Post-Exertional Malaise


Persons with ME/CFS [myalgic encephalomyelitis/chronic fatigue syndrome], however, keep themselves at a balance point. They rest for two hours, do a half hour of activity, rest, then do more. [Actually, I figure 10 minutes out of bed followed by 50 minutes in bed.] The worse the illness, the less overall activity is possible. If an ME/CFS patient does absolutely nothing for a few days, they usually feel pretty good. But go to the shopping mall for eight hours and the crash occurs. Following this activity, the patient will experience an exacerbation of pain and other symptoms of ME/CFS that may last one, two, or three days. This phenomenon is known as post-exertional malaise. Disability lies in the inability to sustain this normal level of activity. The two-day exercise test is the first to begin to explain this phenomenon. The patients with ME/CFS in this study had a significant drop (in oxygen use); something that occurred as a result of the first day of testing and its associated activities which interfered with their ability to use oxygen on the second day, thus leading to the post-exertional malaise. –Dr. David Bell

About annecwoodlen

I am a tenth generation American, descended from a family that has been working a farm that was deeded to us by William Penn. The country has changed around us but we have held true. I stand in my grandmother’s kitchen, look down the valley to her brother’s farm and see my great-great-great-great-great-grandmother Hannah standing on the porch. She is holding the baby, surrounded by four other children, and saying goodbye to her husband and oldest son who are going off to fight in the Revolutionary War. The war is twenty miles away and her husband will die fighting. We are not the Daughters of the American Revolution; we were its mothers. My father, Milton C. Woodlen, got his doctorate from Temple University in the 1940’s when—in his words—“a doctorate still meant something.” He became an education professor at West Chester State Teachers College, where my mother, Elizabeth Hope Copeland, had graduated. My mother raised four girls and one boy, of which I am the middle child. My parents are deceased and my siblings are estranged. My fiancé, Robert H. Dobrow, was a fighter pilot in the Marine Corps. In 1974, his plane crashed, his parachute did not open, and we buried him in a cemetery on Long Island. I could say a great deal about him, or nothing; there is no middle ground. I have loved other men; Bob was my soul mate. The single greatest determinate of who I am and what my life has been is that I inherited my father’s gene for bipolar disorder, type II. Associated with all bipolar disorders is executive dysfunction, a learning disability that interferes with the ability to sort and organize. Despite an I.Q. of 139, I failed twelve subjects and got expelled from high school and prep school. I attended Syracuse University and Onondaga Community College and got an associate’s degree after twenty-five years. I am nothing if not tenacious. Gifted with intelligence, constrained by disability, and compromised by depression, my employment was limited to entry level jobs. Being female in the 1960’s meant that I did office work—billing at the university library, calling out telegrams at Western Union, and filing papers at a law firm. During one decade, I worked at about a hundred different places as a temporary secretary. I worked for hospitals, banks, manufacturers and others, including the county government. I quit the District Attorney’s Office to manage a gas station; it was more honest work. After Bob’s death, I started taking antidepressants. Following doctor’s orders, I took them every day for twenty-six years. During that time, I attempted%2
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One Response to Post-Exertional Malaise

  1. rosemyworld says:

    Interesting study. I was not aware of the evidence of low oxygen levels with this illness. Thank you for writing about it!

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