By Karman Kregloe in Solve CFS.
One of the identifying characteristics and key symptoms of ME/CFS (myalgic encephalomyelitis / chronic fatigue syndrome) is an intolerance to even mild exertion, known as Post-Exertional Malaise or PEM. In simple terms, this means that when people with ME/CFS engage in activity – even just walking to the bathroom or making a simple meal – they experience a sudden worsening of all chronic fatigue syndrome symptoms (usually hours or days after the exertion), often aptly called a “crash” by patients. Fortunately, there are ways to quantify your limits and use a heart rate monitor to stay within those limits, thus greatly reducing post-exertional crashes.
What Exactly is Post-Exertional Malaise (PEM)?
In a study conducted by well-respected ME/CFS researcher Leonard Jason, more than 1500 adult patients from over 35 countries diagnosed with myalgic encephalomyelitis or chronic fatigue syndrome used a self-reported questionnaire to describe their experiences of PEM. Seventy-eight percent of respondents said that PEM occurred as the result of “basic activities of living,” which makes it very difficult to avoid. Patients reported that their PEM symptoms lasted anywhere from one day to six months. Most patients in the study reported limited success with pacing (staying within your exertion limits), but only about 10% of those patients used a heart rate monitor to quantify their limits.
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