Рет қаралды 6,102
This video series is intended to review the clinical presentation, scientific underpinnings, and treatment approach for patients with post-exertional malaise (PEM)/post-exertional symptom exacerbation (PESE).
For an abbreviated version highlighting the clinical pearls, please watch videos 1, 2, and 7. Videos 3-6 offer a deeper dive into the scientific and evidence-based pathophysiology of PEM/PESE.
***
Post-exertional malaise (PEM)/post-exertional symptom exacerbation (PESE) is an altered physiological state and pathognomonic finding unique to ME/CFS that is now being recognized in those with post-acute sequelae of COVID-19 (PASC), also known as Long COVID.
It is critical that healthcare professionals recognize PEM/PESE and support the patient in avoiding a push-crash-cycle which can exacerbate disease processes and contribute to worsened long-term functional prognoses.
In video seven of this seven-part series Brayden Yellman, MD, and Lucinda Bateman, MD, tie everything together, offering insights and guidance on clinical management of those who experience PEM/PESE.
It has been consistently observed that when patients finally break this cycle and avoid PEM for a more consistent period of time, their functional baseline and all aspects of their ME/CFS symptom control improve, independent of any other pharmacological or behavioral intervention.
Managing each and every pathological component of ME/CFS not only reduces the impact and suffering of those specific symptoms, but perhaps more importantly, can reduce the incidence, duration, and intensity of PEM and improve overall function and prognosis.
Video details:
Pacing management/guidance
Avoid the push/crash cycle ("stubbed toe analogy")
Activity modification
Trigger recognition/planning
Budgeting rest breaks
Low-dose naltrexone (LDN)
Note to community members: We advise viewers to always speak with their medical care team prior to making any adjustments or changes to their current regimen.
This video was made possible by the OMF-funded Medical Education Resource Center (MERC) at BHC, our generous donors, and viewers like you.