Very complete article! Thanks.

I noticed that the said prednisone at high doses should begin to work in about 3 weeks. High doses were 60-100 mg per day.

Another statement that stood out "Postoperative myasthenic crisis is common after thymectomy; the incidence ranges from 12% to 34%." (with folks who had previously had a crisis more likely to have one after surgery).

They also quoted 42% mortality rate in the 1960s and earlier vs 6% now.

A good summary and education, although it is somewhat technical for folks who haven't been reading up on MG before.
Thanks Russ

Thanks, a very good and detailed article. Not sure why, but I picked out that acetylcholinesterase inhibitors are usually discontinued in myasthenic crisis. We often talk on here about taking too much Mestinon and I suspect it's possibly a common link to many of the symptoms we hear about. Fortunately, not too many of us will suffer a real MG crisis in our lives.

It was good to see that my own Neurologist was cited in the credits.

Thanks for all of your efforts!

Personally, unless there is something wrong with the thymus, I would not mess with it considering it is needed as part of your immune system even though it gets smaller as we get older. As we age, just more at risk by the thymus activity reduction alone.

Thanks fighter for the link! The article is concise and a good reference. I am seronegative but had an abnormal SFEMG.. My daughter is being treated for congenital myasthenia, My myasthenia is not typical and I never know which antibiotic will cause problems. In November I was hospitalized after my 2nd cricoid pharyngeal myotomy, which was supposed to be an outpatient procedure. Unfortunately there was a tear in the esophagus thus anything I drank went into the chest cavity. They put me on high doses of an antibiotic cyindomyacin to prevent cardiac infection which caused extreme muscle weakness, I could not lift my arms or get 250 ml on a spirometer. If they had asked I would have suggested increasing pyridostigmine along with giving the antibiotic if it had to be that one. I had severe atelectasis on scan but my BIPAP and oxygen helped until the pyridostigmine was increased. and effective .I used breathing exercises after that being careful to break them into smaller numbers. I was hospitalized five extra days.

I am unique in having an exquisite response to pyridostigmine so I am able to respond faster then most when I do get into trouble. I found at home I needed 30 mg. extra of pyridostigmine every six hours dose to dose with the clyndimycin to function normally. not to mention extra imodium to counter the GI effects. I also take acidophilus to keep flora normal. This is something
I have worked out with my neurologist, a range I feel comfortable titrating pyrido stigmine due to medication or exercise causing depletion of acetylcholine at the neuro-junction. I know right away that familiar feeling. The problem comes when I wake up in recovery past the point it can be reversed with medication.

I don't consider myself typical but I have had so many problems post anesthesia with visits to the ICU on BIPAP that I avoid it when I can. I have found for myself that having NACL not Ringers Lactate helps, having good temperature control with the Bear apparatus before and during surgery helps, keeping tidal volumes uniform and oxygenation helps. Once anything gets off it seems I get into trouble easily. Also antibiotics have caused problems many times. Often if my pyridostigmine is increased and titrated it makes all the difference in the world for me. I have surgery in the morning not the afternoon when possible. I take my pyridostigmine an hour before surgery to make sure it is at it's most effective dose.

ON a recent hand surgery they decided to use a tourniquet system to keep the pain meds compartmentalized. I believe it is called the Beer Technique. It worked well for that procedure.

I have not been on this site for a few years so hello to both new members and ones from the past.

Good to hear from you! Hello back GreenMarie!