Dear winic1,

I think you live in the northeast part of the United States, yes? If so, it is summer weather for you now. I wonder if part of the reason you are having more symptoms is because of the heat of summer. I know it affects me very much, and I have to rest more and do everything I can to keep myself cool. The Mestinon still helps me, but it just can't keep up with the effects of the heat.

I don't take all of the supplements that you do, but I've taken some of them, including the Vitamin D3. At least in my case, it did not affect the Mestinon, but maybe other people have had different experiences.

If the heat and humidity may be affecting you, do what you can to stay cool. If you do not have air conditioning at home, consider going to places which do have air conditioning when it is hot, like a library or senior center where you can sit and rest. Sometimes the senior centers in our area offer cooling centers when it is especially hot, so anybody can go there to escape the heat. I use frozen ice packs along my neck and back to help cool myself; they are really for sore muscles, but they help me stay cool. Remember to keep hydrated in the hot weather, too. I am sure other people probably have even more suggestions. I try to do any tasks early in the morning on hot days, before it gets even warmer. Then I can just rest and be quiet when I am weaker as the day progresses. If there are any optional things, like laundry, I just skip them and let them wait for another day when we have a big heat wave like we did this past weekend. Then I just focus on getting through it.

Sending good wishes your way,
Erin