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I definitely have up-and-down days as well. My ALS affects my shoulders, arms and hands. I still drive and there are some days where both my hands can go to the steering wheel and there other other days where I have to lift my right arm with my left hand to get it on the steering wheel. I haven’t been able to figure out why sometimes I can easily do this and other times I can’t.
I have just started noticing that I think the ALS is moving to my mouth. Sometimes when I try to form words I almost feel like I’ve had too much to drink, when I’ve had nothing to drink, and I have to focus on articulating my words. Again, some days I don’t notice this and some days I do.