I struggled for 5 days after 3 mile walk 8 days ago. Then I went for a 2 mile walk yesterday after a few shorter walks on intervening days. Now I'm tired as hell. This is the same 2 mile walk that I did a month ago and I didn't suffer from post-exercise fatigue then -- I was able to run errands the next day. The improvement that started on 6/23 is definitely fading, at least partially.
You'd think, if the improvement was from the diet change and subsequent lowering of ambient inflammation, it should be lasting as long as I'm on the same diet. Conversely, if it is fading, maybe it was from something else. But what would that be?
Over the years I (and my wife) noticed that my condition temporarily improved whenever I changed my environment. When we moved back from Korea in 2014, for instance, I was able to walk more than usual without getting sick. That, despite the fact that moving, across the ocean no less, is a lot of work. We also stopped in Philippines on the way back because the flight was cheaper that way and we figured we'd make a vacation out of it despite my apprehension about doing too much. To my surprise I did just fine. (Or, as fine as I could do under the circumstance). We went snorkeling one day and then a long trip to Sumilon Island to see whale sharks. Activities mostly involved floating around in the water and nothing more. Still, they were all day trips that took a lot of energy. The all-day flight afterward and dragging along 60 lbs luggages was no picnic either. Yet, I did not get sick.
This type of improvement usually last a week and then dissipates as I settle back into routine and novelty wears out. It's as if I'm less likely to get sick when I'm excited. (As long as I don't over-do too much, that is.) This improvement could be brought by extra dopamine counteracting fatigue-inducing 5-HT or reducing the inflammation sensitivity. (I'd predict, based on this dopamine theory, that dopaminergic drugs would have some effect for CFS patients, but that has been already shown).
Was the last improvement caused by this? 2 days before I started seeing the improvement, I had my Internet disconnected. That stopped me from reaching for my phone every a few seconds and brought some measure of peace. It also motivated me to commute to coffee shops a couple blocks away, twice a day. I couldn't live without the Internet altogether, after all. That broke up my normal routine and the cold air in the morning made me feel as if I was going back to work.
Bruce Campbell proposed the idea of energy envelope as part of the pacing strategy. The idea was to view how much you can do without triggering the post-exertional sickness as the energy, and then figure out ways to expand that energy. With inflammations sensitivity theory, you could also view this envelope as the inflammation zone in which you could exercise without getting sick. And then the pacing becomes about managing the inflammation rather than managing the energy.
There would be 2 ways to push this envelope and increase the safe inflammation zone. At the top, you could improve by raising your tolerance to exercise-induced inflammation. And, at the bottom, you could increase the zone by reducing ambient inflammation and thereby making more room for exercise induced inflammation.
The improvement that I saw could be the combination of the two: the diet change lowered the floor of the envelope by reducing the ambient inflammation and the routine change caused by Internet disconnection raised ceiling by reducing the sensitivity. And the combination of the two may have made made the improvement bigger and last longer, making me think for a while that I was recovering.
It seems there are more than one way to lower the floor. There have been patients reporting improvements after taking supplements or practicing meditation. The supplements that they report are often anti-inflammatory. Meditation is also anti-inflammatory. So it's possible they work by lowering the ambient inflammation and thus increase the activity envelope. None of these worked for me, so it is also possible that certain remedy works for certain people.
As for the raising the ceiling, I haven't found any other than breaking off from the routine. If someone finds a way to raise the tolerance and keep it there, that would constitute a cure.
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