The actual mechanism of Post Exertional Malaise (PEM) is related to this concept of Dysregulated Autonomic Signaling to the Microvasculature causing narrowing of the capillaries. This occurs in different locations at different levels of dysfunction for different patients which could explain the difference in Patient experiences. This is where the Researchers fail us… #LongCovid #pwME #POTS #Dysautonomia #pwLC