May is national ALS month. We’ve usually heard of this because of the well-publicized “ice bucket challenge”, where one can donate to the ALS foundation to watch a friend or celebrity be doused with a bucket of ice. That was fun, and for a great cause, but let’s also talk about other ways you can help your ALS friends. Start by giving them the present of breath. ALS is known for its neuromuscular deficits, which eventually affect the diaphragm. After all, the diaphragm is a muscle. Diaphragmatic weakness is the core mechanism behind respiratory difficulties in those with ALS. So, the best gift would be to remind them to take deep breaths. Always. The more you exercise any muscle, the stronger it becomes. Remind them to take in a big, diaphragmatic breath, filling up the lungs. Try the instruction of asking them to sip the air in slowly, and thus deliberately and steadily depressing the diaphragm on the inhale (which contracts the diaphragm). You can even think about how contracting the diaphragm is like contracting a bicep; the slower you contract and more resistance you give it, the more you will feel the strength building. Try doing this by counting with the breath and increase the count with each subsequent breath cycle. Conditioning the diaphragm is no small feat; but with time and training, breathing will become easier and more spacious. Do you know someone that has ALS? Remind them to breathe, and give them the greatest gift you can offer.