Hi,
I am sorry you are feeling lousy. I worked in health care too. I feel the same way as you. Please don't start steroids yourself. I thought I was going to meet my maker from them. Also had pheresis. The Mestinon keet me above the earth.
I noted that you work at NIH. There was a doc from Columbia who went there. If you want to check about her, she was very big in M.G. Her name is Dr. Audrey Penn, maybe you can check into her also. You need help, since it seems your present neuro seems useless. I hope you get help. The breathing issues and swallowing are a b***** and be careful.