Hello Brooksea. I've read some of your past posts, my husband seems to be affected by his ALS in much the same way your husband was. I'm sorry for your loss but appreciate the way you reach out to others with their questions. My husband was diagnosed in Feb., Bulbar onset. He's having lots of difficulty speaking, some choking with eating but no peg yet. Weight is good, all his respiration tests at the Duke ALS clinic are great (over 95%). He has a lot of twitching in his arms. My question, how long does the twitching go on before we see loss of function? He is still golfing and doing yard work. I can't imagine him losing mobility but I know it will happen. Also, he is so hesitant to get the peg, when do you think it best to get this procedure? We both wonder how this disease will affect us both down the road. If you don't mind my asking, what caused the final passing if your husband. Sorry for all the questions, I feel like I'm living in an unknown fog. Thank you so much.