Awareness of post exertional malaise is so key to preventing harm and yet we are still seeing obvious ignorance from medical professionals, or missed opportunities to spread the word when prominent figures are given a platform. 🧵/1
Patient example in our inbox today: #LongCovid since March. Advice to stop-rest-pace from #pwME led to stabilised symptoms. HR Monitoring allowed yoga & small walks. (Learn more here: physiosforme.com/heart-rate-mon…) /2
Consultant told patient it’s been 10 months and it’s time to “get back on your feet”. Referred to LC rehab. Reassured they’d seen some people with PEM and would go extra slow. Rehab programme described as "very gentle GET". /3
This felt like a very relevant study about PEM but... no matter how much googling we did we still couldn’t fully understand it! So we asked the author directly 🙂 👇 mdpi.com/2075-4418/9/3/…
During exercise or triggering that is over the patients limit they seem to get a gastrointestinal barrier leakage. This most likely is due to two separate things: 1) the ability to provide energy; and 2) GUT blood supply reduction after continued exercise.
It would appear short burst activity may be more beneficial. Once the Gastro blood barrier is breached we see a change in renal function resulting in metabolite and electrolyte loss and this depletion results in a failure to recover as the available metabolite are low.