Post-Exertional Neuroimmune Exhaustion (PENE)
Post-Exertional Neuroimmune Exhaustion (PENE) is not just a severe increase in Exhaustion but an increase in a number of ME/CFS related symptoms. For example an increase flu like symptoms, in joint or muscle pain, difficulty concentrating or other cognitive problems, sleeping many more hours than usual or an increase in insomnia.
PENE may result in swollen and sore lymph glands, a sore throat the inability to tolerate any sense stimulation including light and noise sensitivities; an inability to have a coherent conversation or to follow simple instructions. PENE could be described as a systemic inflammatory response to only the slightest increase in activity. Bearing in mind an increase in activity for a ME/CFS affected individual may include spending a little extra time in front of the computer or simply getting dressed without resting.
PENE is a reaction which defines ME/CFS from other chronically deliberating conditions, which incur severe fatigue/exhaustion as a symptom. It is crucial that those with ME/CFS learn to recognise PENE episodes and reduce the frequency. The ME Diary will assist you to do this by helping you monitor any increases in activity that may cause episodes of PENE. Each individual will be different with regard to the levels of activity which bring on PENE. And onset of PENE will certainly differ for each individual, as one ME/CFS affected individual may have an episode of PENE only hours after increased activity, while another may not be affected until days later.
When an individual finds their Activity Baseline and remains consistently within that set activity amount PENE episodes may become less frequent and less severe. Make use of the Symptom Line Graph to spot episodes of PENE and also relate PENE episodes to any increased activity within the Activity/Exhaustion/PENE line chart.
Be mindful that an episode of PENE may result hours or days after increased activity. Use the comments section to comment on any additional symptoms or periods when increased activity was unavoidable. Relate your results when speaking with your GP or Allied Health Professional.
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