Thanks for the reply Abby!

I managed to push my neurologist into doing single fibre EMG. I really wanted him to do the LEMS antibodies as well, given that I started with generalised weakness/fatigue and only years later have the more specific symptoms started, but he said no. Not sure why he wanted to jump into the more invasive test first. The SFEMG is gonna be months away though, and in the meantime I'm bedbound trying to avoid exacerbating my symptoms!

I see a dietitian for unrelated reasons and she is advising I see a speech pathologist (who specialises in dysphagia) because of how bad the swallowing difficulties are becoming, so that's on my radar too.

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