Post-Trip Struggle vs. Post-Exertional Sickness

And just like that, the post-trip struggle appears to be over. I spent 3 hours grocery hopping (yes, shopping hopping) 2 days ago, with over a mile of walking in total, and I didn't get sick.  In fact I've been feeling pretty good. Under the circumstance, that is. It's been 6 weeks in the post-trip jail in all.

It is the same amount of time, by the way, that I used to spend wallowing in over-training syndromes when I was training for Judo competitions. I used to kneel over for 6 weeks at a time when I over-train. Coincidence? perhaps. Or maybe the post-trip struggle is equivalent to the overtraining syndrome. The struggle after the trip to Korean eastern and southern seaboard in 2011 was also about the same length.

This post-trip struggle is also remarkably similar to the struggle I had after the flu shot in 2015. The flu shot is known to cause low grade inflammation, so I surmised that the inflammation lasted for 2 weeks. But the paper on the effect of flu vaccine on inflammation marker found no sign of elevated inflammation on day 7. So the 2 week struggle after the flu shot is not fully explained by the inflammation. If not the inflammation, then it must be the sensitivity to inflammation that went up.

Is the post-exertional sickness also the increased sensitivity? It lasts 2 to 5 days, with most of them 3-4 days. And it coincides with DOMS and lymphocyte activation . The lymphocyte activation, like DOMS, could be the response to the muscle fiber damage. Since muscle fiber damage causes inflammation, the post-exertional sickness is likely caused by the inflammation rather than the increased sensitivity to inflammation.

The accumulation could be likewise. Since the response to an exercise can last for 4 days, it is not unreasonable to assume that the damages from exercise accumulate over that 4 day window. And if the accumulation goes over the threshold, the post-exertional sickness sets in.

In summary, a prolonged period of activities raises the sensitivity to inflammation and therefore you become more likely to get sick. The accumulation crash, on the other hand, is caused by the accumulated damage from the activities. It is the inflammation, not the inflammation sensitivity.

Finally, the post-exertional sickness itself is the sickness behavior triggered by the inflammation in CFS patients who are inflammation-sensitive.

At least, that is my theory.