Panorama your advice is sound. Upon awakening that morning after a typical night of broken periods of sleep, the oximeter read 70%. My breathing was rapid and shallow. I could raise and lower my diaphargm but not much. My diaphargm muscles failed to respond normally. Then it hit me. I took 120 mg of Mestinon (onset 15 minutes) and struggled with my albuterol inhaler. Oximeter read 74%. The telephone handset sat in front of me for a 911 call which I did not make. They could never get here in time. Oximeter readings continued to slowly climb. Remarkably and suddenly the diaphargm began moving. I couldn't believe but I sure felt it. But to be honest with you, it didn't seem like 15 minutes passed. Maybe the onset time is different for everyone.

Now I ALWAYS take Mestinon at bedtime. I have seen both the pulmonologist and the neurologist. And I am looking forward seeing one of the finest MG specialists.

Thanks again everyone.