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PEM Recovery Tracking Template — Instructions
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About This Template
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This template is designed to help you track your recovery from rolling PEM (post-exertional malaise). It was created by Carol at Ticked Off Codess (tickedoffcodess.com) based on the tracking methods she used during her own rolling PEM recovery with severe ME/CFS.
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How to Use Each Sheet
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Daily Symptom Tracker: Fill in one row per day. Rate symptoms 0-10 (0 = none, 10 = worst). For Sleep Quality, 10 = best sleep. Mark each day as PEM, Stable, or Boom. Include heart rate data if you use a monitor (e.g., Polar H10 with HeartGraph).
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Monthly Summary: At the end of each month, tally your PEM days vs stable days and calculate average symptom scores. This is where patterns become visible over time.
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Heart Rate Zones: Log daily time spent in each heart rate zone. The shift from red/orange/yellow toward blue/green zones is one of the most concrete markers of autonomic recovery.
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Recovery Milestones: Write down every win. Hair brushing without crashing. A conversation that didn't trigger PEM. A shower that felt safe. These are your proof of progress.
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Tips for Success
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Track at the same time each day if possible — consistency helps spot patterns.
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Don't push yourself to fill in every field. Skip what costs too much energy.
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Review your monthly summary when anxiety about relapse creeps in.
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Share relevant data with your care team to support treatment decisions.
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Adjust the heart rate zones to match YOUR anaerobic threshold, not generic fitness zones.
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Important Disclaimer
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This template is for personal tracking purposes only. It is not medical advice. Always consult your healthcare provider before making changes to your treatment or activity levels. For more about rolling PEM recovery, visit tickedoffcodess.com.
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