The day after we returned from the day trip to Yosemite was another day of vegetating. Then I was able to run some errands, probably powered Walfed, a generic version of Sudafed from Walgreen. After that, a funk set in: happy chemicals dissipated and all that was left was fatigue and weakness. I struggled to get the laundry done like I used to. I had to have my wife to carry it downstairs and load it up in the car, and then haul it back up when I was back from the laundromat.
Another penalty of 3 days, it was all so predictable. And to think I was going to bike 12 miles today. I'm just an incorrigible optimist.
I used to distinguish the post-extertional struggle and post-exertional sickness. Now I think they are the same thing that are only different in degrees. When I was constantly struggling with ADLs, the 3 day penalties used to completely knock me out. Now that I function quasi-normal when I am rested, the 3 day penalties mean I struggle with ADLs; it feels like I'm back to being my old CFS self. Maybe the post-exertional struggle will eventually go away too and be replaced with DOMS or plain post-exercise fatigue.
DOMS, too, could be the same kind. There was a paper that biopsied CFS patients in PEM and found that there was no micro-tear in their muscle fiber and therefore concluded that PEM is not same as DOMS. But micro-tear is only a hypothesis for the cause of DOMS and DOMS could be caused by inflammation with or without micro-tear. Even if the micro-tear is the cause, the tear for CFS patients could be so minute that biopsy may not be able to detect. And CFS patients, being hypersensitive to inflammation, get knocked out severely for 3 days after a minimal exertion while healthy people only get DOMS after a prolonged maximal exercise. CFS patients further face the peril that a severe case of PEM could chronically worsen the condition. I ought to know, I've done that a few times in my early years of CFS.