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Hi Dave,
Your story is a distressingly common one. A heck of a lot of CFS sufferers were formally very fit endurance and elite fitness people who crashed out (MS sufferers have a similar profile). This fact alone destroys the absurd notion of us being depressed and lazy malingerers with 'exercise avoidance behaviours' - a maligned belief by which the mental health institutions have held us hostage for 50 years, and still do by continued prescription of harmful Graded Exercise Therapy .
As a high energy athlete, you no doubt have a good understanding of physiology. That will go a long way in helping you understand and navigate the condition itself.
For whatever it is, a good rendering is to understand the condition (in my mind) is as a severe 'metabolic injury'. The body's energy system has been pushed too far and burnt out its primary and emergency mechanisms. Cellular respiration becomes greatly impaired and can no longer recycle required amounts of ATP for normal metabolic function.
The 'crash process' (Post Exertional Malaise PEM) can be thought of as a collapse of ATP/ADP supply. The failure in that recycling system of ADP back to ATP via the aerobic (Kreb/Citric Acid) cycle forces metabolism down the emergency anaerobic routes which are initially one ADP sacrificing a P to another ADP leaving AMP and ATP and an exponential collapse in ADP supply.
AMP is hard to recycle and releases a lot of inflammatory signals. It's generally urinated out so the entire body which becomes depleted of fundamental molecules required for metabolism. All tissues are then in a perpetual anaerobic state of fermentation metabolism for which I suspect also has underlying injury to its processes. Any kind of forced activity only causes further injury. It can then take days, week, months to rebuild from scratch and recover to a semi-normal function. Even when recovered, the underlying injury still must be kept in mind managed properly
While active, there is no obvious indication that ATP recycling has failed and that we're burning through ADP. Typically it's masked by adrenaline and we 'feel good' for the period of exertion. It can take days for the crash to present.
To my experience and understanding, crashes are pan-systemic, in all tissues, muscle, neuronal, glandular, etc. 'Brain fog', neurological disfunction, digestive problems, glandular and muscular fatigue can all be understood as simply because your cells can't produce energy.
Some systems my crash before others and in different orders depending on the system being exerted. Physical exercise might lead to body collapse but you might be cognitively fine (for a while). Mental excursion might cause Brain Fog/cognative collapse (I call it Cog Lock), while you body still feels energetic. Emotional excursion might lead to endocrinol collapse and highly distressing anxiety attacks. Digestive excursion can cause GI track collapse. And of course, all these systems are intersectional, its just a matter of which system leads the other systems in collapse.
Enough writing for now. The strongest message I (and many others have) is that you have to take this condition very seriously in order to avoid permanent serious illness (i.e. bed bound, unable to swallow requiring, 24/7 care).
It will seem highly anti-intuitive that 'taking seriously' means doing less of everything even when you feel capable. Every time you hit PEM, it risks further erosion of that injury and ability to recover. The hardest thing is having people (including yourself) understand that even though you are functioning at their level, unlike them, you are function at the edge of a cliff and you can go over that cliff at any moment.
Take care, and best wishes in your journey.
Darryl
