Hi Annie,
Thanks for your detailed reply. My trip to Europe is a river cruise with bus day trips so I should be okay. It was booked last September and might be my last big trip.

I'm much better now that it is cooler here. I have a strange, as yet, undiagnosed low blood calcium condition. I've seen three endocrinologists before I finally found one willing to treat me properly. My low white blood count is a life-long thing, just the white blood cells, not the red, so not anemic.

I am a likely celiac (mom gene-test confirmed) so went strictly gluten-free 8 years ago in order to try to solve the calcium problem. I have fat malabsorption that makes keeping the Vitamin D and calcium in range a bit difficult. My potassium gets low quite easily, despite a banana, orange, orange juice, leafy greens and nuts and seeds every day. I do have low stomach acid and take betaine hydrochloride supplements. Recently we added digestive enzymes too. I've been thoroughly worked up for GI issues - the docs totally missed the low stomach acid as the cause of the diarrhea I had 6 years ago, despite the fact I told them repeatedly that my mom has NO stomach acid. A naturopath made the diagnosis for me and started me on the supplements.

So I likely have more than one condition going on. I have somewhat dry eyes and mouth and the Mestinon's side effects helps counteract those symptoms.

I've had all my IgG levels tested, looking for IgG4 disease - all normal.

Because I've never had a crisis, the various docs keep saying "You don't have MG!". So that is why I keep travelling, assuming each trip may be my last. This calcium problem has been going on for 8 years, the muscle weakness at least 6.

Mestinon has always made my asthma better, not worse, another thing that perplexed the neuro who gave me the trial of it. She said "It isn't a drug of abuse; I'm fine with you staying on it". Thanks for the info on the steroids affecting the tests. I'm on it for summer allergy problems so will try to get tested in fall or winter when my asthma is much better.

I have no double vision or ptosis - another reason docs think it isn't MG.

I really appreciate all your input and will push my family doc to start the next referral and put "red flags" on it so it moves faster!
Flutebell