post exertional malaise (PEM)

What is “rolling PEM”?

~ Helen White ~ Leave a comment

Rolling PEM (post extertional malaise) tends to come on quite late after the multiple exertions that caused it, often creeping up on you unseen and then it comes on BIG. Its a trickster because it can even feel good at the time it starts accruing…I hear just so many people saying that they felt so good while they were in the thick of pushing through the big project or doing more exercise than normal or handling the new responsibility at work, that they felt like they were over ME/CFS; that they even thought that maybe they were getting permanently better at last, that it was a sign that they were ready to take on more. At the height of the adrenaline surge, you can feel as though you are more than coping, that things really are improving, that you are putting chronic illness behind you at last, so you then feel more confident to take on more of the "normal" things than you would otherwise dare...until, suddenly, it has the last laugh! I recently heard a description of it that went along these lines: if normal PEM is a debt that you always have to pay back after the energy overspend, like repaying a bank loan, then rolling PEM is like having to pay back a loan shark with unimaginable amounts of interest added on top. You really don't want to be indebted to that kind of debt collector because it will be utterly ruthless to deal with; there will be no more negotiating or delaying to be had, absolutely no leeway for extenuating circumstances given!

Life in the gap: coercing an AuDHD brain to work within the energy parameters of ME/CFS

~ Helen White ~ Leave a comment

Learning how to slow down, how to pace or stop everything including your overactive mind may be the biggest achievement of your life with ME/CFS when you are also AuDHD because it is THE hardest thing for you...yet slow down or stop you must. The point is, those spaces and pauses between exertion and overthinking, that very void you always dreaded, may hold the very healing elixir, the antedote, you've probably chased after all these years but getting into this state is always doubly tough for you and takes such persistence and focus...perhaps more effort than all the things you ever filled-up all your days with before.

Getting out of the boom-bust pattern of post exertional malaise

~ Helen White ~ Leave a comment

When we normalise over-exertion (as so many of us tend to do) we fail to even notice it any more and so we litter our lives with excuses for why we can't stop right now or take time out to rest. "Its tough at the moment but next year will be better" or "I just have to get through this or do this one last thing" we tell ourselves. In hindsight, its possible to see how we have been living as though caught up in, not just one boom or bust cycle but, a whole series of them, like overlapping circles lasting, in some cases, for a day, a week or month and, in others, as long as a year or even longer. Cycles where we have failed to factor in the appropriate respite before the next cycle of overdoing it begins, so we don't ever get the chance to fully recover from one exhausting thing before the next thing starts. These overexertions, all butted up against each other with no gaps in between, can start to systemically overwhelm us in time. Its not the whole reason for ME/CFS but it can be a big part of a defunct pattern that feeds into the repeated crashes and post-exertional malaise that so define the condition. So how do we spot our own pattern and learn from it; more importantly, how do we break out of it and stop it in its tracks in order to regain some sort of stability?

(Finally) dedicated to pacing

~ Helen White ~ Leave a comment

I am now forced to humbly admit that most of my prior attempts at pacing, over all the many years of constantly dabbling with it, weren’t really pacing at all because I simply wouldn’t stick at it and would then fall back into old habits as quickly as blink. I always had my excuses at the ready as to why this one thing I “had” to push through was outside the jurisdiction of my need to pace or couldn’t be avoided (a dread of disappointing or letting others down being one of the most consistent excuses) when, really, the whole of life has to become one giant, continuous exercise in pacing to make this whole thing work sufficiently enough to avoid the constant boom-bust cycle of flare-ups and chronic fatigue that potentially get harder to recover from each time.

Stabilising the autonomic nervous system as a first crucial step

~ Helen White ~ Leave a comment

There is no separating the nervous system from the various different aspects of how the body has started to misfire over the years, cumulating in whatever burnout or crash led you to where you now are, however much other provoking factors (such as a virus or accident) might have taken the brunt of the blame because, after all, what makes one person respond to those things differently, more devastating and lastingly, than the next person if its not the nervous system? Post Exertional Malaise is a classic manifestation of this whilst tracking its triggers can teach us such a lot about our personal state of misfiring health.