My dad passed from Bulbar Palsy/ALS June 2009. When they put in my dad's PEG, they had to do the surgery very quick, He had Bulbar/ALS, They were afriad they would not be able to get the breathing tube out with his throat muscles not working. It's sure is better tohave it in place before you need it. You can still eat but it is there for a back up. It used to take my dad hours to eat, then he would start coughing. This way was quicker and he could go on to what ever. He even staryted to put back on some weight. One thing to remember is, his insurance company would not cover the surgery unless he could not eat at all, to my this was cruel. We could not let them know dad could eat apple sauce, ice cream ect.. One thing I learned with the PEG, when the tube got cloudy, put some coke a cola in it. I guess the acid in the soda cleans it right out.