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Myasthenia Gravis

Fall asleep during a meeting? Some quick thinking could turn your boss's anger into sympathy once she finds out you have an incurable disease called Myasthenia Gravis.

The symptoms begin insidiously with droopy eyes caused by weakness of the levator eyelid muscles -- often worsening as the day goes on. Weakness and easy fatigability when performing simple tasks like combing the hair or stacking dishes can initially seem like a mere inconvenience, but can gradually progress to the point where you are barely strong enough to take a breath. Your boss may blame it on laziness, but inside your body, cross-wired antibodies are short-circuting the nerve endings where they innervate the muscles -- particularly in your face and proximal muscles of your arms and chest. Some victims like Aristotle Onassis (among the wealthiest men on Earth, and second husband of first lady Jacqueline Kennedy) must resort to using scotch tape to keep their eyelids open.

Don't worry about your boss catching you in a lie. The only way Myasthenia can be reliably diagnosed is using a rarely-ordered electromyogram to catch the flagging electrical twitch of rapidly weakening muscle fibers -- a test only interpreted by skilled neurologists.

Affecting about 50 thousand people in the USA, Myasthenia tends to be a lingering illness -- but it can easily kill you. A bad upper respiratory infection can quickly exhaust a myasthenia patient, and a crisis of weakness may cause death from helpless respiratory arrest. In this situation a life-saving shot of Tensilon can temporarily reverse the symptoms -- also serving to confirm the diagnosis in the emergency room. But because most ER doctors never bother to perform a "Tensilon test," you are more likely to be intubated and placed on a ventilator several times before anybody ever figures out what's wrong with you. Don't forget to insist on a C-T scan of your chest. A 20% of Myasthenia patients also have a malignent thymoma.

There's no cure for Myasthenia Gravis, but long term malignance with Pyridostigmine can help you tolerate the symptoms for years, although don't expect the drug to help you stay awake in meetings -- especially if you spent the whole night reading this website!

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