Angell, I'm glad to help. We've all been through life, and doctoring, H@!! at some point.
What do YOU want your doctor do for you? Are you kidding?!! Wow. How about thinking. How about a little research before they ask stupid questions.
Here's what s/he could do. The most important thing is to put a patient in the ICU if an MG crisis could be imminent. A lot of doctors still don't do that. You need round the clock monitoring at that point of O2 and ECG.
1. First, assess O2 and supply oxygen (or BiPap/intubation depending upon severity). Adequate ventilation is absolutely the first thing to be done! If you can't breathe (well), you could die. Very few ER doctors walk an MG patient around a few paces with an oximeter on. If your O2 is low while lying down, how is it while moving around? And the pulse tends to go up if your heart is working hard to get you oxygen.
2. Assess overall strength by doing a clinical exam documenting what "strength" your muscles are on their 1-5 muscle strength scale.
3. Do an arterial blood gas (while off of oxygen, because it can skew the results). If it shows "hyperventilation," that does NOT mean the patient is anxious. They can't breathe well and a crisis could be imminent. Pulmonologists, not neurologists, read the results and make recommendations.
4. Hook up an ECG because hypoxemia is particularly hard on the heart (and brain).
5. Do a bedside spirometry or full PFTs in a pulmonology lab (if a patient can tolerate it). O2 and ABG are not necessarily indicative of an impending MG breathing crisis.
6. If breathing is poor (low MIP and MEP, low O2, etc.), assisted breathing might be in order such as a BiPAP.
7. Implement additional therapy if it's determined that the patient is in an MG crisis, or even an exacerbation (the step before a crisis)! It's called "preventative medicine!" The norm is to do plasmapheresis or steroids. It all depends upon how bad you are. Steroids should be a temporary fix with a relatively fast taper (a month).
8. Redo the clinical exam and/or O2/ABG/Bedside spirometry to see if the treatments are working BEFORE they discharge you.
9. Suggest a followup appointment with your neurologist (after they discharge you).
10. Suggest a followup appointment with a pulmonologist to have an overnight oximetry (or do it at the hospital!). Why? O2 readings tend to drop even more while MGers are sleeping!
For heat exhaustion or heat stroke, they should've not only administered fluids, but checked your metabolic panel first AND cooled your body off. Duh.
More than one thing might've been going on here, and a good ER doctor will assess both the possible heat exhaustion and potential MG crisis.
I've attached PDFs below that might help your docs. If they don't have the inclination to do a fast search on an MG crisis, OMG, why are they doctors?
When we can't move or breathe well, how can we take the lead on our own care? You might want to consider bringing a copy of a PDF with you to the ER next time (hopefully, there won't be a next time).
You need to make sure that you are adequately hydrated when you are exposed to hot weather. That' wouldn't necessarily help with MG, but it does cool your body down somewhat. Cool packs on the neck and wrists or a cooling vest helps, too.
I'm glad you had an influx of cash. You really need more assistance, too, though. Work the system and find some (when you feel better!).
Take it easy, okay? You really can't do much more than rest and sleep now. If you had an oximeter, your wife could slip it onto your finger while you're sleeping to see how you're doing.
Annie
http://emedicine.medscape.com/articl...iew#aw2aab6c10
http://www.med.unc.edu/neurology/neu...ences-2007.pdf