Felis Catus
Senior Member (Voting Rights)
I'm not sure if this is the right place to post this. Perhaps it should be in a separate thread.
I've been wondering why some people don't recover or don't fully recover after an episode of PEM/crash and others do.
It seems that some people keep overdoing it, keep crashing, e.g. even for years while trying to work while others deteriorate quite quickly in comparison.
Sometimes I wondered how often others experienced PEM but having been in some patient groups for years and having built relationships with other patients, I see that some people are crashing really often (in comparison to me) but they bounce back.
At some point I started thinking that the ability to bounce back is what distinguishes those who remain stable or improve from those who get worse. But what would be the underlying mechanism? Why would someone bounce back and someone else with a similar level of functionality/severity or even higher functionality wouldn't? Is there a process which basically determines one's trajectory and the patient's circumstances can only accelerate it but not change its course?
I know no one knows. Just thinking out loud.
I don't think it's about crashing soft, i.e. that if someone does just a little bit more above their threshold, just the right amount of not too much, that it leads to recovering from subsequent PEM as opposed to doing more than that. There are people who e.g. need help with food prep and putting the dishes in the dishwasher (because those activities trigger PEM) but they can go out weekly or multiple times a week for a few hours, crash each time, recover to pre-crash levels and maintain the same level of health for years. Please don't get fixated on this particular example. It's just an attempt to illustrate that some people fully recover from an activity which seems far more taxing than what they can manage without triggering PEM. And the point it that some people can keep doing it without deteriorating while others with the same or similar severity or even in better health deteriorate from seemingly smaller endeavours.
I've been wondering why some people don't recover or don't fully recover after an episode of PEM/crash and others do.
It seems that some people keep overdoing it, keep crashing, e.g. even for years while trying to work while others deteriorate quite quickly in comparison.
Sometimes I wondered how often others experienced PEM but having been in some patient groups for years and having built relationships with other patients, I see that some people are crashing really often (in comparison to me) but they bounce back.
At some point I started thinking that the ability to bounce back is what distinguishes those who remain stable or improve from those who get worse. But what would be the underlying mechanism? Why would someone bounce back and someone else with a similar level of functionality/severity or even higher functionality wouldn't? Is there a process which basically determines one's trajectory and the patient's circumstances can only accelerate it but not change its course?
I know no one knows. Just thinking out loud.
I don't think it's about crashing soft, i.e. that if someone does just a little bit more above their threshold, just the right amount of not too much, that it leads to recovering from subsequent PEM as opposed to doing more than that. There are people who e.g. need help with food prep and putting the dishes in the dishwasher (because those activities trigger PEM) but they can go out weekly or multiple times a week for a few hours, crash each time, recover to pre-crash levels and maintain the same level of health for years. Please don't get fixated on this particular example. It's just an attempt to illustrate that some people fully recover from an activity which seems far more taxing than what they can manage without triggering PEM. And the point it that some people can keep doing it without deteriorating while others with the same or similar severity or even in better health deteriorate from seemingly smaller endeavours.
