Friday, 25 February 2011

Post-Exertional Malaise

imageHere are three articles on Post-Exertional Malaise from the CFIDS Association of America, which I think everyone should read. Not just ME/CFS/CFIDS sufferers, but those who aren’t too. (Perhaps especially the doubters and the ones with vested psycho interests.)

Anyway, the three articles; Unraveling Post-exertional Malaise talks about how post-exertional malaise is defined and what it feels like:

A physician with CFS says, “My PEM feels like a worsening of my baseline CFS symptoms – more fatigue, headaches, neck/back muscle achiness (but not outright pain), problems concentrating/reading. My insomnia also sometimes increases temporarily and at its worse, my throat hurts and my lymph nodes feel more tender.” Andrew, a person with CFS (PWC) says, “I can’t focus enough to watch TV. Conversation becomes difficult. Any kind of stimulation feels like an assault on my senses.”

In Post-Exertional Malaise: Cause and Effect, those of the “Wesley School”, would be particularly recommended to read the section which explains what PEM is NOT. And it gives clear evidence for why it’s not, Kinesiophobia, defined as “an excessive, irrational, and debilitating fear of physical movement and activity resulting from a feeling of vulnerability to painful injury or reinjury.”

As I think we’d all conclude from listening to our own bodies, the more likely causes demonstrated by CFS patients are abnormalities in the central nervous system, cardiovascular and energy metabolism system, and immune system.

And in Post-Exertional Malaise: Perception and Reality, you start to get a much clearer, measurable, idea of just how severe PEM really is:

In the test/re-test protocol used by VanNess and colleagues, the 20 percent decrease in cardiopulmonary function in CFS patients during the second [maximum exercise] test is unique. Variation in cardiopulmonary function has been measured in people with pulmonary hypotension, end-stage renal disease, cardiac problems and cystic fibrosis; none of these patient groups exhibit more than a 7 percent variation in function.

That seems to suggest we are almost 3 times more incapacitated than people with those diseases. ‘Bout time this was properly recognised, isn’t it?

1 comment:

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