Is PEM cumulative? - public thread

Jonathan Edwards said:
I don't quite follow which way you think it fits. According to Myhill's theory you should be poleaxed right at the time of exercise and gradually recover over about four days. But an impact hitting at 48hrs would not fit that - it would be a late deterioration rather than a gradual improvement.
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We do get hit within a short period of time after the activity, it is just the worst seems to come 24-48 hours after exercise. The muscles used directly in the activity are hit much harder than any "PEM" that affects the rest of the body.
 
A discussion about corticosteroids preventing PEM has been split from this thread and can be found here:
Use of corticosteroids to prevent PEM

Regarding how we might test the 'is PEM cumulative?' question, I don't think I have ever heard of more than 2 CPETs being done in a sequence. It would be really interesting to see what happens if people with ME did a CPET every day for say five days, compared to healthy controls, monitoring changes around ventilatory threshold as well as bloodwork.

Of course there's some risk to such a study. But some people would be prepared to do it, e.g. some people like me who have children also with ME who desperately want answers for the next generation.
 
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Hutan said:
It would be really interesting to see what happens if people with ME did a CPET every day for say five days, compared to healthy controls, monitoring changes around ventilatory threshold as well as bloodwork.
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I agree that repeated testing over a period of days would be interesting. However, I would not suggest trying to push up to any thresholds. I would be interested to see what happens with the sort of low level aerobic activity that can induce PEM. I have never really understood the value of seeing what the maximum capacity is ME. What would seem more interesting is whether one can show reduced power output for the same amount of oxygen to CO2 conversion. Most people manage living a normal life without doing any anaerobic exercise. The problem for PWME is that they cannot manage even at the low level aerobic stage.
 
The primary function of Glucocorticoid receptors is metabolic. Hence the name Gluco...

Hutan said:
It would be really interesting to see what happens if people with ME did a CPET every day for say five days, compared to healthy controls, monitoring changes around ventilatory threshold as well as bloodwork.
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Sounds like Hell to me...
 
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Does PEM block PEM for anyone else?

Most of the time PEM is just a nasty headache for me which means I'm not fatigued and I don't have muscle weakness. While I do rest when I'm in PEM, my body doesn't usually force me to.

The other day I woke up with a PEM headache and took a shower regardless. A shower by itself would normally cause fatigue and a mild pre-PEM headache. Combined with another activity on the same day, I would probably get PEM. But on that day I had no further symptoms and felt good all things considered. On the following day however, I got fatigued just from sitting upright!

For obvious reasons I haven't extensively tested if PEM blocks more PEM, but now that I'm severe, I might be forced to test it just by trying to get through the day.
 
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OrganicChilli said:
Does PEM block PEM for anyone else?

Most of the time PEM is just a nasty headache for me which means I'm not fatigued and I don't have muscle weakness. While I do rest when I'm in PEM, my body doesn't usually force me to.

The other day I woke up with a PEM headache and took a shower regardless. A shower by itself would normally cause fatigue and a mild pre-PEM headache. Combined with another activity on the same day, I would probably get PEM. But on that day I had no further symptoms and felt good all things considered. On the following day however, I got fatigued just from sitting upright!

For obvious reasons I haven't extensively tested if PEM blocks more PEM, but now that I'm severe, I might be forced to test it just by trying to get through the day.
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A lot of people report feeling better during the delay period. Slight PEM -> forcing activity -> temporary improvement in symptoms -> full PEM next day
 
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