I realize this messed up all of the margins...but can't figure out how to fix it...oh well...the mixed up nature of it mirrors how i feel right now anyways...so quite fitting
Post-Exertional Malaise: Resources for You
Post-exertional malaise or relapse is a hallmark symptom of CFS. Here’s how one person with CFS described it:
“Muscle wilting meltdown, air gulping short of oxygen feeling, brain blood vessels flayed on a laundry line in the wind, metal rods in the back of head . . . someone crushing your ribcage, limbs giving out, mesh bag constricting head, ‘pingers’: those first small headaches that warn of bigger headaches, ‘back of head clamp’ headache, increased gravity feeling, being pushed backward into bed, temple-to-temple headache, weak arms as if bound down by stretchy ropes, eyes and brain blanking with a kind of pulse through the head . . . Harm and damage often come from these collapses, though on the outside they may look like ‘malaise.’”
Over the years we have developed and published many articles and resources about PEM. We collect several of them here for the benefit of those new to the subject and ready reference for others.
Overview articles About PEM:
- The Hallmark of CFS
By Suzanne Vernon, Ph.D. | Originally published Feb. 3, 2010 in CFIDSLink
This article describes PEM and research results from the Pacific Fatigue Lab.
Link: http://www.research1st.com/2010/02/03/the-hallmark-of-cfs/ Unraveling Post-Exertional Malaise
By Jennifer M. Spotila, J.D. | Originally published June 2010 in CFIDSLinkPart 1 of 4: This article examines the definition of PEM and how CFS patients experience it.
Link: http://bit.ly/PEM-Pt1- Post-Exertional Malaise: Perception and RealityBy Jennifer M. Spotila, J.D. | Originally published August 2010 in CFIDSLinkPart 2 of 4: This article examines objective evidence of PEM and how it differs from fatigue in other illnesses.
Link: http://bit.ly/PEM-Pt2 - Post-Exertional Malaise: Cause and Effect
By Jennifer M. Spotila, J.D. | Originally published August 2010 in CFIDSLinkPart 3 of 4: This article examines the topic of kinesiophobia and what mechanisms may cause PEM.
Link: http://bit.ly/PEM-pt3 - Post-Exertional Malaise: Power to the PeopleBy Jennifer M. Spotila, J.D. | Originally published September 2010 in CFIDSLinkPart 4 of 4: This article examines what patients can do to cope with and avoid this incapacitating symptom.
Link: http://bit.ly/PEM-Pt4 - Click here to download Jennie Spotila’s four-part PEM series in PDF format.
Articles About Balancing Activity and Rest:
When Working Out Doesn’t Work Out
By Christopher J. Snell, Ph.D., Mark Van Ness, Ph.D., and Staci Stevens
Originally published summer 2004 in theCFIDS ChronicleThis article examines exercise and ways people with CFS can balance activity and deconditioning.
Link: http://bit.ly/LzU6ye- Doc to Doc: The “Skinny” on Exercise and CFS
Q&A with Drs. Lucinda Bateman, Nancy Klimas and Susan Levine
Originally published summer 2006 in the CFS Research Review This interview with three expert physicians explores recommendations to avoid PEM and deconditioning.
Link: http://www.cfids.org/cfidslink/2006/exercise-cfs.pdf - Alternative (t0) Exercise
By Sabine Miller | Originally published winter 2008 in the CFIDS Chronicle
This article presents one woman’s approach to nontraditional forms of exercise to combat PEM.
Link: http://www.cfids.org/pdf/alternative-exercise.pdf Managing Your Energy Envelope
By Bruce J. Campbell, Ph.D. | Originally published winter 2009 in the CFIDS Chronicle
Dr. Campbell presents nine strategies to help manage energy and use it to its maximium effect.
Link: http://bit.ly/energy-env- The “E” Word
By Jennifer M. Spotila, J.D. | Originally published Oct. 2010 in the CFIDSLinkAs a follow-up to her four-part series (above), Jennie looks at ways that people with CFS can be active without triggering PEM
Link:http://www.cfids.org/cfidslink/2010/100604.asp
Articles About PEM-Related Research Issues:
- To PEM or Not to PEM: That is the question for case definition
By Leonard Jason, Ph.D., and Meredyth Evans | Originally published Apr. 27, 2012 on Research1st.com
This article looks at the way that PEM is described in various case definitions.
Link: http://www.research1st.com/2012/04/27/pem-case-def/ - From Discovery to Application
By Dane Cook, Ph.D. | Originally published Apr. 16, 2012 on Research1st.com
Dr. Cook refers to two recent biomarker studies and connections between them.
Link: http://www.research1st.com/2012/04/16/from-discovery-to-application/ - Breaking Ground
By Kim McCleary | Originally published Feb. 23, 2012 on Research1st.com
One of the research projects announced as part of the Research Institute Without Walls will examine patients’ cognitive performance and blood and brain markers after modest physicial exercise challenge.
Link: http://bit.ly/A6isBo - Toward Consistency
By Kim McCleary | Originally published Feb. 8, 2012 on Research1st.com
This article summaries a publication from members of the CFS Advisory Committee about ways to better standardize research data in the study of CFS, including standard measures for PEM.
Link: http://www.research1st.com/2012/02/08/toward-consistency/ - PFL Testing for Post-Exertional Malaise & Disability
By Staci Stevens and Christopher J. Snell, Ph.D. | Originally published Nov. 18, 2011 on Research1st.com
The Pacific Fatigue Lab has become the premier center for test-retest exercise testing to document PEM.
Link: http://www.research1st.com/2011/11/18/pfl-testing/ - Exercise Challenges Reveals Potential Biomarkers
By Kim McCleary | Originally published June 2, 2011 on Research1st.com
Research results published by Kathleen Light’s University of Utah team following modest exercise promise blood markers for CFS and PEM.
Link: http://www.research1st.com/2011/06/02/exercise-challenge-reveals-potential-cfs-biomarkers/
Webinar Videos:
Minimizing Relapses: Pacing yourself through the holidays
Guests: Bruce J. Campbell, Ph.D., and Dane Cook, Ph.D.
Recorded Nov. 18, 2010
Link: http://www.youtube.com/watch?v=bE4xGCw_3Ng&feature=plcp- Treating CFS & FM: The Stepwise ApproachGuest: Charles Lapp, M.D.
Recorded May 20, 2010
Link: http://www.youtube.com/watch?v=sw5HcimeSOY&feature=channel&list=UL - NOTE: We are in the process of scheduling a webinar on post-exertional malaise and will post details soon.
Other Topics That Intersect with PEM:
- Cognition & CFS: Resources collected at http://bit.ly/cognition-resources
- Orthostatic Intolerance & CFS: Resources collected at http://bit.ly/oi-outs-ins
- Joint Hypermobility: Article by Dr. Alan Pocinki at http://bit.ly/vIUKPp
- ANS Dysfunction Junction: Article by Dr. Pocinki at http://bit.ly/xRrzHr
Kyle Kenney is the CFIDS Association of America’s summer science communications intern. Kyle is a sophomore industrial engineering major at the Georgia Institute of Technology and a native of Charlotte, North Carolina. He has family members with CFS.
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