Trach vs BiPap

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ptich

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It seems that some patents first get BiPap, but some others (like AHands) are advised to have a Trach. Why ? Is it because insurance refuses to cover BiPap ? Or they had some tests ruling out BiPap (like swallowing air) ?
 
As your muscles deteriorate, even the Bipap can't push enough air into your lungs. That is when the trach becomes the only option, as there is no mask leakage etc to deal with.

AL.
 
I understand it, but it seems that a few PALS are suggested to have Trach even before they go 24/7 on BiPap, and some are even before the get BiPap at all.
 
I think it depends upon the pulmonary function. I am at about 80% on a bad day, so a pi-pap at night works wonders for me. I actually find myself getting stronger in some ways. For instance, I can jump a couple of times on both feet. But then I don't have ALS, just some weird neuromuscular thing. A PAL probably would not be able to re-gain gross motor functions, I would imagine.
 
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