HEy there! I, too, "twitch" due to the Mestinon - not fun! I take 5 - 60 mgs a day and the BIG boy @ night - 180 in addition to 30 mgs of pred right now.
My suggestion is to always have the phone by you and someone you can call in case you EVER have problems breathing - have a code or something like punching in a number in case you can't speak...........
Once the med situation is figured out you will feel so much better!
Hang in there!

Erin