Hi,

I recently started cutting my Mestinon pills in quarters, and I only take 1/4th of a pill. This has helped with the stomach cramping. I've had negative blood tests and EMG studies, but my eye still droops and I always have double vision.

I took the covid19 vaciine with zero issues, but I don't take cellcept or azathioprine. I don't do IVig.

Thanks Colleen. I am not managing the fatigue well at all. Since I've just started using the mestinon within the past several months, I have been able to "titrate" it to enough to get me through work without enough to give me side effects like nausea and headache. I actually....for the first time ever in my life.....had to quit a job (a second one) without giving 2 weeks notice (due to extreme fatigue) I quite literally couldn't get up and going to make my shift.

My current full time employer knows I'm having problems but there's not much I can do except use the mestinon and muddle through the day. I have completely stopped doing anything on my days off except for resting. The depression is absolutely killing me with all this. It's so physically hard to get up and go that I have no desire to try to get out and do any activities.

My appointments are coming up in September with Mayo and I have hope for a definite diagnosis and treatment. In addition, I hope to schedule surgery to remove my pituitary macroadenoma. Between having both myasthenia and the macroadenoma I wonder which causes what symptoms. I'm holding on by a thread and waiting for time to pass until my appointments!

I would appreciate any comments/suggestions/advice from the group!

Steph