Matt Lazell-Fairman
@mfairma
I’ve never had a doctor understand PEM well enough to recognize it, aside from ME docs. So while I know POTS and EDS patients can benefit from careful exercise, the idea of NIH running an exercise trial in Long Covid terrifies me.
When you know PEM, it’s easy to see the rhythms it imposes in your life, but when you don’t, the disconnect between exertion and crash make it hard to recognize why some days are inexplicably so much harder.
It took me months to realize and I only did when the trigger was sufficiently strong. I began to pace, but didn’t realize until I stopped working how much I was still overexerting.
I was in a rolling crash, getting sicker and sicker, but the constant exertion made it hard to see my baseline.
It’s tougher to recognize the milder you are, the earlier you are in your illness, when you’re pushing every day to keep things moving. Patients ignorant of PEM may miss the signs. Their doctors definitely will.
NIH could carefully segregate patient populations, to exclude those reporting PEM. But will every patient recognize it? And what about those who develop PEM sometime after onset, as my wife did?
If subjects develop PEM from the treatment, will that be monitored carefully enough to minimize harm? Will it be reported?
Our concern isn’t just for subject safety, though, but for how any results will be sold.
Long Covid is an umbrella disorder, but that’s not getting through to the medical community or public. It’s treated like a vague, confusing monolith.
However carefully run the study, any positive finding for exercise in LC will be applied indiscriminately. The state of clinical care for LC and ME is so poor that to expect different is laughably naive.
A positive finding for exercise could pour gasoline on a fire the community has only just managed to begin to smother. For all of us harmed by exercise, traumatized by gaslighting, that’s horrifying.