@cowboytodd I’m on Firdapse (amifampridine phosphate), my version of 3,4 Dap. My condition, regardless of continuing use, is variable day to day. I do have flares that seem unexplained at times, but the variability of LEMS is just part of my everyday life. If you feel like you’re slipping into crisis, I hope you will get in touch with your neurologist and medical team for help.