Myasthenia gravis; Making an informed decision for my Treatment Path

Posted by carrie13 @carrie13, Feb 3, 2022

I have been diagnosed with MG. I’m trying to make an informed treatment decision: IvIG, steroids or Imuron.

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Thanks for reaching out to me Colleen!
I recently was diagnosed with MG. I am a 69 year old woman and three months ago my hands just stopped working one day. The next day the left side of my mouth started to droop and I could not swallow anything other than liquids. At first I went to a hand surgeon who immediately referred me to a neuromuscular diagnostic center. At first they thought I might have ALS but quickly ruled this out; then they thought I had BIM and ordered blood tests in order to support the diagnosis. The blood test results came back and they thought the results had been skewed because I was on prednisone. A few weeks later they submitted more blood work and they came back exactly the same as the first. They had ordered additional blood tests and luckily one of the tests they ordered showed I had MG. Since then I have been put on Mestinon and now I have to decide what treatment I would like next. My new neurologist has recommended I start Azathioprine. I am very afraid of all medicationd so I have read lots of information about the other treatments that are available including steroids which I don’t do well on, IVIG treatments and this medication he recommended. I’m lucky that I have two pharmacists and an anesthesiologist in my immediate family and they have rendered opinions but they are all different from one another. I am very afraid of the long-term effects of some of the treatments ; those being steroids and Azathioprine. I’ve been told that it is difficult to get an insurance company to support the IVIG treatments because of the cost. I plan on beginning the recommended drug in hopes that I can tolerate it. I am very worried about my ability to swallow. For 3 1/2 months I have been drinking ensure diluted with water. This is all new to me and there are absolutely no support groups near me as I live in Maine. I would love to hear from anyone about any suggestions they have. Thanks for contacting me Colleen!

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Hi, I am a 50 year old woman and I have been fighting Myasthenia Gravis for over 15 years now. I have many suggestions to helping you, but please remember we all have differences and what works for one, may not for another and always verify with your team of doctors first. The first thing that always makes my heart drop is the normal pushing prednisone/steroids first because it has horrible long term damage. Worse mistake I made, it not only caused significant weight gain, but messed with my temperature gage where I freeze to the point that my bones hurt to burned up to the point I felt like I was literally burning from the inside out, I became Irritability and I became snappy over the tiniest things, it caused significant bone density loss where I am just one point from having osteoporosis, and it caused diabetes. Not to mention that it makes significantly weaker before it starts to help you. Nothing I was told about before I was put on it. After I said enough and stopped it, The irritability, snappiness, and diabetes went away, but all the others stayed. I have talked to many others and it seems that the side effects are more common in women, but I didn't do an official study so that may not be true.
I have been on IVIg and the most important thing is to ask for Tylenol and benadryl if you can take them, before you get the infusion. This will help you to avoid the side effect of aseptic meningitis that can last up to 3 day after. Also, if you start to feel a head ache coming on, do not wait, tell the nurse and have her to slow it down and she may also want to give fluids with it. I also take Mestinon and I do well with it, but I talked to others who didn't so well, so best to take the advice of your Neurologist.
Little things that help me with symptoms: Avoid the heat like the plague! If you have to be somewhere that is hot, take lots of ice packs, or something to keep you cool. If you start have a hard time breathing, take a deep breath and count. I suggest doing this when you are not symptomatic to know what your norm count is. My norm count is 17 before taking another breath, but for most, that is the number that tells them to call the ER. While you are waiting for the Ambulance or driving to the ER, put lots of ice on your chest and get it as cold as tolerable if not colder and this will help relax your muscles slowing down the crises until you can get to the hospital. A cold damp rag or put your fingers on the air conditioner and get them cold and hold over the eye that is drooping and this will open it again but only temporarily. Helps if you are driving. Using something cold on whatever area helps until you can take your meds or get more advise from your Neurologist.
Stress, Heat, Viruses or any kind of sickness, Menstruation, Not enough rest, Over exertion in which the level of activity will most likely be way less than you are used to and you may have to take rest breaks several times throughout the day and do not allow anyone to call you lazy because you are not lazy, you are properly caring for your medical health. All of these things effect your MG. Also, make sure to get a list of medications to avoid like No muscle relaxers, beta blockers, cipro the antibiotic, the medications that have been known to cause MG crises. You can also find this list on the MS foundation website. Keep that list with you at all times. I hope some of these suggestions help.


Thanks for your insights @diane50. I hadn’t heard the advice to put ice packs on your chest at the start of a crisis. I do the counting breath test once a week, too, so I can remember what my baseline is.

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