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Hi Alice, my situation is similar to Mary’s. I have multiple autoimmune diseases, Sjogrens, Hashimoto’s, Raynauds, gluten intolerance (probably celiacs). I have been gluten free for many years so it is hard to tell now without a colon biopsy. I also am seronegative and have a positive SFEMG test. My double vision and droopy eyelids were the first to appear. I also have cancer and neuropathy. If your husband hasn’t been put on Mestinon that should be tried. I take it every 4 hours around the clock. If I miss a dose or am late my legs become so weak that I have trouble lifting them and tend to shuffle and have fallen a number of times. I have no trouble telling when it is time to take my mestinon dose. It even effects my breathing at night. Good luck. Amy