Well, the soprano voice is definitely neurologically-related. I'd gone off TimeSpan Mestinon mid-January in preparation for a neuro consult and the voice issues started right after that when breathing issues increased. Then, I switched to a Mestinon generic which I took in low dose for just a few days. My voice didn't get better with the changed prescription. I've been off all Mestinon variations since 12 days prior to last week's SFEMG and just now decided to try one of my remaining TimeSpans. It helped return my soprano voice to within a normal range. My voice is still cracking and weak/wispy, but this is the best it's been in almost a month. I feel more stable with the TimeSpan compared to dosing every few hours.

I do need to see another neurologist since this neuro wants me to stop taking Mestinon altogether since the SFEMG was negative. There's a neuro who specializes in LEMS 6 hours away in Houston, so I'm going to see if he can help me get a diagnosis and easier ongoing access to treatment, maybe something more effective than Mestinon since I'm not as 'returned to normal' as I would like.