I cannot recommend Dr Terry Patterson enough. She is unmatched as a doctor in this field. Her knowledge, care and understanding are as deep and vast as the oceans. She has treated someone important to me for 20 years and allowed her to maintain a great quality of life. This is the answer you are looking for. She is one of the leading researchers in this field, she is one of the beneficiaries of the Phillies ALS benefit. There should be a shrine built in her honor someday.