Definition of Weakness

[spadra]

Ok, I know this subject has been debated before, but I though I would get a fresh perspective.

Shortly after the first of this year (and a very stressful Christmas holiday), I developed body-wide twitching, buzzing, vibrating, etc. and an achy left shoulder / arm / hand that has ached every day since. My GP referred me to a neuro in early February, who after a brief interview, proclaimed “You don’t have ALS” (which I thought was interesting because I never mentioned any concern about it). He then conducted the standard hammer based reflex tests, pushed down on my outstretched arms, etc. (but no EMG) and sent me on my way. He said if I feel “weakness” to give him a heads up. On the drive I home it dawned on me “what’s HIS version of weakness?”.

Fast forward to late April. The left arm / shoulder / hand still aches and seem to be stiffer than before. Pinky and thumb are the worst. I also have get the feeing of a very low voltage electric current in my arm as well. My “gross” strength has not diminished that I can tell - I can still hoist heavy, unwieldy objects, such as my squirmy children. However, as an example, when I play the saxophone for any length of time, my left arm / hand will start to shake as if fatigued and I start to have a hard time keeping even pressure on the mouth piece with my jaw / lips. My pinky will start to ache / fatigue when I type for any length of time. I also have the “perception” that I’m starting to lose some dexterity, but I have always been a clod, so it’s hard to tell.

Sooooooo, am I presenting “weakness” and is it time to call the neuro again? I don’t want to bop down there and be told “you don’t show clinical weakness” and waste the time and ridiculous amount of $$$$ that my neuro charges on an unneeded office visit. However, I don’t want to put my head in the sand either.

matt

 

[joelc]

When you experience weakness you will be aware of it. From what you have said you are not experiencing weakness. Something is going on but it is not ALS or weakness.

 

[awieleba]

Matt~

I assume that being on this site, you have a slight concern for MND. If you have insurance, then I would get an emg on your shoulder/arm/hand. Why not? I do know what you mean. I can lift my kids..all 3 and grocery shop and all that. My weakness is more like when I am looking at a shirt at the store and I hold it up, my whole arm shakes? My limbs feel tired alot, exhausted even if I did basically nothing. But if I had to pick up my daughter, I could do it. BTW, I had als ruled out after a year of twitching, weakness, buzzing, and slight atrophy of hands and feet.
Take care

~april

 

[lydia]

I read something the other day that compared weakness to fatigue. It said that fatigue is when the muscle tires after repeating a particular task multiple times, whereas weakness means that you wouldn't even be able to do that particular task the first time.

I have experienced similar complaints as you Spadra (and April) and have always described them as muscle fatigue, and take care to describe it carefully to doctor (for all the good it did). I would call neuro back, it can't hurt!

Lydia

 

[Zaphoon]

Lydia,

That was good! The kind of weakness ALS brings on is due to neuron death. The neurons do not come back to life, either. So, once the weakness is there, it is there to stay and only get worse.

For instance, you may suddenly notice that you are no longer able to pick up a bowling ball. If the weakness in this scenario is due to ALS, you will never be able to pick it up again. (If I'm wrong, somebody spank me.)

Somebody needs to come up with a way to resurrect dead motor neurons along with a way to prevent their death altogether.

Zaphoon

 

[spadra]

Thanks to all for the comments! The knowledge base here is phenomenal to say the least.

Once I get a few dental issues resolved (crown yesterday, root canal on same tooth this afternoon - yikes!) I'll head back to the neuro. I've got great insurance, but my out of pocket for my first visit was nearly $100 and he didn't even do much. So, I need to be judicious with my visits.

April - I see a lot of my symptoms in you. In the course of your ordeal, have you ever had issues with your mid-section? Prior to all this twitching - buzzing nonsense, I endured about four months of transient muscle soreness and a feeling of internal pressure that was isolated to the area from my ribs to my shoulders. The internal "pressure" wasn't gas related that I or my GP could tell. I know that "pressure" is not the best descriptor, but it's all I can come up with. Bottom line - It was pretty uncomfortable. Anyway, the only reason I bring this up is that when the twitching - buzzing started, the "pressure" feeling abruptly stopped and hasn't returned. I have a feeling it's all connected, but not sure how.

matt

 

[awieleba]

Matt~

Not sure if I had that, I had sooo much going on with onset of my sx that I think I have every sx that anyone has every described! Before all this, I had a pressure feeling in my upper abdomen, even get a ultrasound on it but fond nothing. Was the pressure felt when taking in a breath at all?

april

 

[hopingforcure]

Good explanations all. I agree Kim we need to find a way to regrow motor-neuron's, I have so many people ask me if steroids would help us? I have to explain that while that is a good idea in theory, not having the nerve contact the muscle, sort of just makes the steroid thing worthless.
I agree that once you have weakness it does not change, some of the other muscles might create synergy and help the others, but it is never not weak.. You just never get better that is for sure, once a muscle is weak, it sure stays weak..UGGH...

 

[spadra]

April -

As I alluded to, the sensation was almost indescribable, but here's a stab at it. My chest / shoulder would ache (pick a side, but mostly right) soon after I got up in the morning and would continue all day, every day. Drawing a deep breath seemed to be a bit more difficult, and my ribs seemed to crack and pop a lot more. The "pressure" would increase to a point where I would feel a wave up my chest and neck into my head and get a very strong (but vague) "something ain't right" feeling. I would feel quite agitated until it settled down (probably some type of fight or flight response). It would settle after a bit, my heart rate would decrease, and I would go about my business not knowing when the next delightful little episode would occur (maybe next week, maybe later that same day). At times, it seemed to have a digestive component and a big dose of simthicone would help. Most times however, the simthecone had no effect at all. Had gallons of blood work done, a chest x-ray and an upper GI, all of which came back just peachy.

All of this nonsense ceased abruptly when the twitching - buzzing nonsense showed up (traded one for the other - awesome!). Coincidence? Possibly. Are they connected? Probably.

I just turned 44 and have had near-perfect health until the middle of last year. Trying to describe all of these various and sundry symptoms to my doctors has been a real treat.

matt

 

[awieleba]

Matt~

I know nothing about this but some one else brought up on different thread. Maybe that thoracic outlet syndrome? It has pain in chest/shoulder area and cause arm/hand weakness and even atrophy of hand/thumb muscle? I have had pains in my shoulder and clavicle. but not for any length time. And dont have them anymore. Just get the emg, not a waste of money.

 

[spadra]

EMG for me!