Managing post exertional malaise

It is good to get tested to make sure you don't have cardiovascular or other covid-linked problems. I caught covid last March on a 7-day 350 mi bike ride and was sick for about a week. The long covid (LC) hit after that, and the main symptom was post-exertional malaise (PEM). So, I went from biking up to 80 mi/day to 5 mi on a exercise bike followed by a nap. Overall, I went from 100% to 30%. PEM is a waiting game, you can exercise/rest, but only to the extent that it doesn't trigger PEM because it can take hours or days for PEM to subside. If you are feeling "like your own self" one day, don't push it because the PEM crash is in the background. Resistance (weights) is easier than aerobic exercise. PEM is triggered by exertion, stress, not enough sleep, and who knows what else. Consider keeping a food log; covid can trigger food intolerances in some people (for me, it was celiac after having H1N1 years ago). My LC did go away, but it took 8 months.

This link is not a peer-reviewed paper, but has useful info: https://www.yalemedicine.org/news/long-covid-symptoms. These CDC guidelines are for doctors, so info more for what they should look for. https://www.cdc.gov/coronavirus/2019-ncov/hcp/clinical-care/post-covid-conditions.html

Do NOT try to exercise right now! Google "post exertional malaise." At the moment, pushing yourself could lead to long-term worsening of symptoms. Rest as much as you can for the next month or two, then gradually increase activity and see if you can tolerate it without feeling worse the following day.

You are absolutely right. For last few weeks, if I do a little too much one day, I can feel it the next day. I guess I need to nudge the throttle forward a little at a time, can't rush this. Your suggestion makes good sense.

Thank you all for sharing your experiences! I appreciate your support and advice. I had been pacing myself fairly well since I had the crash that prompted me to reach out to this community, but I am back in another (albeit milder) crash that started yesterday. I think this time it was triggered by driving - I was in the car for about 2 hours driving back/forth to appointments. I really find driving to be very exhausting because it’s just constant focus.

It’s really frustrating to accept that this is my life now, and really scary to not know how long it will last. Up until yesterday, I was feeling pretty good. Pacing myself for sure, but also functioning fairly well within those constraints. I had even convinced myself that I was improving and would be back to normal soon. The crash this week has made me realize that I am not out of the woods, that I am still vulnerable, and it scares me.

I was a cereal breakfast person but after 2 covids I crash near 4-5 hours to last 6-7 I have to have a substantial Bft and a nap and a snack midmorning to get to 1PM. If i'm planning on going shopping I have to skip BP meds till I get back.
So goes the battle for 3 yrs. However I'm 86