1. I also have fibromyalgia and in my experience exercise will always cause PEM and pain is a signal I use to help limit my PEM when I do. So to me pain and stiffness that's increasing with exercise is probably in some part PEM. So I guess the question is is it increasing as your exercising? If so then yeah I would think this is part of PEM so be careful.

  2. As a king, make sure you personally hold every county in your capital duchy, then switch the duchy to elective. This makes you the only elector. Then every time your primary heir changes make sure to elect them to inherit the duchy too. They will inherit all of your holdings within the duchy, not only the duchy title itself. Here, succession solved.

  3. Yeah I don't find succession that difficult to deal with in fact if anything I actually kind of enjoy that it forces a split on the realm otherwise some of these realms would just never split at all. My biggest problem with succession is that it sometimes chooses the weirdest dutchies and counties to give the second son. I find often the second son gets way more than the first and third+. It's why I either use Scandinavian succession or feudal succession. That way I make sure that my first son keeps the most important duchies I only keep two dutchies each time.

  4. That's still less than 2.5 years in. Not that long (especially given the context of the past few years lol)

  5. Yeah it's a little insane to think that CK3 is over because it's only been a few years without a lot of content. I mean a game like The Sims 4 is still profitable and is still coming out with content and it's been out since 2014...

  6. I would also add to go to a rheumatologist and ask for testing among these markers:

  7. I went from moderate to severe in 2018 and I experienced this. Some of the things that really helped me was the idea of radical rest I spent a lot of time literally just sleeping. If I was that tired I would just let my body sleep as long as it wanted to even if that meant I was only awake for a few hours a day. It took about 3 years before I went from being that severe to moderate again and a lot of it was just resting way more than I thought I needed and pacing as strict as I could handle it. So I used my wheelchair pretty much exclusively during this time I did not walk. I did everything I could to reduce the amount of upright time I experienced.

  8. It's helped mine. You do have to be on it for longer than a few months. And it's also heavily dose dependent.

  9. Shoplifting is connected to theft and theft is connected to poverty. Car theft is also heavily connected to poverty. You really need to Google this and actually look at some academic papers before sprouting nonsense.

  10. Police officers in Canada are paid handsomely, well over and above what other people in much more difficult jobs receive.

  11. You can be well paid and still earning poverty wages Canada actually has a high cost of living and most people there can't even afford a house rented or bought. Their market is actually worse than the US market because at least you could go to another state. In Canada it's all high priced unless you live where no one else lives.

  12. Get on Guanfacine and NAC first, see how much it helps the basic inflammation, and if it makes you feel inflammation free but sluggish you can try microdosing adderall occasionally, but not more than a couple mg a couple times a week at most. Avoid stimulants, they increase inflammation, our fatigue is the result of chronic neuroinflammation so more agitation doesn’t equate with more energy. In some cases calming compounds will release energy, like with benzodiazepines or THC you sometimes get paradoxical effects.

  13. Please remember that guanfacine is very likely to make you tired and the study for this was very small and for long covid. And inflammation can be caused by just eating. Please remember that some of us actually do just fine on stimulants. Nac doesn't do anything for me and guanfacine made my brain fog worse because it made me incredibly tired.

  14. Your problem is your tolerance is through the roof because you're at such a high dose. You need to actually manage your tolerance. I'd suggest taking a long break and maybe switching to something else like Ritalin or Vyvanse. And start at a low dose and it's okay to sleep on stimulants and it's also okay for them to not be able to keep you up when your body is telling you that you need to rest. It's important that you use it only like a cup of coffee. Something to help get going, but not something to keep you up indefinitely through the day.

  15. There's lots of evidence that it's linked to viruses I mean the majority of autoimmune diseases are linked to viruses as well. This isn't a new field of research it's been around for like a long time. Post viral illnesses are incredibly common.

  16. I've just been diagnosed with FND and I still get PEM. It doesn't mean you can't have both CFS and FND but I do understand I'm still questioning my FND diagnosis. It doesn't mean you can't get another opinion but as you said speak to your CFS specialist. Then go from there, have you had a look at all the symptoms list from FND?

  17. You have to understand FND is not a real disease. It was made to basically say it's in your head and you should just exercise it away. It's basically made up by neurologists who didn't know how to handle non-epileptic seizures. FND has no real treatment and the treatment isn't substantiated by any actual science.

  18. FND is just another word for basically it's in your head. I personally would not do it.

  19. I don't think it's possible to increase function within a week. The best you could really do would be to prepare for a crash. And for that I would limit walking and use my wheelchair whenever possible and rest with any free time I have. Basically trying to offset any crash.

  20. I'm not from the UK so I can't say if this helps or not but here in the US it's really hard to get opiates. It's hard to get tramadol! However a lot of doctors here are prescribing suboxone instead. It's supposedly a safer alternative since it blocks a good portion of the high feeling and the possibility of overdosing while still giving you the opiate. Basically its Buprenorphine (a form of morphine)/naloxone(same thing as LDN just higher dose). If they're wary of opiates this might be an avenue.

  21. Look, as much as I absolutely fucking loathe that shitheel and have voted against him and anyone even loosely associated with him at every opportunity, the problems we are having in Austin this time are simply not his fault.

  22. But it is because if they had hired more crews for clean up they wouldn't have this issue. It's not like other places don't have trees. The problem stands that they don't actually pay for the infrastructure and the people needed to do the job. Most power plants are running at short staff right now. It all comes down to money. As someone else said sometimes it's possible to reroute power using a grid system, but not happening here.

  23. Have you tried any of the medications for gastroparesis? Mestinon, reglan, or anything like that? You'll have to try all those medications first before you'll get a feeding tube. It can be sometimes really hard or really easy to get a feeding tube it largely depends on the doctor. A lot of doctors wanted me to be at 90 lb or less before they would do anything so just to warn you how restrictive it can be.

  24. I am on domperidone and it helps a little but not much. Metoclopramide (Reglan) can’t be taken continuously because of the high risk of neuropsychiatric side effects, namely tardive dyskinesia, so doctors won’t prescribe it on a long term basis. I don’t know if prucalopride is available where I live but I’m not too hot on trying a psychotropic drug.

  25. I would try to find a doctor who'd be willing to put in a g tube at this point it does seem like you are at that stage or at the very least you're rapidly approaching it. It may be time to start interviewing doctors and figuring out which one will actually help you achieve this goal

  26. Yeah basically confirming what we already know that there are at least a few distinct phenotypes within MECFS. Will probably find different results when testing for people with combination of pots and eds. Makes me wonder too about having all of them and what that would look like with these microRNAs.

  27. Consider extended release beta blockers these tend to have less side effects. Reducing pots symptoms can be a very big improvement some. It does suck that we often have to be our own doctors. I also use a H1 and H2 blocker for MCAS.

  28. There's evidence that cfsers have active ebv at higher rates, though no studies have been able to really prove anything about it. It doesn't consistently correlate to severeity of symptoms, antivirals don't improve symptoms, even general anti-inflammatories (steroids) which would be expected to reduce the symptoms if they were caused by chronic inflammation from a active virus don't often improve symptoms. Many healthy people have ebv active at levels similar to cfsers as well.


  30. I'd suggest going through the health rising articles as they have broken down a few of the studies.

  31. I wonder if there would be less child covid deaths if our obesity rates weren't so high

  32. Ok, ill do it. What he said. You ready to come off your high horse now?

  33. I do singing training mostly to teach my body to be okay with less O2. I started it based on the fact that COPD patients can often be at low O2 levels and not even know they are so low. Something very similar happened with COVID. Which means my body shouldn't be sending me "Omg you are dying signals" when I go from 95% to 90% when I walk.

  34. Thanks so much for your reply. How did the mestinon help you? Did it help any with energy at all? Or did it help with PEM?

  35. It did help with my energy levels, it helped regulate my BP, and it even dropped my standing heart rate by about 20 beats per minute. Reduced fainting and near fainting feelings dramatically. Not sure that it help PEM once I hit that wall, but before the wall it definitely helped give me a little bit more of an envelope. And some things like muscle spasms were also reduced. I'd still be on it today if it wasn't for that side effect.

  36. ADHD + CFS here, it does help me feel more awake, but because of the extra energy, it's easy to be tempted to actually want to do all kinds of stuff. My own theory is that the normal activeness of ADHD is being surpressed by the tiredness, and using meds surpresses the activeness, but also introduces more energy, which makes you feel both.

  37. Just to note that people with ADHD actually have an understimulated brain. I know people think of it as overactive because it leads to symptoms that we would align with the idea of overactiveness, but stimulants do not affect people with ADHD any differently than they affect people without ADHD. They don't calm the brain or suppress activeness they actually stimulate the brain to create activity because what people with ADHD are missing is that. We have low levels of most neurotransmitters especially in the frontal cortex which is why stimulants activate this area though we also have it in other areas as well which are harder to activate unfortunately.

  38. I'd say this is pretty normal for most of us who have ADHD and who have MECFS. The brain fog is so killer. Feeling more awake even if I never get out of bed is still better for me than feeling tired for the whole day. To me this is a symptom of ADHD and therefore is perfectly in line with how you would use them. Patients with narcolepsy also need stimulants and for the same reason to feel awake.

  39. Spoken like someone who's never tried to use government services that are supposedly free. I'm sorry nowhere in America is mental health care free. You have to pay for it either through insurance or through your own cash. Sometimes you can get 24 to 72 hours of free care for someone who is at the moment suicidal or for drug addiction but even then it's only for a few days and usually does not come with long-term medication which is something that you kind of need when you're going through a psychotic break.

  40. What would you expect them to do? You lied to them and then expected them to what torture you until you told the truth? There are a lot of people who are wanting to commit suicide everyday who actually just say yes to the damn thing and then talk to someone next time just say yes.

  41. And we allow him to continue remember that this is on us every day that he's allowed to continue things that are blatantly unconstitutional.

  42. my theory is that it can come from people anticipating/assuming that their partner will have a negative reaction to something, and thinking that they can avoid dealing with such a reaction by sneaking around. if a cheater knows that their partner will be unenthusiastic or upset about them taking a certain action, the cheater rationalizes lying to their partner as being easier to deal with than renegotiating a boundary with their partner ahead of time. it's a fundamentally flawed strategy that only delays and worsens future conflict.

  43. Yep this. And the kicker is it can be either real or perceived. My partner has sometimes kept things from me because of my perceived reaction. Previous partners and religion played roles as well. Eventually we figured it out and came out the other side, but I assume there are a portion of people who this is true for and then they're a portion of people who just enjoy the power of it.

Leave a Reply

Your email address will not be published. Required fields are marked *

Author: admin