My neuro told me not to have surgery on my neck, but didn't tell me why. And, you need your diagnosis confirmed one way or the other...and NOT by one of those 'Lyme literate' doctors, either.
Half of them are scammers that bilk people out of thousands for needless and potentially harmful antibiotics. When and if you really NEED them, they are much less likely to work. Your body will build up resistance to them.
ALS should be confirmed or taken off the table by a qualified neuromuscular specialist.