Hi and welcome to the forum

I am male and at 43, I like to think I'm still young yet Although there are days when I certainly don't feel it. Such is the wonderful nature of this condition

Yeah, the mestinon can be a twitchy drug for sure...

As far as "staying active" goes, I've never been anywhere near your level of activity. I've never enjoyed running etc. Although I do enjoy skiing a lot and while a day on the hill can really beat me down, I choose to spend my energy doing it with my daughter. I willingly pay the price over the next day or two if I push it a bit hard. I try to keep my time on the hill to a level that works for me though. When we went on a multi-day ski trip over Christmas break I limited my time on the boards to 6 hours per day maximum.

Your normal will change, yes, but it doesn't mean that you cannot do what you enjoy at this stage. The really important thing is to listen to your body (which is something that I certainly learned the hard way over the past few years since I developed the condition.) If you push it, you will pay for it on the back-end. Think about if you're doing a triathlon and you sprint through the swim, how much do you have left for the bike & run? You have to choose whether or not it is worth it to you.

The recommendation regarding exercise I got from the MG specialist I went to last year was "If you can do it... do it. Your muscles will stop you when they're going to stop you." I think that if I were used to running at the level that you do I'd want to keep it up until and unless the condition started to stop me and then I'd adjust as needed. You don't know at this stage, your MG may not progress beyond your eyelids...

Cheers, and feel free to shout out any questions you have as you're working through the learning process about the condition.

Brian.