Dear MG_Kat33,

I agree, it can be hard to know what is urgent. It is hard, and you may have to use your judgement. There could be a step in-between going to the ER and not getting care. If you know the doctor you will be seeing, and you are concerned about your symptoms but think it is not quite time to go to the ER yet, you could make an appointment to see the neurologist even though your insurance has not yet begun. They may be able to adjust your medications and help you, or start you on Mestinon if you are not already taking it (didn't you say you are not presently taking Mestinon?). That might be more affordable than going to the ER. However, if it is very hard to breathe, you may have to go to the ER anyway. If you are struggling to breathe so much that you cannot speak full sentences, for instance...maybe you can only get a few words out a time...that is a concern. If your difficulty breathing makes it hard to sleep at night, that is a concern. If you notice that you are choking more, or drooling more (these things can happen also) these are also bigger problems. If you are struggling to walk very significantly or falling, then that, too, is a problem. With these sorts of symptoms, then you do need to seek urgent assistance. I would say basically, if your breathing is so difficult that you are concerned with it and it is a struggle to breathe, go to the ER or call 911. It is very hard to worry about the financial end of it, but the hospital can work with you about the payment if necessary. There are options with payment plans and other arrangements. Getting the treatment you need is essential, especially during this hot summer weather. Please take good care of yourself.

Take care,
Erin