I'd sure quit smoking right now. I'd ask the PCP to recommend an interventional cardiologist. I'd stop eating all white carbs - like bread - which your liver makes into artery-clogging cholesterol. (Don't worry about a little fat.) No sodas and things not nutritional. And I would start walking, a little more each day. Actually I did all this, except for I never smoked.
Has your rheumy pushed on all the "tender points" to check for fibromyalgia? I got poked by 4 docs before one asked me if it hurt, which it did, but I thought they were feeling for lumps and just tolerated it. I had the blood tests, all negative too, so fibro was the one left. It causes pain all over, tiredness, possibly weakness.
I didn't get toradol shots, but tried all the other NSAIDs, max doses of Tylenol, then was put through all the "fibro drugs" which didn't help or gave me bad or awful reactions. I only get 3 tramadol a day. Rheumy says there is nothing more to try. I read an article about a study that showed a little zinc, magnesium and melatonin help with sleep. Not sleeping is a fibro thing too. Just a thought to ask the rheumy.