I have just had a call from the Respiratory Physio who I have never met. Although not diagnosed, there is a suspicion of MG or associated condition (I already have Luous/UCTD). I have weak respiratory muscles, in particular the diaphragm with fatigability.

She gave me plenty of advice; try to gain a few pounds (weight) as my BMI is 18 and do more exercise! I already keep active and walk my dog for 2 - 3 hours daily although this can be an ordeal. She wants me to add cycling/swimming or interval training to my day! I tried to explain that I could no longer sustain increased exercise or pace but she was adamant. I felt stupidly tearful after this conversation as I have always been madly energetic until my fitness has been gradually taken from me. I feel really disheartened especially as the physio then went on to tell me that there was nothing she could do to help . .