I am sorry to hear about your father's situation.

30mg of mestinon is a very, very low dose (a starter dose or if someone doesn't tolerate it well due to GI symptoms) and mestinon is used for MG symptoms, NOT treatment of MG. A usual dose is 60mg every 4 hrs. People can even go as high as 120mg every 4hrs. He may just be shaking from being so weak and trying to use a muscle that has no strength. Truly, mestinon is not going to be the big concern here but lowering his dose lower than he takes at home is not a good idea.

He needs MG treatment if he is in MG crisis. And pneumonia is very serious for MG. Since he responded well to plamapheresis in the past, have they considered doing another exchange for him? There is also IVIG. That is a batch of other people good antibodies that they infuse. I don't understand if they have not done any treatment for MG while he has been in hospital.

Since he is able to squeeze your hands, perhaps he could communicate by writing??

Wishing you all well!!