Hi Melly:
My husband did go from arm and limb onset to the bulbar one, although he can still breath without a BiPap, etc. he's speech is slurred and I can barely understand what he's saying. His breathing problem at night is the phlegm, so he asks me to turn him on his side almost every 45 minutes which helps him to sleep.
He's swallowing is also affected, but wouldn't go for a a PEG; it takes me about an hour and a half to feed him, although slowly he eats meat, I get him filet mignon which is soft and easier for him to chew, since he doesn't like chicken nor fish, sometimes I convince him to eat chicken salad, I feed him lot's of vegetables even broccoli, cauliflower, carrots, except corn, because it get's in his tooth and it bother's him a lot.
And believe it or not, GrampAL can tell you, he keeps on smoking, of course with my help.
Guess everyone is different, some people's ALS runs slow, other's goes very fast, my husband started with symptoms around June 2005 and was DX Oct. same yr, at that time he could still walk with my help, right now he depends totally on me.
Hope to have been of help.
Paty
Husband's Caregiver
Baja California, Mexico