Julie Hunter is no stranger to chronic illness. The personal trainer and chronic illness movement coach had lived with conditions like fibromyalgia and symptoms from a traumatic brain injury for years before she became sick with COVID-19 in August 2020.
But Hunter says that her bout with COVID caused her to develop a symptom she had never experienced before – post-exertional malaise – that profoundly impacted her ability to exercise.
“It took a while for it to become evident that I was dealing with post-exertional malaise because at first, I wasn’t pushing my body. I was resting and completely cutting out intentional movement,” says Hunter.
Five months after her acute COVID infection, Hunter began to experiment with reintegrating more activity. It was then that she began experiencing intense “crashes.”
“It wasn’t just the intense fatigue I was experiencing in the earlier months [with COVID],” Hunter says. “I was feeling intense flu-like symptoms and extreme pain, [even after just] walking for 15 minutes.”
Because of her history with chronic illness, Hunter says she was already familiar with the term “post-exertional malaise,” also known as post-exertional neuroimmune exhaustion or post-exertional symptom exacerbation (PESE), before receiving her diagnosis for myalgic encephalomyelitis, or ME/CFS, six months after her mild COVID-19 infection.
PESE is the hallmark symptom of ME/CFS, a highly disabling and
still largely misunderstood complex multi-system chronic illness often triggered by a viral or bacterial infection. PESE affects people differently but is generally defined as the worsening of symptoms after even minor physical or mental activity. These symptoms vary person to person but often include muscle and joint pain, sleep disturbances, migraine, nausea, brain fog and other flu-like symptoms that can arise anywhere from 12 to 48 hours after exertion and last
hours to months at a time.
