Wound up going to ER it was a pretty big flare had to start a 5 day IVIG cycle, feeling allot better besides headaches and occasional chills, hopefully back home tomorrow

My double vision started 6 months before the symptoms moved to my neck and arms. So it sounds like you are transitioning from ocular to Generalized MG. I haven't gone to the ER for any symptoms yet, but I have gone to bed several nights telling myself I'd go if I still felt as bad as in the morning as I did when I went to bed. I'm on pyridostigmine 4x120mg. Helps some but not enough yet to go to back to work. Waiting for next doctor appointment to start other meds.