Fatigue

What is fatigue?

Fatigue is a feeling of weariness, tiredness, or lack of energy. It can interfere with your usual daily activities. Fatigue can be a normal response to physical activity, emotional stress, boredom, or lack of sleep. But sometimes it can be a sign of a mental or physical condition. If you have been feeling tired for weeks, contact your health care provider. They can help you find out what's causing your fatigue and recommend ways to relieve it.

What causes fatigue?

Fatigue itself is not a disease; it's a symptom. It can have many different causes, including pregnancy and various medical problems, treatments, and lifestyle habits such as:

• Medical problems:
  • Chronic (long-lasting) diseases such as diabetes, COPD (chronic obstructive pulmonary disease), and heart, liver, kidney and thyroid diseases
  • Untreated pain and diseases like fibromyalgia
  • Anemia
  • Infections
  • Parkinson's disease
  • Sleep apnea and other sleep disorders
  • Recent stroke
  • Mental disorders such as depression and anxiety
• Treatments:
  • Cancer treatments such as chemotherapy, radiation, and bone marrow transplants
  • Recovering from major surgery
  • Taking certain medicines, such as antidepressants, antihistamines, and medicines for nausea and pain
• Lifestyle habits:
  • Not getting enough sleep
  • Staying up too late
  • Drinking too much alcohol
  • Substance use
  • Having too much caffeine (which can keep you from getting a good night's sleep)
  • Getting too little or too much exercise

Overwhelming fatigue is part of a disorder called myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). The fatigue caused by this disorder is different from a tired feeling that goes away after you rest. Instead, the fatigue in ME/CFS lasts a long time, does not get better with rest, and limits your ability to do ordinary daily activities.

What can I do to manage fatigue?

If you've had fatigue that does not get better after several weeks, call your provider. They will ask questions about your sleep, daily activities, appetite, and exercise. They will likely do a physical exam and order lab tests. Once they decide on a diagnosis, they can tell you what treatments might help.

You can also make some lifestyle changes to feel less tired:

• Get regular physical activity
• Improve your sleep habits
• Stop smoking (if you smoke), since smoking is linked to many diseases that can cause fatigue
• Manage stress
• Eat a healthy diet and avoid alcohol

It also may be helpful for you to keep a fatigue diary. This can help you find patterns throughout the day, such as when you feel more tired and when you have more energy. It can also help you plan for activities that may give you more energy.

NIH: National Institute on Aging

Flu Shot

What is the flu?

The flu (influenza) is a respiratory infection. It is caused by influenza viruses that infect your nose, throat, and lungs. These viruses can spread from person to person.

Most people with the flu get better on their own, without medical care. But for some people, the flu is serious. It can cause complications and sometimes even death. People who are 65 and older, under age 5, pregnant, or have certain health conditions are at higher risk of flu complications.

Getting vaccinated against the flu each year is best way to lower your risk of the flu and its complications.

What are the benefits of getting a flu shot?

There are many reasons to get a flu shot each year:

• It may keep you from getting sick with the flu.
• If you do get the flu, it may be less severe. You may also be less likely to have complications or need to be hospitalized with the flu.
• If you have certain chronic health conditions, getting a flu shot may help prevent the flu from making your condition worse. For example, if you have COPD or diabetes, the flu can worsen your condition so much that you might need to be hospitalized. Getting a flu shot can lower this risk.
• Getting the vaccine during pregnancy not only helps protect you from the flu during and after pregnancy. It also helps protect your baby from flu during their first few months of life.
• It has been shown to lower the risk of severe life-threatening flu in children.
• It may also protect the people around you, including those who are at higher risk of complications.

How do flu shots work?

The flu vaccine causes your immune system to make antibodies about two weeks after you get the shot. These antibodies provide protection against infection with the flu viruses that are in the vaccine.

Who needs a flu shot?

The U.S Centers for Disease Control and Prevention (CDC) recommends annual flu shots for everyone 6 months and older, with a few rare exceptions.

Flu shots are especially important for people who are at high risk of developing serious complications from the flu.

There are different types of flu vaccines. There are injectable vaccines (shots) and nasal spray vaccines. There are also some vaccines especially for people 65 and older. Ask your health care provider which one is right for you.

Who should not get a flu shot?

There are some people who should not get a flu shot:

• Children younger than 6 months of age.
• Have severe, life-threatening allergies to flu vaccine or any ingredient in the vaccine. This might include gelatin, antibiotics, or other ingredients.

Some people need to talk to their provider before they get a flu shot. They include people who:

• Have an allergy to any of the ingredients in the vaccine.
• Have ever had Guillain-Barre syndrome(GBS). Some people with a history of GBS should not get a flu vaccine.

If you are moderately or severely ill, you usually need to wait until you recover before getting a flu shot.

Why do I need a flu shot every year?

You need to get a flu shot every year because:

• Your immune protection from the vaccine declines over time. You need to get the shot every year to boost that protection.
• Flu viruses are constantly changing, so every year, the flu vaccine is updated. The flu vaccine will include protection against the viruses that will most likely be common during the upcoming flu season.

When should I get the flu shot?

For most people who need only one dose of the flu vaccine for the season, September and October are usually good times to get it. It's best to be vaccinated by the end of October.

Some children need two doses of the flu vaccine. They should get their first dose as soon as the vaccine is available. They need to get the second dose at least four weeks after the first.

If you are pregnant, talk to your provider about when to get the vaccine. When you should get it can vary, based on how far along you are in your pregnancy.

Do flu shots cause side effects?

Flu vaccines have been shown to be safe. But like any medical product, they can cause side effects. If you have any side effects, they are usually mild and go away on their own within a few days. Common side effects include:

• Soreness, redness, and/or swelling from the shot
• Headache
• Fever
• Nausea
• Muscle aches

The flu shot, like other injections, can occasionally cause fainting. In rare cases, some people have a serious allergic reaction.

Centers for Disease Control and Prevention

Heart Failure

What is heart failure?

Heart failure means that your heart can't pump enough oxygen-rich blood to meet your body's needs. Heart failure doesn't mean that your heart has stopped or is about to stop beating. But without enough blood flow, your organs may not work well, which can cause serious problems.

Heart failure can affect one or both sides of your heart:

• With right-sided heart failure, your heart is too weak to pump enough blood to your lungs to get oxygen.
• With left-sided heart failure, your heart can't pump enough oxygen-rich blood out to your body. This happens when the left side of your heart becomes either:
  • Too weak to pump enough blood.
  • Too thick or stiff to relax and fill with enough blood.

Left-sided heart failure is more common than right-sided heart failure.

What causes heart failure?

Heart failure can start suddenly after a medical condition or injury damages your heart muscle. But in most cases, heart failure develops slowly from long-term medical conditions.

Conditions that can cause heart failure include:

• Arrhythmia (a problem with the rate or rhythm of your heartbeat)
• Cardiomyopathy
• Congenital heart defects or other types of heart diseases that you are born with
• Coronary artery disease
• Endocarditis
• Heart attack
• Heart valve diseases
• High blood pressure
• A blood clot in your lung
• Diabetes
• Certain severe lung diseases, such as COPD (chronic obstructive pulmonary disease)
• Obesity

Over time, left-sided heart failure can lead to right-sided heart failure.

Who is more likely to develop heart failure?

Heart failure can happen at any age. It happens to both men and women, but men often develop it at a younger age than women. Your chance of developing heart failure increases if:

• You're 65 years old or older. Aging can weaken and stiffen your heart muscle.
• Your family health history includes relatives who have or have had heart failure.
• You have changes in your genes that affect your heart tissue.
• You have habits that can harm your heart, including:
  • Smoking
  • Eating foods high in fat, cholesterol, and sodium (salt)
  • Having an inactive lifestyle
  • Alcohol use disorder (AUD)
  • Illegal drug use
• You have other medical conditions that can affect your heart, including:
  • Any heart or blood vessel conditions, including high blood pressure
  • Serious lung diseases
  • Infection, such as HIV or COVID-19
  • Obesity
  • Diabetes
  • Sleep apnea
  • Chronic kidney disease
  • Anemia
  • Thyroid disease
  • Iron overload disease
  • Cancer treatments that can harm your heart, such as radiation and chemotherapy
• You are African American. African Americans are more likely to develop heart failure and have more serious cases at younger ages than people of other races. Factors such as stigma, discrimination, income, education, and geographic region can also affect their risk of heart failure.

What are the symptoms of heart failure?

The symptoms of heart failure depend on which side of your heart is affected and how serious your condition has become. Most symptoms are caused by reduced blood flow to your organs and fluid buildup in your body.

Fluid buildup happens because the flow of blood through your heart is too slow. As a result, blood backs up in the vessels that return the blood to your heart. Fluid may leak from the blood vessels and collect in the tissues of your body, causing swelling (edema) and other problems.

Symptoms of heart failure may include:

• Feeling short of breath (like you can't get enough air) when you do things like climbing stairs. This may be one of the first symptoms you notice.
• Fatigue or weakness even after rest.
• Coughing.
• Swelling and weight gain from fluid in your ankles, lower legs, or abdomen (belly).
• Difficulty sleeping when lying flat.
• Nausea and loss of appetite.
• Swelling in the veins of your neck.
• Needing to urinate (pee) often.

At first you may have no symptoms or mild symptoms. As the disease gets worse, your symptoms will usually bother you more.

What other problems does heart failure cause?

Fluid buildup and reduced blood flow to your organs can lead to serious problems, including:

• Breathing problems from fluid in and around your lungs (also called congestive heart failure)
• Kidney or liver damage, including cirrhosis
• Malnutrition if fluid buildup makes eating uncomfortable or if your stomach doesn't get enough blood flow to digest food properly
• Other heart conditions, such as irregular heartbeat and sudden cardiac arrest
• Pulmonary hypertension

How is heart failure diagnosed?

To find out if you have heart failure, your health care provider will

• Ask about your medical history, including your symptoms
• Ask about your family health history, including relatives who have had heart failure
• Do a physical exam
• Likely run heart tests and blood tests, including a brain natriuretic peptide (BNP) test

In some cases, your provider may refer you to a cardiologist (a doctor who specializes in heart diseases) for tests, diagnosis, and care.

What are the treatments for heart failure?

Your treatment will depend on the type of heart failure you have and how serious it is. There's no cure for heart failure. But treatment can help you live longer with fewer symptoms.

Even with treatment, heart failure usually gets worse over time, so you'll likely need treatment for the rest of your life.

Most treatment plans include:

• Taking medicine
• Eating less sodium and drinking less liquid to control fluid buildup
• Making other changes, such as quitting smoking, managing stress, and getting as much physical activity as your provider recommends
• Treating any conditions that may make heart failure worse

You may need heart surgery if:

• You have a congenital heart defect or damage to your heart that can be fixed.
• The left side of your heart is getting weaker and putting a device in your chest could help. Devices include:
  • An implantable cardioverter defibrillator.
  • A biventricular pacemaker (cardiac resynchronization therapy).
  • A mechanical heart pump (a ventricular assist device (VAD) or a total artificial heart).
• Your heart doctor recommends a heart transplant because your heart failure is life-threatening and nothing else is helping.

As part of your treatment, you'll need to pay close attention to your symptoms, because heart failure can worsen suddenly. Your provider may suggest a cardiac rehabilitation program to help you learn how to manage your condition.

Can heart failure be prevented?

You may be able to prevent or delay heart failure if you:

• Work with your provider to manage any health conditions that increase your risk of developing heart failure
• Make healthy changes in your eating, exercise, and other daily habits to help prevent heart disease

NIH: National Heart, Lung, and Blood Institute

Legionnaires' Disease

What is Legionnaires' Disease?

Legionnaires' disease is a serious type of pneumonia caused by Legionella bacteria. The disease got its name when a group of people at an American Legion convention became ill with this type of pneumonia.

Legionella is found naturally in freshwater, such as lakes and rivers. It can also be found in soil. But people usually only get sick from it when if it grows and spreads in man-made water systems. These systems can include hot tubs, fountains, and the plumbing systems of large buildings, such as hotels or nursing homes.

Legionella can also cause Pontiac fever. This is a milder, flu-like illness that doesn't infect your lungs.

What causes Legionnaires' disease?

You usually can't get infected by drinking water that contains the bacteria unless you aspirate it (accidentally breathe the water into your lungs). The bacteria don't spread from person to person. Disease outbreaks happen when many people are exposed to the same water source that contains the bacteria.

Who is more likely to develop Legionnaires' disease?

Most healthy people who come in contact with the bacteria do not become sick. You are more likely to develop an infection if you:

• Are over the age of 50
• Are a current or former smoker
• Have a chronic (long-lasting) disease such as diabetes or kidney failure
• Have a chronic lung disease such as COPD or emphysema
• Have a weakened immune system due to a disease such as HIV or cancer or are taking medicines that suppress your immune system
• Live in a long-term care facility
• Have recently stayed in a hospital or had surgery requiring anesthesia

What are the symptoms of Legionnaires' disease?

The symptoms usually show up 2 to 14 days after you were exposed to Legionella bacteria. Most of the symptoms are similar to those of other types of pneumonia. But Legionnaires' disease may also cause gastrointestinal symptoms and mental changes.

The symptoms of Legionnaires' disease may include:

• Cough
• High fever
• Chills
• Headache
• Chest pain
• Shortness of breath
• Fatigue
• Nausea and vomiting
• Diarrhea
• Confusion

What other problems can Legionnaires' disease cause?

Legionnaires' disease can cause life-threatening complications such as respiratory failure, kidney failure, and sepsis.

About 1 out of every 10 people who get sick with Legionnaires' disease will die from complications of the illness.

How is Legionnaires' disease diagnosed?

To find out if you have Legionnaires' disease, your health care provider will probably order a chest x-ray to see if you have pneumonia. If you do have it, lab tests such as a urine or sputum test can check for the Legionella bacteria. Your provider may also order a blood test to see if you have been exposed to the bacteria.

What are the treatments for Legionnaires' disease?

If you have Legionnaires' disease, you will likely need care in a hospital. The treatment is with antibiotics. Most people will recover, especially if they were healthy when they got the disease. Getting treatment early can increase the chances of getting better.

Can Legionnaires' disease be prevented?

You can lower your risk of getting Legionnaires' disease if you:

• Clean all your water-related devices regularly. This could include portable humidifiers, water heaters, air conditioners, and nasal rinses.
• If you haven't used your faucets and showerheads for a week or more, flush them by letting the hot and cold faucets run for at least two minutes before use.
• Avoid exposure to water sources such as decorative foundations or hot tubs if you don't know how well they are maintained.
• Use windshield cleaner in your wiper fluid tank in your car instead of water.
• Ask about how well your buildings' water systems are maintained.

Centers for Disease Control and Prevention

Lung Diseases

When you breathe, your lungs take in oxygen from the air and deliver it to the bloodstream. The cells in your body need oxygen to work and grow. During a normal day, you breathe nearly 25,000 times. People with lung disease have difficulty breathing. Millions of people in the U.S. have lung disease. If all types of lung disease are lumped together, it is the number three killer in the United States.

The term lung disease refers to many disorders affecting the lungs, such as asthma, COPD, infections like influenza, pneumonia and tuberculosis, lung cancer, and many other breathing problems. Some lung diseases can lead to respiratory failure.

Dept. of Health and Human Services Office on Women's Health