hi all , just an update have seen neurologist from barrow confirmed MG amazing experience saw 2 drs both spent two hours examining me and discussing treatment options and the drawbacks of each , also discussed possible thymectomy as a future possible treatment down the road , right now we are going to keep on the pyridostigmine 60 mg 3 x a day and they also added prednisone up the dose will be upped to 60 mg per day ,in the meantime we started the insurance paperwork for approval for IVIG treatment , and i think Imuran possibly , tough call with the prednisone as i'm diabetic just called my endo to keep him updated , was in the ER two days ago as i was experiencing shortness of breath ,difficulty swallowing rather be home drs said if that happens again just go to the er and they will admit me and get it sorted out, once again thanks you guys rock ,dave