I noticed difficulty speaking in March '07. I thought it was stress. After a very relaxing vacation in June '07 I still had troubles speaking, in fact it was getting worse. After months of visits to various specialists and numerous tests I was diagnosed with bulbar onset ALS in Feb. of '08. It is now the spring of '11 and my progress has been slow. My speech is garbled and I am using a communication device exclusively. My left arm is showing weakness but I am still walking, in fact I feel pretty good. I started BiPap in Feb. of '10. It helps me get thru the day. I treasure every day!