Hi,

You sound very much like me when I am very symptomatic. Sounds like you are having an exacerbation. I was told (and be aware I was receiving treatment at this point) that if I had difficulty managing my saliva, it's time to head in to ER. In your case, I would follow the doctor's advice about eating becoming difficult and to go to ER. You can choke in just a flash--it happened to me twice and required a Heimlich.

As for the pain, it could possibly be muscle strain from the chest muscles trying to compensate for weakness, it could be soreness from the pulmo tests when you were giving maximum effort. It could also be an infection or inflammation, although I would say that's unlikely. In any case, with the pain and the increased weakness, I would say a day of rest is essential to see if things improve. Do not eat alone and make sure whomever is with you knows how to do a Heimlich. If you live alone, go online and learn how to give a Heimlich to yourself (anyone with swallow issues should learn this!)

You could also call your doctor's office an ask for an after hours call back. Tell him about the new stuff and then do what he says. If you do go in to ER, tell them you are in the process of being diagnosed with MG and give them your doctors' info. I've had very good luck every time I've gone to ER and the staff has been responsive and eager to learn.

Good luck. Keep us posted.