From one who has diagnosis from doctors that DONT count. In other words not neurologists. The ENT who diagnosed my speech issue or loss as clearly myasthenia doesn’t count. He even angrily said who is your neuro. And aren’t they treating you! Then there is my New York cardiologist (I live in Iowa) that says all that’s wrong with me is myasthenia Gravis that needs aggressive treatment. Oh also the advanced eye Clinic who were first to start writing down myasthenia. I sure agree that the time of day your husband is examined is very important. Oh and if he is better in cold weather wait till summer maybe. My first Mayo Clinic appointment was December and even I knew I was way too good that day to get a true best exam. An exam that ended with my admission to hospital was after an extremely hot shower that left me unable to walk for an hour. The neuro said “you can hardly talk” when I finally got to her. Sculptor44