I was just diagnosed with LEMS by a neurologist in Green Bay, WI. He has never seen this disease before, and based his diagnosis on a negative tessalon test ( which is positive in MG ), and an abnormal EMG which indicated LEMS. Thoracic and abdominal cat scans were negative for small cell lung cancer - I smoked for 20 years but quit 20 years ago-and all my antibody tests were negative including MUSK and voltage gates calcium channel blockers. I have been referred to Mayo in Rochester 10/16/12. Should I get a PET scan or spinal tap before I go there ? Should I have a consult with an oncologist ? My proximal leg muscles are weak, my knees buckle, I have orthostatic hypotension and profuse diaphoresis, trouble walking, gastroparesis, tachycardia, and depression. Steck