[Panorama]

I had a visit with my neurologist today. It has been 3 months since leaving the hospital after a MG crises. I was infused for 5 days while in the hospital. A month after leaving the hospital, I infused for two days.

I am currently in my second Prednisone taper. I was taking 60 mg for two months. I am reducing my Prednisone dose by 5 mg every two weeks. I do not believe I will do the every-other-day thing this time around. I have been on 1500 mg of Cellcept for three months. By the time I get down to 10 mg of Prednisone every day, I will have been on Cellcept for 6 months. I just started the 40 mg dose.

My symptoms are present, but not pronounced. My energy dropped about a month after my last infusion. I have been experiencing painful cramps in my feet, often while driving the cab. I am also having cramps in my ankles and shins while sleeping. My doctor prescribed 600 mg of Gabapentin for the pain. My calcium is good at the very high end of the range at 10.1 mg/dL. My potassium is also good at the high end of the scale at 4.7 mmmol/L.

I have a painful hip joint. My neurologist ordered a bone density tests. He wants to check for osteoporosis.

There were a few issues with my blood tests.

1. Glucose Serum 155 mg/dL (normal 65 to 99).
2. BUN 34 mg/dL (normal 8-27).
3. BUN/Creatinine Ratio 34 (normal 10-22). -- Kidney issue -- Prednisone side effect.
4. Carbon Dioxide 33 mmol/L (normal 18 to 29). -- only 3 into the high range.
5. WBC 17.7 x10E3/uL (normal 3.4 to 10.8). -- Prednisone side effect. May improve when Cellcept kicks into action.
6. Neutrophils (Absolute) 15.5 x10E3/uL (normal 1.4 to 7.0). -- another Prednisone white blood cell issue.
7. Immature Grans (Abs) 0.3 x10E3/uL (normal 0.0 to 0.1). -- response to infection, inflammation or other stimuli of the bone marrow.

I've been consuming too many sweets. I need to cut out the almond milk coffee drink. Each one has a handful of white chocolate chips. I also need to cut out other sweets that I been eating. I should also note that I gave the sample before my breakfast. I may have only had a glass of Almond Milk more that two hours before giving the sample.

My B12 and Folate was good. I am on the low end of normal for Vitamin D at 32 ng/mL. I work night and rarely see the sun. I am currently taking 1600 IU of Vitamin D3 each day. I wonder if I should up the dose another 400 IU.

My neurologist wants me to infuse in a month. Then going forward he wants me to infuse every three months.

I need to work on the above numbers. Any suggestions will be appreciated.

-Mark-