Why is showering so PEM/OI inducing

It’s been many years since I was able to but even in my early years of ME/CFS it would be a trigger. Even if sitting on the floor, the getting to the bathroom, washing, drying, getting back from the bathroom… I assumed the sustained activity and being upright was the reason, some other movements could be more broken up, but maybe there were temperature factors too. Without fail my body would go heavy and achy and start screaming at me in the hours after. And usually PEM would follow. But not always.

Having a shower is one of the first things I’d do if I woke up well.
 
When my head goes under the water for the first time I get extremely chilled before I warm up from the warm water.

As part of my next day PEM (from showering or anything else) I will wake up with a migraine. If I let chewable aspirin dissolve under my tongue soon before going to sleep, I won't have the migraine the next day. I use St. Joseph's Low Dose Aspirin and take 8 of them which is a full dose.

This is how I use aspirin when I get a migraine because swallowing regular aspirin doesn't work for me. The prescriptions I tried in the distant past also didn't work for me. Since St. Joseph's is the only aspirin I have, this is what I use before I go to sleep. But since I'm taking it preemptively, I don't know if swallowing regular aspirin would work or not.

Aspirin makes my ears ring and throat close a little so I take it sparingly and do my best to avoid exertion and my other numerous migraine triggers.

I've had ME/CFS since 1983. I've been bedridden since 2007/2008. My showers have become less and less frequent. I only showered twice this year.
 
The OI-showering connection is supposed to be because of heat and humidity making your blood vessels widen, so blood drains from the top down. Sitting definitely helps me for a long shower, when I'm doing hair as well as body, and that would make sense, as it would slow down the blood pooling.

When we redid my bathroom, we ended up with a configuration that means the fan sucks cold air from under the door past my lower legs as I sit on the shower stool. It happened by accident, just because the door is right beside the shower and the shower is walk in (wide open, no shower door). It's brilliant, because it cools my lower legs and makes me last longer.

The walk in shower makes it nice and easy to get out quick if I'm getting dizzy. Tends to happen at the end of a long shower.

I agree with @Trish about the palaver. The time you spend in the shower is a small portion of the time it takes to do the whole thing. So you're really on your feet or semi-upright for a long time, no matter how much you break it down or plan ahead. I have dry skin so there's a non-negotiable moisturising part at the end that feels like the final straw.

Like others, showering does help my pain, but makes everything else worse.
 
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Trish said:
I save some energy by living day and night in nighties that only get changed after showering, and just adding clean knickers daily and cardigans when needed, and a skirt over the top so I look dressed if we have visitors.
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I can usually get dressed, but I have been doing that a good bit recently as my joints have decided to all fall apart at once and I just can't get dressed twice. Hadn't thought of the skirt addition, which is genius.
 
Oh another thing I have found helpful is showering by lamplight rather than using the full lights when having a full shower. Definitely not recommended if unsteady or at risk of falls.

I use two small portable lamps that are suitable for bathrooms/outdoors, neither of which has direct light. It makes it easier - calmer, more relaxing. So for me, there's definitely a sensory element to the wrecking nature of showering.
 
Sean said:
Interesting. I tend to move about a bit in the shower, changing from one foot to the other, turning around frequently, etc.

Maybe that is an unconscious learned thing to dynamically maintain balance and blood flow.
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Yes if I am somewhere with no option to sit down eg on the side of a bath a very quick shower moving would be what I do. But that is far more exhausting than seated shower. I don’t have to lie down after a seated shower.
 
Same with eyes closed.

I prefer showering in the evenings, mornings are not so good.

I am able to stand during a shower for many years now, but I still have to sit when my arms are up washing my hair and stay sitting while rinsing. I feel weak quickly if I try to wash my hair while standing.

We have a heated pool in my building but the water is too warm and I almost collapsed years ago. I barely made it up the lift to get home. Even before ME I wasn't able to sit in hot tubs or whirlpools because the water is too hot. It would negatively affect me for days and lower my BP.
 
I forgot to say I only shower on better days, usually recently about once a week. It wipes me out for the rest of the day and sometimes the next day or 2. I also have a problem of feeling cold afterwards for several hours even if I'm well wrapped up in bed and the room temperature is the same as usual.

I need the shower to be warm to hot, as a cool shower makes me shiver which is extra exertion and exhausts me faster..
 
It just occurred to me there’s probably a lot of sensory things going on when showering. A number of people have mentioned the elements. There’s thinking, coordination, a body having lots of touch signals, temperature changes, balance, noise, even movement/visual things.

Looking at this from a signalling/sensing change and internal regulation angle I wonder if there’s something there beyond or on top of straight energy usage and effort?
 
After some experimentation, I think that the main correlating factors for me are (in no particular order):
  1. Temperature changes
  2. Physical stimuli to the skin and muscles from water/scrubbing
  3. Physical effort of getting to/from shower, washing, sitting, dressing and undressing + the duration of the continuous activity
  4. Light and noise
  5. Regular OI issues with not being horisontal
 
One thing I can not do is take a very short shower after power walking. I have to go to bed feeling sweaty which is the price I pay. I can scrub my feet which feels good.

So even if I feel good after my walk, the shower thing is too much and I get a chest pressure feeling and my arms feel weak. It feels like PEM but most likely not.
 
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