Thanks for the reply. This has been extremely frustrating and scary to be fine one day and so weak the next out of nowhere. I have received 3 treatments of albumin/exchange. They put a port in which was extremely painful later that night, but does make the process much easier. I felt better after first one, but have been about the same after last two. Hopefully, I’m making progress. Had a rough morning with a lot of weakness. After washing hair and putting on clothes I couldn’t get up out of chair. After resting about 20 minutes I was able to get up, but still felt weak. Still not seeing much progress with mestinon. Now taking 4 X day 90mg plus 1 @ bedtime 180mg time release. Hoping to find something that works.