Hi, Mark, and welcome. I have just a few comments.

Pyridostigmine is the generic name for Mestinon. So you are taking quick-acting Mestinon, plus time-release Mestinon. I wasn't sure if that was clear to you. Pay attention to when your symptoms are worse. The quick-acting kind of Mestinon only lasts three to six hours for most people. You might get some results by changing the dosing schedule of your two kinds of Mestinon (with the doctor's OK, of course).

Keep seeing the neurologist. He might put you on another drug, like Imuran, along with the Prednisone. Imuran takes a long time to start working, but it helps some people reduce or get off the Prednisone eventually.

I came down with this disease in the fall of 2009. By the spring of 2010, my symptoms were as bad as they ever got. Now, four years later, I'm better than I was then for sure. Not every patient is like me, but a lot are.

So nice to hear a happy Obamacare story!

Abby