### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
HELLO, I HAVE CPK LEVELS THAT HAVE PEAKED AT 2900 AND CURRENTLY ARE AT 1585. I HAVE SEVERE MUSCLE WEAKNESS PARTICULARLY TRUNK AND LEG MUSCLES. I ALSO HAVE MUSCLE TWITCHING CONSTANTLY (LEGS TRUNK GLUTEALS ARMS) .ALSO THERE ARE SEVERE MUSCLE CRAMPING WHENEVER THE MUSCLES HAVE TO DO ANY TYPE OF HEAVY WORK RESULTING IN PAIN IN THAT PARTICULAR MUSCLE. WHENEVER I DO ANY TYPE OF MODERATE TO HEAVY EXERCISE SUCH AS SHOVELLING SNOW OR USING A CHAINSAW TO CUT FIREWOOD MY BREATHING AND HEART RATE INCREASE SUBSTANTIALLY AND I BECOME VERY WEAK. I HAVE BEEN EXPERIENCING THESE SYMPTOMS FOR 2 YEARS NOW. I HAVE BEEN TESTED FOR ALS, I HAVE HAD A MUSCLE BIOPSY(RIGHT THIGH) BOTH WITH NO ABNORMALATIES SEEN. THIS CONDITION?? IS STARTING TO BECOME DEBILITATING . the second character in my email address is the number 0

### output:

Serum CK levels, along with careful physical examination, may be used to monitor myositis Other muscle enzymes that may be elevated include the following:Lactic deny Chat Doctor.  Occasionally CPU levels may be normal because of patchy involvement. Although there's no cure for polymyositis, treatment can improve your muscle strength and function. The most commonly used medications to treat polymyositis include:, Corticosteroids, RituximabPhysical therapy. A physical therapist can show you exercises to maintain and improve your strength and flexibility and advise an appropriate level of activity.