operation as you did in 2014 and feel the same exhaustion still. I force myself to,walk but end up going to bed even earlier due to the exhaustion. I barely make it to 6 pm some days. I did not have this exhaustion before my operation. I feel very limited in life due to almost always being tired. Good luck to you. REPLY Rika Erasmus December 4, 2015 at 8:46 pm # Good day Carolyn and all who wrote, My heart breaks to read of so many people having to experience this terrible debilitating exhaustion. I also had it for many years of my life. No one understood, nor did I until I was diagnosed with Poli-Dermatomyositis. Then at least I knew I wasn’t a hypochondriac and the pain and exhaustion was real. Still my husband, friends, colleagues did not believe as you don’t have a splint, scar, wheelchair or anything to confirm your invisible disease. Finally I went on a fruit-bread only diet for 5 years for my colon, not knowing just how much I would benefit from it. Today I am much better although I have to control what I do. Now I take care of my Mom (83) and my husband after a quintuple bypass (3 years ago) and a heart attack (2 months ago). I have much understanding of Mom’s pain and husband’s severe fatigue. I still have relapses but I thank God for good food and grace. Thank you for your blog and to the others out there – check your diet (raw foods as far as possible), always believe in tomorrow, see every day as a challenge (not a problem) which can be hard, fill your mind with beautiful things, go out in the sunshine and nature, sit/lie under a tree and watch the living things – ants to birds etc. I pray for you all. May you also one day have your energy, health and better days back. In the meantime I hope more people will read and try to understand. REPLY Carolyn Thomas December 5, 2015 at 6:57 am # It’s so encouraging, Rika, to hear from somebody like you who can say “it’s much better now”. And excellent reminders for coping with chronic exhaustion – and not just for patients but for everybody! PS a “fruit-bread only diet”? I’m not familiar with that… REPLY Bharat January 3, 2016 at 1:19 pm # Thanks for your information and sharing it. REPLY DeDe October 22, 2015 at 4:30 pm # Hello, I was wondering if you also have a conversation for people living with heart attack survivors. About the last week of June 2013, my husband had a heart attack. This was a little under a year after my Mother died of heart failure. I, naively, thought we’d make it through this but things are really bad. I only guessed that some of the fighting was coming from exhaustion/fatigue because I have known him so long. If he doesn’t get that nap – all hell will break lose. Our lives have become one march from Sunday to Sunday. Cardio rehab, lunch, naps, grocery store, supper, to bed… repeat. Very little if any room in his life for me or anybody else. Depression? Certainly. Fatigue? Absolutely. Divorce? I hope not. REPLY Carolyn Thomas October 22, 2015 at 6:47 pm # DeDe, thank you for sharing your perspective. You have eloquently described an unfortunately common reality for many spouses of chronically ill people. You might be interested in reading this post called “Living With Heart Disease – and Your Whole Family“. And if you can find it (I think it’s out of print but may be available at your local library or used book shop), read Dr. Wayne Sotile’s excellent book called “Heart Illness & Intimacy”. For example, he writes: “…the patient may not be the only one profoundly affected by this diagnosis. Coping with a heart illness also involves spouses and other immediate family members dealing with an endless volley of stressors while trying to figure out how to resume a semblance of normal day-to-day life…” Best of luck to you… REPLY Valena October 21, 2015 at 9:51 am # Greetings, Boy, that is enlightening. Thank you for the information. Does that get any better at all? Does it ever go away? My husband, 45, had a heart attack 8 months ago, barely survived and is still recovering after a stent surgery and barely above heart failure. Doc said he’ll need a Ventricular Assist Device in the years to come if he doesn’t get healthier. He did cold turkey quit the bad smoking habit, but can’t lose weight and doctor is very vicious about it. We tried walking at around month 3 for about 2 months and he lost 3kg (I lost 6) but then he was hit by the fatigue again. He not only gave up walking, he gave up dieting and gained back those kilos and then some. I’ve been pressuring him to walk again, to no avail, and the irony is that it’s a 150+ person begging a 100 kilos one for action/losing weight while it was the other way around 15 years in a row. He is too tired all day yet too energized at night; he gets like a 4-5 hour nap in the afternoon and 3-4 hours per night and he’s up by 6. He’s stubborn, stupid and proud and tries to go on as he used to but fails miserably. He’s unemployed, literally sitting his ass in a chair in front of the computer playing online chess, watching movies, and moping around the house all day, with only doing dishes, taking garbage out and cleaning the pet’s pen as his responsibility, those being neglected too lately. He misses doctor appointments, misses test appointments or any outdoor errands, blaming fatigue all the time. I don’t know for the life of me what to do with him. I don’t know if it’s depression causing the fatigue or the other way around, and whether to press or bully him in chores or walking. I believe that the more he stays at home and mope around, the more lazy his heart will become and the worse it would get, but I’m afraid to press him any further and whenever I search on the net about it the information is scarce. Of course he’s too embarrassed and proud to admit anything to his doctor when he visits, and I’m banned on tagging along because I’ll tell on him. REPLY Carolyn Thomas October 21, 2015 at 2:11 pm # Valena, I can only imagine how maddeningly frustrating this must be for you. I’m not a physician so cannot comment on your husband’s specific circumstances, but I can tell you that it is not surprising at all that a person who feels as bad as your husband does might be depressed and fatigued. It’s a miracle he was able to quit smoking – that is an amazing accomplishment in itself. As I’m sure you’ve already noticed, “bullying” him about what he should do or not do isn’t working. We don’t make changes because others tell us what we need to change – that motivation can only come from within. You may be banned from accompanying him to doctor visits, but can you speak to his doctor about your concerns? Ask specifically for a physician referrals to a trained therapist and to a supervised cardiac rehab program. And meanwhile, although you are very worried about his health, remember that you have control only over your own behaviour – not his. Try to live the healthiest life YOU can (especially around cooking – as they say, “you lose weight in the kitchen and get fit in the gym”) and invite him politely to join you when appropriate for brief healthy outings. Best of luck to you… REPLY Rika Erasmus December 4, 2015 at 8:02 pm # Dear Valena, You cannot do much but to support him positively. You can suggest some things or phone the doctor and tell on him. In the end he is the one to make the decision on living better. Fatigue is a terrible thing which few people understand. But do not let him “bully” you. They don’t mean it but it does happen. Take a stand and let him do things for himself – assist him but do not baby him – you will not survive. Have empathy and support but you cannot live his life for him. Love him, don’t spoil him into becoming a brat. Take careful notes, be aware of his physical and mental state – but also yours. Good luck. REPLY Carolyn Thomas December 5, 2015 at 6:51 am # Words of wisdom, Rika. Thanks… REPLY Luann S. Martin October 7, 2015 at 12:33 pm # I have had severe fatigue since my heart attack and heart surgery to replace my mitral valve. Nothing helps me but a nap, and it needs to be uninterrupted sleep of a couple hours. I am 10 months post-op and just want my life back! Will that ever happen??? REPLY Carolyn Thomas October 8, 2015 at 7:21 am # Hi Luanne! I’d check with your cardiologist if I were you, just to rule out any cardiac reason for your unusual fatigue. Many of us, however, do live with the kind of fatigue you describe. Best of luck to you…. REPLY Teri Gasser September 8, 2015 at 4:46 pm # Had my first and, I hope, last heart attack two weeks ago. I am 54, not overweight (lost 15 lbs last year), active, eat well, healthy cholesterol #s. Yup I’m the last person you’d guess would have a heart attack but I did. Had a heart cath and stent placed 13 days ago. No one warned me about this fatigue. It wasn’t uncommon for me BHA to hit a wall in the afternoon, but a 15 minute power nap and I’m gold. Not anymore! Now I’m okay until the afternoon but then I’m noodled. Just can’t do anything. Thanks for posting this because I wasn’t finding a reason anywhere else. Any chance I’ll get some energy back? Any ideas on when? REPLY Carolyn Thomas September 9, 2015 at 7:01 am # Hi Teri – you are in very early days still. This kind of ‘hitting the wall’ exhaustion often comes as a shocking surprise to freshly-diagnosed heart patients. For an explanation, see also: Why Taking a Shower Is So Exhausting for Heart Attack Survivors And YES you will get some energy back over time – if your doctor has not yet referred to a supervised cardiac rehabilitation program, insist on a referral. Best of luck to you… REPLY psychtld August 30, 2015 at 9:35 am # Thank you for this resource. I’m just at the beginning of being treated for (strongly suspected) heart failure. Almost diagnostic is that the medication regime is working. Fatigue is, of course, a prevalent effect of the medication. I’m having to use my very elementary training in health psychology from my undergraduate days in order to find things out – I’m in Finland and (contrary to what the world gets to hear about this place) things are not great here. I screenshotted the stuff that Kelly send you, since it seems a good list of ideas and would fit nicely on my phone. The Spoon Theory thing … not actually a theory in the sense we know theory to be BUT it is probably a very useful metaphor for one’s available energy budget. Once again, thank you. REPLY Carolyn Thomas August 30, 2015 at 9:54 am # Best of luck to you in your heart failure treatment. The Spoon Theory, by the way, is a classic within the chronic disease community – whether you believe it qualifies as an academic “theory” or not! REPLY Becky July 3, 2015 at 9:57 pm # Carolyn, Thank you, thank you for all this information. I thought I was going crazy. I had a heart attack in December 2014 and the blockage could not be stented. I have been exhausted ever since. On the days I work, I am in bed right after dinner. Days I do not work, I take 2-3 hour naps and still have to go to bed early. I am behind in every aspect of my life and am spending much less time with my precious grandchildren. I was very healthy before this “stress-induced heart attack” at 52. Please, please tell me this is not how I will feel the rest of my life. REPLY Carolyn Thomas July 4, 2015 at 5:00 am # Becky, I can’t tell you with 100% certainty how long you’ll feel this way, but what I can tell you is that there may be some effective ways to address this fatigue. I don’t think I felt anything like “myself” for a full year following my heart attack. First, tell your physician that this is a quality of life issue and needs to be addressed immediately. Ask for a medication review; some of the meds you’re taking may be contributing to this fatigue and can be changed/reduced. You might also be depressed (not an uncommon reality for heart patients) – depression is exhausting. You might also want to ask about getting a sleep study done (many heart patients have undiagnosed sleep apnea). Something non-heart-related may be contributing to your fatigue – ask your doctor to help figure this out with you. Meanwhile, hot weather can also play havoc with our fatigue – stay cool! If possible, see if you can reduce your work hours, at least temporarily. Follow the tips in this post as much as you can. Lastly, this sounds counter-productive, but try to get a good walk or yoga stretches in every day to balance that crushing fatigue with moving your body in a healthy way. Best of luck to you… REPLY Connie Stufflebean July 1, 2015 at 8:47 pm # Yes I’m still very tired post four weeks and it’s really more sleepy. REPLY Carrie May 11, 2015 at 6:35 pm # Wow, I’m late to the game reading this article. I have congestive heart failure and the exhaustion is excruciating. Worse, my heart failure is caused from pregnancy so here I am, with 2 small kids to care for, and I can’t get out of my own way. You’re so right. This is NOT the same as what others call “being tired” or even “exhausted” – this is a beast you can’t fathom unless it strikes you. REPLY Carolyn Thomas May 11, 2015 at 7:43 pm # Hi Carrie and thanks for sharing your experience here. I can’t imagine living with this “excruciating” fatigue while also PREGNANT and caring for 2 LITTLE KIDS!! I sure hope you are able to get some help from others during this exhausting time. I agree – until we actually experience this kind of crushing fatigue, it’s impossible to fathom how debilitating it can feel. Best of luck to you… REPLY Anna in France August 24, 2015 at 3:49 am # Wow – your comment really made me think. I had my heart attack last October and also struggle with fatigue intermittently. Some days I’m full of energy, others I’m wakkowed from start to finish BUT I am retired. I cannot imagine how I would cope with young children to care for. I don’t know how old your children are but I do remember a wonderful game my daughter used to like playing. She would pretend she was my maid and do the tidying up and dusting – if you’ve got boys perhaps playing a butler would do as well. Failing that – prioritize – a bit of dirt is good for the immune system & who cares if things are untidy! I wish you the very best of luck. Above all, enjoy your little ones – they really don’t stay that way for long. REPLY Carolyn Thomas August 30, 2015 at 9:51 am # I love that “maid” game you and your daughter used to play, Anna. Never too young to get little ones to tidy up. It’s interesting how fatigue can be so intermittent (and thank goodness when it is, so we get a wee dose of normalcy in between!) REPLY Ann McDonald October 25, 2014 at 12:00 pm # This fatigue thing has really gotten my attention now! I have had issues with sleep problems since I was in my twenties but have always been able to pick up more than my share of the load literally and figuratively. Now at age 80, I find getting up to start the day is more than difficult. I try to maintain a fairly regular bedtime, around 11:00 pm. I usually go to sleep within a half an hour. Then awaken after 2 to 3 hours sleep to urinate. Then it is a crap shoot to see when I go back to sleep. Then after another 2 to 3 hours of sleep, I awaken. I take care of the dog’s needs and take my meds and insulin and eat breakfast. Back to bed for another 2 to 3 hour nap. Even so I feel very sluggish, and doze off to sleep again. I have several health issues. Mild COPD, type 2 diabetes requiring insulin, CHF, multiple joint replacements, and two years ago I underwent spinal fusion of L3,4,5, and S1. Each of of the surgeries had its complications of varying severity but the back surgery involved an episode of anaphylactic shock due to an allergy to dilaudid. Each of these surgeries was an attempt to remain more capable of caring for myself. As a matter of fact that is almost all I can do. Back spasms are incapacitating and that interferes with much in the way of exercising. I feel as though no one believes the degree of tiredness I experience. There is a sort of intimation that I would be cured of my problems if I got up and moved more! And if I wasn’t depressed. Well, darn it all anyway! I am depressed. As for moving: after one or two pm, I do get some chores accomplished. I recognize that I am my own worst enemy in many ways. But what shall I do about the fatigue. REPLY Carolyn Thomas October 25, 2014 at 1:30 pm # Hello Ann – your first sentence leaped out at me: “I have had issues with sleep problems since I was in my twenties…” which likely means sleep has been a problem long before your chronic illness diagnoses (which only make fatigue and sleep problems worse even if they don’t directly cause them). I hope that some of Kelly Young’s list of tips (in this article) might help you, and if not, please ask your doctor for referral to a sleep study. Best of luck… REPLY Shara Homme December 19, 2012 at 9:29 am # Carolyn, I’ve just located your blog today, and I can’t wait to read the other articles. ~^_^~ I’m living in Halifax, and I have a diagnosis of Ebstien’s Anomaly (severe range) and Wolff-Parkinson-White syndrome (unsuccessful ablation). Your article on fatigue, to me, is the most ironic first entry to read. This fatigue has been a part of my life since a very young age. Until my diagnosis at 12 (I’m now 32) due to a rather scary passing-out event with one of a series of unsympathetic gym teachers, I’ve struggled with this bone-gnawing exhaustion. It’s very difficult to not relent to the additional feeling of depression and uselessness heap additional mental health scars to your already long list of health concerns. It hurts a great deal, I’m sure, especially if you’ve experienced a life of being ‘able’ then rather suddenly, unable. Very few heart ‘traumas’ leave visible marks on the body, and very few people, be it your social circles or your job, will expect nothing less (and usually more) than they would of an average, healthy human. It often breeds feelings of strong disappointment in oneself and being ‘left out’ or ‘sold short’ in life and loads of ‘Why can’t I do this?’. I find my body responds quite ‘loudly’ to any of these feelings. (they say depression hurts…hooo boy…) Do you find anyone else with these responses? REPLY Carolyn Thomas December 19, 2012 at 1:32 pm # Hello Shara and welcome to my site. You are so right – most ‘heart traumas’ are invisible to others. I often think it would be ever-so-handy if I wore a neck brace or a leg cast or some other type of clear signal to those around us, as I wrote about here a few months ago for National Invisible Illness Awareness Week – did you know there was such a thing? REPLY Judy Reed December 18, 2012 at 1:37 pm # Thank you for posting this. I just went through a period of major fatigue following a couple of driving trips…it is difficult to explain that this is not just being tired, this is bone crushing, can’t get out of the chair fatigue….and it seems to take a long time to leave. Not sure all the tips work for me but I have used some of them. REPLY Carolyn Thomas December 18, 2012 at 1:49 pm # Hi Judy – I just read your blog account of your 400 mile drive even though you’d been feeling sick. What were you thinking, girl? Well, you were likely thinking how great it would be to spend Thanksgiving dinner with family – which turned out to be true, right?! But it’s always a trade-off. Sometimes, I’ll say YES to something I really want to do if it involves those I really want to be with – even though I KNOW what the resulting consequences will be. Sometimes it’s worth it – other times, not so much, which is why it’s important to be able to assess that risk/benefit ratio ahead of time! (PS I love that photo of your new screen door/gate!) REPLY lauren December 17, 2012 at 10:02 pm # I have to comment on the list of 25 tips from Ms Young, Carolyn. I think some are very misguided and conflicting. “Budget energy” and “balance rest and activity” can’t be compatible with “go till you collapse” and “caffeine”. And the latter two aren’t good for you no matter what your health diagnosis. Not knocking the daily cup or so of coffee, but advising caffeine as a fix for this type of fatigue is a joke, I hope. When I experience this debilitating fatigue I can’t and don’t want to be planning what I will do when I feel better, I am just trying to remember that this is not for always and I have to accept it in the moment. I think there are many other tips in this list that are helpful and I was glad to see you address the topic. I could never have believed that I could have random and sudden episodes of exhaustion so severe that I sit in the truck in the driveway and cry because I am too tired to get out and go in the house. REPLY Carolyn Thomas December 18, 2012 at 5:43 am # Thanks for your input here, Lauren. Your description of sitting in your driveway crying because you’re too tired to get out of your vehicle sure rings a bell for me, too. I know I have pushed the limits when I find that I’m both crying and shaking at the same time. Kelly’s list came from a number of different readers living with the crushing fatigue of rheumatoid arthritis, hence her broad range of suggestions. At one time or another, I’ve tried pretty well each option myself – yes, especially caffeine! I would not personally advise others: “Go til you collapse”, but I have to admit I have certainly done that a number of times depending on circumstances, as many patients do, and then always paid a big price for it after the fact. That’s what leads to sitting in the driveway crying, doesn’t it? REPLY cave76 December 17, 2012 at 6:56 am # I haven’t had a heart attack (fingers crossed) but I know all too well what that profound, unrelenting fatigue feels like—– for 15 years—- from Lyme disease but it doesn’t matter what condition or disease causes it. Here’s what helps me be kind(er) to myself and, perhaps, to show to friends and family who just can’t understand: Christine Miserandino’s essay The Spoon Theory. REPLY Carolyn Thomas December 17, 2012 at 7:20 am # Thanks, Cave, for that link to the Spoon Theory. It’s a must-read, especially for our family or friends who have never experienced the kind of fatigue we’re talking about here – no matter what our diagnosis, as you say. REPLY

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