When is it time to quit work?

[myohno]

I had a double cardiac cath on Friday because my echo showed my ejection fraction to now be at 45% but my cardiologist said that the mitral regurgitation has increased and now my right side of my heart has become affected.  I'm short of breath with most everything I do and even a simple shower wears me out. I don't sleep well at night and I'm fatigued absolutley all the time.  I was told that I now have  increased pressure in my lungs, which by the way they had found two nodules on my right lung and I have lost over 40 pounds not trying. I'm just so darned worn out!  When I get up to get ready for work, I feel like I've had a workout just from taking the shower and getting myself together!  By the time I get to work, I'm already exhausted and could use a nap!  I feel like I have to push myself ALL THE TIME!  Does anyone know at what point should I give up work and just relax for awhile?

[Encephalomalcia]

Staying active is good, but if your work is causing you stress that is not good.  Stress is very hard on ones heart and with todays work there seems to be more stress than ever.  If you are not feeling well and need to rest, than that is what you should be doing.  Pushing yourself will only drive up your blood pressure and the high blood pressure will further damage your Left Ventricle.  What you have is a very serious heart condition involving the left side (the most important side of the heart).  If you can afford it, taking a rest from work would help you to get the rest you need.  Do not push yourself.  If you feel you want to take a nap, do it.  Try to keep your blood pressure down.  Glad to hear that you are taking Lisinopril, which is one of the best ace inhibitors and has actually shown in studies to increase lifespan.  In Europe, the people work less hours a week, get more paid vacation, get a year off of work after having a baby, etc. and they live about 3 years longer than we do in the US.  Take off of work if you can.  Take care and rest, and I am sure you will start feeling better.  Make sure to keep the water off and weigh yourself daily.  

[myohno]

Sorry, I meant to say that after they first started the Coreg and titrated it up to the 25mg twice a day, I went up to a 50% EF, still with only the left side affected.  That's why I think of resting. I have disability insurance through my employer which is what I used last time when I had the 37%.  I guess I don't understand that if I had been at 37% and only left ventrical affected gave me the same symptoms I feel with 45% now but both ventricals affected.  So if both ventricals aren't doing what they need to do, but I am at the 45%, wouldn't that be a determining factor for the disability?  My fear is, honestly, I have missed so much work, I get sick all the time, I catch absolutely everything and I fear my employer will tire of it eventually.  Of course I bring doctors excuses but , hey a business has to do what they have to do and the conversation has come up!  I'm really beginning to worry!

[myohno]

It's amazing you say that because I returned to my cardiologist and it's almost verbatum to what he said!  I didn't really understand everything but he has now increased my lisinopril to 40 mg a day and the lasix to 20mg everyday instead of when up 3 lbs or more!  What was your daughters EF?  I had neglected to say that when I first had the virus they found me at a 37% EF but then titrated me on the coreg and lisinopril.  They also said only my left ventrical was enlarged.  After being on the meds for about 1 1/2 years, now the EF has fallen to the 45% but now the enlargement is the entire heart.  I thought that if I took time off to just let my body rest, was an idea because if I'm doing nothing than normal everyday activities, why is the EF falling and why is the rest of the heart enlarging?  Please tell me more about your daughter!

[grendslori]

Try and stay working.....it gives you a purpose in life which is very important. Without it people become depressed and give up on life. ""What's the point??"" An EF% of 45 is not bad, it's just shy of being normal. The symptoms you are describing would put you into a NY Class of IV which is having symptoms even at rest; your EF% doesn't agree with that. You have Congestive Cardiomyopathy (Systolic) which means the pumping action, pushing the blood out of the heart is impaired. This type of cardiomyopathy is usually caused by a virus; the other main type of cardiomyopathy is a hypertrophic cardiomyopathy which is where the walls of the heart are too thick which makes the filling of the chambers impaired. This form of cardiomyopathy is generally genetic, but can be sporadic where no one in the family has this disease. That happened to my daughter. She was one of the worse cases seen with this disease; all of her ventricular walls were 4cm thick with muscle 'bridging' throughout the chambers. She was a Class IV heart patient which means she was having severe symptoms at rest (angina due to a lack of blood flow to the thickened walls). Believe it or not, we got the call for her transplant while she was at work! It is always better to stay working for your own spirits. If you do choose to leave work, you may want to look into getting disability, I'm not sure you will be able to with a near normal EF%. You might want to check that out before you quit your job.  

[myohno]

Hi joebee39,

Thank you for responding!  My diagnosis is Idiopathic Cardiomyopathy.  I was told I got it from a virus because I don't fit the classification anywhere in my family  or knowledge elsewhere.  They have also said I have the nonischemic cardiopathy with moderate global hypokinesis. He said it was only in the left ventrical before but now in both.  When I saw my cardiologist on Thursday he had me admitted me the very next day in St Johns Mercy Heart Hospital which is 2 hours away from my small little town.  He had also thought that I might have some Coronary Artery Disease but they did not find a single blockage!  I am currently taking 25mg Coreg twice daily, 30 mg Lisinopril once a day, and one baby aspirin. I take lasix if I'm up 3 pounds in a day, but that hasn't happened lately because it just keeps falling off! I have learned several things but the thing I can't stand is my primary doctor, (who by the way is leaving in August) always tells me, not to worry and let him do the worrying!  Had I not gone to the St Johns clinic because my primary doctor was overbooked, he would not have sent me to the cardiologist!!!!  The clinic doctor did after she told me I was pale as a ghost and I told her I just cant' seem to pull it together and I'm totally wiped out!  She had me at the cardiologist the next week.  I cannot imagine how tired you must feel if you are at 15% EF!!!!!!  How in the world do you get up and even move????  If I take the steps, I feel like I'm going to pass out!!!!

[joebee39]

An EF of 45%, while below normal, should not be enough byitself to cause the symptoms youo are experiencing. What is your diagnosis?  What type of cardiomyopathy do you have?  I'm not an M.D., just a CHF patient with dilated cardiomyopathy and an EF if 15% and with the medications I take, which include Coreg,Amiodarone, Lisinopril, Torsemide, Spironalactone and coumadin, my symptoms are nowhere near as severe as yours.  I also have an implanted cardiodefibrillator with right atrial pacing to regulate my heartbeat and protect me from sudden cardiac arrest.  You should ask your cardiologist about these medications and find out what he or she thinks is an appropriate drug regimen for you.  Taking time off from work to relax for a while will probably help you feel better during the time you are relaxing, but if you have CHF it probably won't have any curative benefit.  Make a point of learning as much about CHF as you can.  As they say; knowledge is power' and when suffering from a serious, potentially fatal affliction like CHF you need to be able to ask sharp, well informed decisions and understand the answers,  If the medical terms are confusing or not meaningful to you ask your cardiologist to explain.  Take careful notes during your appointments and always arm yourself with questions prior to each appointment,

My very best wishes to you.