Hi Tillie. I'm Nancy, AKA ECpara. I think we can share our experiences with our husbands, both having Bulbar Onset ALS. Tom is still very mobile and does not have the emotional liability. He is unable to talk and uses his PEG for about 95% of his nutrition - he'll "eat" a tablespoon of minced food for the pleasure of tasting, but it is hard. His day to day survival seems to be concentrated on clearing his throat of phlegm and saliva. We go to Mayo in 2 weeks to see if he's a candidate for a research trial for "acthar (sp?)". We will also be looking into Botox injections and/or radiation to reduce the saliva. As his swallowing gets worse, we'll probably look into a suction machine as well. No bi-pap yet, but I do think his breathing is a little weaker. The Mayo appt will shed light. If you have time, drop me a line and let me know how similar your husband's ALS is. What a journey we're all on. God Bless, Nancy