I really appreciate all your good wishes, thank you. Yes, DPS refers to Diaphragm pacer. Since I still am able to do many things by myself, I think getting this done may keep me off a trach/vent, either for many years or till I die. I am still getting enjoyment from my life and have reasons for my strong will to live. Just that will alone may help me to live longer. I empathize with anyone with a neuro disease of any type. and Hope all here have good results from whatever approach you take to handle this. I'm a veteran (Viet era) and I use the VA exclusively with very good care. Of course I'm a little nervous about surgery especially since I don't like holes in me, but it seems to be the best option from what I read, and my Neurologist has a favorable opinion of it, he has a few patients who have it and are satisfied. I'll use the pacer with my PAP machine and a cough assist machine. I've been living with ALS for around 8 years since the first symptom and they think my type is atypical. They really seem to be learning about it in many labs and I think within 5 years there may be a good treatment. That's my guess.