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Old 08-01-2013, 12:19 PM
AnnieB3 AnnieB3 is offline
Grand Magnate
 
Join Date: Feb 2009
Posts: 3,306
15 yr Member
AnnieB3 AnnieB3 is offline
Grand Magnate
 
Join Date: Feb 2009
Posts: 3,306
15 yr Member
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Jennifer, I'm sorry for what you've been through too but I want to offer up some concrete help for your situation. No, guys, I'm not "back" but I can't turn away from a newbie.

Frankly, Fortunatos and Heat Intolerant, being left in a hallway for 2 hours where Jennifer could've stopped breathing seems to be a far bigger issue here than reckless comments by a medical professional.

Have you been seen by a neuro-ophthalmologist? When you are seronegative, it can help to get the opinion of other specialists. An N-O can evaluate the cause of any double vision, objectively calculate fatigable ptosis and do a Tensilon Test to see if your ptosis improves.

You should see a pulmonologist as soon as possible. You don't want to put your health at risk to see one, however. I've included a few PDF's below to give you more info. They can evaluate your breathing problems thoroughly. They should do full PFT's (pulmonary function tests) and make sure they include the neuromuscular specific ones: MIP (maximum inspiratory pressure) and MEP (maximum expiratory pressure). MIP and MEP will show how you are doing at breathing in and out. Make sure you ask to get ALL of the "tries" and not only the highest one. Why? Because trends in those tests are important to look at when you have a disease that is fatigable. Other breathing issues like COPD are "static" and don't usually change from breath to breath. At least not as dramatically as MG does.

If you are close to an MG crisis, breathing can change very quickly. If you are still doing very poorly, and your breathing tests are reflecting that, they should run an arterial blood gas (ABG). That "shaking" you are referring to (see article below) could've been a buildup of CO2. Right before CO2 builds up, the ABG can look like you "have" hypoventilation or hyperventilation. Judgmental and sexist doctors can automatically say that you are anxious when, in fact, you are not.

This psycho babble when someone is not breathing or moving well helps no one. It does not appear that they did any objective measuring of your condition via PFT's or an ABG. Did they even do a clinical exam and rate your weakness on a scale of 5? If you are weak, for example, your "rating" can be as low as 1/5.

Did they try the Ice Pack test on ptosis? Did they do an upward gaze exam to see if they could fatigue your eyelid muscles? Did they go to medical school?! They all have quick access to any medical info they might need. Even a layman can Google the steps to assess MG.

When the body needs more oxygen, the heart beats faster to get it more. When that doesn't work anymore, the O2 begins to drop and the CO2 begins to rise. I can't believe they dismissed even that small drop accompanied by the rise in your heart rate. DUH. This is basic body mechanics. You need muscle strength to breathe that oxygen in and CO2 out. It's a pretty simple equation and people who are healthy do not have those issues.

A neurologist is not a pulmonologist. You need both to help you if you have MG. So don't expect more from one kind of specialist. You need to have someone assess your breathing very soon. You do not sound "stable" and should not let your poor treatment at the hospital keep you from seeking out help again. An MG crisis is an emergency! If you can't breathe well, can't move well, can't swallow or feel that things are going downhill (fast or not), you need to dial 911. The EMT's can give you oxygen and assess what's going on and might help your eventual care by an ER doctor.

When I fell recently and hit my head, the triage staff threatened me with paralysis if I didn't let them put one of those damn collars on me. She proceeded to call me an idiot if I didn't. No, those comments are not at all professional, let alone nice, but that's what they are tending to do these days to cover their legal derrieres. It's sort of funny that it's not at all about you but making sure THEY don't get harmed.

Have you taken photographs of your face when you are doing okay and when you aren't? If you use the same face angle, lighting, exposure and distance from camera, the photos will be taken more seriously. If you have MG, the difference can be quite dramatic. You can also do an ice pack test yourself by putting even a cold washcloth that's been soaked and then put in the freezer for a bit (softer than a gel pack) and then take another photo.

Even if it's not MG, it's not nothing. This is not all in your head! It's in your muscles/nerves.

I am sorry for what you have been through. What you need to do now is to get some more opinions from other experts. And check in with your primary doctor too, if you have one, to rule out other confounding possibilities like a thyroid issue. I hope you get help soon.

Annie

http://www.ncbi.nlm.nih.gov/pubmed/3610940

http://curecmd.org/cmd-care/in-depth-tutorial
Attached Files
File Type: pdf NMDiseaseCausingAcuteRespFailure.pdf (120.9 KB, 1703 views)
File Type: pdf NonInvasiveVentilation.pdf (76.9 KB, 1703 views)
File Type: pdf MGCrisisExtubation.pdf (73.1 KB, 1823 views)
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"Thanks for this!" says:
anon6618 (08-15-2013), Online User (08-01-2013)