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I don't recall reading this before in one of these articles: "People who are asymptomatic or have a mild case of COVID-19 can also face prolonged illness. Sometimes, these symptoms take weeks or months to appear." Perhaps it refers to organ damage rather than symptoms falling into the ME-like...

It's absolutely your choice; 'disabled' is, and has to be, a self-definition. When I was first diagnosed, 21 years after becoming ill, I found it enormously enabling in strategies such as not making unfeasible demands on myself, asking for reasonable adjustments, understanding that a powerchair...

I think the point of the Chronic Illness Inclusion Project (Leo's on their board) was that the social model can exclude chronically ill people. It's certainly something I've felt keenly over the years, as I've worked with a lot of Deaf and disabled artists; even though I had no fixed...

Yes, a much better analogy. I describe it to other people as crossing an invisible threshold, or triggering a twitchy signal. A bit like Prof. Garner being followed by his invisible speed cameras, but no-one will tell him what the speed limit is. I often don't feel myself cross the...

I wonder if this has anything useful to say about people who worsen permanently after activity that takes them beyond the PEM threshold, or after another illness?

I never get the PEM sore throat without swollen lymph nodes. Someone once explained that they swell because they've recruited additional blood cells to come and fight an infection, and because of this I assume there's some kind of immune component to PEM. If the PEM is mild, my swollen nodes...

That's really interesting, and has perhaps convinced me a little more that I don't get it. Those two symptoms are the most reliable indicators that I've overdone things, but I've never had them after working on a computer – not even after spending many hours redrafting and reorganising someone...

Just watched this morning's broadcast by the UK's Chief Medical and Scientific advisors. No mention of ongoing problems after Covid. In one sense, not surprising: we don't even have a reliable prevalence rate yet, let alone know whether most people will eventually recover, and anyway such...

I'm not convinced I can recognise PEM from cognitive activity. I might have to read several descriptions to know whether or not I get it, and whether or not it's different to PEM from physical activity. My response to too much concentration is usually after reading, and consists of a tight...

With regard to anyone else, I don't know. I suspect there are many different patterns. I've got a nearly 45-year history of ME of my own to look back on, though, and I do appear to recover – eventually. My overall level of function is far better now than in the early years, or at many different...

This makes me wonder why some can recover from accumulated PEM – eventually – whilst others seem to reach that point of no return and never recover their previous function. We so much need to unpick the mechanisms underlying this.

For me at least, my underlying level of energy impairment is probably more important. I don't developed additional exercise intolerance (above and beyond whatever is normal when I start the activity) until the underlying impairment changes. Typically, I can do low-level activity pretty...

Me too! It's something I started even as a baby, with my Dad pushing my pram around the Derbyshire peaks with a radio shoved down the side playing Test Match Special. Later, I started getting out of the pushchair to walk a bit until I got too tired, then later still we began going on hikes of...

Interesting! Thank you, I hadn't heard that. I haven't had swim coaching or read about technique and training methods since I got ME in the mid-1970s, so that's new to me. Yes, I do understand that. I use the term 'training zones' loosely, but I am comparing like with like – my own heart rate...

Oh, no – I sympathise, I'm prone to labyrinthitis. Horrible! I hope you're better soon.

PEM just baffles me. There are frequent minor exceptions, where for no obvious reason PEM doesn't match up to effort expended. I've come to expect that, but a handful of times a year there are aberrations that seem to defy all logic. I had one four weeks ago. Usually, when I'm able to swim, I...

I think it depends (as always!) on what you mean by 'fitness'. I too can build muscle in my shoulders, arms and core when ME allows me to swim – to the extent that people notice the increased shoulder tone, and I'm aware of being able to turn over and sit up in bed more easily. (I can't do the...

That's why I added 'in addition to'. I think questionnaires need to put more emphasis on the accumulation of daily or weekly activities than they do on specific types of activity. Otherwise, it can appear that people are able to do more than they really can, due to the fact that they may...

There's all that, plus judgement. Whether it's judging how to go through a door frame without colliding with it, how to phrase a sentence without offending, how hot the food on your plate might be, how long you might be able to continue standing up before your legs go, how much money you need to...

The more I read, the more I'm coming to the conclusion that the best way to estimate physical and mental fatigue levels in these studies might be to ask a short series of simple questions about general function before the illness, and then again afterwards. At least for adults, a picture of the...