Immediate PEM (without delay)?

[Mrparadise]

Dear PR

If I am correct, the symptoms of PEM usually set in 24-72 hours after the exertion. For me though, it is pretty much just after the "draining event" itself, when I start to notice the symptoms of PEM. As I have POTS as well it could be related to that but I wanted to ask if some of you also have almost no delay. As I am mild, I do sometimes do some push-ups (maybe 15 in a row) and as soon as I am done I get very tired with muscle aches and a really high HR which stays high for a very long time. Also I feel pretty depressed after over doing it.

Many thanks in advance for your inputs!

 

[Howard]

My P.E.M. typically kicks in between 15 and 20 minutes after any physical exertion or physical touch (direct pressure applied to any muscles - ex. If someone were to wash my feet).

The duration is based upon multiple factors.. all relating to the amount of muscle stimulation. Washing my feet merely leaves me with a poisoned/exhausted feeling for 20 to 30 minutes. Significant bodily movement may keep me down and out for up to eight hours.

I seem to feel few of any side effects the next day, or days beyond the exertion. Although I may feel a general tiredness.

I used to have POTS, too, but was able to resolve that by balancing out my electrolytes and nutritional intake.

H

 

[Springbok1988]

Back when I was mild, PEM would set in right after the trigger. Now that I’m moderate-severe, it sets in the morning after the event.

 

[helen1]

For me, PEM is not delayed. It happens during or right after over-exertion.

 

[Mrparadise]

Okay so that means that it is not really unusual to experience PEM just after the trigger - thanks to everyone for your responses!

 

[Rufous McKinney]

Okay so that means that it is not really unusual to experience PEM just after the trigger

If my case, particular talking or chatting to someone can lead to a near zombie coma and almost semi-conciousness narcoplepsy...very quickly thereafter- within 20-30 minutes.

But thats not as typical if the PEM stemmed from more normal over exertion. i sometimes pull out of the Zombie state and dont get further PEM (but mostly, the rest of the symptoms arrive the next day).

 

[Wishful]

If my case, particular talking or chatting to someone can lead to a near zombie coma and almost semi-conciousness narcoplepsy...very quickly thereafter- within 20-30 minutes.

While my symptoms weren't quite that dire, socializing did trigger PEM in around that time frame. Once I understood that, I just gave up socializing.

My physically-induced PEM had a consistent 24 hr delay. My guess is that physical exertion triggered cytokine release after that time delay (the immune system can have very consistent time delays, even for several days) and those cytokines triggered the brain's role in generating PEM symptoms. Maybe it's 23.5 hrs for the t-cells to do their part, plus 30 minutes for the glial cells to do their part.

For those with rapid response PEM, what's your minimum delay from starting the exertion? Maybe the trigger is the cognitive effort of forcing your muscles to work (and knowing what the result will be).

 

[Rufous McKinney]

Once I understood that, I just gave up socializing.

I rarely socialize as there is no body interested.

I was upset, not invited to the downstairs birthday party outside. All the other neighbors there, but me not invited. i decided they are all really rude. My view of humanity, plummetted further.

I moaned to my daughter of course- she said" Typical" (that I waasn't invited).

Then she says: "You wouldn't have gone"....

(that was funny, had beemy husband and I beenn invited, I'd have gotten really stressed out, I have no gift for this 4 year old, and cannot chat more than 20 minutes without a big PEM pay off.)

 

[Rufous McKinney]

Maybe the trigger is the cognitive effort of forcing your muscles to work (and knowing what the result will be).

well, I'm not really usign muscles...its using thoughts and a bit of jaw/vocal chords.

It feels to me like quick onset cognitive PEM is running out of ATP.

And physical stuff is more involved in- LPS leaks, lactate issues, burning wastes and processing muscle stuff.

 

[Wishful]

And physical stuff is more involved in- LPS leaks, lactate issues, burning wastes and processing muscle stuff.

My experience is that my PEM was not triggered by duration of exertion, it was triggered by straining muscles in ways they weren't used to, which damages some cells, which triggers the immune system, which 24 hrs later releases IFN-g, which triggers the glial cells (and increased IDO and thus TRP-KYN conversion). I doubt that climbing a few steps up a ladder, or washing a window for a minute or so would cause those other results you list. The 24 hr delay for IFN-g rise from exertion is well known. Not proof that it's responsible for PEM, but it does fit nicely.

 

[Seadragon]

For me, PEM is not delayed. It happens during or right after over-exertion.

Same here most of the time.

 

[seamyb]

When I was more severe It would be the day after exertion. Now that I'm mild it seems to be immediate. Although there was a period where I had no PEM at all (while still pacing), but a pretty constant fatigue.

It's a mindfuck of a symptom. It does what it wants.

 

[Rebecca under the papyrus]

When I do just a bit too much I will be very exhausted immediately, which also comes with muscle pain and feeling shitty. But this will be better the next day.
When I do enough to trigger PEM, I will be more exhausted right after exertion, but the real PEM kicks in the next morning and takes 2-3 weeks to clear up.
When I was milder it was also the next day, but lasted only a few days.

 

[Howard]

Along these same lines, does the type of P.E.M. (nearly instantaneous, or delayed by 24-plus hours) point towards a particular brand of CFS/ME.. and/or somehow indicate which coarse of P.E.M. recovery action(s) to take?