I make sure I’m not overdoing it

Photo of a person tying their shoelaces

Philipp, 49 years old

“I watch out for signs I’m overdoing things, and I do something about it when I feel drained or have trouble breathing. I mostly notice my heart problem when I’m climbing the stairs, walking uphill, lifting something heavy or talking for a long time.”

Seven months ago, I had a . I’d just turned 48. Now I have heart failure as a result of the . My heart doesn’t work as well as it used to because of the damage caused when the oxygen supply was cut off.

The problem had probably started months or even years before. Because my heart wasn’t working properly, fluid had been building up in my body without me noticing it. I thought to myself: “I guess I just have to accept I weigh 115 kilos now instead of 90. I just eat too much and don’t get enough exercise.” It rattled me but I put it down to my age, habits and slow metabolism. I didn’t think a serious illness was the cause.

The medication I was given after the attack flushed all the fluid out. I lost almost 25 kilos within the space of a few days!

Both sides of my heart are affected

Unfortunately, my wasn’t diagnosed until more than a week later because my symptoms weren’t typical and I hadn’t had any heart problems before. The only thing I had was a pain that kept bugging me at the top of my back and a feeling like I needed to belch.

It was a major . One of the three main vessels was blocked so there was no blood getting to the anterior wall and apex of my heart, and parts of my left ventricle.

That means my heart failure isn’t clearly on the left or the right, it’s on both sides. My heart doesn’t pump enough blood into my body or my lungs.

Luckily, it’s recovering really well though. At the last check-up, the cardiologist could see that it was already pumping much better than three months ago.

I take a total of nine medications

I take four medications for my heart failure: a beta blocker, a diabetes medication, an anticoagulant and a medication that flushes out the excess fluid, reduces my pulse and expands my blood vessels. Apparently, these “fantastic four,” as my doctor calls them, are the four medications doctors prescribe nowadays for heart failure brought on by a .

Together, they protect the heart. The lower blood pressure means the heart doesn’t have to work as hard, more fluid is flushed out through the kidneys, the blood vessels expand and there’s no further damage to the muscle of the heart.

I also take two medications to keep my cholesterol down, two anticoagulants/antiplatelet drugs and one medication to protect my stomach.

So I take a total of nine different medications – sometimes twice a day. It can be a bit of a challenge keeping track of them all.

My low blood pressure worries me

The problem is my blood pressure is very low now. I take several medications designed to reduce blood pressure, to lessen the strain on the heart and prevent further attacks. But I think it’s a bit too much.

My blood pressure is often 90 over 60 when I get up in the morning and in the evening. That’s more or less the lowest your blood pressure can go. It only reaches 110 over 70 when I do physical exercise. That makes me feel fit and I’d really like it to be that all the time.

I’ve told the doctors but they want to keep all my meds at the current level – partly because my blood pressure is higher than normal when I’m at the doctor’s. I’m always anxious about the check-ups. It’s a real case of “white coat effect” and the results aren’t what they’d normally be without the stress.

I’m not going to stop bringing it up though because it sometimes makes me fell unwell. It makes life difficult for me at work too because I sometimes feel weak and can’t concentrate properly.

I feel safe in the cardiac rehab group

Since finishing rehabilitation, I’ve been going to a cardiac rehab group once a week. It’s really good because I can constantly push my body more while under medical supervision. I’m hooked up to an ECG and my blood pressure and pulse are measured too.

I spend the first half an hour on an exercise bike. Then I do some weight training to strengthen the most important muscles in my stomach, back, arms and legs.

It really motivates me to see the progress I’ve made. Seven months ago, I started at a level of 40 watts on the exercise bike. Five months later, I’d got to 30 minutes at 100 watts and now I’m already up to 120 watts. Another good thing about the cardio rehab group is that I get out. I have a fixed day for training and I get to talk to other people in the same situation as me.

My daily walk gives me structure

I’m now at a point where I feel confident enough to do exercise on my own. I take a brisk walk every day for one and a half hours. That’s really important to me – it gives me something to structure my day around and I always do it. I don’t even think about it anymore. I just know I have to do it and I do it. Period.

I bought myself a smartwatch that measures and records my heart rate. That way, I know I’m not overdoing it. I know up to 100 beats per minute is okay, but not any higher. It’s very comforting to have that information.

The watch also means I can keep track of my progress because it’s all recorded. Three weeks ago, it took me much longer to do my route than it does now, for instance. Achievements like that motivate me to carry on. I can see I’m getting stronger from week to week. I’m actually fitter today than I was before the !

Rehabilitation was really important

On the post-surgery rehabilitation program, they adjusted my medication and I started doing cardio exercise and pushing my body more. They also ran courses where I learned a lot about my illness: the causes, and also the risk factors and what I can do to control them. It motivated me to do what I can to make sure it doesn’t happen again.

As well as exercising regularly, I’m more careful about what I eat now. I steer clear of animal fats so things like scrambled eggs with bacon or butter. Instead, I use cream cheese or margarine or eat my bread without any fatty spreads.

I also stopped smoking – right away. The day I had surgery after the was also the day I had my last cigarette. The shock was enough to make me quit. I can still feel the mental dependency – there are typical situations, mostly stress, when I crave a cigarette. But they’re much less common now.

Relaxation techniques like muscle relaxation helped me

When it all happened, I didn’t feel anything to start with. I just sort of functioned and didn’t have time to be scared. My wife was the one who was scared.

But it was depressing to be feel so knocked out and feeble. The post-surgery rehabilitation program really helped me process everything and learn how to cope with the new challenges. Part of it was learning to change habits and look after yourself.

We learned some relaxation techniques too – a new one every two days so we could each decide which one worked best for us. Progressive muscle relaxation was great for me. You tense each muscle in your body, one by one, and then quickly let go. That’s my back-up when I get very stressed and realize it’s getting out of control.

Now I’m more aware of my own limits

I’ve made a lot of changes. I take better care of myself and realize earlier when I’m overdoing things. And I’ll say no to things before they even get a chance to get too much for me. That was a radical change in my mindset.

At work, I don’t feel I have to do everything myself. I’m happy to delegate tasks to colleagues who’re younger and fitter than me. I look after myself better and I’m more aware of my own limits. And other people do actually accept that, which is also good to know.

I don’t feel too restricted. I’ve always been one of those people who don’t try to do more than they’re comfortable with. People who’re used to always giving 120 per cent probably have more trouble coping with this sort of illness.

I take a break when I feel drained or have trouble breathing

I watch out for signs I’ve been overdoing things, and I do something about it. If I spend 45 minutes on the phone, for instance, I run out of breath. I notice I can’t finish my sentences properly or I can only say every second word. Three or four months ago, I would only have been able to talk for ten minutes.

Climbing stairs is more difficult as well. I have to walk slower and take lots of breaks. And I can’t lift anything heavy yet.

In hindsight, I remember I’d been feeling less and less fit and actually had the same symptoms six months before the . So I unconsciously started avoiding strenuous activity and put it down to my age. I thought to myself: “Jeez, you really have to lose weight and quit smoking.” But it didn’t occur to me it was anything to do with my heart.

I’ve had to make some changes at work too

In my job, going back to work when you’ve got a health problem isn’t that easy. I work in film and TV, assembling and dismantling stages and organizing everything that involves. My work is always project-based and we often work 80 hours per week when we’re on a project. So it’s a bit difficult to say: “I’m only going to work half-days now.”

Where possible, they assign me to TV studio projects that only last one or two days now. But there’s no guarantee. Next week or the week after, I might have to fight to only do 40 hours instead of 60 or 70.

I do more organizational work now, mostly from a desk. One good thing has come out of my illness – I find it much easier to stand up for myself and only work normal working hours.

A few things have changed in my relationship

After a , it takes a long time to recover and regain your strength. It’s a gradual process. I can’t help my wife as much as I used to because I can’t exert myself as much.

You avoid overdoing things sexually as well – without even realizing you’re doing it. The good thing is that we’re able to talk about and agree on these things.

My wife suffered more than me in terms of mental health. It was really a big shock for her. She was worried I’d die on the operating table and she kept worrying about me afterward too. She ended up having panic attacks and worrying she might have a herself. She had the same symptoms as me but they couldn’t find any physical causes. It was her anxiety. She started psychotherapy to help her get through things. It’s doing her the world of good.

Today, I’m grateful I survived and I enjoy every moment. I make adjustments so I don’t overdo things and I follow all the recommendations I’ve been given: no more smoking, healthy eating habits, exercise and no alcohol. They are, quite literally, life savers.


Our real-life stories summarize interviews with people who are affected by the medical condition. Our interview partners have given us permission to publish their stories. We would like to express our sincere thanks to them.

The real-life stories give an insight into how other people cope and live with a medical condition. Their opinions and comments are not recommendations by IQWiG.

Please note: The names of our interview partners have been changed to protect their identity. The photos are of models.

Comment on this page

What would you like to share with us?

We welcome any feedback and ideas - either via our form or by gi-kontakt@iqwig.de. We will review, but not publish, your ratings and comments. Your information will of course be treated confidentially. Fields marked with an asterisk (*) are required fields.

Please note that we do not provide individual advice on matters of health. You can read about where to find help and support in Germany in our information “How can I find self-help groups and information centers?

Über diese Seite

Created on November 28, 2023

Next planned update: 2026


Institute for Quality and Efficiency in Health Care (IQWiG, Germany)

How we keep you informed

Follow us on Twitter or subscribe to our newsletter or newsfeed. You can find all of our films online on YouTube.