Nancy, Here's the honest answer: It's different for everyone.

MG is not predictable. Even if you take really good care of yourself, your immune system can "flare" and make MG worse. Taking care of yourself and not "pushing" it does help though. Eating well, sleeping enough, living as stress-free as possible, getting infections taken care of right away, staying out of the heat, etc. are all ways to keep your immune system happier.

There have been times when I knew I was getting worse and rested more. Then there are times like lately when I'm not overdoing and my MG has decided to flare. In general, I do know how ticked off my MG will get depending upon what I do. And you only get to know that through experience with it. But, again, it can surprise you.

It's a day at a time deal with MG. I do the best I can and hope it will behave itself. That's really all you can do. If you get worse, check with your neuro or other appropriate docs like pulmonologists.

As far as a crisis being inevitable, without doing a poll of every MGer, that's hard to say. I've had one crisis, plus many exacerbations (where you get worse but not bad enough for the hospital). I would rather not have another crisis, so I do what I can to avoid one.

There's no magic bullet. Just take good care of yourself.

Annie