Anacrusis, If you have a mild headache and a sprained ankle, acetaminophen might get rid of your headache but not the ankle pain. It's basically the same with Mestinon, though it can get more complicated than that.

For some people, Mestinon doesn't do squat for the eye are muscles. Only Pred does. For me, it helps to a point but the more I do, the weaker I get no matter how much Mestinon I have. Mestinon is only a helper drug and is not a CURE!

Also, the smaller muscles, like those in the face/head/neck, tend to show up weaker in the initial course of the disease. The "work horse" muscles of the arms/legs/trunk tend to take longer to weaken (though that's not true in everyone) but then they can tank for longer too.

My eyelids are the first to go but also the first to recover when I get weaker. My eyelid, eyebrow and facial ptosis are my best indicators of how I'm doing. If my eyelid ptosis doesn't recover with Mestinon and rest, then I know I'm in need of more rest and drugs. But, again, everyone is different. When I'm "double drooping" as I call it when both eyelids are really bad, my bed is the only place I'll be.

For example, if you overdo things one day, it might take a day or more to recover. If you have an MG crisis, it can take much longer to get better. It's not only what you "supply" MG with - like Mestinon - but what the muscles "demand" to have in order to work. Make sense?

And if you take too much Mestinon, you can actually overdose less weak muscles while you are trying to alleviate the weakness of weaker muscles.

No easy algorithms here in MG land. Just trust your instincts and try to have the best balance you can.

Annie