Well ALS is evolving and not always in a negative way though never positive. I have gone from sucking my lungs out every hour on the hour to maybe once every three days. But I am sucking salvia out of my throat every hour. The difference may seem subtle but one procedure involves wearing a mask and sucking the liquid out with remote vacuum pressure. The other one involves sticking a wand down my throat and sucking from the tip of the wand.
And the picture is of my latest addition, a buck I forgot I had ordered some time back.