Talk:Post-exertional malaise

Second paragraph
The paragraph below is confusing and doesn't have a source so it's a bit hard to figure out what it is saying. I think it might be saying that the post-exertional malaise symptoms are a worse version of whatever the other symptoms in the diagnostic criteria are? That doesn't entirely make sense since the criteria don't say "only these symptoms count as PEM". Also I think it's pretty obvious that symptoms in the diagnostic criteria are those commonly made worse or caused by PEM. This paragraph wasn't as prominent until I put others under subheadings to improve readability, and I couldn't think of an obvious heading or topic it was about. It could go back on the page with a source, but lower down and I'm not sure where would be best? "Symptoms caused by PEM" could be a heading but there would be specific research about the most frequent symptoms for that. ~Njt (talk) 00:42, January 30, 2022 (UTC)

"Depending on the criteria a patient meets (Systemic Exertion Intolerance Disease (SEID) for ME/CFS's minimum core symptoms, the Canadian Consensus Criteria (CCC) for this criterion's ME/CFS symptoms, or the International Consensus Criteria (ICC) for myalgic encephalomyelitis (ME) and its ME symptoms) will correlate with the patient's symptoms that will worsen."

Executive summary wanted
Is it possible for there to be an executive summary that captures the concept? I find the concept to be confusing and the page is too long for me to read. I realize this might not be possible.

This sentence does not parse for me: "Depending on the criteria a patient meets (Systemic Exertion Intolerance Disease (SEID) for ME/CFS's minimum core symptoms, the Canadian Consensus Criteria (CCC) for this criterion's ME/CFS symptoms, or the International Consensus Criteria (ICC) for myalgic encephalomyelitis (ME) and its ME symptoms) will correlate with the patient's symptoms that will worsen." Remove the parenthetical comment and it is apparent. But I do not know what to replace it with.

Added A Paragraph Of Which Symptoms Worsen And The 24-72 Hour Delay. I Have PEM But Charts And Graphs Don't Tell Me What I "Feel" And When It Happens and I don't even know, from an average patient and general public reader point of view, what PEM is. Although these are not studies relating this information on the symptoms and the 24-72 hour delay (there may be and they may be in the charts and posted in the page somewhere) the average reader won't come away with much of an understanding if a short blurb is not included as to what it feels like and patient reporting on the worsening symptoms and when. Since it is "the marker" and "core symptom" little understood by patients, caretakers, the medical field, etc., I thought it best to include a brief explanation. I also included a new post under "Learn More" as i feel this page correctly and succinctly defines PEM.

Also, there are 3 citation errors and if I can I will try to correct. My edit did not create them as they were there prior to my edit.--DxCFS (talk) 08:54, 16 August 2016 (PDT)


 * Although this was years ago, I felt similar when I looked to edit for another reason today. I have now added subheadings and shortened the very start. ~Njt (talk) 00:42, January 30, 2022 (UTC)

I have moved two citations not used in prior text from the references section to here. If you can figure out where in the article these citations should be used, please move them back.--Samsara (talk) 08:42, 7 November 2016 (PST)

The visual editor seems to be getting "stuck" as it is a pretty big page now. Perhaps breaking off notable research to its own page will help. I will leave it to others to make that decision.--MEcfsFMS (talk) 21:34, 15 October 2018 (EDT)

PEM
PEM is usually delayed 24-72 hours and I did an undo on a revision that removed that information.--MEcfsFMS (talk) 09:22, 17 October 2018 (EDT)


 * PEM is usually delayed 24-72 hours. My whole world fell into place when I learned that information. Studies, ME/CFS organizations, and patients are reporting this delay and are in agreement.


 * Additionally, patients and ME/CFS advocacy groups have been requesting testing (CPET and other measurements) be done 48 and72 hours out because of the delay and they want PEM captured several days out when it onsets. --MEcfsFMS (talk) 09:39, 17 October 2018 (EDT)

Changes to lead -- Pwc (talk) 02:07, May 22, 2022 (UTC)
I'd like to change the first part of the lead from "Post-exertional malaise (PEM) refers to a worsening of ME/CFS symptoms after minimal physical or mental exertion, which can be delayed 24-72 hours or more" to "Post-exertional malaise (PEM) refers to a worsening of ME/CFS symptoms after physical or mental exertion which may be minimal, and which can be delayed 12-72 hours or more. The delayed nature of PEM is regarded as a key feature of it."

The reason for the adjustment to the word minimal is that I think it may cause some confusion. Everyone has a different definition of minimal, and the use of the term there may lead people to believe that if someone can still engage in some minimal activities without PEM, that can't be ME/CFS. I'm also concerned that it may give the impression that PEM means it is impossible to engage in activity that isn't minimal, when the delayed nature of PEM means that it is often possible for people to engage in substantial activities, but only prior to PEM starting. The word "minimal", or an equivalent, also isn't used in most definitions of PEM, including the ones that are cited in that sentence.

The second change, adding “The delayed nature of PEM is regarded as a key feature of it.” is because the delayed nature of PEM is widely regarded as a defining feature of it, and many definitions, such as the CDC one here, either say it is typically delayed or emphasize it as a feature.

The third change, changing "24-72" to "12-72" is because the CDC definition says PEM typically occurs after "12-48" hours, so I think that lower bound should be included.

The definition of PEM is important so I thought I'd explain my changes and check for any objections. Thank you --Pwc (talk) 02:07, May 22, 2022 (UTC)