Module 2. Case study part 3.

It looks like Rebecca does experience PEM. What is your first priority?

Rebecca reports also experiencing severe PEM episodes after family gatherings, even when she ‘just sits and talks.’ She also crashed badly after attending her niece’s graduation ceremony. She’s confused because she ‘wasn’t doing anything strenuous.’ Background noise, bright lights, and emotional experiences seem to trigger the same response as physical exertion?

Rebecca’s partner comes to a follow up appointment with her. She is struggling to understand why Rebecca is not able to always be consistent in her activity. She’s worried that Rebecca will just get more and more deconditioned. What would you advise?

Rebecca wants to try and help with housework. What strategy is consistent with pacing?

Which multy-disiplinary action is most important?

Rebecca requires an ultrasound. After her hospital appointment (travel 30 min, waiting room 40 min, tests 25 min), she experienced a severe crash lasting 3 weeks. She missed her follow-up appointment because she was bedbound. The specialist notes she’s ‘non-compliant.’

How could you have organised her care to avoid this situation?