ALS – amyotrophic lateral sclerosis, Lou Gehrig’s disease or motor neuron disease – is indeed tragic and terminal. The initial symptoms can vary from person to person. One sufferer may have trouble holding a pen or lifting a glass of water, while another person may experience a change in vocal pitch when speaking. ALS is typically a disease that involves a gradual onset. In addition, the rate at which it progresses in sufferers also differs. Symptoms can begin in the muscles that control speech and swallowing or in the hands, arms, legs or feet.