Question: I am 73 years old. About a year and a half ago I started having difficulty walking. My thighs and buttox would start to fatigue and cramp, as if it were running out of blood oxygen in my legs, which made me compensate by pushing through and then my back would start to hurt. It has progressed to where I can hardly walk and I fatigue very easily. Also, when I eat, my jaw also gets very tired and hurts. I have to slow down and concentrate on chewing, otherwise my jaw feels like it will lock up. Earlier this year, while checking for peripheral caudication with a CT Scan using contrast on my legs, it was discovered that I had a huge build-up of fluid in my thorax. To date I have had over 6 liters of fluid drawn off the area just below my right lung in three separate thorocentesis procedures in 3 months. I can feel the fluid starting to build following the thorocentesis last week. 4 years ago I had a stint placed in my right coronary artery. My cardiologist ruled out congestive heart failure with a nuclear scan that indicated everything was functioning normally. I have shortness of breath and get tired very easily. Occasionally I experience angina and pop nitro to relieve symptoms. About 2 or 3 years ago my fingernails started drying up and splitting off in layers. The ends of my fingers are constantly peeling and flaking and my nails have pretty much stopped growing as have my toenails and hair. Finally, in the fall of last year something happened to my taste sensors and everything seems to taste the same. When I think of some kind of food that I have enjoyed all my life, I order it or fix it and 3 or 4 bites into it, I really don't care if I finish. Since last fall I have lost 45 to 60 pounds and have absolutely no energy. Up until the last couple of years I was fairly active and could travel and enjoy life... now, no so much. I have a Family Physician, a Pulmanologist and a Cardiologist. They sort of keep each other informed and all three of them are very good at what they do and very thorough. I'm at my wits end...

Dr. XXXXXXX
I have not had a TB test to rule out tuberculosis.
The fluid drained from my thorax was sent to the lab and no malignancy was detected.
My blood work has been extensive and has not revealed Vitamin B12 or Vitamin D deficiency as I take a D3 supplement and Folic Acid. I do not take a B12 complex supplement as a deficiency was not detected.
None of my doctors has suggested the possibility of myasthenia gravis. The neurologist I saw tested for various neuropathies but was unable to put a cause for the muscle weakness.
What kind of doctor would I see to either confirm or rule out myasthenia gravis. I know that both my primary care and pulmanologist were unable to find any changes in my facial muscles and I see no noticeable difference either.
Do I need to go back to the neurologist for another round of polking and shocking?
Thank you for your response.
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Dr. XXXXXXX
As I was researching myasthenia gravis I was introduced to the function of the thymus gland. No mention of the thymus gland has ever been made by any of my doctors.
My research also mentioned a connection between the thymus gland and the the lymph system. I understand that the lymph system is responsible for draining the excess fluids produced by the body. Could a compromised lymph system be responsible for the fluid build-up in my thorax, which is the other major issue that I have.
Since the thymus gland is responsible in part for the cells that make up the immune system, could there be a correlation between the thymus setting up a condition where my immune system setting up an attack on my neuromuscular transmission.
Im just trying to put together a reason for all these problems happening to me in such a short period of time. They just all seem to be interrelated.
Just a note... I am not a hypochondriac!