Unable to exercise due to dizziness and fatigue after surgery and Covid

[SomeBigGuy 110]

I have a question for folks that may have experienced this. I'm not convinced it is 100% related to my surgery since I had some of these symtpoms, albeit milder, prior to my surgery. I felt like the dizziness and general weakness went away the first 4 weeks following surgery, and I was able to walk 2 miles easily without stoppoing, and 4-5 miles a day with minimal rest. I was really looking forward to going back to the gym once I was cleared to lift weights.

However, I caught Covid, and was mostly stuck in bed for 2 weeks over Christmas and New Years, around the time I was working in solid foods again. Since then I'm barely able to walk 1 mile without stopping, and even then I need to rest for over an hour to feel right again. It's gotten progressively worse, especially in the last two weeks, to the point that I don't feel comfortable driving when the vertigo and extreme fatigue hits. It's to the point that I'm falling off my treadmill if I go more than a half mile. It went from being somewhat disruptive previously to debilitating now. Luckily I work from home, but even that is starting to get disrupted.

Over the past year I was evaluated for heart issues, had 3 MRI's, a CT scan, echocardiogram/ultrasound, had my carotid checked, been to two opthamologists and tried two different pairs of glasses, checked out by a Neurologist and Neurosurgeon, evaluated by an ENT, went to a hearing and balance specialist (no Menieres disease, inner ear crystals, etc), normal BP (between 110 and 130 systolic, and 70-85 diastolic), Blood Sugar has returned to my pre-diabetic levels (92-98 fasting, and no higher than 130 when checked 2 hours after eating). Pulse Oximeter is showing O2 staying between 95-98. CPAP was re-titrated to treat sleep apnea following the weight loss. Blood labs showed Total Cholesterol and LDLs somewhat high, but decreasing steadily since my surgery in November, High levels of Iron and Calcium though, but everything else plus thyroid were normal. Heart rate has dropped from pre-surgery rate averaging around 80-90 bpm down to 40-55, but my PCP wasn't able to determine why. My father and grandfather (currently 92) both have a normal heart rate between 45-55 for their whole lives, so maybe that one is hereditary.

Thanks for reading and any advice is appreciated!

[Arabesque 7,240]

Orthostatic hypotension is common after the surgery. That is your blood pressure drops on rising & then resettles again. Did they check your blood pressure sitting & then standing? I had a tendency towards low blood pressure before surgery now it’s something I experience every day & am almost 5 years post surgery.

Periods of low energy while losing isn’t that uncommon either. I remember at around the 3 month mark suddenly feeling so tired again. At the time I thought I really should get more active & started to walk on my treadmill. But I couldn’t do it. Was so tired I worried I’d fall asleep as I was walking & I was wreaked after a couple of minutes. That nixed that idea.

Plus the doughiness in the head & inability to focus can last well into the second month too.

However, what you’re experiencing could be related to having had Covid. Back in the day it was known as a post viral response: lethargy, low energy, cold sweats, blood pressure issues, etc, I used to get burning on the soles of my feet too. Could last for months after having one of the more severe viruses like glandular fever, influenza A, etc. I’ve had two bouts after having pityriasis rosea & then human parovirus. I remember struggling to walk up the two flights of stairs to my apartment & I had a chair placed in front of the white board in my classroom because even standing was exhausting. Now of course everyone calls it long COVID but it’s the same thing.

My last thought is you’ve picked up the vertigo virus. It’s a parasitic type virus that attacks when you’re run down post another virus. I got mine after influenza A. The vertigo, lethargy, etc. wasn’t pleasant. Occurred randomly for a couple of years after the initial bout. Generally over the counter anti nausea meds manages the vertigo otherwise a script for stemetil or similar helps. I carried it in my bag just in case I had a vertigo attack.

Just some suggestions. Hope you start to feel better soon.

[SomeBigGuy 110]

Thanks! I did get evaluated for Orthostatic Hypotension and POTS with my primary care doctor doing the tilt table test and with the balance specialist, but both tests were negative. I used to have the Orthostatic hypotension previously but it was caused by my blood pressure medicine. Since I've been off of it, that particular dizziness has gone away. Now its more of a persistent feeling of motion, almost like its someone jiggling my glasses.

It's just frustrating because I keep trying walking to exercise, but I'm stuck to using the treadmill or sidewalk and not going too far from the car. I'd prefer walking in the woods on trails, but I don't want to get stranded where my wife couldn't help me back.

The brain fog is no joke. I had a lot of trouble with it before the surgery, had a one month or so break, then after covid, it came back even worse.

Regarding other viruses and vertigo, I'll check back with my doctor when I go back next week to see if they can prescribe anything for that.

Hoping you're doing well and feeling better yourself! Thank you again for replying!

[ChunkCat 728]

I agree with Arabesque, this sounds like a post viral syndrome. I'm so sorry you are going through this! You were doing so well!! What many people (and doctors) don't understand is getting any sort of virus that hits the body hard can result in a number of conditions afterwards, some caused by trying to recover from the virus, some caused by opportunistic viruses showing up when your system is low from one virus already, and some can actually be autoimmune conditions that are triggered to show up from a viral infection. Any of these could be contributing to your condition.

A few years ago I got cat scratch fever (that's what I get for fostering litters of kittens! LOL). I was sick with it for a few weeks. My immune system had already been behaving badly that year, I have an autoimmune disease that flared so bad it effected my digestive system, my eyes (I was having vision problems), as well as my joints. But the virus kicked my butt royally. Then a few weeks later I started spiking high fevers at night out of the blue. I was so exhausted I started sleeping more and more every day until I was sleeping about 18 hours a day. My doctors were absolutely useless and said it was probably chronic fatigue syndrome caused by the autoimmune flare and started putting me on courses of steroids. My bones started aching so bad I would cry. I could barely walk to the kitchen to get a glass of Water. My GP made out I was pain med seeking so I fired her, her lack of support was appalling. I started fainting when I tried to shower. I had vertigo all day. After fainting twice with temps over 104 I ended up in the ER where they did labs and said nothing was wrong, it was probably a virus and to go home and sleep it off. A week later I ended up in the ER again where a wonderful doctor said I was experiencing acute kidney damage from dehydration due to the fevers and that I was NOT leaving the hospital until someone figured out what was wrong. I was in the hospital for almost 2 weeks, two different hospitals where I continued to run fevers at night up to 105, it was absurd.

Then suddenly one day the fevers and pain stopped. The infectious disease doctor was baffled. But when my advanced labs came back they finally understood what was going on---I had atypical Epstein Barr Virus. Atypical because mono didn't show up when tested for in the ER and I only had one lymph node swollen on my whole body, a tiny one behind my ear. Apparently atypical presentation doesn't show up on mono tests, only the two week test. Epstein Barr Virus is notorious for showing up with other viruses and generally making a pain of itself.

It took me another two months before I could reliably get out of bed, and honestly my body took several years to return to a new normal. They thought I had POTS but turns out it was just severe physical deconditioning from the virus and bed rest.

All this to say--if you still can't figure out what is going on after a couple of months, you might want to consider talking to an infectious disease doctor or immunologist, whoever is in your area that can treat long Covid and can test for other viruses that might be complicating the picture, as well as autoimmune conditions. Your symptoms sound so viral or autoimmune in origin. My Dad ended up with post viral arthritis. Viruses are such weird things and they can really give our bodies a hard time!

Oh and one suggestion. You might want to give this device a look, it was made by two guys, one who had long Covid. https://www.makevisible.com/ I've considered getting one as I love that it helps track your activity in relation to pacing which is shown to help with post viral recovery, and in managing autoimmune conditions, chronic fatigue, fibro, etc...

Edited February 16 by ChunkCat

[SomeBigGuy 110]

Thanks again @Arabesque and @ChunkCat for your advice earlier. I haven't been checking in as much, dealing with continuing health issues. Healthcare providers are difficult to get scheduled with in my area, so I'm just now getting to follow up with them. I've been waiting to get scheduled with a Neurologist since August, but no luck. I've had to burn my days off with work due to Covid at the beginning of the year, so I'm not able to get in with a specialist since the closest one available is about a 4 hour drive from here.

There's also no immunologists with availability in 2024 within 4-5 hours from here either, so I'll be waiting on that for a while. I am getting in with a cardiologist to see what is going on. My heart rate is dipping down to 28-29 bpm in my sleep, and I wake up feeling exhausted. I'm on a CPAP and also getting another sleep study scheduled in April to see if adjusting that will help.

I'm still just walking about 1-2 miles a day. I walked 4 miles a couple weeks ago, and was hardly able to get out of bed for 3 days. I've never been that drained from that relatively small amount of exercise before. Luckily I was able to work from home and had my laptop in bed with me, but it was a struggle with the 12 hour shifts.

I am getting frustrated since I've gained weight back, and I'm 10 lb heavier than I was at New Years, but my primary care thinks whatever issues I'm having is killing my metabolism. I'm starting back on my pre-op diet this week to try to lose a little more. If anyone has any suggestions, please let me know, I am open to them. Thanks!

[ChunkCat 728]

I'm so sorry you are struggling with this still and that you aren't able to get in with a specialist. Post viral issues are both literally and figuratively exhausting. What you experienced with the walking 4 miles and not getting out of bed for 3 days afterwards is caused "post exertional malaise" and it is common in long covid as well as things like Chronic Fatigue Syndrome. I experience it a lot. That device I linked to earlier is supposed to help you gauge where your body's threshold is regarding this and keep you right under it so that you can still be physically active without triggering that backlash. It is a really frustrating thing to experience, especially when a few months ago you could have walked that distance without issue.

I experience this still every time I try to push beyond 5,000 steps a day. This is a vast improvement over what triggered it pre-op, but it is still nowhere near where I want to be. I'm going to add in some strength training components to see if strengthening the muscle function in my body will help me be able to push the threshold up a bit, but if not I'm going to find a physiologist who can help me figure it out because I hate the physical limitations that come with these viral conditions and general deconditioning.