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I MuSK+ Myasthenia Gravis.  My first symptoms were ocular and started in 2001.  I tested negative at that time for Achr+ MG.  It was generalized by 2003 when a test for MuSK became available but by then it was noted in my charts and no one ever mentioned that there was another type of MG or another test,  more one doctor did comment that my symptoms would seem to be from MG but “you’ve been tested for that so it is ruled out”.  Sixteen years and 3 opthamologists, a neuro-opthamologist, 5 neurologists, and several primary care doctors, later a new neurologist says, “This is MG I’m sure of it”.  to which I said, “No that was ruled out long ago.”  She said , “I don’t think you have had all the tests, we are going to test you for MuSK.  Well, SHAZZAM!  She explained that a positive result would be anything higher than 20; mine was 640.  We tried mestinon with little success; then she referred me to Dr, Levin at Cleveland Clinic.  When he examined me he told me that mestinon would never be successful with MuSK MG and recommended Rituxan infusions every six month for 2 years.  I thank the lord every day for that man.  My double vision was gone shortly after the first infusion and it just kept getting better; my neck muscles were strong again, my eyelid stopped drooping, my smile wasn’t as lopsided, I had more stamina (which is still not nearly what I would like but I am 77 years old), I do not choke any more although my jaws can get tired while eating.  Basically I am what I guess is called minimal manifestation which means that I have minor daily symptoms.  Some who have had Rituxan infusions reach full remission.  I have not had an infusion now since October of 2021 and am doing fine.  I know there is now a new drug out which is supposed to help MuSK patients and I’m grateful that an alternate is available although I would not hesitate to have Rituxan infusions again if it becomes necessary.