Dr Maria Farrugia and Caroline Carmichael of the West of Scotland Myasthenia Service set up a pilot study to investigate a physical and psychological approach to improving fatigue in patients with myasthenia gravis. Ten patients were recruited and all reported significant fatigue, rather than muscle fatigability, and in whom their myasthenia was felt to be relatively stable and so were unlikely to experience medication changes during the trial period. The trial involved one 10-week program looking at various lifestyle aspects which may influence/exacerbate fatigue. Each week a different aspect of their lifestyle was addressed with input from physiotherapy, neuropsychology and specialist nurses. The program has been completed and we look forward to the final assessment and report on this pilot study.