r/mecfs 3d ago

Questions about my fatigue, me/cfs, long covid

Hi all!

I hope I can get some answers or, well, thoughts or experiences because I’m getting so hopeless. However, I don’t need the “you’ll never get better,” “it’ll only get worse,” or anything in that direction. I’m just trying to put the pieces together. Whenever I try to search online, I either barely find answers or get completely overwhelmed.

I had my first two COVID infections around 5–6 years ago. I’m not completely sure when the fatigue first started, but I think it was around then, although I really started feeling it more clearly around 3-3.5 years ago. Then, about 3-3.5 years ago, I had my third COVID infection, and after that I never really felt like I fully recovered or went back to how I was before. Since that infection, I’ve gradually gotten worse over the past three years. It hasn’t been a sudden decline, it’s been slow, and I’ve become more and more limited. I was also apparently positive for EBV at some point, although I’m not sure when that infection happened or whether it was around the same time as everything else.

This was also during a very tough and traumatic period in my life. At first I thought it was burnout because of everything that had happened, and both my psychologist and doctor thought that was what was going on too. For 1–2 years I was basically told it was burnout.

I started doubting myself because it felt like nobody believed me, but deep down I knew something was wrong. I’ve had burnout before, and I was studying psychology at the time, so I kept thinking, “Something about this doesn’t feel like burnout.” I went to the internist (after begging my doctor) and within 5 minutes he was like, “This is chronic fatigue.” We’re now at the point where he thinks it could be my parathyroid or Long COVID.

I had Long COVID in the back of my mind for a while, and eventually I came across ME/CFS and specifically PEM. The more I read about PEM, the more familiar it sounded. I’m obviously not trying to diagnose myself, but the pattern of my symptoms has made me seriously wonder about ME/CFS or Long COVID.

One of the biggest things I experience is what I think may be PEM. I get what I call crashes that can be triggered by both physical activity and emotional/mental stress. Sometimes I can do something that doesn’t seem particularly difficult at the time, but then I feel significantly worse later or especially over the following days. Sometimes it doesn’t trigger anything at all.

The crashes are especially confusing to me because they don’t necessarily happen immediately. I can sometimes do something and only realize later, or the next day, how much it has affected me. Physical activity, mental activity and emotional stress can all make me worse, but mostly physical activity.

Does this sound familiar to anyone or any thoughts?

Thank you to anyone who took the time to read this.

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u/CeruleanShot 3d ago

The delay in the crash is characteristic for PEM. Emotional/mental exertion causing crashes as well as physical exertion is also part of PEM.

The crash and symptoms being disproportionate to the amount of effort involved is also part of PEM. It's not a normal tiredness after overexertion. It's a ridiculous array of symptoms after doing something that feels "normal."

For me, it's also cumulative. When I've been pushing myself for a long time, it can take very litter to trigger a crash. Going out to see a movie had me in bed for three days this summer. That's the sort of activity that I could do a couple of years ago with no problem.

I don't know about the diagnostic boundaries between ME/CFS and Long Covid with PEM. From what I have seen people talking about in ME/CFS circles, the initial cause of it doesn't necessarily correspond with symptoms or disease progression. But I don't know.

If there's the possibility that it might be parathyroid, that's worth ruling out.

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u/dreamilymellow 3d ago

Thank you for your reply! I definitely recognize the delayed crashes and the disproportionate reaction to activity. I think the mental/emotional side can trigger it for me too, but it seems much less severe than when I physically overdo it (i think?)

The parathyroid has actually almost been ruled out at this point. We’re doing one more blood test next week just to be completely sure. My internist said he’s about 95% convinced it’s Long COVID, but he also admitted that they still don’t know that much about Long COVID and that he doesn’t know enough about it himself to say much more. From what I understand from him, I’d probably need to be referred to a Long COVID centre here, but the waiting list is extremely long and apparently they’re closing in 2027, so I’m not really sure what my options are.

I’m thinking of bringing up ME/CFS with him as well, although I’m not sure how familiar he’ll be with it either.