I was diagnosed about 1.5 years ago. The Neuro Op started me on Mestinon gradually to help my body adjust. I think it was 30mg for a few days or weeks I forgot and then 60 3 times a day. My symptoms went away for months and this past January I had begun to have speech issues. I find that anytime I am upset or sick my symptoms increase. The doctors have told me to expect variations. I take 60mg 3 times a day unless I am at a social event and I have been told to go up to 90mg which I sometimes do once or twice a day but never in less than 4 hours.
I could only drive short distances with a patch when I was diagnosed and my eyes were horrible with night light and most of that is resolved. I have not had to use a patch (yet.)
Hang in there.
Karen