Old 12-07-2017, 12:16 PM #1 (permalink)
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Default Very Worried- 32/

Hi all,

I'm a 32 year old female with a history of anxiety and insomnia that I've been taking ssri's for for over 10 years.

A couple months ago I was holding something and all of a sudden it dropped from my hand. I thought nothing of it. More recently, over the past few weeks, I've noticed an odd muscle jerk in my arm when at rest. Again, I have gotten muscle twitches before, usually when going through a bout of sleeplessness, so I wasn't concerned, even though this seemed different, and I am sleeping fine at the moment. Over the past 2 or so weeks, I've noticed my arms have become weaker. I recently suffered a very early miscarraige and was getting bloodwork done frequently to check hormone levels, so I associated the weakness with that, even though ive gotten bloodwork before and it hasnt felt this way for days after. Now, over the past few days, I'm experiencing twitching all over my body, my hands tremble, my fingers feel stiff and its more difficult to hold a pen and even scratch my dog. My left hand pinky and ring finger are tingling like pins and needles. For a few days my right arm and then my left arm have felt strange, like they ache, and i feel like i have to move them, but that has gone away and now they just feel weak. My hands are also ice cold (I should mention that I have primary mild Raynauds disease and have had this since I was 15. Also have a shortened 5th metacarpal on my left hand, subclinical hypothyroidism, and b12 levels in the 200's).

The weakness and twitching are freaking me out the most. I'm terrified something is really wrong. For a few days I convinced myself that maybe the technician drawing my blood went through the vein and its causing an issue with my ulnar nerve, but that wouldnt explain the twitching, and even though I've had blood draws from both arms, the chances of that happening on both arms seems low.

Can anyone provide any insight? Do i sound paranoid and off base? Please help!

Thank you so much for reading.
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Old 12-07-2017, 03:38 PM #2 (permalink)
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Default Re: Very Worried- 32/

LB, very sorry about your miscarriage. The odds of nothing seriously wrong are greatly in your favor. Thyroid and B12 levels, not to mention mild anemia if you are having frequent blood draws and I would imagine feeling some stress, perhaps not eating a perfect diet, etc., can all bear on the experiences you describe. With an SSRI in the mix, drug interactions are possible as well, and the hormone levels you are being tested for, even if normal, can influence this as well.

In all likelihood, really honing in on a healthy lifestyle and coming to terms with the miscarriage as it seems fairly recent, and follow-up testing isn't exactly helping, will see your symptoms diminish. However, if things haven't improved in another couple of weeks, you might consider a workup by a primary care physician other than your OB-GYN. I would also take a look at possible long-term nutrient depletion related to whatever drug regimen you are on (Google these terms and you can find a database showing possible depletions for any drug(s)), and consider short-term [standard, not high-potency] B-complex supplementation and ask about your iron levels.

Best,
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Old 12-08-2017, 09:03 PM #3 (permalink)
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Default Re: Very Worried- 32/

Hi Laurie,
Thank you so much for your reply. I do agree with you that improving my diet and managing my stress will help things. I didn't realize that antidepressants can cause things like twitching and nutritional deficiences. I've been on the same driug for a decade and have taken thyroid hormone on and off.

While the rational part of me knows my chances of having ALS are so tiny, the anxious part of me overwhelms everything else. Yesterday i had a lot of localized twitching in the ring finger and middle finger on my left hand. I could see it. It freaked me out. As I said in my initial post, my fingers tire out much quicker than they used to, as do my arms. Moreso my left arm/hand. They are completely usable though, so that means they aren't "clinically weak", correct?

I'm wondering if Raynauds disease could contribute to finger twitching considering the poor circulation, but I havent found much connecting the two. My sister-in-law's father is a neurologist, so if this continues I may check in with him and see what he thinks.

Thanks again for your input.
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Old 12-08-2017, 10:03 PM #4 (permalink)
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Default Re: Very Worried- 32/

Please:
1) read the Pinned Post titled Read Before Posting, and
2) see someone regarding your health anxiety.

Follow thru with the Neurologist to rest your als fears.
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Old 12-10-2017, 10:35 AM #5 (permalink)
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Default Re: Very Worried- 32/

Thank you for responding. I just want to add that last night my arms felt so incredibly weak that It felt like an enormous task to lift a fork to my mouth. The body-wide twitching has continued, though its not all day. I woke up this morning about to have an anxiety attack and was crying to my husband. I dont understand why my arms and hands/fingers have gone from seemingly fine to extremely weak in a matter of 2 weeks.
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Old 12-10-2017, 11:37 AM #6 (permalink)
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Default Re: Very Worried- 32/

Nor does anyone here. It's best to take any further concerns to your doctor, as your symptoms do not reflect ALS in the least. ALS works nothing at all in what you are experiencing. That's great news for you.

Good luck and take good care on the future.
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Old 12-13-2017, 01:30 PM #7 (permalink)
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Default Re: Very Worried- 32/

Thanks to everyone for replying. I went to my promary care doctor today and told him my complaints of twitching/cramping and weakness. I said I googled and was worried and he knew what I was hinting at. He did some basic strength tests on my arms and tested my reflexes. He said my arms did not show any signs of weakness and my reflexes were normal. He took blood to test for iron, etc, especially since my iron level was 26 last month before i miscarried and had lots of bloodwork done. He also gave me a b12 shot. I asked him if I should see a neurologist and he said not right now and lets wait and see what the bloodwork says and go from there.

My questions: If my reflexes were normal is that a good sign that im okay? I feel like im now hyper aware of every movement my body makes and its making me feel and think things that I probably wouldnt if I was focusing so much.
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Old 12-13-2017, 01:48 PM #8 (permalink)
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Default Re: Very Worried- 32/

Normal reflexes and strength certainly signifies the motor nerves and muscles are OK, yes. Like we said, follow through with being treated for any nutritional deficiencies that make it harder for nerves and muscles to do their job, and in all likelihood, you will be fine.

All the best.

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Old 12-14-2017, 06:51 AM #9 (permalink)
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Default Re: Very Worried- 32/

Thank you again lgelb. One more quick question: I am noticing a lot of extra mucus in my throat, like I have to swallow but no matter how much I do it feels like its just sitting there. I have a history of post nasal drip but i dont have much of a cold right now. I know I sound totally anxiety ridden (I am) but could this be something? My left thumb is also twitching like crazy.
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Old 12-14-2017, 07:45 AM #10 (permalink)
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Default Re: Very Worried- 32/

Please stop adding symptoms every time one of your other questions have been answered. You asked in your first post if your symptoms sound like ALS and you were told, now 5 or 6 times, that it does not.

Should you have any further questions, please re-read the stickies; you'll find what you need to know there. If that still does not answer your questions, please speak again to your doc. The good folks here know ALS, not why you can't clear your throat.

Take care and goodbye.
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Old 12-14-2017, 10:13 AM #11 (permalink)
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Default Re: Very Worried- 32/

Bestsfriendstilltheend, Sorry about that. I appreciate everyones input. I am so riddled with anxiety about this that I got a last minute neurology appt today. I’ll update this post after to relay what Dr says and then you won’t hear from me again (hopefully).
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Old 12-14-2017, 02:54 PM #12 (permalink)
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Default Re: Very Worried- 32/

I saw the neuro. He asked me questions and did a quick exam. He said everything was normal and he could confidently say I don’t have ALS. He didn’t want to even do any follow up testing.

However, I of course noticed something when he tested my knee reflexes, my right leg went a significant amount higher than my left. I specifically asked him if I had hyper reflexes and he didnt say no he just said something along the lines of its a lot more complicated than that. Isnt a brisk reflex, especially on one side, concerning? Could it also just be anxiety causing it? My GP tested my relfexes yesterday and they werent uneven like that. I really wish I hadnt seen that. I need to trust the neuro bc he knows what hes talking about and I should feel good about the results. Why is that so hard.
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Old 12-14-2017, 03:08 PM #13 (permalink)
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Default Re: Very Worried- 32/

Some people have naturally brisk reflexes. The only way to tell if it's normal for you, or a sign of a problem, is to track it and any changes over months.

With regards to your doctor saying it's more complicated than that- it's really complicated, they are right. Medical professionals look at patterns of symptoms when it comes to a disease like ALS. While you hear about twitching or brisk reflexes being a sign of ALS, it's only a tiny aspect of what doctors are looking for with regards to warning signs. ALS causes a large constellation of symptoms- and it's a specific combination of symptoms that give them cause for worry. There are many subtle cues that you can't detect yourself, but an experienced clinician can. Please do not second guess a doctor because you read somewhere that unilateral brisk reflexes might indicate ALS.

It's like having a cough. How many conditions include a cough? How does a doctor differentiate between a throat irritation and lung cancer? The same process goes into a neurological assessment.

I am very glad you have been cleared of ALS. I am glad you no longer have any cause to be here. This is a good thing.
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Old 12-14-2017, 03:21 PM #14 (permalink)
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Default Re: Very Worried- 32/

Remember your original question? Yes, now you're sounding "paranoid and off-base," if I may say so kindly.

One knee going higher than the other in the absence of other significant findings is just not reason to worry, and we have already established nutritional deficiencies that your most recent labs are pending for(?), with good treatment options.

If this anxiety is keeping you from living your life, I would really seek counseling as you have good reason to feel stressed, pre-existing anxiety and a lot going on.

Best,
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Old 12-14-2017, 03:48 PM #15 (permalink)
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Default Re: Very Worried- 32/

Thank you Shiftkicker and lgelb. This specific doctor has a subspecialty training in EMG and neuromuscular disease, and told me he just diagnosed a case of ALS at the hospital. I should probably trust his judgement and let this go. I have been seeing a therapist and am actually seeing her for a session tomorrow. Also, just a note— he said my twitching was likely from anxiety and good quality rest and relaxation should help.
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