Hi, Mark. You certainly have a lot going on!

First, Gabapentin, AKA Neurontin, can not only make MG worse, but has been shown to cause it in some people. Also, it is excreted through the kidneys and, by the looks of your numbers, is a big concern. Where is your pain (the hip?) and have they figured out why you're having it?

When they saw that elevated carbon dioxide level, they should have done an arterial blood gas. The body needs to keep those numbers in the normal range! So when you say "only" 3 into the high range, that's not the correct way to think about this particular test. Well, that and it is 4 above normal. The body needs those numbers to be in the normal range or you can end up with things such as metabolic acidosis. Please ask your pulmonologist to do an ABG (if they think it's necessary) and to make suggestions!

The kidneys are no small issue either! Only a nephrologist can tell you if those are a temporary swing in the levels or a permanent one! What were your numbers before Pred?

My Dad had kidney failure from high BP from a blown aortic valve due to rheumatic fever (oy). You do not want your kidneys damaged!

I think a second opinion is necessary. Were those levels ever run before you went on Pred? Again, don't assume that this is no big deal and that they'll go back to normal when off of Pred. Your kidneys are having trouble RIGHT NOW!

Almond milk is packed full of sugar. If you have sugar only, your glucose will spike a couple of hours later. All sugar is bad (which you obviously know). Sorry, but that's not my opinion, but scientific fact (sorry to the sugar growers on this planet, but that's the deal). And given that your glucose is high AND you are on Pred, you might already have Pred induced diabetes. Only an endocrinologist can tell you for sure. Did they check your A1C level?

What was your B12 level?

Cramps in the feet/calves can be due to poor circulation, lack of oxygen, and so many other reasons. And your test results are a look at your body in ONE MOMENT in time. Electrolytes fluctuate, as do other numbers. Muscle cramps are not only caused by those changes either. Do you have a BiPap? Do you have sleep apnea?

Don't rely on one doctor (internist or neuro) to deal with abnormal test results. You can't assume that the cause of these results are from Pred!

You should take a serious look at your diet and calculate what amounts of potassium, magnesium, etc. you are having with each meal. Seeing a dietician might help, too. If you have kidney damage, there are specific diets for those who do.

And how is your heart? When was your last EKG? Have you had an echocardiogram (ultrasound of the heart)? Is your BP elevated?

In my humble opinion, you are not having thorough doctoring. These are no small issues you bring up and need attention.

Your body is the only one you have. Sorry if this sounds like a lecture or that I'm being condescending—which I'm not. I've seen too many people rely on drugs to help them, instead of changing their daily food/water plan, etc. Our bodies are amazing, but they need our help.

I really hope you'll seek out more help. I'm fairly concerned about the way things look (at least from here). You need good specialty doctors to keep an eye on things for you and an internist to pull it all together.

Take good care of yourself, okay?


Annie