MYASTHENIA GRAVIS
PROBLEM
Myasthenia gravis (MG) is a chronic disorder in which the body’s immune system mistakenly attacks and destroys proteins that help muscles respond to nerve impulses. This causes people to have muscle weakness that is worse with use and better with rest.
Eye muscles and muscles that help with chewing, swallowing, and talking tend to be affected the most. MG can be treated but not cured.
People with MG generally have to take medicine for the rest of their lives to control the disorder. Surgery to remove their thymus gland may be necessary.
TREATMENT PLAN/CARE
A.Wear a medical alert tag and keep a list of medicines and the dosing schedule, along with the name and telephone number of your neurologist, in case of emergency.
B.Dentists and any other healthcare providers should know that you have MG because many medicines can make your MG worse. Some examples of medicines that can be problems for people with MG are birth control pills, some antibiotics, and some local anesthetics. Many medicines can be problematic, so you should never start a new medicine without talking to your neurologist first, even if you took it in the past without having problems.
C.Take your time when eating. Establish routines and take small breaks between eating. Small frequent meals thoughout the day are advised instead of large meals. Choose foods that are soft and easier to chew and avoid foods that require a lot of chewing.
D.Any time you feel worse, particularly if you are having trouble with chewing and swallowing, you should contact your neurologist and plan to go to the hospital, because MG could possibly affect your breathing. You should have a plan for emergencies that includes how you will get to a hospital, child-care arrangements, and how to contact your neurologist.
E.An annual flu shot is recommended because infections can make MG worse.
F.Emotional upset and stress also can make MG worse. Your healthcare provider can supply you with information on handling stress effectively or assist in referring you to a counselor.
G.Surgery can make MG worse, so it should, when possible, be planned with your neurologist. Some changes in your medication schedules in the weeks before the surgery can make problems less likely.
H.Plasmapheresis may be recommended to you. This procedure is performed to remove the antibodies that make the disease process worse. This procedure is similar to donating blood. Blood is removed from a vein, the antibodies are removed, and then the blood is donated back to you in another vein. This procedure may be offered to you many times, since the effects are not permanent.
Activity: It is best to plan your activities to take advantage of the peak effects of your medicine and to avoid getting overtired.
Diet: A diet high in potassium-rich foods has been found by some to be helpful because low body potassium is associated with muscle weakness.
Medications:
You may be prescribed steroids or medications that improve muscle strength.
You Have Been Prescribed: ___________________________________________________________
You Need to Take: ___________________________________________________________
You Need to Notify the Office If:
A.You have worsening or new symptoms.
B.You are unable to tolerate your medicines because of side effects.
C.Other: ___________________________________________________________
Phone: ____________________________
RESOURCE
Myasthenia Gravis Foundation of America, Inc.: www.myasthenia.org
PATIENT TEACHING GUIDE