Fatigue

[MooseMom]

I am now 9 mos post tx.  My labs are fine and I'm chugging along pretty well.

However, I have felt really tired lately.  It seems more muscular than anything.  I sleep well, so it's not that.  I feel like I'm moving through treacle.  In January.  I've always gone for a long walk each day, but lately it really tires me out; my daily walks have become more of a chore than a source of calm and pleasure.

I am on 25 mg atenolol and 5 mg amlopidine for bp.

I'm on 5mg pred, 4+3 mg tac and 720 mg twice daily myfortic.

My bp runs, on average, 115/68.

In the past, atenolol has been known to cause me to feel fatigue in my major muscles, so my dosage was reduced.  I don't know if that could be the culprit now.

My next clinic appt isn't until early May.  Yes, I could talk to my tx coordinator, and yes, I could go see my local neph or PCP (and I will probably end up doing those things), but I was just wondering if any of you might have some insight.

I don't feel unwell, just tired.  I really have to push myself to get stuff done.  I had more energy 4 months after surgery than I do now, 5 months later.  I just can't figure out why.  Any ideas?

Thanks very much.

[Deanne]

Fatigue is hard to deal with. Have your meds changed recently? Amlopidine causes fatigue for me, I think, but your dose is pretty low on it. Do you take your bp meds in the morning or evening? If in the morning, is it possible to switch to evening to see if it makes a difference?

Do you suffer from spring allergies? Could this be a possible culprit, too?

[boswife]

I dont think that 'post' you have the hemoglobin type issues, but thats when bo is tired/wore out/ no energy etc... 

[MooseMom]

Hi Deanne.  Thanks for your reply.  No, my meds have not changed except for the fact that I have been off Zetia since early January.  I've been taking the two bp meds for literally decades.  I take my bp meds in the morning just like I've done for years.  I guess I could ask about switching them to the evening; that's a good question. 

I don't have spring allergies.  It's not spring yet here in Chicago, anyway! ::

[MooseMom]

I dont think that 'post' you have the hemoglobin type issues, but thats when bo is tired/wore out/ no energy etc...

Oddly enough, I didn't have hemoglobin issues even with an egfr of 14.  I never did have to be treated for anemia.

I don't have any other symptoms, although it does occur to me that my bp is rather low, though not THAT low.

[jeannea]

Lack of red blood cells or whit blood cells could do this. For BP, atenolol is prob more of a problem than amlodypine. Are you having restless sleep from prednisone? I go through cycles of bad nightmares. Are you eating some protein every day?

To be honest, I have this problem too. For me it's a combo of my physical state and depression. You can call your coordinator and ask for advice but unless your labs are off it's unlikely you'll get a lot of helpful advice.

[MooseMom]

Thanks for that, Jeannea.  I got my latest lab report back last Saturday, and there were no red or white blood cell count abnormalities.

I'm not having any sleep issues from the pred.  I've been taking temazepam (sp?) for about 6 years, and suspecting that the pred might cause sleep problems, I asked for, and got, an increased dosage.  I don't have any issues with sleep that I know of.

I do eat protein every day.

I agree that I probably won't get much helpful advice as long as my labs aren't funky.  Perhaps it is something I'll just have to live with, or maybe it's just a "phase".  I guess I just want to be told that there's nothing horribly wrong and that my muscles aren't about to implode or something.

I probably did suffer from depression before tx (who doesn't?), but I can't say that now.  I'm sorry to hear that you are having problems with depression.  Are you being treated for that?

[Chris]

I get tired still after walking either dog and I am 12+ years post tx. I miss my insomnia tho that I had for many years tho, which really took off post tx.
 
I would bring it up with your doctor and show them your labs to see what they think about your red and white blood cell counts.
 
What about blood sugars on your lab sheets? Try a snack while in route to see if that helps if you do not have a blood sugar monitor. High and low blood sugar can make you tired to and you do not need to be a full blown diabetic either.

[MaryD]

Could it be that you are mildly sleep deprived (your new post-transplant body has different needs), and that an occasional snooze in the afternoon may be required?

[jeannea]

Yes I am treated for depression. But it still gets to me esp in the winter.

But being tired may not have some big cause. It could even be (sorry) getting older. If your docs say you're ok, you could try an exercise program to get stronger. Or you could try afternoon naps. That's what I would choose.

[MooseMom]

Chris, I have my blood sugars tested regularly.  I've never been diabetic, but since tx meds can cause diabetes, I get it checked.  So far, no probs.

As for sleep deprivation, I sleep better than I used to, but my hours are wonky.  I usually read late into the night, going to sleep at around 1:30 AM.  However, I don't get up until about 9:30, so there are my 8 hours. 

MaryD, I used to take an afternoon nap, and maybe I should start doing so again.  I guess I just don't like the idea of sleeping my life away.  I fight the desire to take a nap, so perhaps I should just have a bit of mercy on myself and do it anyway.

Jeannea, winter is almost over; the difference in the angle of the light tells me so.  You should come see my garden; so many things are popping up.  I think it would show you that spring is on the way, and maybe you'd feel better!  LOL!  And you're right; being tired may not have some big, scary, easily identifiable cause.  And yep, I am simply getting older; that could explain it all.

I've always exercised and have enjoyed it.  But now it just seems suddenly so much harder. 

I've been diagnosed with dry eye (nothing to do with renal problems, rather, just age!), and when your eyes feel all heavy as a result, you probably also feel sleepy and fatigued.  I could fall asleep right now!

Thanks, everyone, for your thoughtful replies.  I will start having the occasional afternoon nap to see if that will help.  If it doesn't, I think I will approach my regular neph or PCP (they're in the same practice, although the neph is there only two afternoons a week) to see if maybe my bp meds might need adjusting.  Thanks again!