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Wiggin02

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Hi guys.
I've been a creeper of this board for a few months and have finally decided to post. I have only just been referred to a Neuro for my symptoms, and he hasn't even gotten back to me on an appointment date. I'm a health profession student, so plenty of associated anxiety. I have been diagnosed with Labile hypertension because my blood pressure goes through the roof when anxious.

Symptoms:
- Bilateral, but pretty asymmetric (left sided) tremor -- hands, legs, jaw, tongue (started noticing in 2/2016 and has gotten worse). I originally wrote this off as serious because my dad has essential tremor. My left thumb is impossible to steady when in certain positions (like typing on cell phone)

- Fasciculations: Started back in 2/2016 but has gotten worse. Also asymmetric -- especially noticeable in left calf, forearm, thumb, and lip.

- Fatigue: I just felt really tired throughout the day at random points. I tried to manage my carb/protein intake more closely because I thought I was hypoglycemic.

- Deep pain: One of my original symptoms, the front and back of my lower left knee hurts all of the time and has gotten worse. I originally attributed this to being new to running and constantly turning on that knee at the local track. (I used to be obese, but started running a ton and actually eating healthy most of the time) I actually gained a little bit of weight this summer but quickly lost it again once school started. One thing I would due to deal with the pain was actually sitting on my leg (bent at the knee under my behind) for hours at a time until it fell asleep. Could I have just damaged the knee? I also get some radiating pain down to my left foot and some in my left wrist and hand.

Most of these symptoms were progressive but I managed to attribute them to BFS and tried not to worry about them. I worked over the summer and the symptoms didn't bother me other than shakiness in front of patients and chronic pain.

Recent onset of symptoms - 3-4 weeks ago, has gotten worse

- Weakness: I was playing soccer and noticed my left leg just felt really heavy and weak. It didn't get better. I can force myself to lift my foot to walk, but I feel like I have to give extra effort. I am constantly testing myself for foot drop and just feel like I'm making it worse. I feel like my left toes try to stay on the ground a little longer and they feel colder. When I dangle both feet with shoes on, my left foot swings more limply, presumably due to decreased muscle tone. It makes me feel clumsy, but I haven't fallen yet or anything. I jump up stairs on one foot to make sure I can still lift my left foot. Some of my toes on either foot can handle less resistance than its counterpart on the other foot with a general trend that the left feel weaker.
My left arm/fingers feel heavier and shakier and I feel like I am fighting off wrist drop in a similar way to my foot and foot drop. Same story, I can make them work but it takes extra effort. I am at the point where I think the tremor is actually just my muscles getting weak.

- Exercise intolerance & fatigue: My left leg feels hot, painful, and heavy after playing basketball or running. I'm scared to do anything in case it worsens symptoms or increases the progression. Exercise makes tremors worse -- jaw and hands especially. I feel I can't raise my left foot as high as my right after playing for a while. I started working out my left side extra hard for a few workouts but quit because I was worried I would just increase progression.

- Fasciculations: More frequent after mostly calming down over the summer. I get a painful one every once in a while somewhere in my hamstrings.

- Atrophy: My left calf isn't necessarily way smaller, it just looks different to me -- like stretched out or something, not bunched up like my right and painful at the top. My left bicep is definitely smaller than my right, but I haven't measured over time to declare actual reduction in mass.

- Pain: chronic and worse, not alleviated with much besides acetaminophen to an extent. Hurts my ability to sleep.

- Bulbar stuff: Jaw tremor (worsened with exercise and stress), I feel like I have a weird lisp when I say certain words or when I just finished exercising. I don't notice the weird sensation if I'm chewing gum, so I chew basically all of the time. Because I'm chewing gum, I feel like I'm biting my tongue more often. Tongue shakes and twitches when I stick it out. I don't think I'm having swallowing difficulty, but my tongue feels thick in the back and I feel like I have to clear my throat more than I used to. Sometimes my left side of my face feels numb and less mobile than the other side.

- Other random observations: Alcohol seems to helps with speech issues and diminishes tremor to some extent. Recreational marijuana seemed to make my shakiness better but I became more aware of my bulbar concerns. Sometimes I think my left side isn't as receptive to pain, not numb, just slow to react.

I also started doing electric stimulation for pain in my knee and other areas and I got really freaked out because my left side would take a little more stimulus to get a response and that side's muscles tend to tremble more when stimulated than the right side.

I'm a mess. I can't study for long periods of time without ending up on the Internet and I only sleep well in little spurts.
I guess if I have to wait months to see a Neuro I'll have given my symptoms plenty of time to get worse.

The only things I feel like I have going in my favor is that pain is not a strongly associated ALS symptom and that I haven't heard much of someone having unilateral onset to the point where their arm and leg are afflicted at the same time plus bulbar symptoms. It sounds like a ridiculous presentation to me, but that's one of my little glimmers of hope.
 
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Absolutely nothing out of all that suggests ALS. Not even one symptom of ALS.

However all of those descriptions added together paints a very clear picture of anxiety. Debilitating as anxiety is; at least it's not terminal like ALS. You probably already know you need to get a handle on it. Lurking here for months has done nothing positive for you.
 
Wiggin, sounds like a pretty classic case of health care student syndrome. Pretend you're well, eat, drink & sleep better, study off line, keep water at hand, and get a massage. Make sure you're stretching before working out, morning and night.

Labile HTN can cause and exacerbate pretty much everything you mention -- it strains your energy reserves -- so if you are not on a beta blocker or CCB, I'd explore that before the possibility of a CNS disorder, which, apart from anxiety is unlikely.

Best,
Laurie
 
Thanks for your feedback. I feel slightly better just airing it out there because I haven't told anyone about my issues other than my PCP and my fiancee. All of my friends and family say I've been acting distant.
 
If you have been a creeper here and reading posts, how can you post what all the others post here that we respond to as not being ALS?

The answer is because your anxiety has taken over.

You have NO ALS symptoms. Please get to a doctor and get treated for your own sake.
 
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