When should you go in? Yesterday. The basic guidelines for when someone with MG should go in, and this is from neurologists, is when you:

1. Can't swallow.
2. Can't breathe in or out well.
3. Have increased generalized weakness.
4. Any or all of the above.

You really should've gone to the ER yesterday. I know that none of us like to admit we are worse and need help. But take it from someone who knows what a crisis is like, you do NOT want to wait. I crashed so quickly that is was very scary. It is not predictable how quickly or how badly you will get.

And you can't really tell today, on T-Day of all days, how you are doing. You have to be evaluated by objective means like breathing tests, clinical exam, arterial blood gases and oximetry.

Muscle spasms are a HUGE sign that you need help. Right before my crisis, my muscles got so bad my entire mid-section spasmed, front and back. Do you still have spasms off of Mestinon? That's one thing they will try to determine, if you are having a myasthenic crisis from not enough meds or a cholinergic crisis from too many.

And when your MG is bad, you will "pass out" from being so weak. Again, very dangerous. What if you had stopped breathing while you were sleeping? In a hospital setting, they can also see what your oxygen saturation is while you are sleeping. Mine dropped to 66% during my crisis.

If you are still bad before Monday, you need to go in. Period. Please just do it. Do you live alone? Is there anyone who can be with you while you are not doing well?

MG is manageable but not when it rears its ugly head like it's doing with you right now. Not without the cavalry. So let them help you. I hope you will be okay.

Annie