Originally Posted by limpy

Dave, have you tried 3,4 Dap? It is the go to drug for Lems. I take it with mestinon and it makes a difference in strength. I also have other suspected autoimmunes, so am not near normal and have to do plasmapheresis as well. I am hoping to get on some immunosuppressant other than prednisone soon, as it doesn't do anything for me other than raise my blood sugar and make me feel worse.
Only certain doctors can prescribe Dap, but it is free in the US on a compassionate use basis through Jacobus Pharmaceuticals. If you haven't tried it, you really should give it a try. It is similar to mestinon in that it is short acting and only intended for symptomatic relief and not an immunosuppressant. No major side effects and has been used to treat Lems for over two decades.