Getting a Colonoscopy When You Have Myasthenia Gravis

I know everybody loves to get colonoscopy! I just recently had my third colonoscopy, but it was the first one after being officially diagnosed with myasthenia gravis (MG).

Magnesium prep

Although I was having MG symptoms at the times of my first 2 colonoscopies, I was not yet diagnosed, so there was no reason not to do the regular magnesium prep. But each time I did the magnesium prep, within just a few minutes after ingestion, I would become weak. I felt like wet noodle for the 2 days after drinking it. Just moving any part of my body was a chore. However, thank goodness there was never any real breathing issues!

Colonoscopy prep with myasthenia gravis

This time however, because I was officially diagnosis with MG, I was given 3 days of Metamucil, 4 Dulcolax tablets, the silver bullet (suppository), along with 2 days of a liquid diet.

I was so pleasantly surprised at the difference! I didn't mind the preparation. Now mind you, none of us look forward to a colonoscopy. But, when you have a condition like MG and you're given a medication that is contradictory, it can cause havoc in the body!

The problems I encountered

The problems I did encounter with the prep had nothing to do with myasthenia gravis. I am a type 2 diabetic, and it is made worse by the prednisone, especially when I was on a higher dose. Thank goodness I'm no longer insulin dependent like I was, but I still take 3 different medications to help control my blood sugar.

So, during the 2 days I was on the liquid diet, I had to stop taking my diabetes medications because my blood sugars were dropping. I actually had to drink sugary things to keep it at the correct level. Along with that, I have osteoarthritis, stenosis, and other spinal issues. I take a high dose prescription anti-inflammatory for those conditions, but I had to stop taking that medication 5 days prior to the colonoscopy. Yep, I was hurting pretty bad.

The day of the procedure

The day of my colonoscopy, I was able to take my regular doses of Mestinon, so it was in my system during the colonoscopy. The doctor that was performing my colonoscopy, incidentally, was also the anesthesiologist. I was sedated intravenously with fentanyl and propofol and it was increased incrementally during the procedure. My respiration was monitored by continuous oximetry throughout the procedure.

We omitted midazolam due to myasthenia gravis and my history of obstructive sleep apnea. By the time the procedure was done, I was wide awake and moving freely, before even being back in my room. I was able to take my next dose of Mestinon right on time.

A slight flare Later that evening

Later that evening, I did end up having a slight flare around 8:00 PM. My head was drooping forward and I was unable sit up straight (worse than normal at that time of the night). I was also having a bit of trouble with swallowing, talking, and eyelid sagging.

I took my normal dose of Mestinon. But instead of the usual 15 minutes, it took almost 40 minutes to take effect. My husband and I stayed up a bit later so I could get a little more Mestinon in me before going to bed. The next morning, I felt fine and refreshed ... or at least just as fine and refreshed as I ever do!