someone asked me this in a DM and I didn’t have a clean answer so I’m asking here. how do you actually separate a new symptom onset from a PEM crash triggered by something you did 2 days ago. they can look identical. brain fog, HR climbing, legs like sand.
but one means something changed in the disease and one means you overdid the grocery run on tuesday. what I use now, 18 months in: I check my log for anything unusual in the prior 36-48 hrs before I panic about a new symptom. if there’s a clear trigger (stood too long, stressful call, skipped a rest window) I call it PEM and ride it out. if the log is clean and nothing explains it, that’s when I actually call the neuro.
before I started tracking I couldn’t do this at all. everything just felt like the illness getting worse, which is its own kind of scary when you’re already being told it’s anxiety. curious how other people draw this line, especially early on before you have enough log history to compare against.