I agree as well with taking your prescribed dose in the morning.

First thing upon waking, I take my first dose of Mestinon with milk. After some morning tasks that I am able to do such as tending to our pups and kitchen duties, I make breakfast then I take my full dose of Imuran and Prednisone. By this time I am able to determine where I'm at in terms of what my body is capable of doing. Some days I can do more so I go down my list of things I can do and pick one based on my condition at the time. At around noon or one, I take my next Mestinon and a 2 to 3hr nap. I take Mestinon before my nap because my body tends to do a bit better upon waking. After my nap, I help my wife with dinner, then take my next dose of Mestinon. After I eat, I either do the dinner dishes or I'm just sacked out for the rest of the night on the couch.

MG is something that cannot be anticipated or relied upon to be stable enough to plan your life beyond the moment - it's frustrating. However, it's possible to manage some semblance of a life with it. Some days I wake in the morning and an hour later I'm back in bed. Some days I am able to perform more muscular activities such as outside work and then I'm screwed for two days. Sometimes it feels like the meds aren't working and sometimes they do...just keep taking them as prescribed - the alternative is worse.

Good Luck!