Positives

• One person with MCAS found that incorporating small amounts of paced exercise, as advised by their long COVID doctors, was beneficial, though they noted that the approach might vary depending on the severity of post-exertional malaise (PEM) Reddit.
  
  
• For a patient with POTS, a long COVID clinic recommended short walks and recumbent biking, which reportedly helped them feel “a little better” at times Reddit.
  
  

Negatives

• A patient shared that despite pacing their exercise, their condition worsened significantly, leading them to become bedbound and unable to continue their studies Reddit.
  
  

Hurdles & Side Effects

• Out-of-pocket physical therapy runs roughly $75-$150 per session, and a typical 12-week course at twice weekly can total $1,200 in smaller towns and up to $8,000 or more in major cities, even before deductibles and copays kick in Miracle Rehab Clinic.
• Patients describe difficulty finding a therapist who understands PEM, since standard graded-exercise approaches can worsen symptoms; the Workwell Foundation maintains a directory connecting patients to PTs trained specifically for ME/CFS and Long COVID exercise intolerance Workwell Foundation.