It has recently come to my attention that some patients report PEM lasting less than 24 hrs. This surprised me, perhaps because my experience with people with ME/CFS/SEID has shown much longer recovery periods. However, all the people I know personally have moderate/severe ME/CFS/SEID, so my perception may be skewed. I think of PEM as extremely debilitating. A day or two of PEM, while abnormal, doesn't seem as life-destroying as the condition is, in general.
It seems to me if I had PEM that lasted only one day, I'd be able to do much, much more than I do now. Yeah, I'd have to take a day of rest, even in bed, but it would be worth it to be able to go for a walk in the woods once in a while, for example. I wouldn't think twice about doing a 2-day CPET if the resulting PEM only lasted a day or two. I know many patients are very concerned about PEM from a 2-day CPET crashing them for long periods, or even permanently, so surely I'm not alone in having a long recovery period from PEM.
So now I'm curious -- how long does your PEM last typically?
I'll go first. My PEM takes 4-5 days to hit, but it hits like a truck. I feel fine, and then a few hours later I'm like death warmed over. I get extreme exhaustion (not a little fatigue), muscle pain and stiffness, muscle weakness, significant increase in cognitive dysfunction, sore throat, swollen glands. Often I have other symptoms as well, but that varies. Previously, these symptoms would continue for 3-6 weeks, often for months, even with bedrest.
Now that I'm as functional as I've ever been with this illness (thanks to many symptomatic treatments), my PEM threshold is higher. My most recent PEM episode was the mildest I've ever had, lasting only 10 days. I was able to work about half my normal work schedule, but spent all my remaining time in bed recovering. I thought that was pretty good for PEM.