My husband was diagnosed with MG four years ago. He is on Mestinon. For the past six months he has been having a lot more trouble with weakness and short of breath. He has pain in his shoulders, chest and arms after just walking a short distance and when he stops and rests it will go away within an hour. One doctor says this is his MG advancing but another thinks he might also have fibromyalgia or fibromyalgia rheumatica. We are totally confused. At this time he is really unable to do much of anything. What should we do?
Pain which only comes on with exertion and is relieved by rest sounds as though
it is exertion related, this would suggest that the problem is due to MG rather than
fibromyalgia or polymyalgia rheumatica.
Polymyalgia rheumatica can be outruled by doing a sedmentation rate which
should be dramatically increased in PMR.
There is no definitive test for fibromyalgia so I would be reluctant to leave him with this label
without further investigation.
If his MG is becoming more aggressive then it is time to become more
aggressive with therapy including the use of steroids, plasmapheresis,
cyclosporin and azathioprine.
If this requires a second opinion or referral to some one who specializes
in the treatment of MG then I suuggest that this pointhas been reached.
If you require assessment at the Cleveland Clinic Dr Kerry Levin in our
Neuromuscular Dept specializes in the treatment of this problem, the number for appointments
with Dr Levin is (216) 444 559
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