Post-Exertional Malaise and M.E
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Hello friends,
For my next M.E Awareness article, I thought I’d highlight one of the key symptoms of M.E ~ Post-Exertional Malaise or PEM. Some of you may be very familiar with this term and some of you may have never heard of it before. If you fall in the latter group, hopefully you’ll find this article informative and give you a little bit of insight into the symptom of M.E.
What is Post-Exertional Malaise?
Post-Exertional Malaise {PEM} is where doing activity beyond your physical or mental limits causes an exacerbation of your symptoms. So after any activity, you begin to experience a worsening of symptoms, this usually happens between 24 to 72 hours after that activity. The severity of the PEM will depend on how much energy the activity has used ~ the more energy used, the worse it will be and therefore the longer the recovery time will likely be.
Many people with M.E often refer to PEM as Payback, as it really can feel like you're paying for every single activity you do.
Personally, for certain activities, I experience some form of PEM almost straightaway.. For example after showering, dressing or eating a meal, my energy levels will dip, I'll experience heighten fatigue and sometimes even an increase in my pain levels. I'll then have to sit down, drink something and sometimes have a snack to recover from the exertion.
While PEM is mainly linked to physical activity, you can also experience it after doing something that requires more mental or emotional energy.
It's good to note that it's one of the key symptoms Doctors, who know about M.E, use to diagnose you with the condition. It was one of the symptoms my diagnosing GP picked up on and referred me to a specialist clinic to confirm the diagnosis.
Is It Preventable?
Personally, I've found that preventing PEM all together when you have M.E isn't really possible. However, pacing out your activity and planning out precautionary rest can help to sometimes control the severity of the PEM. Which, in turn, will help lessen the days you have to spend recovering from the activity you have done.
Here's some handy basics of pacing that may help you:
Find your baseline of activities {physical, mental and emotional} that in general you find you can cope with.
Break up activities into small amounts and include rest and relaxation periods in between.
Decrease activity when you're experiencing PEM so you don't worsen your symptoms
Find a good balance between activity and rest.
I also wrote quite an in depth article about how to pace and plan, using information I was given by the M.E Specialist I saw when I was first diagnosed. You can read that here. I broke down every step so it's a lot to take in but once you get the hang of it, you'll find it'll become almost second nature and hopefully you'll find pacing as a beneficial way to manage your M.E and any PEM you will experience after you've done something.
Treatment:
The main way to treat PEM is with plenty of rest, to allow your body time to recover from whatever activity you have done. The amount of rest you'll feel you need will depend on the severity of the PEM. Sometimes it might simply be an afternoon or it could be a week, but it is vital to give yourself that time to recover.
As it causes an exacerbation of many other M.E symptoms, you can also help ease its effects by treating those individual symptoms. For example, if I'm experiencing higher pain levels due to PEM, I'll usually swap onto a stronger pain killer or if my nausea has worsened, I'll make sure I have some of the medication I have for that and will eat foods that are lighter on my stomach.
While on a daily basis, I don't find napping beneficial, if my level of exhaustion is too much to cope with and I simply can't stay awake, I'll allow myself to sleep during the day. Sleep is a time for your body to heal and while I usually wake up feeling unwell, I'm sure its done my body some amount of good.
It's also good to keep a check on your mental wellbeing when you're experiencing PEM as it can be extremely upsetting to deal with. Making sure your bigger activities, the ones that will likely mean a more severe version of PEM, are worth it definitely helps. Speaking from experience, there's nothing worse than having to deal with worsening symptoms and questioning whether what you did was actually worth it!
Hopefully that's given you a little bit of an insight into this key symptom of M.E. and maybe some ideas on how to manage it if you have M.E yourself.
If you have any tips on how you manage your PEM, please feel free to share in the comments. Also if you have any questions, you can always email me via the contact me box in the side bar on my home page.
Stay Safe.
L x
