Been awhile since I last posted here on this group. I decided to visit today and saw this thread/post. From my own experience with MG, I have had since 2011. One of my biggest issues is with the bulbar area. Swallowing/speech/chewing and such. I can say from experience that it is one of the big things as to wrong swallowing could lead to aspiration of liquids and foods. I myself had a Crisis due to pneumonia and silent aspiration of liquids and foods. Which lead to me actually dying for a few seconds when both my lungs collapsed and I couldn't breath. I was in the hospital almost for a month. Plex was the only thing that brought my swallowing back. But now 2 almost 3 years later I am doing a bit better. My Neuro gives me IVIG when my swallowing starts to slow down. I know when you start to feel that you are swallowing wrong it is time to seek alternative treatment or a combo of treatments. I currently am taking Cyclosporine, getting IVIG once a month and taking 30mg Mestinon every 4 hours. I will say, chin tuck my speech pathologist taught me when swallowing gets difficult. I hope for everyone to be able to find the right treatments to help with swallowing as to it is VARY dangerous.