The first day of tests at Mayo Clinic consisted of a battery of pulmonary tests. The result was as expected.

Strong lungs. Weak muscles; specifically diaphragm and intercostal muscles.

Intercostal muscles are several groups of muscles that run between the ribs, and help form and move the chest wall. The intercostal muscles are mainly involved in the mechanical aspect of breathing. These muscles help expand and shrink the size of the chest cavity to facilitate breathing.

As with the more well known diaphragm, you need those muscles to breathe. For whatever reason, mine were weak.

The afternoon tests included the aforementioned EMG— electromyography. Think of being poked with dozens of needles in dozens of muscles (including the tongue); each needle an electrode of sorts used to measure electric impulses.

Electromyography is an electrodiagnostic medicine technique for evaluating and recording the electrical activity produced by skeletal muscles. EMG is performed using an instrument called an electromyograph to produce a record called an electromyogram. An electromyograph detects the electric potential generated by muscle cells when these cells are electrically or neurologically activated. The signals can be analyzed to detect medical abnormalities, activation level, or recruitment order, or to analyze the biomechanics of human or animal movement.

What I said but with more words, more syllables.

Here’s the clinical interpretation of the EMG test results:

This is an abnormal study. The electro diagnostic findings are most consistent with a length-dependent, large fiber, atonal predominant sensormotor peripheral neuropathy with superimposed polyradiculopathy versus polyradiculoneuropathy. However, the possibility of an early stage diffuse disorder of lower motor neurons with underlying peripheral neuropathy cannot be ruled out.

In essence, ALS is on the way.

It looks like a motor neuron disease; not many of those, and ALS is on the list.

My neurologist:

This likely is ALS. It would be wise to get your affairs in order.

I’m a curious person so my wife and I had already done a long and serious study of possible diseases over the previous year. After all, my first neurologist, a year earlier, had identified ALS as a potential disease. That was my conclusion, too.

We were ready. Almost.