Hi, Kevin. Welcome. Your wife is really lucky that they figured out what caused her crisis. Immunosuppression can bring on all kinds of "latent" viruses and bacteria in the body. After I had steroids, I got a staph infection, had an antibiotic and then got clostridium difficile (secondary infection of the GI tract).

With all those antibiotics, I hope she is taking acidophilus! She needs to keep as many good bacteria in her body to avoid the secondary kind of infections. The kind that is refrigerated is often best to take. If she's uncertain of what to take, she can ask her primary doctor.

Almost anything can make MG worse. Heat is my biggest culprit but infections, stress, lack of sleep, etc. can all do it. Surgery too, obviously for your wife! What is usually done before surgery for those with MG is plasmapheresis or IVIG. So if she ever has to have surgery again, they have to take that precaution!

I am curious, did she have gall bladder stones? The reason I'm asking is that some people who have a lack of stomach acid can get gall bladder problems. We all lose stomach acid as we age. It not only helps digest food but fight infection. I haven't had stomach acid for decades and used to have infections a lot. I take Betaine HCL (mild acid usually made from beets) to digest my food. DO NOT try any over the counter without a conversation with a doctor though!!!

That's really great that she is better. A crisis is really scary. I've only had one but that's enough. Lots of exacerbations though too. If she doesn't have a good pulmonologist, having one is essential. If she starts to feel worse, breathing-wise, then a pulmonologist can do the tests to see how much worse, etc. I know what my base-line pulmonary function tests are and what numbers are bad for me. It's different for everyone. My pulmy has standing orders for when I'm worse, which is great. She'll do arterial blood gases if necessary too. Neurologists are the ones who diagnose MG but often it's the pulmys who manage it. They will work together in the hospital for MG care.

The key for me to keep me doing okay is to make sure I don't get overheated and always balance what I do with the right amount of rest.

I hope that helps. Please tell your wife to come on over! This is a great forum filled with very compassionate people.

Annie