Post Exertional Malaise (PEM)
What is Post-Exertional Malaise (PEM)?
Post-exertional malaise (PEM) is a severe worsening of the symptoms in ME/CFS patients. ME/CFS or Myalgic Encephalomyelitis / Chronic Fatigue Syndrome is a complex and disabling illness, hard to diagnose and treat.
People who suffer from this illness experience unbearable headaches, severe joint and muscle pain, fatigue, dizziness, loss of memory, devastating weakness, tiredness, and non-restorative sleep. Due to the debilitating symptoms, ME/CFS patients are disabled to do their daily routines as before the illness.Â
What’s happening during PEM?Â
When ME/CFS patients perform physical, mental, emotional, or orthostatic efforts, the body gets tired and worn out much more quickly than in healthy individuals. Losing enormous amounts of energy leaves the person breathless and disabled.
The worsening of the symptoms kicks in between 24 and 48 hours after the activity, which is when the patients feel severe pain and weakness. Most of the time, they end up bed-bound for a couple of weeks. PEM is like energy debt, so the less you owe, the sooner you’ll pay it off.
Medical professionals refer to this phenomenon as a “crash” since it describes the body’s response to surpassing its energy capacity. When individuals with ME/CFS engage in physical, mental, emotional, or orthostatic activities, their bodies struggle to adequately deliver oxygen and glucose, depleting their energy reserves and causing a system breakdown.
The doctors recognize this issue as a “crash” because the body crashes after exceeding the energy use. When ME/CFS patients perform any physical, mental, emotional, or orthostatic effort, their bodies don’t deliver oxygen and glucose correctly, so the system stays without reserves and practically fails.
PEM – ME/CFS connectionÂ
The most evident factor for improving this condition is to limit the activity to available energy and allow physical and cognitive breaks throughout the day. Don’t rush through your activities, stretch them out, and schedule breaks between your tasks. Opt for limited or abbreviated activities, to avoid PEM if suffering from ME/CFS.