Hi Abby,

This is a wrong way of looking at MG.

Many autoimmune diseases tend to fluctuate in severity, and if you add to that the fact that muscle strength and endurance can be effected by numerous other factors, you can easily see why the symptoms change in their severity over the course of time.

Not every improvement is long-lasting remission and not every worsening is a relapse. MG decreases your reserves and therefore your ability to easily adjust to what for others may be minor and hardly noticed changes in the environment.

The best way to assess MG severity (and this too has its limitations) is probably by using the MG composite score.

http://www.ncbi.nlm.nih.gov/pubmed/20439845

http://www.aan.com/news/?event=read&article_id=8885

Many times a few days of rest, can lead to significant improvement, without the need to make any changes in medications. (just like a few days of over-doing it can do the opposite).

Hope you feel better soon.

Alice

Hi, Mike,

It's not you which is refractory, but your disease!