I want to say a couple more things and then I'm going to remove myself from this thread.
Carlos- you made this statement:
Some start with Limb-onset and can swallow and talk normally for several years whereas others start right with Bulbar-onset and can no longer swallow or talk.
For those folks (PALS with Bulbar-onset), a Protocol like that, which has lots and lots of supplementation in the form of capsules and/or tablets that need to be swallowed every day is frankly overwhelming, time consuming and energy consuming and, they might even choke.
I have Bulbar Onset ALS. When I first started the Deanna Protocol I had a hard time swallowing the capsules, so I opened them up and put them in a drink. After two or three weeks, my ability to swallow improved significantly, and since that time I have swallowed over 50 pills a day. Really without much of a problem.
But, if that didn't happen for someone,if their swallowing didn't improve, they could open the capsules, (all but one supplement is a capsule, or a powder), like I did and put them in a fruit drink, or a protein drink, or whatever. And, as for choking, all of us with Bulbar could choke on pretty much anything. That should not be a reason not to try something. And, if you ate on a feeding tube, you can mix a majority, or all of a morning or an evening dosage of pills together and take via your tube. And, you can take your hourly dose of AKG and follow with some water or other liquid. It's really not that much volume and certainly not as hard as some want to make it out to be. (This is more about attitude than anything else.)
And, if you're going to do a protein drink, I suggest you choose a raw protein based drink and not a basic whey based drink. Garden of Life's RAW PROTEIN Organic powder is a far superior source of protein for PALS than Muscle Milk. I'll let you all do the research as to why.
Remember- You can't continue doing the same thing and expect a different result. And, you sure shouldn't allow fear to run your life or set your course through your ALS experience.
Goodbye and good luck.