So sorry Bewickersham! My husband started with ALS in his tongue, too, sometime in spring of 2011. He was diagnosed with Bulbar Onset ALS in February 2012. Of course we were concerned hearing that this type of ALS is largely faster progressing than the more typical limb onset ALS. But we are both thankful this is the path his illness has taken and he continues to be totally independent. He had a PEG tube put in November 2012 and it has prolonged his life since he stopped eating over a year ago. He has been able to keep his weight up with 6 cans of Wal Mart brand liquid nourishment "plus" and Benefiber added to 16 oz. of water per day. He can still walk without any aid, drive, type, play golf, mow the lawn and do light yardwork. Yes he misses talking, he lost that ability about a year after diagnosis. And more than that he misses eating. Now we are dealing with the reality that his diaphragm is affected. But he deals with the hand he's been dealt with courage and grace. No two ALS patients are alike, but here's a glimpse of someone who continues to thrive 3 years after first seeing symptoms like your brother. Blessings to you both!