You know your body best, but in my case I would probably take a mestinon and see if that helped. If I am away from home (in particular out of town) I always wear my medical alert bracelet that tells people I have MG, and to check my wallet for more info. If you feel it is not something you can handle, don't hesitate to call for help

Depending on how crappy i felt,i agree with some mestinon then rest with phone in hand.look online for directions for puting ICEon phone. Stands for in case of emergency call so and so.put 2-3 peoples names and cell ##s. Er workers look there for people to call when you can't speak. Try to rest if alone inpublic where someone can see you. Once for another illness i asked a person walking by to just stop for 5 mins.all went well and he was very willing. Nice people still exist!! My heart goes out to latest police officers killed and injured. Son is paramedic and i used to worry about physical injuries from lifting etc,now i worry about alot more.

Is it ok to take 2 mestinons in four hours? I wonder if that would make things worse.

Not sure what u mean by "if you can get up or shallow"??? Do u mean "shallow breathing"?? Like others, I wud take a mestinon ... and I always wear my medical alert bracelet, have the accompanying wallet card that explains MG and what meds I can and can't take, etc. And I always make sure to have my cell fone with me for possible emerg. call.

And on the Mestinon dosage, I take 60 mg tablets four times a day. In the above situ, I wudn't hesitate to take another one, even though it wud mean two times 60 mg within a four hour window ... but it wud be a new situ. for me and I'd take it up with my neuro doc at the next available consult appointment I could get.

I carry my meds with me just in case that happens. I would take three mastodon right away as that has helped me in the past. You can read my journal for my history. Good health to you.

Of course I would take an extra mestinon pill.

My neuro gave my prescription that said take as needed with the warnings of the upper limit to take. Doctors who say take only X per day on an exact schedule don't really understand how mestinon works, how our disease works, and also probably don't trust us to not overdose.

The usual medical statement says: "Doses of 30 to 120mg are given at intervals throughout the day when maximum strength is needed (for example, on rising and before mealtimes). The usual duration of action of a dose is 3 to 4 hours in the daytime but a longer effect (6 hours) is often obtained with a dose taken on retiring for bed. The total daily dose is usually in the range of 5 - 20 tablets but doses higher than these may be needed by some patients. "

Doctors and patients have some obligation to include common sense, and everything written about the treatment of MG with mestinon emphasizes its "as needed" use. My only hospitalization for MG was early on when I actually believed I should take 3 per day --spaced at 8 hours from a neuro who didn't treat MG and read it in some guideline somewhere and passed it on to me. In the hospital, I got a real MG expert who immediately moved me to 90 every three hours and then told me to go the "as needed" route. I took more in the morning when I wanted to be active and cut back evenings and overnight.
Good Luck
Good Luck

I would talk with mu neuro first but I have taken a mestinon and rested then when my next does was ready I just subtrated one pill from that dose.