"Mom?"
"Mom! What do you think about this terrible scarf? Mom... are you listening to me too?"
We were at a local charity shop aiming to find a costume for my daughter to wear as Darbus in her upcoming school performance in the high school musical. I tried to listen and pay attention, but I was starting to feel far away, disconnected, and completely exhausted.
For the past 48 hours, I had been going in and out of work, attending meetings that required focus, and generally fulfilling my duties as a mom/wife. I was not keeping up (I'll explain more later), and I was about to pay the price.
At tea time, I couldn't talk to the bed, suffering from pain, desperately trying to fall asleep, but unable to relax into a comfortable nap.
I crashed.
I crashed due to post-exertional malaise, and a 36-hour hell ensued.
What is post-exertional malaise (PEM)?
Post-exertional malaise (PEM) is the worsening of symptoms even from mild physical or mental exertion, typically worsening 12 to 48 hours after activity and lasting for days or weeks..
Other names for PEM include post-exertional symptom exacerbation (PESE) or post-exertional neuroimmune fatigue (PENE).
PEM is one of the diagnostic criteria for myalgic encephalomyelitis (ME), also known by the more misleading name chronic fatigue syndrome (CFS). I am more than just ongoing persistent fatigue. The Institute of Medicine recently convened a panel of experts that released a report titled "Beyond Myalgic Encephalomyelitis: Redefining the Disease." The panel recommended the use of the following diagnostic criteria.
For a diagnosis, the patient must have three of the following symptoms.
- A significant reduction or impairment in the ability to engage in pre-illness levels of occupational, educational, social, or personal activities lasting more than six months, accompanied by fatigue.