Could this be ALS?

[triplejjj]

Hello all. I am a 20 year old college student from Wayne, PA. For the past two months I have been suffering from some strange symptoms. Two months ago when it started I started feeling extremely fatigued and tired. Because of this I took about two weeks off with literally no exercise. During this time I started to develop some stiffness right above my right ankle, which seemed like nothing too serious. Two weeks later and the stiffness was now in both of my calves, ankles, and in my right forearm (still had not exercised). This is when I started to worry. I saw the doctor and was given a neurological exam and a TON of bloodwork which showed nothing wrong. I was a bit relieved, but still worried. Then over the next two weeks everything stayed the same with few developments. Then in the past two weeks I have begun twitching. The twitching can come on anywhere (arms, back, legs, feet, shoulders), but it seems to mainly be in my calves. In my short time on here I have read that twitching can be BFS, but what worries me now is that my twitching is accompanied by stiffness and tightness in my calves and right forearm. My calves also feel very crampy and if I flex them they soon cramp up. Also over the past two weeks I have began to play some basketball, and my dominant hand has stiffened up. The stiffness is in my thumb and although it doesn't seem to be weakness (I can do push-ups on my fingers, grip things, I have tested my thumb just by gripping things with it and my index finger and it hasn't shown any true weakness) the stiffness makes my thumb feel weak and makes it uncomfortable performing fine motor movements. I would describe it as my thumb feeling swollen. As for overall weakness I seem to tire out from exercise very easily and after exercise I will twitch a lot. I can however still jump about the same height as before, run, do pushups, run up stairs, etc. I am seeing a different doctor in about a week, but I am currently just worried that this could be ALS. I know at my age it is unlikely, but the twitching accompanied by the stiffness, tightness and fatigue has really been on my mind.

Current Symptoms include: Tire out easily from exercise, constant stiffness in calves and right forearm wrist and hand, twitching all over, but I feel like it is mainly in my calves. Soreness upon exercising (played basketball two days ago and my whole body felt sore the next day and still is), Also have a ton of joint cracking in my ankles, wrist, fingers..I can crack them constantly, which wasn't the case before.

Any responses would be appreciated and thank you for taking time to read this.

 

[st123]

Hi, so sorry you're feeling poorly. I know how anxious it make you feel when things aren't right. I'm no expert, but wanted to let you know that your symptoms are not like anything my Dad ever had. Good luck at your next appointment - I hope they help you figure out what's going on.

 

[triplejjj]

Thanks you for your quick response. Yeah I have felt very worry some throughout these months and thats one of the problems determining, which of my symptoms are stress or "real"...thanks again- John

 

[sadiemae]

With ALS weakness will be the first symptom, clinical weakness versus perceived weakness.

Do NOT confuse "perceived" weakness with clinical weakness, nor confuse fatigued feelings with true muscle weakness. True physical muscle weakness and clinical weakness do NOT come and go. It is permanent and on-going to the point where you completely lose control and can no longer use that limb, (forever), and then it MIGRATES from there to other parts of the body

ALS twitches are caused by dying muscle tissue as the nerve endings disconnect between the muscle and brain which in return cause the muscle to die and shrink. This is a SECONDARY action and it ONLY happens AFTER the muscle has started it's dying process, NOT before. So with that, ALS twitches (by the time you notice them or IF you even notice them at all) will most certainly have some kind of weakness or immobility of the muscle involved at the same time. Also, ALS twitches and symptoms usually start in a hand or a foot and will migrate from that point forward progressively and continually and relentlessly. They will NOT be random twitches like BFS has. You won't have a twitch in your finger one second, and a twitch on your back the next and a twitch in your calf the next and a twitch on your tongue the next with ALS. ALS starts in one spot and progresses continually through your body, not at random. ALS twitches are usually very fine and again, have WEAKNESS associated with them.

Twitching in ALS is a direct result of the disease running it's course. It is NOT a pre-curser symptom! In other words, if you have twitches that are associated with ALS, it means the disease is ALREADY running its course because muscles diseased with ALS don't begin to twitch UNTIL micro fibres begin to die and disconnect.

BFS "weakness" on the other hand, is pretty much only fatigue and although you may "feel" weak or drained-out, if push comes to shove and you put aside the pain, fatigue, stress or whatever else you have, you still have your real strength. I mean if a car was coming at you and you had to jump out of the way, you still could, where an ALS patient couldn't move at all.

 

[triplejjj]

Thanks you for your response... I have read this, my twitches seem like BFS because they can come anywhere in my arms, legs, feet, hands and, back, but what worried me about them is that they seem like they are more frequent in my calves and much more noticeable there too. Thank you again-John

 

[sadiemae]

What about weakness? You will have weakness long before twitches. Weakness meaning you can not even use your calves.

 

[triplejjj]

Oh alright... My calves have just felt fatigued, stiff, and shaky, which I was worried may be some form of weakness. But i can still hop up stairs on 1 leg, so I guess this is more of a perceived weakness/fatigue. Thanks for the info.

 

[kiwisally]

G'day, sorry you are feeling so unwell. Everyone gets anxious when things aren't right. I'm not a doctor and only have first hand experience with my own case so it would be totally irresponsible for me to offer you any sort of medical opinion based on the little information you have provided. I can assure you that your symptoms are nothing at all like mine and that at your age it would be next to impossible for you to have ALS. Having said that I do think that it would be a very good idea for you to go back and see your doctor again, about your health concerns, because they are so troubling to you as to bring you to this site asking if we think you might have ALS, after you have been told by qualified professional that they can find nothing wrong with you neurologically. Good luck to you.

 

[notgivnup]

Wait for the doctors to do all the tests needed. They are the experts. And try not to worry it will not change the future. Be patient it is a long process eliminating everything else. Hoping for a good diagnosis for you.

 

[sadiemae]

Thank you for listening. The chances of a 20 years old who can hop up stairs on one foot having ALS is pretty remote.

 

[HelenL]

I'm sure you've been tested for mono, and all the other typical college illnesses. Stiffness in your legs after no exercise is probably pretty common. What are your B-12 and V-D levels at? Sounds like the fatigue is a big factor in you, and if it makes you feel any better, you have virtually no chance of having non-familial ALS at your age. Take some vitamins, drink lots of water, eat some berries, and go to your doc next week. I'm not trying to make light of your situation, but college students are notoriously bad at eating properly. Good luck, and keep us posted.

 

[patricia1]

If you still have concerns go back to your PCP. He or she will be able to investigate with more test and referrals.

Good luck and try to have a fun summer .
Patricia

 

[triplejjj]

Thank you all for your time and responses!

 

[triplejjj]

I'll make sure to update this once I see the doctor again.

 

[notme]

At the risk of annoying anyone--while I do doubt that your symptoms are ALS-especially given your age--cramps and spasms can be all sorts of things.

If simple things like hot baths or whirlpools, moderate stretching, etc don't help--get checked for things like perhaps a potassium deficiency or something similar.

Exercise intolerance can also be seen in various viral conditions. (hard to find--viruses) Low B-12 is another possibility. Stiffness accompanying these things might be something of a rheumotological nature as well.

With your age, it might be hard to be taken seriously with doctors. Find a doctor you can trust and explain, with no hysterics or assumptions, what things are 'different' with no known cause.

If all the bloodwork is normal and strength is normal--it does sound more systemic than ALS onset would be. Muscle fatigue that improves with rest can have several causes.

Another possibility if you have mainly pain and discomfort is fibromyalgia--very real--and very, very uncomfortable. Good luck to you!