Saturday 24 February 2018

Post Exertion Malaise - A very foggy day

© yourachingart_cfs
Today has been a very tired, sleepy and brain fogged day.
"Post-exertional malaise (PEM), or post-exertional symptom exacerbation, describes a delayed and significant exacerbation of ME/CFS symptoms that always follows physical activity and often follows cognitive activity.PEM is a highly characteristic clinical and diagnostic feature of ME/CFS. In some respects, PEM is an illness within an illness."  - M.E. Association
The onset of PEM typically takes 24-48 hrs. Today's PEM is from Thursday's seizures.

I sleep in until lunch time (accidentally) then forced myself to get out of bed to try and help with sleep hygiene (though I would have loved to have stayed in bed all day). I've literally had to drag myself through the day. Putting on some comfy "day clothes" - jersey harem trousers, a baggy t-shirt and a cardigan. (So basically day time pj's). I then got myself downstairs and took my meds and got something to eat and drink and the lay on the sofa with my heat pad as my lower back is still spasming and half slept/half watching the TV. I did manage later int he afternoon to play a couple of rounds of Rumikub (an game) with Dad before retiring back to the sofa and my brain was fogging up and my speech was slurring. I then went back to laying on the sofa with my heated with the TV for company. Next task was to get up for tea and we had company which took a lot out of me and after a while I returned to my comfy setup on the sofa.

I just thought I'd do a little post before heading to bed and hopefully reading this you'll have learnt a bit about PEM.

The thing with PEM is it's always a catch-up day. Every day is filled with PEM from something, it is just that some days its worse than others. Days like today are my bad days when my symptoms and fatigue and functioning levels are worse where as I get other days where I can push through it.
"PEM causes intense exhaustion as well as an upswing in other symptoms that last for at least 24 hours after physical exertion. That may not sound so unusual to those unfamiliar with it — after all, we all need time to recover after a tough workout.
When it comes to PEM, though, little about it is normal or familiar to people without ME/CFS.
It's not just about overused muscles or needing a little extra rest.
PEM can range from moderately stronger-than-normal symptoms to completely disabling. In a mild case, the person may have extra fatigue, achiness, and cognitive dysfunction. In a severe case, PEM can bring on intense flu -like symptoms on top of extreme fatigue, pain, and brain fog strong enough that it's hard to even form a sentence or follow the plot of a sitcom. 
That's hardly what the rest of us go through after a hike or a trip to the gym. Also abnormal is the amount of exertion it can take to put people in this state.
As with the severity, the exertion needed to trigger PEM theories case-by-case. For some, it might kick in after a little bit of exercise on top of a day's regular activities. For others, is incredible as it may seem, it can just take a trip to the mailbox, a shower, or sitting upright for an hour."
- Very Well