Hi, Seamus. Welcome to MG and the forum! Do you want to go by Seamus or another name? We're pretty informal here. It's a very supportive place to be. This disease is terribly unpredictable and it helps to talk to others who have it.

There are other people in NZ with MG. I have a friend who has it who lives there. She pretty much feels the same way about docs there, unfortunately.

Since you're in the midst of summer there, you need to be careful while out in the heat. It can make your MG much worse. If you live near the coast - and who doesn't in NZ - then the humidity will make things even worse because your body can't cool down as well.

Pyridostigmine Bromide comes in both tablets and syrup. You'll find that it kicks in about 30 minutes after taking it and then wears off about 2-1/2 hours after taking it. So most people have about two good hours of it.

Sometimes it's the dose amount that needs increasing and sometimes the frequency of the dose. It's not a perfect medication but it does help with symptoms. The number one "mistake" MGers make when first on Mestinon is that they think they're all of a sudden super human! Try not to push yourself. If you do, you can get rapidly worse and end up with what's called a "myasthenic crisis" where you get much weaker and may not be able to swallow, talk, walk or breathe well. If you ever get that bad, you should dial your NZ version of 911 (for an ambulance).

I hope you have a good way to communicate with your neuro. It's so important to let them know if you are worse or have any changes in your MG. It can take awhile to get used to MG, so take it easy! Keeping a journal at first helps. It also helps to write down all doses of Mestinon so that you don't forget you took some and then accidentally get a double dose. If you get too much of it, you can have a "cholinergic crisis," where you get weak from too much acetylcholine.

If you haven't already, you can go to www.myasthenia.org for more information. Though I've gotten more from these guys than a website! They do have good information there though.

I hope you'll take it easy, give yourself time to get used to this disease and learn as much as you can.

Annie