Hi. Do you happen to have a more informal name? Welcome to the forum.

The first thing you need to know about MG is that "push" is not something you should ever do. EVER. MG pushes back, as you clearly found out.

Yes, it sounds like you were in an MG crisis. That's very dangerous and requires a 911 call immediately. You don't know how fast you will go downhill.

What they usually do for someone with an MG crisis is, well, first get them on oxygen! It sounded like you had a low oxygen and that's why you had chest and arm pain. You CAN have a stroke or heart attack if your oxygenation is too low! Did they even slap an oximeter on your finger? That's almost standard procedure now in ER's and clinics, even if you don't have MG. So they failed big time.

They will usually do a clinical exam of your muscles to designate how weak you are (i.e., 2/5 on the clinical exam scale is pretty weak). They often do arterial blood gases to see how much carbon dioxide is building up in your body due to low oxygenation and poor breathing. They should do breathing tests but that depends upon how bad you are doing. If you can't breathe well at all, breathing tests are pointless and silly!

So, they should've done 1. An oximeter reading and 2. A bedside spirometry or peak flow meter and 3. An arterial blood gas. A neurological clinical exam should've been done too!

Depending upon the hospital, they will either try IV Solu-Medrol or plasmapheresis. Again, this can be different depending upon the treatment you're already on (none, in your case in March). Some patients do better with IVIG.

I know, all of this is knew and I'm throwing a lot at you! You really need to get yourself a pulmonologist ASAP, along with the neurologist you already have. They work together in a hospital when an MG patient goes into a crisis. Hopefully, you won't have that happen again.

With MG, the more you do, the relatively weaker you get. You "use up" the muscle gas all of us need to keep our muscles strong more quickly than normal people do. That "gas" is called Acetylcholine/ACh (ah-seat-ill-co-lean). Antibodies attack the area where the nerves and muscles come together, known as the neuromuscular junction. Due to that, not enough ACh gets to our muscles and they get weak.

And heat is your #1 enemy. It can make MG exponentially worse. Not only heat from the summer months but heat from exertion, infection, sitting in your car without A/C, etc.

Panic attacks, as I'm sure you know, don't cause a drop in O2 levels! So that's a very easy way to differentiate what's going on. I have a Nonin oximeter and it is invaluable! They have less expensive ones on Amazon.

Who would want to repeat an MG crisis? They're absolutely scary. I've had one and I've done everything since to avoid having another. That ER did not do their job well. Make sure the hospital nearest your home knows what they're doing ahead of time, just in case you do get weaker at some point. Ask your neuro where he practices.

I hope that answers some questions. There's a big learning curve with MG, so keep asking. Your life will change. No more long hikes! Especially not without a cell phone. Take it easy.

Annie