Day 10 of ALS Awareness Month: Today’s facts come from a “guest author,” a pALS named Catherine Scott. Catherine has familial ALS and has seen too many relatives succumb to the disease. She puts into words so well the horrible dilemma pALS and their families face: when one’s diaphragm and intercostal muscles no longer work and breathing is impossible on one’s own, should one have a permanent tracheostomy (often with ventilator) placed? Please read this excellent short piece on why that decision is so personal. In the U.S., 90% of ALS patients choose NOT to have a tracheostomy.