Now it's been almost 6 weeks and I'm still struggling. I can only manage a mile every other day. And I'm back to logging ADL (activities of daily living) because they have effect my condition next day. I'm not a happy camper.
Repairing the damage from exercise should not last more than a few days. Delayed onset of muscular soreness only lasts 3 to 5 days and so does the immune response to an exercise. So, the prolonged inflammation, if it exits, must be from the accumulation of oxidative stress.
Searching for oxidative stress and prolonged inflammation turned up a paper on oxidation-inflammation theory on aging. It states that chronic oxidative-inflammatory stress prevents adequate homeostasis and therefore the health. (I always thought that CFS is strikingly similar to aging, and this paper fits in with that). But it does not state that accumulated oxidation damage causes prolonged inflammation. It only mentions the homeostatic deterioration caused by oxidative-inflammatory stress as the cause of aging, which probably only means oxidative stress and inflammation happens together. I couldn't find any paper that says accumulated oxidation damage causes prolonged inflammation after the stress is over.
So, on to the second possibility. If the inflammatory response to the damage from an exercise should not last more than a few days, the post-trip struggle cannot be caused by the damage, or accumulation of it. Instead, the prolonged stress must have raised the sensitivity to inflammation. If you are more sensitive exertion and ensuing inflammation, you are more likely to get post-exertional sickness. And the oxidation-inflammation paper works better with this theory: the stress caused the homeostatic thermostat to become more sensitive.
One may think that it does not matter weather it is the inflammation itself or the sensitivity to inflammation. The end result is the same: you are weaker and you are more likely to get the post-exertional sickness. But you can always recover from the inflammation with rest. The increased sensitivity, however, is a fundamental worsening of CFS and there is a possibility that you may not recover. It is a re-injury. Post-exertional sickness that lasts a few days, on the other hand, probably doesn't make CFS worse fundamentally. It is a terrible nuisance that robs the quality of life, however.
The lesson is that prolonged or traumatic activities can worsen your CFS fundamentally and therefore should be avoided at all cost. But I already knew that, of course. I have plenty of experience. Back in 2008 when I felt better, I went on a biking trip only to seriously worsen my condition for a year. Then, I climbed up the Telegraph Hill in 2009 while self-practicing the Graded Exercise Therapy. My condition get seriously worsened again till 2011. It's been very, very slow improvement since then.
I went on this trip knowing the danger because the last trip went well. Two and a half years ago, we stopped in Philippines for 5 days on the way back from Korea and did some snorkeling. Unfortunately, I don't have any objective data to compare because I only started wearingg Fitbit since 2015. Looking back though, it probably was easier trip. It consisted mostly sitting on the planes and buses. The little activities that I've done was basically floating on the water. And it included one full day of rest doing absolutely nothing in the hotel.
And this is the danger of going by the memory and subjective feeling. You managed 7,000 mile trip, so you think you could manage 1,000 mile trip. But I probably walked much more this time. And that was beside all that driving. I'll have to limit my next trips to 5 days at a time, with a full day rest every two days, and no more than 6000 steps of walking each day.
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