Hi Fred,

Good question. At your age, and given the fact that you respond so well to mestinon, I think I'd be very hesitant to mess with things right now! However, if you decide you want a chance (and it's a pretty small one) of being "pill free" some day, I'd definitely look into a video assisted thorascopic thymectomy (VATT) or some other minimally invasive one. I know a man who had it done at age 69 and did OK.

Also, if you are seronegative or MuSK positive, the chances of having relief of symptoms from thymectomy are not really good at all. Only those who are ACHR positive seem to get that benefit.

Good luck making your decision. Surgery becomes a little more of a "big deal" with every passing decade, so take your time!