Around here, you only go to the ER if you are pretty sure you will probably die if you don't. Because otherwise, they are more likely to increase your odds of things going badly, than decrease them. It's not a good place. And I doubt they've ever seen a case of MG. And I noticed my gp, who is part of the huge system that owns everyone around here, still hasn't entered MG on my medical record, probably because the neurologist is outside the area, and she is still reluctant to call it that because she's never had a seronegative MG before. But, the pyridostigmine works, other people can see the difference in me, so if it isn't MG, then what is it?

Really suspect she hopes I'll just go away. Scary to have to diagnose someone based on only symptoms and your own intelligence, instead of having a lab report to do it for you.