I am a 77-year-old retired physician who has had lower motor neuron ALS for 5 years going on six. I have done a number of things that I think are related to the very slow progression of the ALS. Only my left arm was involved until 2024 and then my right leg became involved. But I still walk without an assistive device. Rachael has been my Personal trainer for the past 2 years, and I believe her work has also contributed to the very slow progression of the ALS. She is very inventive in finding ways to exercise my muscles that still have strength. ALS is a hypermetabolic disease and I lost 20 lb of muscle prior to starting personal training with Rachael. Since initiating personal training with my weight has been stable and sometimes increased. She is also skilled at leading large exercise classes. There are very few personal trainers with her expertise in adapting resistance training, as well as aerobic training, to the client's needs and abilities.