I am the president of a large construction company, this syndrome has brought me to my knee's, and has cut my productivity at work at least in half. When I diagnosed myself with ALS I could literally do nothing. If it where not for my Vice president, who I brought in the loop, I and our company would have been in deep trouble. He gave me the space to come to terms with this thing, which I am still doing, and see numerous neurlogists who all gave me the clear signal. It also allowed me to slowly start to build back up my tolerance to the stress and pressure that comes with my position, and accept that this thing is not going away anytime soon. That is one thing that can get overlooked, the financial burden this must place on alot of people and there families. I did make up a BS reason to step away from work for awhile when mentally I was in the worst place I could be, I was only off for about a month, and it only made the symptoms worse, pacing the house all day and thinking about your impending doom is not healthy. Getting back into work is somewhat theraputic, although there are days I get up, and I know it is going to be a bad BFS day, and I just try to make it through the day, and accept not much is going to get done.