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CGinVA

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Des Moines
As a background, I have a history of intermittent severe anxiety for which I have never taken any medications. The worst anxieties I have had have been health-related that were unfounded. So even before I ask my question, I know the answer is to see my doctor and get labs and an EMG. I am scheduled to see my PMD in a few days for labs.

I have been an an endurance athlete for years, running and cycling. After having the flu and then bronchitis in December I pushed hard to try not to lose too much fitness. After a few months I was back to close to normal form but noticed that very week or two I didn't quite have it for one work-out and had to cut it a little short or go easier than I usually would have had to. During this time I was experiencing regular health-related anxieties that were at times rather overwhelming. Over the course of a few months my fatigue levels increased as I felt stressed nearly all of the time. At first I cut my workout time in half. But when even those shorter less intense workouts I had trouble completing, I decided I needed some time off from cycling. This further increased my hypochondriasis and anxiety to where I had trouble sleeping. Now I hike without difficulty (I was able to go 9.5 miles a couple of weeks ago and dropped one of my fiends who is in decent shape) and lift upper body once a week.

My upper body lifting strength is totally the same as always. I don't have any fasiculations or noticeable atrophy or muscle asymmetry. My leg muscles have strength, just not the fitness that they used to with regard to cycling which has taken a big dip. Not sure if it is weakness or just fatigue. But once my cycling endurance started to drop it dropped fairly quickly which made me even more anxious.

I have tightness in the lateral aspect of my left soleus muscle which may represent a mild strain from recent hiking and recent efforts to try to correct a rotated pelvis and mild spinal curvature which I have had for at least 4 years. It feels similar to other knots I would regularly get in both legs when cycling hard. My pelvic rotation from what I read may be related to being right leg dominant and/or a mild leg length descrepancy. My right leg has always been stronger than my right. Subjectively the disproportion hasn't changed in at least 3 years. I used to lean to the dominant side when walking down steps but when I noticed it a couple of years ago I have succesfully worked to improve it.

I may just have burn-out triggered by 4 grueling workouts over 7.5 hours each week and an extended period of severe anxiety. I have read about adrenal fatigue, depression/anxiety-related fatigue, and chronic fatigue syndrome on some other forums and I am hoping it is one of those processes rather than ALS.

Based on my symptoms what do you think? Thank you for your time.
 
No, it does not sound like you have ALS. It's very clear from your post that you realize the extent of your health anxiety and that the odds of you having ALS are almost non-existent. You also know that you have things going on that could be the cause of the issues that concern you. Since you know the answer to assauging your fears, please do make that medical appoiontment. Some of the people on this forum have an extremely difficult time reading even short posts, and many are so limited in movement that they can barely type even short replies. This is a place to support people living with this very rare and horrific disease, and we honestly don't have the energy, physical or emotional, to help people who clearly don't have ALS. Anyone person here with ALS would exchange health problems with you right now, no questions asked and no doctor's exam needed. Please get help for your anxiety and stay away from ALS sites.
 
Thank you for your considerate post and reassurance.

I became more concerned when reading Ottawa Girl's post about not being able to complete work-outs as being an indicator of early ALS and when reading a website that stated: "In early stages, the weakness may present itself as a problem with muscle endurance."

My thoughts and prayers are with those afflicted with this terrible disease. Sorry to burden you and others with my question.
 
I also read this on the ALS Association website which has me worried: Other early symptoms vary but can include tripping, dropping things, [U]abnormal fatigue of the arms and/or legs[/U], slurred speech, muscle cramps and twitches, and/or uncontrollable periods of laughing or crying.
 
I doubt that we can say anything more than Nuts already said but I will give it a one time shot. I do not know the context of Elaine's comment that you quote. I know her initial symptom was hand DYSFUNCTION. I am leg onset and my ability to hike/ walk well or far went before cycle ability. I was a hardcore spinner before. And my first symptom was my ankle collapsed. I had walked several miles that day through snow covered uneven terrain I would be amazed if any neurologist suspects neuromuscular disease. I do not think you have ALS but your health anxiety will let you find reasons to think you do if you let it. We will not argue with you. You asked our opinions you have received 2 concurring ones. Now go to your doctor and see what their opinion is
 
Thank you Nikki. You have no idea how much I greatly appreciate the added reassurance. From your other responses I see that you are a great help to many people on this forum.

I tried to find the blog post about the exercise intolerance but could not, so perhaps it was someone else.

Right now I think that my loss of fitness is probably anxiety related since I don't have any focal muscle weakness, twitching, or atrophy. From what I have read, chronically elevated cortisol levels caused by stress are catabolic, limit recovery, and alter thyroid and testosterone levels which can cause fatigue.

I realize that I might simply be a hypochondriac but when I read that ALS can present with fatigue as an early symptom and that it may be more common in endurance athletes I got pretty freaked out. The internet can be a mixed bag.
 
Fatigue as an early symptom? Never heard of it. Anybody got any examples?

A lot of Americans experience chronic fatigue, so there will be some people who experience fatigue prior to being diagnosed with...anything. But it doesn't make any sense to me to call it an early symptom of ALS.
 
I think the confusion comes from this. After clinical weakness sets in it takes more energy to accomplish any given task. I was not tired before but now I have leg weakness everything is so much work. The fatigue improved after I got my afo because it takes less energy to get around with it than without. But it isn't like tired muscles. It is just plain tired. Is it an early symptom? I suppose so I am still considered early stage by my neuro. But it definitely came after clinical weakness
 
That makes sense, Nikki. I guess that doesn't seem so "early" to me.

I read CG's post. No signs of ALS, there, CG. In fact, I think it's a waste to do an EMG. Let an Internal Medicine doctor lead your health investigations. --Mike
 
Thanks to all for the responses. They really did make a BIG difference for me and my supportive wife. I will definitely make an ALS donation in your honor and appreciate all the gifts I have been given.

I am going to see my PMD Tuesday and skip the EMG (especially after I read what it entails).
 
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