bny806,
As far as your questions, when my meds wear off I can feel the first symptoms in my face, it is difficult to smile and my eyes tend to feel heavy. When I was first diagnosed, my voice was so nasally I sounded like Kermit the frog for months, but it will get better when you get the disease under control. I'd say the trembling is from the MG also, very common for me even now that I'm under good control. My onset came slowly over the course of 6 months so I can't really pin it on any one event. But my doc wants me to get an IUD when I start on Cellcept next month, do you have any recommendation on that?