My MG is almost entirely in my swallowing and some droppy eyes. I take 60MG of mestinon 4 times a day, stage them around eating with one at about 7:30 am, then 12:00, 5:00 PM and one when I go to bed. I have tried adjsting the dose (Usually 60MG) but could not really find a good mix so staying with 60x4=240 a day. I have read some comments abut buiding a tolerance for mestinon, but most neuros dismiss this, after all it's just really a bandaid, not a cure. I jut had a Thymectomy, May 13 at Columbia in NYC and have been advised to just keep up with the meds I've been able to deal with.. I only take mestinon. I keep a close watch on my eating, no big steaks or anything like that... try to stay soft and Im getting by. I almost always have a feeling of a lump in my throat, but dealing with it and don't want to upset the apple cart by making any drastics changes yet... really not sure anymore what a normal meal is.