Is PEM triggered by physical exertion the same as worsening triggered by sensory stimuli, cognitive exertion or emotions? What are the implications?

Jonathan Edwards said:
Are we sure this is not sleepiness. Sleepiness with car vibration is surely something lots of people are familiar with. Both I and my wife fall asleep in a vibrating car but not in a train. The sleepiness is irresistible but nothing to do with tiredness. And of course some people feel sick with vibration and lots of people feel sick I a boat. I suspect these are vestibular effects, not to do with muscle.
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I am of the motion sickness group. Whilst I’ve not the greatest ENT including ears I’m not sure it is vestibular - I’ve had labyrinthitis to compare and it gives me vertigo where I almost feel like I’m tipping on the bed or at sea.

you see I get motion sick with everything and it’s genetic as another family member also gets it to a similar level. We both find driving less exertion than being a passenger due to it and could never sit in the back. Weirdly I was ok on coaches in the very straight roads in Australia back in the day. Get it with films, and the more jerky the film and bigger the screen the more likely. I got so motion sick snorkelling in a life jacket looking at fish I had to hold on to the instructor to get back to the boat. I was sick then but not always (though I would never eat a load before any journey because of it)

these aspects make me think it’s processing load where the visual vs body movement is different. I’ll get a banging headache and exhaustion which carries on after.

train is interesting because I’m generally better on certain lines and the speed makes a difference. I’ve a faster (and quicker to get there) option to central london which tilts and has narrower carriages (I look in the centre and try and avoid windows but you can’t when it’s that narrow - I can’t read or look down) vs a slower but takes ages and I can’t stand the seats option. There’s an actual point on the track 40% into the journey where I go from managing because it must have not had to tilt yet or the extra speed hadn’t yet turned on to knowing I’ll just about survive that last but before I feel like I’ll pass out. To me it’s like being on a virtual reality roller coaster. I have to lie down with no sensory for hours after. That was obviously when I was more well. The alternative is doubling the journey and in back agony due to seats and injuries so I’m exhausted from that snd can’t read etc but I’m less having too hold the bottom of the seat the whole way so the utter body crumbling and brain flashing lights tinnitus walking stumbling ly with my hands out to find somewhere to lie down isn’t the same. And the after effects are consistent with the quite different experience ie tired in different ways.
 
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I've seen the direct transformation in my face in front of the mirror while getting my hair cut at the salon. Fine when I sat down in the chair and completely different 40 minutes later- sunken eyes and face. Being upright, swung around in the chair, and talking with the stylist for almost an hour (one time it was 2 hrs!). I didn't think I would make the 10 minute walk home. I was swaying all over the place on the sidewalk. When I got home I called a friend and called the wrong person 3 times!!

It felt like PEM and like I did gymnastics during my outing, but I recovered after a couple of hours.
 
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I’d say it’s hard to separate out cognitive from physical. Interaction with other people in person especially outside your home involves both types of exertion. When I was working from home would it have been sitting up at my table on my laptop or concentrating on telephone meetings that was causing me to go mentally and physically drained needing to lie down. Most physical activity that I do requires concentration emptying and filling the dishwasher, putting shopping away. Driving means I’m upright and concentrating. Going to an appointment upright, walking and concentrating.
 
NelliePledge said:
I’d say it’s hard to separate out cognitive from physical. Interaction with other people in person especially outside your home involves both types of exertion. When I was working from home would it have been sitting up at my table on my laptop or concentrating on telephone meetings that was causing me to go mentally and physically drained needing to lie down. Most physical activity that I do requires concentration emptying and filling the dishwasher, putting shopping away. Driving means I’m upright and concentrating. Going to an appointment upright, walking and concentrating.
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And the brainwork of multitasking any combinations of physical & mental effort is another exertion in itself. Eating a meal while talking to someone isn't two kinds of exertion, it's three.
 
Eleanor said:
Before I got ill, car travel always used to make me sleepy - a pleasant sensation as long as I wasn't the driver. Now it makes me tired-but-wired - the opposite of sleepy. Also dizzy, wobbly, verbally incoherent and with the sensation of continuing to move for hours afterwards.
(edited to add, this is just as a passenger - I can't drive any more)
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Yeah for sure this is about the constant need to use muscles to balance out the vibrations and movements, completely different from the droning buzz and minor shaking that a healthy body can get used to. And highlights the key difference between somnolence and fatigue. Those are just different issues here.

When exhausted enough, being in a normal car is closer to being in a rally race, or maybe a roller-coaster. Zero of the normal pleasantness drifting to sleep here. In fact the noise alone is exhausting, if not painful to endure.
 
AliceLily said:
Brain fog to me just sounds so trivial.
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I expect that it does sound trivial to people who have never experienced it, or maybe had it briefly during a flu or whatever. However, like Chinese Water Torture, experiencing it daily with no expectation of relief, can probably drive some people to suicide. Maybe "Brain Crippling" is a better term?

Adding in other symptoms, such as hypersensitivity or neuropathic pain certainly makes the phenomenon worse, but the fog on its own is quite awful.
 
Creekside said:
I expect that it does sound trivial to people who have never experienced it, or maybe had it briefly during a flu or whatever. However, like Chinese Water Torture, experiencing it daily with no expectation of relief, can probably drive some people to suicide. Maybe "Brain Crippling" is a better term?

Adding in other symptoms, such as hypersensitivity or neuropathic pain certainly makes the phenomenon worse, but the fog on its own is quite awful.
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Yes, I agree. I know all about it. I have experienced the hell of it.
 
Here is another one that shows the difficulty with separating these out. Although I think it is worth it and doing it slowly.

I'm now getting trouble with my eyes having been someone with perfect eyesight. Being aware that partly I've just hit 'that age' where you get long sight I'm conscious of talking about this and being misconstrued as jumping to conclusions.

However I'm also someone who is severe, not 'very severe', but firmly well down that severe category and had a bad number of years before so have experienced a lot of decline and deterioration in response to bad circumstances over that time.

Probably the muscles that get the most used now are my eyes. Humans need that contact with whatever be it TV or some other screen etc.

I've now got to the stage where I've gone from someone with no glasses to being given numerous pairs each with a different prescription for phone, screen, TV/people and it seems each eye is different (which is I guess not that unusual) to try and stop them getting exhausted so quickly.

So it's not that my eye muscles give me PEM, but that as they get exhausted I'd imagine the job of being able to interpret the information coming through gets harder because eventually they stop doing the job .
 
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