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Scotiaspirit

Distinguished member
Joined
Nov 21, 2015
Messages
209
Reason
PALS
Diagnosis
11/2015
Country
CA
State
Nova Scotia
City
Dartmouth
I am awaiting a neurologists exam with further testing to either rule out or rule MND as my doctor refers to it. I am now 53 years old.

My symptoms started about 1 1/2 years ago. Over that time, I have lost over 60lbs, unexplained weight loss; despite trying to diet other times in my life, I could never lose weight, and now not even trying to diet, the weight is melting off. I went from a 50 inch waist size now down to 38 and still getting smaller. :confused:

People around me, started commenting, Paul, you have lost a lot of weight off your arms and legs, comments, like me arms are getting thin, my legs are getting thin, and my shoulder muscles seems to be wasting away. Actually, prior to last June, I was feeling quite well actually, despite the weight loss. For the last two summers, I have been getting muscle cramps in my legs, started very sporadically, primarily my right leg more than any other part of the body. They really started to increase in frequency in this past summer.

I have been complaining of a weird feeling, not really pain, but like a tiredness in my muscles of the arms and legs for the last nine months, especially after waking up in the morning. My internal medicine specialist, did testing on all the minerals, electrolytes, magnesium, calcium, potassium etc. Was even tried on calcium channel blockers for the cramps, but nothing seemed to help. I have had a neuropathy in my R rib cage for over 25 years and been on Neurontin (Gabapentin) since about 1995.

Recently, since September, my doctors have tested my blood work, electrolytes, kidney function etc., to rule out low electrolytes for causing muscle cramping. They have also been getting progressively weaker, not in a fast way, but gradual slow bit over time. I compare it to having a large rock pile, taking one stone away from it each day, on a daily basis, you do not notice much change, but over a time lapse frame, it is quite noticeable decrease, with physically noticable atrophy in my upper arms and upper leg muscles.

I have had what I would say are very gradual increase in muscle fasciculations, my wife first noticed them, in my right leg. They were pretty active in late October, and I made an appointment with my doctor, and he advised there is something neurological going on, especially with the prior tests finding nothing in the blood work and my urologist did some kidney blood work to rule out any kidney problem for causing these symptoms. (increased frequency in muscle cramping).

In late part of October, the fasciculations started getting to the point of 24/7 and have since spread to both legs, both arms and in my intercostal muscles in the chest area. I do not have pain (other than the let cramps that I now get; and of course the chronic neuropathy in my rib cage which I have had since 1993) and my doctor put me on a drug called Baclofen for the cramping as of one week ago yesterday. When the fasciculations started moving to other parts of my body, he advised that I would need to see a neurologist "sooner rather than later" was his words.

He advised he has treated two other patients with Motor Neuron Disease and he is concerned that I am showing some symptoms of what he called Motor Neurone Disease and reaffirmed that due to my unexplained weight loss, the atrophy of the muscles, have all been ruled out for low electrolytes, low minerals, lyme disease (negative) on two seperate tests done, and they do not feel it is MS related showing up at the age that I am now. BTW, I do have a half sister that has MS and she was diagnosed with the disease at age 33 over 11 years ago and her first and main symptom was sudden blindness. I have not had a symptom like that.

Since October at about Halloween, I woke up one morning and my right ankle had lost about 70% of its motion, the other limbs still have the motion as before, other than I tire easily now. I can still walk without an aid, but have to sort of drag my right foot now. I used to walk several kilometers two to three times per week, especially in the woods, and now my muscles tire after walking several hundred metres, to the point where I have to sit and rest them. This muscle tiredness is progressing quite quickly in the last several weeks. I have also had unexplained episodes of dropping glasses of water, computer mouse etc., out of my right hand on occasion.

Something is obviously progressing at a slow and steady rate. I don't have pain per say, other than the charlie horse cramps that I get from the muscles tiring quickly. I can still feel everything normally, as per sense of touch, etc. I have not lost any feeling of nerve endings.

I used to do speeches at Toastmasters, and the last speech I did in October, I started to get cramping like feeling under my chin muscle toward the end of my speech, which was another new thing to contend with.

I will not know more until the neurologist runs his tests, but if it is determined that I have this disease MND (ALS), it will surely change my life. No matter if it is or is not MND, something is progressing quite rapidly in my body, still a question mark on what the exact causation will be.

Funny thing is, while these symptoms were gradually building in my body, I felt something just wasn't right, but of course one would never think something like this could be the causation.

Until I see my neurologist for the nerve conduction studies and spinal fluid tap, it is still possible I have MND, but of course, there are many other things that could cause this from what I have read. My wife is upset and has a fear, as she has looked after two patients with ALS that were in the nursing home she works at. She knew them well and I asked her what their symptoms were like, and she said, Paul, you really do not want to know.... she just said that they (symptoms) are bad, especially in the later stages of this disease.

I do know something is wrong with me; but until I get the neurologists opinion, I am still hoping it will not be this disease, and I certainly have a great deal of respect and feel so much compassion to those who are suffering from this horrible disease. You are all very brave, and certainly do not deserve to be going through what you are enduring. I am truly amazed at how so many of you cope and keep a positive attitude while enduring so many hardships. You are in my thoughts and prayers.

May the Blessings Be.
Scotiaspirit
 
Scotia,
It's good that you're getting further evaluation and tests. I agree that MND is a possibility but it is a positive either way that what you have had so far is comparatively slow progression of weakness, fascics notwithstanding. However, since ALS is a fatal disease, as you know, meanwhile you may want to pull together information on financial and social resources that you may need. When is your EMG/NCV testing scheduled?

Best,
Laurie
 
I have my first consult with this doctor on Tuesday of this coming week
 
I should have clarified in my last post that I see the neurologist this coming Tuesday. I am unsure if he will be doing the nerve conduction studies that morning or not yet.
 
Paul, will be thinking of you Tuesday.
You will let us know how you go?
God bless, Janelle x
 
I will keep you all posted
 
I saw Dr. Juven***le (he is a neurologist/oncologist) today in Dartmouth, Nova Scotia; and he ran EMG (nerve conduction studies) as well as some other tests. He actually spent 1 hour 45 minutes with me despite his waiting room being filled with other patients waiting to see him. He concluded that it is very likely (high probability) I do have ALS. It is more pronounced on the right side of my body so far. He did say there is a type of compression syndrome that can take place in the spine that can cause some similar symptoms, however, with my weight loss, he reviewed years of my blood work, other tests, and the "unexplained" weight loss as he termed it; along with muscle atrophy, he advised there is a high probability that we are most likely dealing with ALS in his opinion.

In the coming days or weeks, I now have to go get an MRI done, see a pulmonologist to have breathing studies done and swallowing studies done. He feels the gastropariesis (I have had for about a year) could be related to the ongoing ALS symptoms. It is not 100% conclusive yet, but his words it is a high probability that I have ALS.

I am headed to our cottage for a couple of days for R & R just to get away from the normal routing so I can relax and reflect on my new norm. Time to make very moment count, time to start living life for every precious moment. May the Blessings Be. Paul
 
You need to get to a neuromuscular specialist who really knows ALS now so any of the other things it could be can be properly ruled out. I've never heard of gastropariesis as an early symptom, certainly it presents in late and end stage for many PALS. Get to someone who knows ALS.
 
Dear Queen of Hearts. My gastropariesis has been an ongoing problem for a couple of years and he DID NOT diagnose me as having a high probability of ALS on that symptom. I have ongoing tests over the last year; including MRI, CT Scan, comparative physicals, they measure the actual circumference around my arms and legs, belly, neck etc. I had GI surgery twice, and my gastropariesis could be from that. I happenned to ask the doctor if people with ALS get gastroparisis, and he acknowledged yes. They have looked for possible spinal tumours, (all negative so far). Over the last year, I have had tests for ongoing and increasing muscle cramping. Parkinsons, MS , Mystasisis Gravis (sp?) and Huntingtons have all been ruled out. In addition to the earlier symptoms that fasciculations started constantly in late October. I did have intermittent ones prior to that, but did not even note the problem. I have had trouble swallowing for the last six months, I drool out of the side of my mouth especially when relaxing. Trust me, I would prefer any diagnosis than ALS, knowing it is a deadly desease. I have one of the best neurologists in Eastern Canada according to his medical peers. They have ruled out everything, and as he advised, it is a slow methodical ruling out of so many other diseases to arrive with ALS. I feel like my world has been turned upside down, which I feel so many others in this forum have had to go through those same emotions. I got a call from my family doctor today who his secretary said to me, he wants me to come in to discuss my ALS diagnosis. If I cannot trust my doctors and medical care team, who have come up with this diagnosis, who can I trust?
I am sorry if the mention of gastropariesis sparked a negative response from you. This is suppossed to be a forum for helping people with ALS. If you folks don't want me here, just say so, and I will leave, feeling sad and shocked to why, but nevertheless bewildered. I would give anything and everything to have a different diagnosis that ALS, believe me! Scotiaspirit
 
I am sorry you took offense at Tillie's comment. I believe the comment was triggered by your identifying your specialist as a neurologist/ oncologist. To answer your question about who to trust with this diagnosis, we tell everyone to see a neuromuscular specialist to confirm a diagnosis. It has happened more than once on this board that someone reports a diagnosis by a neurologist that is overturned by a neuromuscular specialist. There is a statistic that 10 percent of initial ALS diagnoses are proved incorrect. While some of those are by neuromuscular specialists I strongly suspect most are by neurologists who do not have that subspecialty. That is not to say your doctor is not brilliant and of course may be correct, rather it is to say with such a devastating diagnosis you need to be sure. Neuro-oncology is an important specialty and your doctor is no doubt the best person for many conditions but ALS is not a neuro-oncological problem
 
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Scotiaspirit we have a lot of anxiety ridden people who throw out random symptoms trying to get a diagnosis of als. They also see a gp or the like and not a neuromuscular specialist. Most of us have had the experience that if a doctor who doesn't specialize in als is treating you you do not get optimal care. There are breathing considerations in particular, ot,pt,etc that you need to have treated by a very knowledgeable als specialist so you don't get the wrong treatment.
 
Everyone is welcome here and Queen of Hearts is a very kind and caring person. With a diagnosis like ALS everyone wants to make sure that you see a specialist that knows and works directly with Neuromuscular disease. With this being a fatal and serious disease we want to make sure you are getting the best of care. You will receive the support and love from everyone on here and will never be judged. You just have to know that everyone on here, who has or cares for some with ALS, has been on this journey and have experienced the pain of the diagnosis experience.

Our thoughts will be with you and our hearts. You will also come to learn that anything that is said here is only meant to help and Tillie has experience it all. Her dedication to this forum along with everyone else is truly inspirational.
 
My intention was not to take offence to Tillie or anyone else's comment. You all give so much time and effort from the heart and my emotions are very raw at this time, I apologize if my comments are construed as otherwise. My family doc called me in today to discuss my options, I was advised to get all my legal and financial matters in order. My family doc used to be chief of staff at Capital Health and he reiterated to me today that I was seen by the very best neurologist on ALS in our part of the country. My doctor advised that I am his 3rd patient with this disease, unheard of to have that many ALS patients by one doctor. In fact there are seven other doctors in his practice, not a single one of the others had a patient with ALS. He said most GP's don't even get a single ALS patient in their career. I do trust the competence of my doctors, especially my family GP who I have had for 24 years now. He methodically had me checked out by Internal medicine specialist, urologist, nephrologist, anthesiologist, general surgeon and batteries of tests spanning over two years so far. I asked him about getting another opinion, he advised a doctor that I saw at the hospital over three weeks ago was also a neurologist who specialized in myopathies (sp?). I am not sure what myopathies even are? He read me her letter, and she said something about a bulbar (sp) disease and felt that a nerve conduction study was needed urgently without delay. I will have to look up these terms to famaliarize myself with them. I still hope with all hope that it will be something different than ALS, but my family doc believes without any doubt I have ALS. He said all the tests so far have ruled out other causes. He advised there is no single test to conclusively determine ALS, that it has been a long road of deducting all other causes. The paradox about all this, other than the large amount of weight loss (arms, shoulder and legs), the cramps and loss of use of my right foot, I don't feel that sick! I have certainly felt a lot worse with colds or flus, if that makes any sense. I have a lot of researching to do to learn more about these diseases and effects. Am I scared? I am somewhat fearful for what is likely to take placee with my body as per the talk with my doctor, but it agonizes me to feel like I will be a burden to my family as my doc advised I will need 24/7 care around the clock in the later stages of this disease.
 
I'm sorry but you report that both your arms and legs are wasting away - unusual presentation for ALS, but possible. Yet you now say they are telling you bulbar. Bulbar onset ALS begins by the tongue wasting away.

I truly hope they find a definite diagnosis for you soon so you know exactly what you are dealing with.
 
Don't be quick to judge

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Thank you for your comment to Scotiaspirit. He clearly has some genuine, serious issues going on. At some point he will know definitively. I just hope he continues to run into supportive people like yourself willing to encourage him.

Paul, while reading this post I spent some time praying for you! It's ironic that your name be Paul because it's this Apostle's words that come to mind as I think of you....

2 Corinthians 1:8-11 "We do not want you to be uninformed, brothers about the troubles we experienced in the province of Asia. We were under great pressure, far beyond our ability to endure, so that we despaired of life itself. Indeed, we felt we had received the sentence of death. But this happened that we might not rely on ourselves but on God, who raises the dead. He has delivered us from such a deadly peril, and he will deliver us again. On him we have set our hope that he will continue to deliver us, as you help us by your prayers. Then many will give thanks on our behalf for the gracious favor granted us in answer to the prayers of many."

Bless you brother Paul!
 
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