Like most of you, I’ve experienced my fair share of garden variety pain over the years (caused, in my case, by things like a ruptured appendix, broken bones, knee surgery, or popping out two babies the old-fashioned way).
But none of those even came close to the chronic pain of refractory angina caused by my current diagnosis of inoperable coronary microvascular disease (MVD). The chest pain caused by this disorder of the heart’s smallest blood vessels is episodic, intense, frightening and resembles what my “widow maker” heart attack symptoms felt like in 2008. Except this kind of pain happens almost every day. It’s generally well-managed most days by meds (including my trusty nitro spray) and the non-drug, non-invasive TENS therapy recommended by my cardiologist as well as my pain specialist at our Regional Pain Clinic. But sometimes, it’s alarming enough that I clutch my chest and wonder:
“Is this something? Is it nothing? Should I call 911? Is today the day I’m having another heart attack?”
As you already know if you live with chronic pain like this, pain can literally change your personality. If it’s chest pain, it can also make you feel anxious and worried in a way that having pain from knee surgery never can. No wonder pain is so utterly exhausting!
As Sir John Lubbock correctly observed in his 1894 book,
“A day of worry is more exhausting than a week of work.”
Too true, Sir John.
In the blog called Journey of a Tired Heart, the question “Is exhaustion an emotion?” is asked, and then answered beautifully:
“Is exhaustion an emotion? I don’t think so, but is there a state of being more intense than exhaustion?
“I can’t think of an appropriate word to describe it, but it’s the state of physical exhaustion to the degree of leaky emotions.
“You know what I mean: when your eyes are tightly closed and you finally fully exhale, relaxing every muscle in your body and a warm teardrop slides down your cheek. Then another, and another. Just a few though – and it cannot even be defined as crying.”
“It’s not crying.
“It’s all that determination and courage you had to employ to get through the past four hours – at least what is left of them anyway.
“You let them flow, take in a deep breath and then let it out slowly. Just as quickly as they began, they end. No more tears. Just a sweet, wonderful, lifeless kind of surrender that can only be understood by those who have walked the tightrope between life and death.”
Keep in mind that this type of exhaustion is not at all the same as “feeling tired”. It is sometimes described as feeling like having the worst flu you’ve ever experienced.
And exhaustion or crushing fatigue are not only frequent companions of those living with the refractory angina of MVD, but these symptoms can often be among the first warning signs of heart failure or heart disease in general. Such cardiac symptoms often tend to progress slowly over time and we may not even recognize that something is very, very wrong at first. We feel fatigued, gradually unable to exercise and perform work or other basic activities that had once been easy to do. “I just can’t understand what’s going on with me…” is a common lament.
Few things in life can make us feel more exhausted than living with pain. People living with chronic pain (heart-related or not) typically wake up tired, even after having slept for a long time. For many, pain disrupts sleep, which leaves them even more exhausted. The combination of disturbed sleep and having to endure distressing pain can be draining, leaving exhaustion for much of the time a distressingly common state of being.
For some tips on managing chronic exhaustion, read 25 tips to manage the crushing fatigue of heart disease
NOTE FROM CAROLYN: I wrote much more about emotions (and exhaustion) in my book “A Woman’s Guide to Living with Heart Disease“ (Johns Hopkins University Press, 2017). You can ask for this book at your local bookshop, or order it online (paperback, hardcover or e-book) at Amazon, or order it directly from Johns Hopkins University Press (use their code HTWN to save 20% off the list price when you order).
Journey of a Tired Heart (a compelling blog about living with cardiomyopathy, heart failure, an implanted defibrillator, and other exhausting things)