
Improvement from very severe--able to read almost all day now!
TLDR: Small improvement in the long term but helpful to me. This is really an in-progress update. I have a long way to go. Screenshot hopefully gives context for how bad it's been for me at my worst.
I've been either fully bedbound or almost fully bedbound for a little more than a year. Started out very mild. COVID infection Christmas 2022, first crash fall of 2023. Increased POTS and other symptoms started immediately after infection/was declining slowly before my first actual crash.
Progress has been very non-linear and so slow I often haven't been able to notice it for months and months, but right now I'm able to read on my e-reader for pretty much any amount of time and be ok. Feels like a miracle.
Last summer I remember saying (technically writing) "if I could just read all day this would be so much more bearable." I began with pacing my reading in 4 minute increments once a day.
Being very severe is hellish, and I'm afraid to jinx whatever improvement I have (small in the long term), but the fact that I'm actually able to cope and distract myself this way now is really meaningful to me. I've been in total despair and hopelessness for so much of this year. No big promises, but if you're stuck in hell I hope this helps a bit.
Main things I think have helped:
PACING!!
REST!
NOT CRASHING/extending the time between crashes and completely shutting down if I do go into PEM
(pacing is extremely difficult at this level of severity, both physically and mentally)
^Someone awesome recommended the book "Classic Pacing for a Better Life with ME" to me on this sub. My Bible.
Sleep--last summer/early fall I was sleeping an average of 12 hours a day and was very protective of sleeping as fully as my body needed at the time
Things not happening--beyond staying out of PEM, it seems like fewer appointments, changes, stress make a significant difference; the bigger the gap between my baseline and how little I'm doing, the faster my symptoms improve. Basically--act like you're sicker than you think you are (to whatever extent possible).
Breathwork and mindfulness for emotional regulation and stress--I tried tons of different methods and made up techniques to suit me. I don't think the method matters as much as finding something that actually works for you specifically and that you'll really use.
Meds--direct treatments:
Mestinon 90mg, split between 60mg and 30mg (morning and afternoon)
LDN 4.5mg (morning)
Guanfacine 2mg (night)
Low-dose ketamine troches (sublingual) 40mg 2x a day
Management meds:
For sleep--ketotifen and Dayvigo or hydroxyzine sometimes
For POTS--propranolol and ivabradine
For MCAS--cromolyn sodium
Things I'm not sure have made any difference (pos or neg) but who knows:
Supplements (all--I've been in a bad depression and stopped my whole supplement routine, nothing bad has happened but I do intend to re-start some of them like Vit D, iron, fish oil)
Diet--haven't noticed any difference between the variations of my diet (all the way from super Mediterranean/no diary/no gluten to very easy processed food)