Diary Entry #11 - 01/11/2010 - What went wrong?

After having several days to consider what went wrong I now understand. This was all human error. My error for the most part. Here is what I learned. If you are fighting this disease, learn from my mistake:

• I killed her when I reduced her Pyridostigmine. I was so hung up on the vomiting that I underestimated the MG. Which given the chance, came back at her with a vengeance. The mega esophagus user group suggested that she might be OD'ing. They never said reduce her meds on your own. I never should have done this.
• When she stopped swallowing her food whole that was a sign that her jaw, throat and head muscles were too weak to gulp down her food. I was blinded by no vomiting the night before and did not see the first sign of MG attacking.
• When I got to the clinic Thursday morning, she had come back. That was because the 15mg of Pyridostigmine was taking affect. I did not notice this. I should have noticed that is was not enough.
  
• I should have stayed for the X-ray and taken her home. We had become the experts at feeding her. I am positive when they fed her at the clinic she aspirated the food into her lungs.
• When I picked her up the next day the MG was attacking, full force. I am not sure how the clinic did not see these signs earlier. Again, had I taken her home the day before we would have recognized these signs and been able to medicate her before it was too late.
• When we got her home, finally realizing the mistake of reducing the dosage of the Pyridostigmine, we desperately tried to get her some medication. By then is was too late. She was too weak to fight another bout of pneumonia and the MG was attacking every muscle in her body.
  

I cannot make this more clear. NEVER REDUCE THE MG MEDICATION DOSAGE WITHOUT YOUR DVM TELLING YOU TO. I took the advice of somebody who said they were guessing. I was blinded by Sammie's adverse reaction to the meds. She became nauseated when getting the meds. This means she probably did not get all the meds that is why the large dosage was necessary. I should have treated this with anti-nausea medication which was also suggested. Instead I did the worst thing that I could have, and it cost Sammie her life.

I pray to God that somebody reads this and avoids making this mistake.

We were so close and we miss her so much. Hard to live with myself right now.