Roxxy, Years ago I used to be active on this forum, and when I came back I swore to myself I would not get dragged back into trying to help anxious posters who seemed to be suffering from medical anxiety, and who would not listen to reason.
So, as I'm posting here, that means I don't think you're necessarily suffering from anxiety, although your symptoms may seem worse because of the anxiety they cause.
Just because what you describe does not sound how ALS presents, does not mean its in your head, it just means it is not a way that people who are most familiar with ALS have experienced it.
What the people on this forum understand best is ALS, it makes no sense for them to start taking guesses at what else it could be. That helps no one. The exception would be if someone read your post, and had personal knowledge of the same exact symptoms. Its unlikely that will happen here.
Wait for your testing. Don't focus on any disease, it will cloud your perception.
There are tests that can be performed that will show EXACTLY what is happening when you swallow. Your neuromuscular specialist can order this for you. It is usually performed with a speech and language therapist (SLP) and radiologist.
There are three (I think) sets of constrictor muscles that move food down to the stomach after it leaves your mouth. These are involuntary muscles, you have no control over them. This test will show how these muscles all work. Always keep in mind, that its not how you feel, but rather how you "fail", and that is what the testing will reveal.
If your test is completely normal, then, you're feeling the problem. If your test shows you have "pooling" or a delay in movement, or anything out of the range of normal, then something in your swallow process is failing. There is a very big difference in these two things.
Food coming out the nose because of soft palate weakness has nothing to do with constrictor muscles failing to move what you swallow downward.
And, if the muscles aren't moving food downward, that does no mean your epiglottis will necessarily stop moving adequately to cover your airway. This is the number one thing your doctors will look for, they will want to know that you "protect" your airway (the protection is involuntary).
The same for your breathing issues, there are sophisticated test that can be done, or your pulmonologist may wish to just follow you for a while.
Things oftentimes do not move rapidly in the process of being diagnosed. Its just how it is.
Not knowing is hard, but spending time on forums like this one will serve no good purpose for you.
It has been my experience that some people who find themselves here, because they're afraid they have ALS, just become more and more determined to "prove" to this group of people that they don't know, have never met, and will most likely never meet, that they have justification for their fears. Don't let yourself be one of those people.
Trust your doctors, ask for second and third opinions if you don't trust your doctors. Most importantly, don't try to make your symptoms "fit" ALS or any other disease, it will only serve to slow the diagnostic process down for you. And, if your medical team thinks your exaggerating, etc, you run the risk of them starting to think it might be a "non organic" cause. You don't want that to happen. You really don't.
If I were you, I would ask to be referred to a ENT (ear nose and throat specialist). That is the most logical next step, from what I've read of your posts here. You already have a pulmonologist, but, you don't have anyone who specializes with the swallow. Think of the neuromuscular neurologist as being more generalized. They know nerves, and they know muscles, but they will want input from an ENT, SLP, and testing ordered under their supervision.
All of the best luck to you. Be your own advocate. Just be patient during the diagnostic process, its hard, but its really the best way.