Merry Christmas Everyone. Enter recovery phase.

We pretty much all know the behavioral ways to recover from or reduce the length of a crash or flare are pretty simple. Depending on how hard you've been hit they consist of things like cutting down activities (just say No!), reducing stimulation (turning off TV, music, turning lights down), getting to bed earlier, and reducing stress (meditation, visualization, stopping catastrophic thought patterns).
The question this resource asks is whether we can do better than just waiting out a crash? There are certainly no guidelines on how to do that but some ideas are out there. First check out suggestions on how to recover from a crash from Hip, a patient who has studied the disease extensively, then from a blog by a PhD, and finally from a survey taken from the ME/CFS/FM communities.
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From PEM Busters for Physical Exertion

1. Creatine hydrochloride - 2 grams 
2. Citrulline - 1000 mg 
3. Branched-chain amino acids (BCAA) - 5 grams 
4. CoQ10 - 800 mg 
5. Sodium bicarbonate - ¼ teaspoon (1.5 grams) 
6. Catalase - 600 mg (taken after exercise) 
7. D-ribose - (5 grams three times daily) 

All the above should help reduce PEM from physical exertion. These supplements might be particularly efficacious at preventing PEM if taken an hour or so before doing some unavoidable physical exertion.

RATIONALE: PEM Busters Work in Part by Neutralizing Lactate or Reducing its Production 

PEM Busters for Mental Exertion (eg: hectic social or professional events):

• Prednisone at a dose of 20 mg or so taken 4 hours before the event. Some ME/CFS patients have vouched this works very effectively and reliably (though others report ill effects from this corticosteroid drug). See this thread. But also see the warning in this post (which cautions against using prednisone for any extended period of time, and warns that the PEM protective effects do not work for the whole day, they seem to wear off after about 6 to 8 hours).

From Mitochondrial Dysfunction, Post-Exertional Malaise and ME/CFS by Lucy Duchene -for ME/CFS/FM patients with mitochondrial dysfunction

Recovery from prostration fatigue

• Vitamin B-1 (thiamine) (100 mg twice a day)
• Vitamin B-2 (riboflavin) (100 mg) 
• Biotin (5 mg twice a day) 

Postponing build-up of lactic acidosis

• Time-release guaifenesin (600-800 mg) 82

Dr. Goldstein's "Resurrection Cocktail"

Dr. Goldstein's "Resurrection Cocktail" is a different kind of crash buster. It was an IV push that helped to get really sick patients - people who are essentially in a severe crash all the time - out of their beds. It was not a cure - just a temporary aid - but it did get them going for a time.

• Ketamine
• IV ascorbate
• IV lidocaine
• IV thyrotropin- releasing hormone (which raises all biogenic amines plus acetylcholine)
• Nimotop
• Neurontin

Find out more about his "Resurrection Cocktail" and why he chose the ingredients he did.

Further details and associated research papers for each supplement are available on Cort Johnson's Blog Forum from where I copied this extract.  Cort Johnson's research summaries and explanations are highly respected in the chronic illness community by patients, researchers, pharmaceutical and health supplement industries and doctors.... especially doctors who are also patients.

Unfortunately the only way to get the prescription and IV services described above is to go to an alternative medicine practitioner who is also a General Practitioner (Doctor) or an ME/CFS expert specialist.  Mainstream medicine provides no treatment at all and the ME/CFS specialists are difficult to find unless you are able to travel overseas and attend a specialised clinic.  A naturopath or osteopath may be able to service some of these recommendations.  Lyme disease experts usually have a background in ME/CFS and fibromyalgia as well as tick-borne diseases.  Good Luck and Happy New Year.

I take it back about faster crash recovery

I still have not recovered from going to the doctor this time last week.  I started Plaquenil the next day.  I said I was OK relatively speaking the next day post doctor trip but my main crash usually comes the day after that so now I don't really know why I have felt fluey achey with lots of joint pain too, including ankles that feel like they are cracking when I walk on them.  Not knowing why is the story of my life.  I've been looking up my Plaquenil records and cannot find anything consistent, I was on it and off it last year. I had itches, rashes, burning mouth and tongue and boil-like painful spots on my abdomen the first time I was on it after a month.  I quit the stuff but I went back on it even while I still had the itches, quit again then later in the year tried it again and didn't get the rashes.  I still had the burning mouth stuff then and all the thrush medications I was given at the time did not work but it eventually went away to a tolerable level.  I still get a tingly tip of my tongue. 

I've been battling constipation too and trying to detox with various things - lemon juice in water, milk thistle, coconut, grape juice, fibre, stopping my pain killers for several days etc.  I've had a lot of gut pain after eating until a couple of days ago when that seemed to settle mostly.  Everything just seems to be guesswork and the pain was too much. One day I cried emotionally and I don't usually do much crying unless I have sympathetic company and then it can bubble over.  All I know is that I am a mess except I have not had any dizzy stuff.  So it could have been worse.  The house is showing my neglect for a week.  I wasn't well before I went to the doctor so maybe it was all just too much forcing myself to go.

This morning I had to push myself to the dentist at 8:30am.  I chipped a bottom tooth and I was lucky enough to get one of the few remaining appointments before the dental scheme ends on December 1st.  There won't even be another dental scheme under the Enhanced Primary Care system until 2014 and not even the dentist (Francis) new what was happening in between in the public system. 

I had both middle bottom teeth reinforced with filling and she treated my inflamed gums up top which she said were pussy.  That hurt some despite having an injection (up my nose it felt like).  She removed a bit of an overhang where I normally get food caught - the same old place that gets inflamed all the time and gave me a bit of a scale and clean followed up with some desensitising gel.  That's it now.