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Suggest Treatment For Myasthenia Gravis
Question: I was diagnosed with Myasthenia Gravis in 2002 via a blood test that showed antibodies in my blood. With the past 13 years, I'm trying to manage and cope but it is getting the best of me at times. I slur my words almost daily... is it lifelong?
There were a lot of blood tests my current neurologist ran that I have uploaded and attached. I was aware of foot numbing at the soles of my feet so he wanted to find out why. I saw him last week and he diagnosed a B-12 deficiency with borderline diabetes. I've begun supplements and am seeing a nutritionist to lose weight and increase exercise. Do you agree?
There were a lot of blood tests my current neurologist ran that I have uploaded and attached. I was aware of foot numbing at the soles of my feet so he wanted to find out why. I saw him last week and he diagnosed a B-12 deficiency with borderline diabetes. I've begun supplements and am seeing a nutritionist to lose weight and increase exercise. Do you agree?
Brief Answer:
Disease can not be eradicated.It has to be kept under control with drugs.
Detailed Answer:
Hi XXXXXXX XXXX,
Thanks for being on healthcaremagic.com.
I am Dr.Ajay Panwar,a neurologist,here to answer your query.
I understand your concerns quite well.However,as even you must be knowing,that Myasthenia gravis is such a disease,which does not get eradicated.However,the aim of the treatment is to keep it under control and maintain a state of remission,as far as possible.
Would you please tell me the details-What are your symptoms?which antibodies were positive,MuSK or anti-ACHR?Is it a generalized myasthenia,MuSK or ocular myasthenia?What is the state of Thymus?Was Thymus surgery suggested or done?What about steroid therapy?Are you currently on steroids as well?Your detailed prescription?
I hope to see you in follow-up with details and your pertinent queries.
Regards
Dr.Ajay Panwar,
MD,DM(Neurology)
Disease can not be eradicated.It has to be kept under control with drugs.
Detailed Answer:
Hi XXXXXXX XXXX,
Thanks for being on healthcaremagic.com.
I am Dr.Ajay Panwar,a neurologist,here to answer your query.
I understand your concerns quite well.However,as even you must be knowing,that Myasthenia gravis is such a disease,which does not get eradicated.However,the aim of the treatment is to keep it under control and maintain a state of remission,as far as possible.
Would you please tell me the details-What are your symptoms?which antibodies were positive,MuSK or anti-ACHR?Is it a generalized myasthenia,MuSK or ocular myasthenia?What is the state of Thymus?Was Thymus surgery suggested or done?What about steroid therapy?Are you currently on steroids as well?Your detailed prescription?
I hope to see you in follow-up with details and your pertinent queries.
Regards
Dr.Ajay Panwar,
MD,DM(Neurology)
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you so much.
In 2002, I had a thymectomy and the antibodies in my blood are rated at 74 for blocking my acetycholine receptors. I am taking no steroids presently.
Plasmaphersis may be in my near future as it "cleans' my blood.
Symptoms... forgot, sorry. I have generalized MG with weakness in major muscle groups like legs and arms.
Thanks for your help!
In 2002, I had a thymectomy and the antibodies in my blood are rated at 74 for blocking my acetycholine receptors. I am taking no steroids presently.
Plasmaphersis may be in my near future as it "cleans' my blood.
Symptoms... forgot, sorry. I have generalized MG with weakness in major muscle groups like legs and arms.
Thanks for your help!
Brief Answer:
Steroids may be combined with cellcept.
Detailed Answer:
Hi XXXXXXX XXXX,
Thanks for being in follow-up and providing further details.
If your disease activity is not getting controlled on cellcept,adding steroids may be helpful to you.In many cases,steroids are combined with immunosuppressant drugs to derive the maximum benefit.
Further,Cholinesterase inhibitors(like pyridostigmine) can be added for symptomatic management.
I suggest you to please discuss these modifications with your treating neurologist.
If you have some further questions,I shall be glad to have you in follow-up.
Regards
Dr.Ajay Panwar,
MD,DM(Neurology)
Steroids may be combined with cellcept.
Detailed Answer:
Hi XXXXXXX XXXX,
Thanks for being in follow-up and providing further details.
If your disease activity is not getting controlled on cellcept,adding steroids may be helpful to you.In many cases,steroids are combined with immunosuppressant drugs to derive the maximum benefit.
Further,Cholinesterase inhibitors(like pyridostigmine) can be added for symptomatic management.
I suggest you to please discuss these modifications with your treating neurologist.
If you have some further questions,I shall be glad to have you in follow-up.
Regards
Dr.Ajay Panwar,
MD,DM(Neurology)
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you very much... MG is very frustrating and I need and appreciate the advice.
I am considering plasmapheresis again... it worked several years ago and may again.
I do have a question... despite my best efforts, I can not lose weight. For over ten years, I've been gradually adding pounds until now I am borderline obese. The issue is SSRI's (I take 150 mg. of Wellbutrin and 15 mg. of Lexapro) and Dopamine agonists (1 mg. and 4 mg. of Ropinirole) that prevent it; too, I hardly ever sleep well since I also have Sleep Apnea and use a CPAP nightly. What do you suggest?
I am considering plasmapheresis again... it worked several years ago and may again.
I do have a question... despite my best efforts, I can not lose weight. For over ten years, I've been gradually adding pounds until now I am borderline obese. The issue is SSRI's (I take 150 mg. of Wellbutrin and 15 mg. of Lexapro) and Dopamine agonists (1 mg. and 4 mg. of Ropinirole) that prevent it; too, I hardly ever sleep well since I also have Sleep Apnea and use a CPAP nightly. What do you suggest?
Brief Answer:
Physical exercise/Diet/Sleep medicine specialist consultation.
Detailed Answer:
Hi XXXXXXX XXXX,
Thanks for being in follow-up.
Assuming that you can't stop the medicines because of your symptoms,you must be on a strict diet schedule to lose weight.
For sleep apnea,CPAP is the most effective therapy.You should continue it and refer to a sleep medicine specialist for expert opinion on sleep apnea's management.
Hope that I have answered your query.If you have some further questions,I shall be glad to have you in follow up else please close the thread,rate it and write a review.
Regards
Dr.Ajay Panwar,
MD,DM(Neurology)
Physical exercise/Diet/Sleep medicine specialist consultation.
Detailed Answer:
Hi XXXXXXX XXXX,
Thanks for being in follow-up.
Assuming that you can't stop the medicines because of your symptoms,you must be on a strict diet schedule to lose weight.
For sleep apnea,CPAP is the most effective therapy.You should continue it and refer to a sleep medicine specialist for expert opinion on sleep apnea's management.
Hope that I have answered your query.If you have some further questions,I shall be glad to have you in follow up else please close the thread,rate it and write a review.
Regards
Dr.Ajay Panwar,
MD,DM(Neurology)
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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