They often start slowly for a reason (well, a couple of reasons). They don't want anyone to overdose in case they got the diagnosis wrong AND they want to see if a patient has any side effects or adverse reactions to Mestinin before they adjust the dose amount or the time between doses.

So that's what a good neuro would do! Of course, it would have helped if she had discussed how you might adjust the spacing in a week or two.

Mestinon wears off in 3 hours. It kicks in after about 30 minutes of taking it, lasts for two hours after that, and then wears off in the last 30 minutes of that 3 hour period of time. That does not mean that you should take it that often or even take it every 2 hours!!!! Don't play with it yet. That's how people end up in a cholinergic crisis (too much Mestinon/acetylcholine). A myasthenic crisis is when there isn't enough acetylcholine getting to the muscles.

I'd put off the exercise! What kind do you do? This is the point where some doctors do not understand MG. Yes, it's great to be able to keep muscles as strong as possible. But the more we do, the worse we get (relatively).

I hope they do the MIP (maximum inspiratory pressure) and MEP (maximum expiratory pressure) tests. Those are specific to neuromuscular diseases. They show how well we are doing at breathing air in and out.

Be cautious at the dentist. Make sure you sleep well a couple of days before and a couple of days afterward. Stay well hydrated. That will help clear any drugs from your body. Since they put the drugs into the mouth, try not to talk too much over that period of time to reduce the strain on those muscles. Sometimes, the "caines" (i.e., Novacaine) can affect breathing as well.

Keep asking questions! There is a lot to know about MG.


Annie