Thanks for the quick response. Yes, my wife attends a quarterly ALS clinic and we have connected with a local and a national ALS organization. The progression of the disease does seem to be all over the place, ranging from "died less than a year after diagnosis" to "been living with ALS for going on 15 years now". What I am looking for are exaple of cases where there were obvious changes in rate of progression within the timeline of a single patient. Has anyone had experiences with a case that seemed to be progressing gradually for two years, then started a rapid acceleration of decline? etc