We are moving forward! My doctor is willing to treat me!!! Hooray! Here's what we decided together:

1) test for the AChR antibodies again (the third time!)

2) lactate test just in case (my serum CK is normal)

3) no more SFEMGs, because the last one was already abnormal and another abnormal wouldn't add to our knowledge (last time he spoke as if "sliglhtly abnormal" didn't really count; this time it was more like "abnormal is abnormal")

4) if the AChR is still negative, a referral to either NY or Boston--he's going to look into it and recommend one

5) Mayo if I want in the future, to consider congenital myasthenic syndromes (but I decided to wait on that--Boston and NY are day-trips for me)

6) Imuran is a possibility for the future (we decided to wait on that for now)

7) plasmapheresis is a possibility for the future (we decided that since my home situation is good--I am able to do what I need to here--that we will not do that unless I get worse, or unless we don't make any progress by going to Boston or NY)

At this point, I think I would like some evidence that this is an autoimmune disease before starting Imuran. I think that if we can't find that evidence, and I continue to get worse or don't get better, and if the people in NY and Boston aren't able to help, I will ask for the plasmapheresis. If it makes a dramatic difference, I will go on the Imuran.

All in all, I was so relieved to be taken seriously (he didn't utter those terrible words, "depression" or "stress"). He discussed all these options and we came to these decisions together. So, I'm still sick, but I'm no longer so discouraged.

Thanks, everyone, for all your support, and for all I've learned from you here.

Abby