First, I want to commend the International Consensus group for taking such an assertive and necessary step in redefining our illness. But one thing troubles me greatly. In the International Consensus they use the term Post-Exertional Neuroimmune Exhaustion (PENE pen ?-e). Exhaustion is just another word for fatigue. I don't have post-exertional fatigue. I have post exertion symptom exacerbation. Many of use don't feel more fatigued or exhausted after exertion. We feel sicker. Here's a definition I found on the web: Please note the word "exhaustion" in there. I don't think many doctors will soak in the fine distinction because the word "neuroimmune" is there. And we are really not at a point where we can say that our immune and nervous systems are exhausted. Sure, there is some things pointing to mitochondria problems, or our immune system being overactive, but there are also things pointing to Encephalomyelitis as a cause for immune abnormalities and neurological problems. And that's not exhaustion. I'd write to someone about this, but I don't know who to contact and whether it's too late. There is nothing wrong with simply calling it "post exertion symptom exacerbation" (pes-e) It is describes what happens, and without ignoring aspects like the other dynamics. If anyone agrees with me, maybe you can contact one or more of the authors asap. I'm so sick right now I can't do much more than write this.