
This article is coauthored by Ratna Sanka, MD, neurologist, University of Texas Health, San Antonio, and Phil Cogan, MA, MGFA Board of Directors and Crisis Management Expert.
DISEASE & TREATMENT
JUNE 2020 | 5 MIN READ
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Life eventually teaches us the importance of preparing for emergencies before they happen. But life with MG makes this lesson even more important. A myasthenic crisis needs to be handled properly and quickly.1-3 There are many reasons that you may delay creating an MG crisis plan. But wouldn’t you rather prepare for a crisis that never comes than deal with one without the right information? Here’s what you need to know.
A myasthenic crisis happens when worsening myasthenic weakness requires intubation or noninvasive ventilation to avoid intubation.1 In other words, you can’t breathe without a ventilator and need immediate medical help.1,3
There are many reasons for shortness of breath that have nothing to do with MG but may be equally troubling, including lung disease, heart problems, anxiety and more.4 However, any one of the following could signal you’re in MG crisis:
If you are struggling to breathe, it is very important to call 911 immediately.
Before a full-blown crisis, you may experience an impending crisis. This is a flare or exacerbation that could lead to a crisis in days or weeks. The signs vary by case. Take any of them as an early warning—you’ll need closer monitoring at a hospital with aggressive treatment to prevent a full crisis.
You might have a weak cough that is unable to clear your throat. You may cough frequently while eating and drinking. You could have trouble swallowing and need softer foods. Or you might get the sensation of liquids coming through your nose while swallowing.2
Other red flags are a drooping head, speech that's nasal or low volume, or needing to take a breath after every few words.3
If you experience any of these symptoms, you should go to a hospital immediately.
Although breathing, chewing, swallowing and coughing are the most troublesome signs of an impending crisis, there are many others that might be easier to miss, at least at first. These include any worsening of your MG symptoms, from double vision, eye drooping, slurred speech and arm weakness, to falling and trouble walking.
Regular appointments with your doctor and symptom tracking may help you notice these signs early.
To manage the risk of MG crisis, you need to know what can cause one. The list of known MG crisis triggers includes:3
What to do in a myasthenic crisis can get complicated. Be sure to talk with your neurologist regularly about your symptoms to help them know when things are getting out of hand.
It’s important to prepare for a myasthenic crisis ahead of time. Be sure to discuss everything in detail with your neurologist, as every case of MG is different. You should also teach family, friends, caregivers and coworkers about MG and the steps they may need to take if a crisis happens. Even if that day never comes, it feels good to know you have a plan in place to get through an MG crisis safely.
A complete guide to creating an MG crisis action plan is coming soon to MG United. In the meantime, please print the MGFA’s MG Wallet Card, fill it out, and carry with you at all times.
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