If two were normal, I would think that it's adequate.

The reason they repeat the tests, is mostly because for some people it takes time to learn how to do them and than they get abnormal results.

In MG there can be worsening in the second test as compared to the first, so they may sometimes do it a third time just to be sure that there is such a trend.
Or sometimes they will not do more than one, if the patient is on a verge of a crisis and they don't want this effort to push them over the edge.

I would tend to think that a normal MIP and MEP measurement during significant respiratory difficulties would very much go against respiratory muscle weakness as the cause.

So sorry for your experience which made you feel even worse.
What does one have to do these days to get quality service from the E.R. these days?

I'm so happy!! I've broken thru the invisible hospital barrier!!
I ended up visiting a local clinic near my house because my breathing was becoming near impossible (from strangling sensation) and the doctor's dad has MG so he's totally familiar with it and has made it his mission in life to help MG patients navigate the system (he knows how much trouble his dad had initially).

This doctor asked if I had a primary doctor (I said "per se") and he told me he's going to be my primary doctor/advocate/leader/navigator to help me get everything I need! He's of course familiar with MG (more so than the neurologists I've visited so far). He put me on oxygen right away and sent me by ambulance to another hospital. He told me I couldn't leave the hospital until I had appointments scheduled with a pulmonologist & neurologist from the hospital (rumor is the hospital has an excellent neurology department, so I'm looking forward to finding out.)

Of note, they did the MIP & MEP tests again and the numbers weren't as good. The lady today did 3 tests each & did the tests more back to back. The lady yesterday gave me 3-4 minutes to recuperate between tests.

I'm in a waking dream. I'm tempted to pinch myself because this seems so unbelievably too good to believe. Did the universe finally hear me? Am I really going to be taken care of? Did I really find a doctor advocate who understands & will help coordinate for my health? I'm in a state of grateful shock....

Wow. That was a stroke of luck!

I just saw the hospital's neurologist, a super nice guy. I told him about the other E.R. visits & how everything I'd read said to try & avoid arriving at a crisis but that E.R.s have been sending me away. He told me, "Well, I don't want to be talking badly about the other doctors & I don't know what was going on, but screw them, they were wrong." (WHAT?!! )

The doctor tested for muscle weakness & said he thinks I have classic seronegative MG (I prefer 'classy'). He's going to start me on five days of IVIG, so I'll be testing how good my insurance coverage is. I've never stayed in a hospital before.

I'm just so thankful. You guys bore with me during these couple months of complaining & frustration, please bear with me while I experience this new sense of elation. I'm just so thankful they're so WILLING to help me!

If anyone reading is in the Austin, Texas area, let me know if you want the name of my primary doctor who's such a gung-ho advocate for MGers (his dad had MG).

I get my IVIG at infusion center, It's a lot cheaper. Good Luck
Mike

Seishin,

The ER's you visited will likely send you or call you for a survey of your experiences. Please take the time and evaluate them appropriately. It can make a difference.

Well, isn't that incredibly amazing!!! So many of us know that feeling of having a super bad experience followed by finding a super great neuro. Strangling sensation? Are you sure that wasn't what you felt towards the ER doc from last night?

I was wondering something about the MIP and MEP - what were the numbers? The things is that your normal #'s might not be what they were in the 1st ER. My normal MIP is approx. -84. Half of that would be a significant difference for me. So it all depends where you begin and where you end up. Trends in those tests are as important as an absolute number, especially when it comes to MG.

I'm thrilled for you, Seishin.

Annie

Thanks Seishin,

You made me realize how important it is for physicians who had a personal experience with MG to help other patients.

I have been doing this to the best of my ability, but this will motivate me to do it even more.

It also made me wonder (again) why you have (as a physician) to personally experience MG in order to understand it. And also how we (physician with a personal experience of this illness) can communicate it better to our colleagues.

I think it is a very confusing illness and it does cause patients to behave in what may appear a very peculiar way.
I sometimes compare it to someone who is fighting an invisible dragon, that only he/she can see and also not all the time.
So you see that person throwing their sword around in the air, sometimes in unusual directions...

I am very glad that you have found a team of physicians you can trust to take care of you. It makes a huge difference.

A great stroke of luck indeed!

I´m so happy for you......