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After decades of fatigue, answer finally comes for medical mystery
September 26, 2017

Nothing helped boost Justin Kipplinger’s energy level — not even a good night’s rest. The construction worker was always exhausted, and it was getting worse. Eventually, he could barely drag his weakened body from his front door to his vehicle in the morning — let alone handle a sledgehammer or perform the other physically demanding tasks his job required.

For decades, Justin noticed there was something a little off about his health.

“And then, about 15 years ago, it really started affecting me,” said Justin, who is in his mid-40s. “I started feeling like crap, especially over the last seven years.”

No one had answers. Over the years, Justin saw about a dozen doctors, and he walked out of their offices with nearly as many theories about what was sapping his vitality. Was it Lyme disease? An immune disorder? A birth defect? Some other energy-depleting condition that was yet unknown to science?

“When we first met him, he was short of breath at rest, fatigued, and essentially in shock,” said John Ryan, M.D., a cardiologist at University of Utah Health. “He had been misdiagnosed and started on the wrong meds, and he was going downhill fast. We did a heart catheterization on him.”

The procedure solved the decades-long mystery: Justin had pulmonary arterial hypertension (PAH). While the term hypertension refers to abnormally high blood pressure, PAH is a far more serious condition in which an individual has high blood pressure in the arteries between the heart and the lungs.

“When the arteries in your lungs become narrow or blocked, your heart has to work a lot harder to pump blood,” Ryan said. “Eventually, the heart muscle weakens, and that’s when heart failure can happen.”

Symptoms of the disease, including chest pain and a propensity to pass out, often creep up on an individual. Patients may attribute the tiredness to simply slowing down because of age, but that’s a dangerous assumption, Ryan said, noting that without proper treatment, Justin had less than two years to live.

Finally, after such a lengthy and fruitless search for a medical explanation, good news started to roll in. Not only did doctors know what was wrong with him, they discovered he had a particular variety of PAH that responded extremely well to medication. No surgery would be needed. In a short period of time, Justin went from death’s door to making a 180-degree turn in terms of how he was feeling. He was a new man with a chance at a new start. According to Ryan, Justin now has every opportunity to live a long, healthy and vigorous life.

“It’s just indescribable,” Justin said. “I couldn’t be more grateful. I haven’t felt this good in 20 years.”

He’d never had the energy to do many outdoor activities, but these days, Justin can be found playing a round on the golf course, hiking in the mountains, jogging and boating.

“I’m able to do all of it now,” he said with a look of wonder and gratitude. “It’s awesome.”

Learn more about the kinds of conditions treated at the Cardiovascular Center at University of Utah Hospital by checking out the center’s website.