Dear Lewis:

mi Angelita suffers from Amyotrophic lateral sclerosis (ALS). Wikipedia reads that 90% of all cases begin after the age of 45, and 1% begin before age 25 (juvenile ALS). People who develop young-onset ALS are more likely to have a slower progression of the disease.

Individuals affected may ultimately lose the ability to initiate and control all voluntary movement, although bladder and bowel function and the muscles responsible for eye movement  are usually spared until the final stages of the disease. Although the initial symptoms and rate of progression vary from person to person, the disease eventually spreads to unaffected regions and the affected regions become more affected. Most people eventually are not able to walk or use their hands and arms, lose the ability to speak and swallow food and their own saliva, and begin to lose the ability to cough and to breathe on their own. Difficulties with chewing and swallowing make eating very difficult and increase the risk of choking or of aspirating food into the lungs.

Most people with ALS die between two and four years after the diagnosis.. and about 20% of people with ALS live between five and 10 years after symptoms begin. (Cosmologist Stephen Hawking lived for 55 more years following his diagnosis, but he is considered an unusual case).

“Cognitive or behavioral dysfunction is present in 30-50% of individuals with ALS… Repeating phrases or gestures, apathy, and loss of inhibition are frequently reported behavioral features of ALS…  About half the people who have ALS experience emotional lability (exaggerated changes in mood or affect.. Sometimes the emotions expressed outwardly are very different from how the person feels on the inside.. The person experiencing emotional lability usually feels like they do not have control over the emotions).”

Her disease is very, very serious, and the prognosis is poor.

You asked: “How can I rebuild this friendship? Will it ever be the same? Will it ever be more? Will I find what I deeply desire and have done since my teens, true love? Where do I go from here?”

I will be glad to communicate with you further so that you will be able to answer these questions yourself. For that purpose, I ask: do you know the onset age of her disease; are you aware of how serious her disease is, that no one with this disease gets better over time, and that she is highly likely to need hospice care within months or a few years from now?

anita

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