Dr. Lisa Wolfe talked about what we can do to help our patients keep breathing well -- again, early intervention is useful. She presented all the possible ways of treating breathing issues, along with discussing when and why you might do them. Later in the afternoon, Dr. Bob Miller talked about diaphragm pacing in ALS - newly approved for humanitarian use where a surgically inserted device stimulates the diaphragm to help with breathing. Data to date suggest that this helps some patients breathe and may prolong survival in those patients, but more data are needed to see how much of an effect it has. Not all patients are helped by this treatment, but doctors can identify which patients are likely to benefit. Dishan Singh talked about care of the neuropathic foot. He explained that patients may be seen with either flat feet or with very high arches, but that this is only a problem if pain or contractures occur. These issues occur in many different NMDs, although he talked mainly about Charcot-Marie-Tooth (CMT) . Foot pain seems to be common in these diseases and he talked about how to examine patients to identify the precise cause of the pain, and what can be done to relieve it -- which may be as simple as shoe orthotics, or may include surgery. Dr. Anne-Marie Wills talked about how diet affects the progression of ALS, demonstrating that maintaining weight, particularly through a high-fat diet, was associated with longer survival. She also discussed when