I'm looking for information about diagnosing MG. I have a number of weird auto-immune/ fibromyalgia things going on, and a neurologist told me MG is ruled out as a factor, based on a negative chest x-ray, negative EMG, and neg anti-ACHR test.

But when I am tired or flaring I have:

• difficulty swallowing (no prob with liquids, it just feels like food won't go down easily, and I kind of work to push each bite down.)

• double vision (I have difficulty controlling both tracking muscles and focusing)

• muscle weaknesses when I am tired (it feels like I can't hold my head up, and I have to raise my eyebrows to keep my eyes open). My kids and neighbors warn me when I start to get too tired, even before I feel it. They say my face kind of droops, especially around the eyes.

• Hoarseness (one of the vocalis muscles doesn't close -- but only when I'm flaring)
• Shortness of breath when fatigued

Once the panting started I had a spirometry test done, that showed mild constrictive ventilatory defect. But on follow-up it was back to normal. The pulmonologist said I must have just been too tired to inhale fully for the first test.

Now I find my tongue gets tired if I speak for too long, and I start to have unclear diction.

Should I trust that we really have ruled out MG? I feel weird asking about it, since no one seems to think it is a possibility. And I have been off and on sick fairly continuously since 2003, so maybe I'm just grasping at straws here. I haven't had a single-fiber EMG, and I would rather not, as I found the regular test quite distressing (maybe the fibromyalgia ups the pain.) Also, I tend to be a little too passive about presenting my complaints, and bugging my Docs... Any advice or ideas?

Thank you. It is really wonderful that this site exists, especially for folk like me who live in a rural area .
--Shari