@stuartkjones4 Yes; I've had two follow-up remote visits with Asheeta Bawa at my request following the initial and only visit to the NWMH LC clinic last September. I'll continue to request follow-ups with her, just to be sure I'm not missing out on any new recommendations. So far, it's just the Amantadine, which I'm rejecting since the side effects for many people sound serious, the cognitive rehab, which I did, and yes, a sleep study which I declined, because I sleep fine when I'm not in a PEM period. When I told Dr. K. my worst symptom was the fatigue/brain fog, he said "Many people are helped with this drug" but no details; it was a very short visit with him. I've gotten much more info in general from their monthly Zoom support group for LC clinic patients, which he (and I) strongly recommend. At one of those meetings Dr. K. showed a list of treatments he discourages as "useless." At these meetings NWMH docs show up to speak and answer questions about LC from their perspective; these videos are available on YouTube and you can find the list on the LC Support group site.
I'm finding this thread helpful; let's keep posting our experiences as we (hopefully) get better.

Stuart - the best thing I have tried for the fatigue and post exercise malaise is Low Dose Naltrexone (LDN). I am 5 years into my COVID journey and have had my fatigue and malaise lessen a bit so I can now walk about 1/3 of a mile without being winded or tired for the rest of the day but must still pace myself everyday. The LDN gives me an additional small burst of energy about 1 1/2 hours after I take it and it also removes a good share of the inflammation in my body...so less overall pain. My legs are also less weak unless I go completely off my anti-inflammation diet and then they are weak again and painful. Neuropathy is overall better now that I can sleep with less pain.

LDN is started at a "baby" dose for us - about .5 to 1 mg and slowly, slowly worked up to 4.5 mg. For the first two weeks, it made me tired (so I took it at night) and it gave me quite vivid dreams (not nightmares). After two weeks, it gave me insomnia so I now take it in the daytime prior to 2 pm. For me, the 4.5 dose did not work as well as 2.5 so I decreased the dose to where I felt the best. This is typical for many using LDN. Some people even split their dose so they get a burst of energy twice a day.