My father had hand atrophy at the beginning of last year, and then his arm also atrophied. He had cervical spine surgery in April last year, and went to Beijing in April this year to teach you the typology of typical ALS, but now his legs are fine. Is this pseudomyelitis? Is the typology still classic? Dr. Li Xiaoguang replied: If you disagree with the typology. It is best to bring your father to see him. It is not always easy to classify, but it is necessary to combine symptoms, signs and objective findings. Patient’s family member asked: Is it still possible to do a gastrostomy with 40% FVC? It is developing too fast. I went to your office in April and the test was still 102%. They said I could have a gastrostomy without gastroscopy. Is it still possible to do it? Dr. Li Xiaoguang replied: The risk is high. I may not be able to do it. I don’t know if it’s possible to do a radiation-guided gastrostomy, but there are not many places that can do it, and it’s expensive. The FVC was 102% in April and now it is 40%, 7 months apart. Patient’s family consultation: My father was very stubborn and didn’t want to go to the hospital, so he went there after a few days of arguing. Many people say that DSA gastrostomy can be done without gastroscopy and with a ventilator. Professor, if we go for it, will we be unable to get off the operating table? Dr. Li Xiaoguang replied: It’s hard to be sure. There are already several patients in the group who were directly intubated during the gastrostomy, and one who was unprepared for the tracheotomy. Family members of patients: My father is not wearing a ventilator now, asked him if it was difficult to breathe, said no, just a little too much phlegm. His blood oxygen is also above 95. The first thing you need to do is to get a good idea of what you’re doing.