Hello again.

I'm interested to know about the behavior of muscle fatigue-ability in MG and whether there may be any explanation as to why some muscle groups behave differently to others.

I am noticing specific patterns. For example:

1. Finger movements start okay and gradually get slower and slower until the power goes completely (playing the piano, for example). As the power goes, so too does the coordination and ability to sustain motion.

2. Calf and thigh muscles - as well as the muscles for chewing - behave in a similar fashion. Calf muscles: standing with the heels together and rising on the toes (I used to be able to do 60 - now I can only do 5!). Thigh muscles: deep knee bends/lunges - impossible, just fall over, legs give way. Chewing muscles: starts off okay and gets slower and slower (when I persist in chewing once tired I begin to choke on the food).

3. Speech seems to behave somewhat differently. Sometimes it improves with talking and other times it gets worse. I can't find a particular pattern here.

4. Neck muscles - once they're gone they're gone.

5. Eye muscles. Always pretty useless in terms of looking for more than a few seconds in any one direction (upwards, sideways).

With (1) and (2) I notice a further pattern. I call it 'getting over the hump'. When I was in remission earlier in the year, with walking and with these other activities, if I could get past a twenty minute point then things were okay (even if I then paid for it later). However, now my hump is about five minute and I don't get past it so often. Further to this weirdness, I find it is easier to sustain muscle strength if the muscle is moving. For example, if I try to lift my arms, it is easier to keep them up if they are moving about than if I'm holding them still. Same for walking and standing. I can walk for longer than I can stand - what's that all about?!?

I'm interested to hear:

- Does this sound like MG muscle behavior?
- Do others get experience of 'the hump'
- And if so, what scientific explanation there is for this.

Thanks in advance for your thoughts!