What's your first/last sign of PEM?

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To put my data-science lessons to work, I'm trying to develop an early-warning system for PEM. I would appreciate others' input:

For some of us, there's a delay between overexertion (or whatever the trigger is) and the onset of full PEM. In my case, it's often 36-48 hours before the huge increase in pain, weakness, and exhaustion make it clear that I'm in PEM. I'm pretty sure that I would suffer less if I started resting during that mystery period of 36-48 hours, which I call 'early PEM.'

If you also experience a delay before full PEM sets in: 1) have you noticed any changes during the period of delay that make it clear that you've triggered PEM? For example, I used to burp a lot during early PEM.

Also, there's a similar period, which I call 'late PEM,' when I feel fairly normal until I engage in some light activity. This overexertion ends up deepening and extending my suffering. So I also wonder: 2) Do you have a clear sign that PEM has completely ended? What's your last symptom to go away?

Currently, I'm just trying to find an easy - possibly automated - way to diagnose 'early' and 'late' PEM. Some of this effort is for class projects, and partly it's just a self-interested hobby. If it works, then the goal is to turn my method into some sort of app.
 

Wishful

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He's asking for signs before the more common symptoms of PEM. A list of all the uncommon symptoms we experience in addition to the common PEM ones would be lengthy, and not of much use for his project.
 
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1) Phone calls, chatting with a person for 1 hour or so, or me actually doing an errand- can trigger a nearly immediately Zombie Coma- extreme sleepiness about an hour after the CHAT or Lunch or ERRAND.

This MIGHT not necessary continue into full bore PEM but often does.

2) More classic delayed PEM happens....typically the first symptom is my eyes are a mess- my eyes cycle tremendously from pouring to dried out to boulders and rocks to blurry vision and the rest.

The tinnitis starts to come on early in the day- with Brain Crunching (grimacing, something neurological tied in with the tinnitis.)

3) something gut or food induced - IBSd events...often include a PEM crash with particular qualities...mostly the neurological/immune system stuff.
 
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Id suggest ibn that period before crash looking for

increase in heart rate - may just be 10bpm but if you know your resting level well youd be able to tell

talking at a different rate. Id wonder about too rapid talking or more frequently

both of these woukd indicate a “revved up” high andrebergic state that im guessing may precede the crash

but there are diffeent models. Maybe we need time for inflammatory cells to be recruited and multiply. Not sure what woukd signal that. Maybe even feeling better than baseline is a clue (for a variety of reasons)

whats responsible for delay in DOMS? Maybe thats anotger avenue
 

hapl808

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For me, persistent and unpleasant acid reflux (coughing, clearing throat, etc) is often a sign of an oncoming PEM crash. Various interventions (from slippery elm to Pepcid to marshmallow to mastic gum) can lessen the acid reflux part, but the PEM crash still comes anyways.

Sometimes when I overdo it (especially from mental exertion), I'll start getting twinges of the acid reflux immediately. Then usually within 24 hours the full acid reflux starts, then the full PEM crash (headaches, total exhaustion, blurry vision, more severe cognitive issues, etc) starts after that.
 

Woof!

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If you also experience a delay before full PEM sets in: 1) have you noticed any changes during the period of delay that make it clear that you've triggered PEM? For example, I used to burp a lot during early PEM.
Either my arms or my legs (or both) start to drag and feel heavy (if physical PEM)
OR I start to confuse or slur my words or stare at things without a plan for what to do (if mental PEM)

Also, there's a similar period, which I call 'late PEM,' when I feel fairly normal until I engage in some light activity. This overexertion ends up deepening and extending my suffering. So I also wonder: 2) Do you have a clear sign that PEM has completely ended? What's your last symptom to go away?
I totally understand and relate to your description of what you call "late PEM," tho' I wouldn't call it that exactly. Answering your question is hard because I wake each morning with the expectation that I'm going to feel better. Some days, that's the case. Others, it isn't.
 
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Generally- I"m seeing that digestion unravels (IBS-d type), and this can come on as the First Sign as it starts up in the night when I"m sleeping.....

Blaming food/what I ate/ or when I ate it...is very common. (and then I see I ate the very same thing the day before and it was fine)

Today I feel truely awful, and thats from a bit of physical exertion doing two errands yesterday. Now those errands very much were not worth it.
 

blueberry

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A tingling tongue, when I've overdone it, often alongside a strange feeling of energy despite a sense of "running on empty" but being wired and wanting to do more. Those are my early warning symptoms of PEM. One of my PEM symptoms is swollen glands in my neck/jaw area, these going down are ususally a sign that the PEM is passing. But I feel like I'm in PEM full time at the moment :(
 
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Usually, it is the first thing I realize when I wake up in the morning - it's either good or bad. Good means energy and lightness in my lower back and legs - there is the core of all my symptoms: if my legs and back are heavy the rest is usually as bad too.

If it is good, then the rest of the day will be great too. If bad, the happy day(s) are over for months...
 

Woof!

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often alongside a strange feeling of energy despite a sense of "running on empty" but being wired and wanting to do more.
That strange feeling of energy is due to adrenaline, and somewhere on PR is a link to an article on how it connects to PEM. Interesting article.
 
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For me, persistent and unpleasant acid reflux (coughing, clearing throat, etc) is often a sign of an oncoming PEM crash. Various interventions (from slippery elm to Pepcid to marshmallow to mastic gum) can lessen the acid reflux part, but the PEM crash still comes anyways.

Sometimes when I overdo it (especially from mental exertion), I'll start getting twinges of the acid reflux immediately. Then usually within 24 hours the full acid reflux starts, then the full PEM crash (headaches, total exhaustion, blurry vision, more severe cognitive issues, etc) starts after that.
Have you had theories as to why the reflex occurs?
 

hapl808

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Have you had theories as to why the reflex occurs?
Nothing very solid. My guess is neurotransmitter related as that would explain why it happens after mental activity as well as physical activity, and many neurotransmitters are in the gut. So potentially improperly regulated dopamine-glutamate-GABA? But that's not particularly actionable. I've tried all kinds of supplements that should work on either neurotransmitters or directly on reflux, and haven't gotten reliable results.
 

wabi-sabi

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I haven't paid enough attention to this, clearly.

Ironically, I think my best sign of oncoming PEM is feeling good, especially if I'm getting PEM from something physical. If I do enough stuff to get an emotional boost- yippee, I got something done! that is enough to put me in PEM. Any day that I go to bed happy that I have accomplished something, I know I will wake up feeling just awful the next day. It's hard to say how I know it's going away. I never feel normal anymore, just less impaired some days and lately I've been in a constant crash anyway. Can't remember what not crashed feels like, so not sure if I'm just getting worse or just can't dig myself out of the crash, since I do need to eat and bathe every once in a while.

Sure makes it hard to avoid.