Hi Tom, I was diagnosed in 2011 with bulbar als. I still am mobile, but now having some hand weakness and legs are getting heavy. I cannot speak, use iPad to communicate and also have a PEG. My neuro has been after to me to get the pacer. I am on bipap but finding breathing getting worse. My neuro like to have patients use pacer and the bipap. I read all about your experience with the surgery. Which I must say scared me a little. I was just wondering how you like the pacer, how much has it changed your life, good or bad. I am so terrified of hospitals and surgeries, that I am pondering this. Any Input would help.