The Pranger ALS Clinic is committed to providing compassionate care to patients with ALS.
Certified by the ALS Association for more than two decades, we offer treatments that maximize quality of life and functional independence and manage symptoms.
Visit our ALS/Lou Gehrig's Disease page for more information about ALS symptoms, diagnosis and treatments.
Your Visit to the Pranger ALS Clinic
Our goal in the ALS Clinic is to make you as comfortable as possible while still providing world-class care. That means you might meet with as many as 11 different professionals over the course of a visit, but each one is here to make sure you have everything you need – not only while you’re with us, but also after you head back home.
It might seem like a lot, and it’s not unusual for a clinic visit to take up to 4-5 hours. Just remember that we’re all here to help – and we want you to relax.
What to Expect
Here’s who you are likely to see while you’re here:
- A physician to assess your condition
- A nurse who coordinates your care to make sure you’re getting everything you need
- A nutritionist to talk about keeping your body nourished
- A respiratory therapist to help with your breathing
- A physical therapist to keep you strong
- An occupational therapist to show you how to do small but important things like getting dressed
- A social worker to make sure you and your family are getting the services you need
- A research coordinator to make sure you’re aware of (and enrolled in) ALS studies as you wish
- A speech pathologist to help you communicate
- A wheelchair seating specialist who helps you understand mobility options that can improve your quality of life
- A representative from ALSA’s Michigan chapter
It seems like a lot. But for us, each and every person you see is here to make your life with ALS the best it can be. It takes a team effort, and we are all here for you.
Additionally, you are more than welcome to bring a friend or family member to keep you company while you’re here. Your companion is welcome to participate in your appointment.
We suggest you bring a lunch or snack and drink with you to the Clinic. The last thing we want is for you to be uncomfortable here. In case you forget, there are vending machines and a hospital cafeteria nearby, and your companion is welcome to bring you whatever you need.
There’s always paperwork for each visit, so please don’t forget to bring a list of your medications. We understand that patients get asked for the same information a lot – and that we should know it by now! – but it’s important that we have current information on each visit. It helps us to avoid any confusion that might compromise your care.
You’ll be weighed at the beginning of every visit. Once we get you in a clinic room, that’s where you’ll stay for each visit. We like to know where to find you, and we don’t want to make you work too hard.
The Multidisciplinary Approach
Research has shown that active, aggressive management of amyotrophic lateral sclerosis enhances patient survival, and that’s exactly what we do in the University of Michigan’s Multidisciplinary ALS Clinic.
The U-M multidisciplinary team assesses the needs of each patient and develops an individualized care plan that addresses every step of the ALS journey.
Once a patient is diagnosed with ALS, our team immediately begins its work implementing a wide array of clinical services designed to assist families and maximize patient health and function, including:
- Physical therapy
- Occupational therapy
- Nutrition
- Speech and swallowing
- Respiratory evaluations
- Social work
Multidisciplinary Team Member Roles
The U-M multidisciplinary team assesses the needs of each patient and develops an individualized care plan that addresses every step of the ALS journey. Here are the roles of some of the team members you may see during your visit.
Dietitian
The role of the dietitian is to develop an individual program to provide adequate nutrients to maintain weight and prevent weight loss that may occur during the course of ALS.
The dietitian will determine how many calories, grams of protein, and fluids should be consumed each day. In addition, the dietitian can provide input on food consistency, supplementation, and tube feeding formulas.
Speech-Language Pathologist
The role of the speech-language pathologist is to assess speech and communication skills, implement strategies to enhance communication, and assure that persons with ALS can express their feelings, thoughts, and needs.
Instruction in the use of compensatory strategies (such as slowing the rate of speech, separating the syllables, and over-enunciating the speech sounds) can be helpful.
These strategies can also be augmented by communication devices such as magic writing slates, alphabet boards, picture boards, eye scanning boards, electronic devices with voice output, and even high-tech computerized devices.
Our speech-language pathologists will also conduct swallowing evaluations and offer safe swallowing strategies and suggestions.
Social Worker
The role of the social worker is to assess the impact of recent physical, emotional, and financial changes in persons with ALS and the family unit and how the patient and family are coping.
Current and future needs are addressed and suggestions for community resources are provided.
Respiratory Therapist
The role of the respiratory therapist is to obtain measurements of respiratory function and instruct the ALS patient and family in the use of therapeutic measures such as breathing exercises and assistive coughing and in the use of equipment such as a breathing tube.
Physical Therapist
The role of the physical therapist is to assist the patient in the areas of exercise, equipment, and safety. This includes patient and caregiver instruction in stretching and range of motion exercises to help maintain flexibility and reduce cramping.
The physical therapist may also recommend devices and equipment such as an ankle-foot-orthosis, a cane, a wheelchair, or a neck brace to help in maintaining mobility and independence.
Instruction in proper methods for moving, transferring, and lifting patients and recommendations for safety equipment including aids for transfers, lifts, grab bars and shower chairs are also provided. The goal is to promote the highest level of possible function, for as long as possible while avoiding fatigue.
Occupational Therapist
The role of the occupational therapist is to provide persons with ALS options, resources, and information for maintaining independence in activities of daily living.
The occupational therapist assesses the patient’s functional abilities (range of motion, muscle strength, daily activity levels, and mobility) and performance in activity areas such as dressing, feeding, hygiene, and in the work environment.
Adaptive devices such as rocker knives, button hooks, handwriting aids, book holders, zipper pulls, key holders, reachers and grab bars may be recommended to assist weakened muscles, reduce fatigue, promote safety, and enhance life quality.
Pranger ALS Clinic Team
Certified by the ALS Association for more than two decades, we offer treatments that maximize quality of life and functional independence and manage symptoms.
We know that ALS affects the whole family unit, and we offer compassion and support not only to our patients, but also their family and friends.
Treating ALS requires a large, dedicated multidisciplinary team, such as the exceptional group we have assembled at the University of Michigan.
The team is led by Pranger ALS Clinic Director Stephen Goutman, MD, MS, Associate Professor of Neurology at Michigan Medicine. Dr. Goutman's area of expertise is ALS/Lou Gehrig’s Disease where his focus is delivering comprehensive and compassionate care.
Visit the Pranger ALS Clinic team page to learn more about our team members.
Frequently Asked Questions
How do clinic charges work?
Anticipated charges include the neurologist visit and pulmonary function testing. If blood is collected for clinical testing (and not research testing), and laboratory charge will result.
Visits by the pulmonologist, physical medicine and rehabilitation physician, interventional radiology, and speech-language pathologist will be billed. For questions about visits by the dietitian, social worker, occupational therapist, or physical therapist, please contact our program at 734-936-9010.
How do I request medical records?
If you need copies of your medical records sent to you personally or to another medical provider, please contact Health Information Management-Release of Information Unit at 734-936-5490. Medical records and laboratory tests can also be viewed on the patient portal.
What if I can’t make my appointment?
Please contact us as soon as you know you are unable to keep your appointment. This will enable us to offer an appointment to another patient.
Will I need prior authorization from my insurance company for a procedure?
Sometimes a medication or treatment, requires that prior authorization be obtained by your insurance company. Prior authorization from your insurance company can take 10-15 days.
Once the prior authorization decision is made, typically your insurance company will notify both you and us in writing. If after 10-15 days you have not heard from our office regarding the prior authorization decision, please contact our office at 734-936-9010 or via the patient portal. Thanks!
How do return visits work?
Return visits may or may not be scheduled at the time of check out at your clinic visit. Sometimes a return visit is not scheduled due to the need to coordinate multiple visits. If a return visit is not scheduled at that time, we will contact you to schedule one.
Will the clinic complete family medical leave forms or VA paperwork?
Yes, we are happy to complete these forms. Our program receives many requests for family medical leaves and or VA paperwork. Please note it could take 10-14 business days to complete your request.
How can I request medications?
To expedite your medication requests, it’s best to initiate a request through the patient portal or contact our office via telephone 734-936-9006. For urgent requests, please contact us by phone.
Make an Appointment
To request an appointment or to get more information, please call 734-936-9006 and a team member will get back to you within two business days.
More About the Pranger ALS Clinic
The generosity of Scott L. Pranger, a Michigan Medicine ALS Center of Excellence National Advisory Board Member, has led to the endowment and naming of the Pranger ALS Clinic.
The $2 million donation is in honor of Cathleen Pranger, wife of Scott and mother of Sam, who passed away in 2015 from ALS, also known as Lou Gehrig’s disease. She received her care from the Michigan Medicine ALS Clinic.
“The cost of my wife’s care was in excess of $2 million over her life with ALS, which were costs the insurance companies did not cover,” said Pranger. “I want to be able to help other families with the care their loved ones truly need and deserve.”