The 48-Hour Recovery Period in Fibromyalgia & Chronic Fatigue Syndrome

Essential for Function

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Have you ever noticed it takes you a couple of days to recover from a stressful event or over exertion? A 48-hour recovery period is one of the few consistent features of fibromyalgia and chronic fatigue syndrome.

We don't yet know why we need 2 days to recover from ... well, just about anything, but a lot of chronic fatigue syndrome research is focusing on post-exertional malaise -- the intensified fatigue and flare of other symptoms following exercise.

Several research groups have identified genetic and blood abnormalities following exercise.

What we do know about this recovery period is that we're stuck with it. For me, it means taking it really easy for a couple days after anything big -- a holiday, a vacation, or an unexpected stressful event.

I first learned about this issue about 8 or 9 months into fibromyalgia. I was still working as a TV news producer, which means I was running a live show at the end of every workday. That's a stressful event even on the calmest of days, and days were rarely calm. I knew my symptoms got worse throughout the work-week and then improved markedly by Sunday evening, but that just seemed logical. Wouldn't that happen to anyone who was sick?

Then I noticed that non-work stressors made me feel awful for about 2 days. My kids were little then -- as in toddler and preschool ages -- so I had plenty of stress at home, too!

I remember my 18-month-old daughter finding some paint cans and stacking them like blocks, only to have one fall down and come open, right on the carpet. Adrenaline kicked in, I fought panic and started trying to clean it up. My husband came home before long, fortunately, because the surge of stress hormones did me in fast.

Pain was ricocheting around my body like crazy, I was dizzy, and I started to become disoriented. I could barely form a sentence by the time I got to the couch and laid down.

That was on a Sunday afternoon. I was incapacitated until about Tuesday evening and called in sick to work for both days. Wednesday morning I felt pretty good, and while I didn't feel great that Friday, it was by far the best Friday I'd had in months.

It hit me. I'd given myself time to recover from Sunday's stress, so I was at my "normal" on Wednesday. In a typical week, I'd still have been recovering from Monday's stress, compounded by Tuesday's. I then began to see how pushing ahead all week made me unable to recover adequately before I was right back at work. The need for rest and recovery piled up each day, and I was calling in sick -- especially late in the week -- more and more.

Once I left that job to work from home I started being careful about the 48-hour rule and realized that this recovery time was essential for me to remain functional.

It doesn't mean coming to a complete halt (at least, not always), but it does mean taking it extra easy physically and avoiding stress as much as possible (I still have kids, after all!) Even with my symptoms largely in remission, if I don't give myself 2 recovery days when I need them, I pay.

As I've talked to more and more people with these illnesses, I've heard over and over again how crucial this period is to us. Of course, nothing is universal when it comes to these illnesses, but it's common enough to make it worth paying attention and seeing whether you need that 48-hour recovery period too.

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