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richux

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Joined
Apr 27, 2014
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7
Reason
Learn about ALS
Country
UK
State
Yorkshire
City
Guisborough
Hello everyone
I've been reading this forum for a week or so now, owing to worries about my wellbeing.

I will give an account of my symptoms.

It started in January 2014, when I noticed that I began to get pain in my neck, dizziness and perceived weakeness/unsteadiness sometimes in my legs and ankles.

I went to doctor's at the end of January and he thought I had an inflammed joint in my spine, in my neck and gave my a two weeks course of Naproxen.

The pills helped and by the middle of February I seemed to be almost back to normal.

Then in early to mid March I began to feel less well again, but it was more focused on the weakness in my legs and general tiredness. Around that time, or sometime in March, I noticed that the muscles in my legs and arms seemed to be shrinking and this really worried me.

At the end of March I went to doctor's again and said that I was worried it might be a tumor in my neck, who gave me an examination with strength tests and said that she was not concerned and that she agreed with the first doctor's opinions that it was a joint problem.

Since then I have continued to feel weak in my legs and ankles most of the time, though have still been able to walk normally, hold/grip things, turn keys in door handles etc. I do think I have lost some more muscle, it is slight and widespread but more on my legs I think than other parts. I have had occasional twinges of cramp in my calves but not excessive so far. In the last few weeks I think I may have had fasciculations in my lower legs usually at the end of the day when just sitting down after the day's activities.

I have also felt like I'm having to chew food for longer in the last couple of weeks before swallowing it, though I still seem to be able to swallow everything.

I think that the weakness I have experienced until now has been perceived, which might be a reassurance though I am very concerned about my atrophy. Of course most signs of limb onset MND start with one limb and then gradually spread to others whereas mine has been more evenly distributed. However there is no set pattern and it makes me wonder if I may have PMA which from what I've been reading can often be more vague and general.

I have also read the very informative stickies about weakness, but wonder if clinical weakness may be preceded by perceived weakness. I have read various cases of MND that seem to suggest this is so.

So far the main thing that has worried me is my atrophy. My weakness has tended to come and go at times though it is there more often than not. Yesterday I walked a mile to the supermarket and back and carried a fairly heavy bag of groceries back without too much difficulty, though other times I feel as though I wouldn't be able to walk very far.

I don't seem to have any trouble typing (my job is an office job with a lot of typing) though I do seem to make more spelling mistakes, hitting the wrong key, than usual.

The reason my concerns went from a tumor to MND was because my neck pain has now mostly gone, and yet my weakness and atrophy is continuing. Although the neck pain initially started at the same time I have thought that it could be just coincidence that my neck pain started at the same time as the weakness.

I have another doctor appointment this coming Friday because I am still very concerned indeed.

I would be greatful for any comments you may have, thanks for reading.

Ps, I'm a 32 year old male, weight 99-100 kg, down from 102 kg in February, 5' 10" tall, not particularly active and I also have moderate, weight related Fatty Liver.

Regards
Richard
 
Richard, it appears that, in your 30's, your body is in its 40's.

Your symptoms are quite common concerns for people in the "Do I have ALS?" category, but after considering your symptoms one by one and as a whole, I don't think at all that you have ALS.

Best to let your doctors continue their course.
 
Hi

Thanks very much for your input. You are correct, I do through lack of fitness have a body older than my age!

Ps. I don't have any symptoms like tingling, numbness, or anything like that so couldn't rule out MND on that basis.

I will let you know what the doctor says.

Regards
Richard
 
“I began to get pain in my neck, dizziness…” These are sensory symptoms, which points away from ALS…

“…and perceived weakeness/unsteadiness...” Perceived weakness is not a symptom of ALS; clinical weakness is…

“The pills helped and by the middle of February I seemed to be almost back to normal…” ALS symptoms do not come and go…

“I noticed that the muscles in my legs and arms seemed to be shrinking and this really worried me…” Self diagnosing atrophy can be difficult. Do you have measurable differences between left and right? Do you have records from 6 months or a year ago that confirms the atrophy? In my experience with ALS, atrophy does not happen all over at the same time.

“…she was not concerned and that she agreed with the first doctor's opinions that it was a joint problem…” So, why do you not believe your doctors? Are you seeing a different doctor on Friday?

“…occasional twinges of cramp in my calves but not excessive so far. In the last few weeks I think I may have had fasciculations…” Twinges from excess caffeine, excess anxiety, fatigue, etc. are far more likely than twinges from ALS. In other words, twinges are non-diagnostic.

“My weakness has tended to come and go…” Therefore, I would say it is not clinical weakness and ALS weakness does not come and go. (Many here sure wish it did.)

“I… wonder if clinical weakness may be preceded by perceived weakness. I have read various cases of MND that seem to suggest this is so…” Perceived weakness is so common, I do not believe it is predictive of clinical weakness.

“I am very concerned about my atrophy…” Yes, atrophy can be a sign of something wrong that can be fixed—e.g; pinched nerve. I would go see a doctor and have the atrophy confirmed or negated.

Given all your symptoms, I see nothing that points to ALS, but I think your doctor will tell you that on Friday, and he is the expert.
 
Thank you so much for that very good post - you're very helpful. I am still very concerned though about Progressive Muscular Atrophy which from what I have read can be more vague.

In answer to your question, I was not convinced that a joint problem could cause muscular atrophy, could something as small as a pinched nerve cause atrophy?.

As for the atrophy, I don't really have much difference between left and right and don't have any measurable records from a while ago, but my legs and arms (especially ankles, calves and thighs) do look thinner and my trousers are looser fitting also. I'm still wearing the same size at the moment but it all just feels looser.

Thanks again for your message

Regards,
Richard
 
PMA is still a motor neuron disease--just with lower motor neuron signs and no upper motor neuron signs. But its LMN signs are very distinct--fibrillations, hypotonia, hyporeflexia, clinical weakness and, yes, atrophy. An EMG will show widespread acute and chronic denervation. It's signs are not vague.

Yes, a pinched nerve can lead to muscular atrophy. If a muscle is not getting nerve impulses, for whatever reason, the muscle can atrophy.

It still doesn't sound like an MND to me, but as I said, muscle atrophy can be serious, and frequently can be fixed, so have a doctor look at it and he can run blood and urine work to see if he sees signs of muscle loss and take measurements so you have a baseline reference. If he thinks its a nerve proble, he can order and EMG and that will show which nerve, if any, is causing problems. Good luck.
 
Hi

Quick update - during today my right leg was in a lot of cramp in the calf muscle, started out very mild during this morning but gradually became quite uncomfortable during the afternoon. I seemed to notice that standing still brought it on more readily and it made my leg feel rather shaky at times, and again, rather weak.

I have noticed for the first time this afternoon what was also some slight tingling in my right foot, so I am wondering if that was just because I was sat in an uncomfortable chair at work (which I was) or if that was part of my symptoms also

However after work I went for a stroll round the shops after work and when I was walking round the shop the cramp seemed to go and my leg felt a bit better, less weak, more "flowing" in its movement and normal, though I still feel generally a little weak.

It has been odd today because although I have felt very uncomfortable and not great at times when at work, after work things seemed to be slightly better (maybe) and I am hoping that the possible tingling I felt was a sign away from an MND

I'll try and keep you posted.

Thanks
Regards
Richard
 
Hmmm. I see something here possibly as simple as dehydration. Are you on a diet?

Come back after your doctor's appointment if your doctor suspects MND.
 
Hi,

No, I'm not on a diet and I do keep hydrated pretty well.

I'll keep you updated, whatever doctor says.

Regards,
Richard
 
Hi,

Just back from doctor's, he gave me a few small balance and co-ordination and strenth tests and he said those were fine. He couldn't see any obvious atrophy when he looked at my limbs and said that from what I present, there is very low risk of a Motor Neurone condition here.

He did tell me to see him again in a month just to see if there are any obvious changes and if anything major happens in the meantime to contact him straight away.

I have also been booked for blood tests to monitor my liver disease.

So, for the moment, ok. Though it's just a case of waiting now. Hope it all works out.

Regards,
Richard
 
Great news. It did not sound like motor neuron disease, but a wise doctor will follow up. This is a normal precaution and not something you should worry about. Your biggest risk right now is anxiety throwing off all kinds of sensory and perceived symptoms which aren't real. So relax and don't worry about every twitch or feeling of fatigue.
 
Thanks,

I'll keep you updated of anything that happens and the results of my next meeting.

For now, thanks for your feedback.

Regards,
Richard
 
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