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I have been diagnosed with Myasthenia Gravis, although my…

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I have been diagnosed...

I have been diagnosed with Myasthenia Gravis, although my neurologists is not as sure as he was several weeks ago. At any rate he has me on 60 mg of prednisone daily. I have been on that for 1 month. So far, the results are negligible at best. He has asked me to stay on that dosage for one more month and then re-evaluate. MYONLY SYMPTOMS ARE THAT MY VOICE IS SOMEWHAT HOARSE AND I HAVE SOME DIFFICULTY AT TIMES PRONOUNCING CERTAIN WORDS. OTHERWISE, I SEEM TO BE OK. MY DR. HAS RUN A BLOOD TEST FOR ANTI BODIES AND HE DID A ELECTRMYOGRAPHY TEST, BOTH OF WHICH PROVED NEGATIVE. HE HAS ORDERED A GENETIC BLOOD TEST TO BE DONE. HE HAS NOT ORDERED AN EXRAY OF MY THYMUS GLAND.

Doctor's Assistant: Is this a time sensitive issue? What type of specimen are they testing?

SEE ABOVE.

Doctor's Assistant: Anything else in your medical history you think the doctor should know?

MY DAUGHTER HAD AN AUTOIMMUNE DISEASE.

Submitted: 3 months ago.Category: Medical
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Answered in 4 hours by:
3/18/2018
Doctor: Dr Subbanna MD, Neurologist (MD) replied 3 months ago
Dr Subbanna MD
Dr Subbanna MD, Neurologist (MD)
Category: Medical
Satisfied Customers: 6,254
Experience: American Board Certified Neurologist, Internal Medicine
Verified

Hi, I am an American Board Certified Neurologist with vast experience in diagnosing & treating all neurological as well as all other health/medical conditions, and I am very glad to help you with your health concerns.

I see you are suspected to have MG (Myasthenia gravis) and in this regard prednisone has been started, and it has not helped you so far, and also I see there is still uncertainty regarding the diagnosis. As a Neurologist I frequently diagnose & treat this type of health situation and I can certainly help you in this regard.

First I need to ask few questions so that I can gather more information related to your health concerns, kindly answer to these below posted questions, it will help me in gathering additional information related to your health concerns;

1) How old are you?

2) Just double checking on what you have already mentioned above, so no symptoms other than speech/voice related ones that you have mentioned above, am I right?

3) Is the speech issue constant/nearly constant OR intermittent in nature?

4) Are you experiencing “fatigable” type of weakness of the speech muscles? I will explain this in more detail here;

The “usual” type of weakness of the muscles is the one in which weakness is always or almost always present, but the “fatigable” weakness is the one which manifests only when a muscle or group of muscles are used for prolonged periods or continuously for some time and this causes fatigue of the muscles and results in their weakness. So when the muscles are not used then no weakness/or no much weakens - but when the same muscles are used for some time continuously then weakness manifests.

And in this context we are referring the speech related muscles such as laryngeal muscles, throat/pharynx muscles, tongue muscles, and facial muscles etc - which all contribute to the speech in one or other way

To continue the discussion on fatigable weakness of the muscles, for example is your speech generally normal immediately after you wake up from sleep in the morning, and this this the time speech related muscles had rest so when you speak around this time the speech is expected to be normal/or nearly normal, even if someone has MG, and as day progresses you may be using the speech muscles again and again or for prolonged periods too sometimes - then the speech problem may manifest

This type of muscle weakness is called as fatigable weakness and this is very characteristic feature of MG. Fatigue causes weakness of muscles in otherwise normal people too, but MG patients start experiencing fatigable muscle weakness much much faster than the individuals who do not have MG.

So are you having fatigable kind of muscle weakness or is the speech issue you have been having constant and has nothing much to do with fatigue of the speech related muscles?

5) And there are certainly no other symptoms such as double vision or weakness of the arms or legs or swallowing difficulties etc, especially the fatigable type weakness, agree?

6) Is it possible to upload a copy of all the test results you are having with you? I wanted to make sure whether all MG related investigations have been done or not, and also find out whether any additional investigations have been done to rule out any other possibilities

7) Did your neurologist mention what kind of genetic blood test it was? Any family history of any neurological illnesses, especially related to the neuromuscular type?

8) Did you get an injection treatment to see whether your speech improves after this injection (which is also called as Tensilon test)?

9) What are your current treatments other than prednisone (including prescription medications or non-prescription/over the counter medications or herbal/supplements, or non-medication treatments etc)?

10) Is prednisone the only med that was used to treat MG?

11) Are there any already diagnosed medical health conditions such as high blood pressure, diabetes, thyroid, high cholesterol, high triglycerides, autoimmune disorders, or any other?

Kindly reply

Best Regards!

Dr Subbanna MD

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Customer reply replied 3 months ago
I DO NOT WISH TO PURSUE THIS ANY FURTHER. NO MORE CHARGES TO MY CARD.
Doctor: Dr Subbanna MD, Neurologist (MD) replied 3 months ago

Please see all the administrative, technical, payment/charging the card related matters etc are handled only by the company, and for any questions or concerns related to the above matters please contact the company directly and they will help you.

http://ww2.justanswer.com/help - this is their official “Contact Us” page where you will get information on how to contact them through email, chat or phone options etc.

Please contact the company directly and they will help you in this regard.

Wishing you all the very best!

Best Regards!

Dr Subbanna MD

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