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Sprawl

Active member
Joined
Dec 5, 2015
Messages
35
Reason
PALS
Diagnosis
01/2016
Country
US
State
ND
City
Burlington
**Sorry for the length, I didn't realize how long it got until I hit preview.**

I have read thru the sticky's and know that what I am experiencing is likely something different, and I really hope I am in the wrong place. I have been reading posts for the last week and finally got up the courage to put my story on here and see what you all think...

First a little background, I am a 37 year old male. Married with 2 kids ( 7&8 ). US Navy veteran ('97-'05). I have had only a few previous health issues (GERD, Ulcers).

A little less than a year ago I began experiencing minor issues with my right hand. I spend a lot of time working on the computer so I believed it to simply be over use. 6 months later it was still there and seemed to be getting worse even though I had eliminated most of my computer time. So I finally went to see my PCP and he had me do some test for carpal tunnel by putting the backs of my hands together and after 30 secs asked if I had any numbness or tingling. I did feel a slight tingling so he said I had carpal tunnel and sent me to physical therapy and had me wear a brace at night. When I went to physical therapy the did a grip test and on my left hand I believe she said I hit 110 but on my right hand was 40 (I am right handed btw). This is significant to me because my right hand was always the strongest. So anyways, I continue with the PT and after about 2months and no positive progress she referred me back to PCP for a Cortizone injection. I received the injection and waited about a full 2 months cause I had read somewhere that sometimes injections can take that long to take effect. After not seeing any results I returned and I was scheduled for a consult for surgery. The Dr. came in shook my hand, immediately turned it over and looked at it closely. Asked me a few questions, had me remove my shirt and then said he needed to make a call because the muscles in my right arm have atrophied(not sure if that is correct spelling), that he needed to get me over to neurology immediately. He made the phone call there in the office and off I was escorted to neurology. The neurologist did several exams and I will do my best to remember all he said, but this was an unnerving event since I thought I was just going to have a consult for carpal tunnel surgery.

He did a test that I do not recall what it is called but it felt similar to a tens unit, this is the one test that I did not understand if he got any results from. He did some physical tests with pins and the handle to something on my feet, asked me if I could tell which way he was bending my foot or toes. Everything seemed like it was ok there. Then he conducted an EMG, and his words for the results were that "my muscles were chattering when they were supposed to be relaxed". He also did a reflex test and said my reflexes are pretty strong, which I said good, he then told me no, that is not good, they are too strong. He also said my legs were too stiff, and asked if I had trouble walking, I said no. So he scheduled me for an MRI of my C & T spine and brain so he could see if there was a nerve being pinched in my spine or if I had a bulging disk that could be causing this. So I came back 2 weeks later after I had gotten in for an MRI and he reviewed the MRI with me. There was nothing abnormal in the MRI. he then had me lay down and ran through some of the same tests he had conducted the last time with the same results, including another EMG which he said had even more chatter this time. It was at this point he kept asking if I had any trouble walking, breathing or swallowing. I bet he asked each one about 7-8 times over the course of the visit.

At the end of this last visit he sat me down in the chair after the exam and told my wife and I that what is going on is beyond my expertise and then when we asked him if he could tell us any inclination as to what it could be, he named off several things but kind of discounted each one as he went, the only ones I remember clearly was MS, Viral infection, B12 deficiency and there was several others he named but each one he had kind of a counter argument as to why he thinks it couldn't be that. Then at the end of it all he told us that most signs point to a motor neuron disease. I had no idea what that meant at the time but after the wife came home and did some research, I do now! I am kind of freaked out.

Before we left the office that day (last Friday) the Neurologist ordered some blood work and an xray, and put in a referral to Mayo in Rochester, MN. He said he hopes that we can get some results from the labs and xray and we can cancel the Mayo appt. As of now all but 1-2 of the lab results are back and normal. My Mayo appt is scheduled for 1-26-16.

During all this time my hand has been getting worse and worse. What started with what seemed to be simple difficulty typing to now I can type normal with my left hand but have to hunt and peck with my right because my fingers just kind of go all over the place when I try, I can no longer write with a pen and paper, cannot button my own jeans or tie my shoes. My right hand has virtually no muscle mass left and the forearm and upper arms are diminishing quickly. My wife has mad comments that she can see my tricep twitching recently. And probably completely unrelated, but with recent temperatures I get what I can best describe as a shiver in my lower body when exposed to cold (most pronounced in the glutes) even at temperatures that are not what I really feel cold.

Any info or feedback would be appreciated.
 
I think I should clarify that the most severe point of atrophy is between thumb and index finger. So it makes anything that I have to use pressure from my thumb impossible. I am a smoker (and yes I know how bad that is), and cannot even light a lighter anymore. I can still grip some things if I can use the base of my palm and rest of my fingers, but it has to be pretty light as my overall hand strength just isn't there anymore.
 
Sprawl, hopefully, you're in the wrong place. There are other MNDs besides the fatal ones. But since I only know ALS, I'll give you advice about ALS.

My wife died of ALS. She and I both served. IF indeed you have ALS, the VA will accept responsibility that it is a Service-Connected Disability without you having to prove it. You'll immediately be rated 100% Permanently and Totally Disabled, and they'll offer you medical care and generous compensation.

I only have a few thoughts for you from my limited perspective:

1. If I thought I might have a fatal disease, I would maximize my life insurance before I got the diagnosis.
2. The VA has outstanding health and compensation benefits for veterans with ALS and their survivors.
3. IF, in fact, you already have a diagnosis, read our sticky post that is stuck to the top of this subforum For Veterans With ALS. Download the PDF, which is ten pages. Apply for benefits tomorrow without delay, since we're talking big bucks, really. And the VA is very slow. They do, however, expedite ALS claims.
4. If you stop working, apply for Social Security immediately, asking them to expedite the claim under the Compassionate program for TERI terminal illnesses.

Waiting for your Mayo appointment is going to be rough.

Our kids were 15 and 13. After we got a firm diagnosis of ALS, AND got a second opinion confirming it, then we told the kids at first that mom's foot was a problem. Then when it got worse, we told them that mom's walking was never going to get better. The kids learned to accept their mom in a wheelchair and helped out a lot. Finally, I told each child that mom would eventually die and that it was our mission to make her life as comfortable as possible until then. They accepted that with some tears and pitched in very well. Different people will have different stories and different advice, but that's how I informed the kids, and it worked well for us.

Then again, there are other problems this could be. Don't resign yourself to ALS yet.

This is an outstanding community forum if you have ALS. --Mike
 
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Sprawl,
Mike makes some good points, though I have to point out that generally life ins. policy underwriting applies a "prudent person" standard, and you've already gone past that.

I wish I could say that it doesn't sound like ALS or any other motor neuron disease, but it could well be.

You served, so you know about preparedness. You and your wife might want to take stock of your personal, professional and financial resources should your doc be right.

Several people here have gone to Mayo for a 2nd opinion. You can search on Mayo up top with the Search dropdown, as to what to expect. Likely they will repeat the EMG and nerve testing.

We'll be here, either way.

Best,
Laurie
 
Sprawl,
Hello. Our situations are very similar. I am having some issues with my left leg, but my biggest concern has been my left hand. Like you I just thought it was carpal tunnel. I have worked in the telecom/banking industry on a computer for 16yrs. My hands would get very tired with a lot of typing or writing. I would especially notice it if I flipped through a lot of papers and did a constant movement. However one look from a neurologist and he knew it wasn't carpal tunnel. I had a EMG performed with the diagnosis being motor neuron disease (ALS).

I have lost pretty much all fine motor skills in my left hand. I cant pinch, fasten buttons, open a water bottle...anything that would require pressure to be applied. My right hand has started the twitching(as well as all over my body) and I am noticing some weakness starting to hit. My left leg is mainly on a long walk I start to have a slight foot drop and sudden weakness.

I too was referred to Mayo in Rochester and I have a appointment set for 1/7. It is quite a distance for me being that I am in Mississippi. I have decided to look at other options a little closer to home. I have a referral in with Houston Methodist. I am praying I will hear back from them soon and I can cancel the Mayo visit.

I hope you are able to get some answers soon. Believe me I know how hard it is so wait. I try daily not to let it consume me but I worry and stress of the out come. I feel like no one around me thinks it could be ALS just because it is so rare, but I know what is going on with my body. I feel the weakness and the twitches. I feel the loss of strength when trying to do things.
I will be praying for you and your family. My girls are 4&7, they are HUGE helpers! :)

Keep in touch and take care!
 
I truly appreciate everyone's responses. I know for many of you it is no easy chore especially to read such a long winded story.

I will admit that I was "hoping" to get a response telling me that is not ALS and to move on. But I also know that I cant turn a blind eye to the possibility.

Atsugi, I appreciate all the information about the VA, I had no idea that it could automatically be service connected. If the worst happens and I get the diagnosis I fear I will definitely follow your advice. And yes the wait is already wearing on me for the appt at Mayo. We are calling twice a day hoping for a cancellation. Thank you for your kind words and information!

Igelb, We have submitted for a policy but I have not had the physical yet. I will definitely need to look into the Prudent person standard and educate myself on that before proceeding. Yes, I do understand preparedness, just honestly never anticipated I would be preparing for something like this, but then again who would. I appreciate your support, thank you!

Summertime7711, that does sound fairly similar. I wish I didn't have to wait so long for my Mayo appt, its only been a week and I am already anxious about it. Feels like the day will never come. I hope you too get some answers and that your first doctor is wrong. Thank you for the prayers and we will pray for you also.

This seems to be great community and I appreciate all the prayers & wishes from all of you. I hope I am wrong on my fears, and I know better than to try and self diagnose, but in times of uncertainty like this my mind just wont stop racing. I will definitely keep everyone updated as I learn more.

PS sorry for all the typing and grammar mistakes in my original post.
 
Sprawl,
Just FYI-I just got off the phone with Mayo. I moved out my appointment on 1/7 @730AM to 2/5. So they now have an opening if it would be possible for you to go earlier.
I am waiting to hear from my referral from Houston Methodist and thought it was best to move out Mayo to have more time.

I hope they can get you in sooner and use my appointment if that even works for you.

Take care!
 
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Thank you for the information! My wife just got off the phone with them and they show no openings still. We are going to try again in the morning in case the system just hasn't processed your postponement. The scheduler also said that if there is a person who is having trouble swallowing they would get slotted first, understandably so. So that may be what happened.

This waiting game is driving me loony, I have an appt tomorrow to talk to my PCP because I am beginning to get bad anxiety over this whole thing. This was just supposed to be a simple case of carpal tunnel!
 
Yea I thought about it after I replied that they may have a cancellation list and someone got moved into my spot.
I completely understand your frustration and anxiety. I am right there with you. I had to get something to help me sleep but I'm trying to keep my cool during the day. I stay on here reading quite a bit and researching. While I think it is good to know everything I can it also scares the hell out of me. I have brain MRI and repeat EMG next week, but I do not see my local neurologist again until 1/26. This waiting game sucks! A week was just wasted between my two Drs not being able to speak and fax. I just want to scream WTH!? In todays world can we not use email or electronic file transfer? Very frustrating. Hang in there!
 
Wanted to post a quick update with some additional information:

First, is that I scheduled an appt with my PCP on Friday because of the anxiety over this whole ordeal (I have never felt like this before or had issues with anxiety). He prescribed me Lexapro and it seems to be taking some of the edge off.

Second, is I want to mention a few things more that I have noticed, in hopes that it may point away from this dreadful disease:

My weakness and atrophy are in my right arm. I can lift and extend my arm in full range of motion. But the muscles are, by my estimate 30-40% smaller than the left side as of now.
Grip strength seems to have stagnated, not getting worse but also not improving, hoping that's a good thing.
My thumb can still squeeze and move, but with any pressure no matter how light I cant extend it back out.
I have noticed twitching in all muscles of my arm and have begun to feel it in other areas like my back, but I have noticed no weakness in that area. Though I believe that could easily be from my anxiety, right?
My hand has recently began to feel "arthritic pain" for the lack of a better description. and when ever I try to move my fingers independently my hand kinda bounces and shakes all over the place. MND would mean I shouldn't have this pain, right?
I have had a couple cramps in my right calf but no problems standing or walking nor have I noticed any weakness.
I have had no problems with breathing or swallowing.

Any of your input is greatly appreciated.

I still have my appt at Mayo in January, and nothing will change that. I am just wondering if any of this sounds hopeful to point away from a MND?
 
Pain is a good sign.

To Nikki: Yeah, I goofed for a moment, so I cut that out of this post. I haven't had my coffee yet.
 
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Mike I think summertime made that comment about her EMG not Sprawl
 
Sprawl,

Re pain, if it's independent of the inability to move, that's good. If it's an artifact of weakness (stiff or pressured because it's not getting as much position change as usual), that's not as good.

Certainly have your wife extend and bend if/as possible the fingers/wrist/elbow or whatever's not moving as much (supporting the rest of the arm while she's doing that; it's called passive range of motion exercise) which would be a good idea even if you weren't having pain. Heating pads and massage can be good, too.

Yes, new twitches can be from anxiety or sometimes changes in posture/position because of weakness elsewhere. Or sometimes they predict greater weakness in a new area, because they represent dying nerves.

Re progression, the changes aren't day to day generally, so one or all aspects staying the same for a while does not signify one way or the other.

Problems only in the upper limbs with no leg, breathing or swallowing issues as yet would be consistent with upper limb onset. So that isn't really a clue, either, though it does argue against a systemic disorder.

I wish you had presented something we could use as a counter-argument, but these aren't. I would continue your "hope for the best, prepare for the worst" strategy and enjoy the holidays in their own right.

Best,
Laurie
 
Laurie, please forgive my ignorance with this next question. You mentioned it "does argue against a systemic disorder", can you please explain what this means? I am not very savvy in ways of medical terminology.

I really was hoping too that some of this would help make a counter -argument as you said.

To try and elaborate as best I can for the pain, it is kind of a dull pain. It kind of feels like if I had clenched my fist for an extended period of time and how that would feel after I let it loose. But this pain is not in the area that I have the most significant atrophy. It is more in the joints of my fingers.
 
No question here is ignorant, if asked in honesty.

A "systemic disorder" would be something like a B12 deficiency or something that affects potentially the entire body, something that in your case we would hope to blame for generalized weakness. But you're not showing generalized weakness. Since ALS affects primarily the motor neurons, it's not "systemic" in the sense I meant.

Joint pain can occur in any joint that isn't getting the workout it's used to.
 
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