Status
Not open for further replies.

FirstTermMed

Member
Joined
Dec 6, 2011
Messages
12
Reason
Learn about ALS
Country
US
State
MI
City
East Lansing
Hi everyone! I've been following the forum for several months now and find myself inspired by all the members on here =)

Now where to start, my name is Ali and I go to Medical School in the Caribbean (I know what your thinking, but yes it is legitimate, promise) and I just finished up my first term. About twelve months ago I developed a twitch in my left arm which in a few months spread to my other arm and the rest of my body save my hands and face, I was subsequently diagnosed with BFS. During that time I have had fevers, joint pain, burning in my chest, muscle pain, rashes, and most recently a lump in the back of my throat with difficulty swallowing. Being in the Medical field I naturally assumed this was auto-immune related and an ANA test came back positive 1:640. To clear my bases I've had, CT's, MRI's (have a small syrinx cavity in C-spine), EMG's and all manner of blood work.

I'm waiting on my specific antibody tests to come back, but what really worries me is the EMG I had done. It was supposed to just involve my legs, it ended up being all my limbs, with mention of sharp waves and etc. The Neuromuscular specialist after half an hour of discussion came into to the room and stated that she was very surprised by the findings, and wanted an MRI done again of my Cervical/Lumbar region, antibody blood test, and a skin biopsy. When I was walking out, they stopped me in the hallway and had me come back for more NCV tests of my forearm. This perplexed me later on, and I called 3 days later to get a copy of the report, but was informed that it hadn't been finalized yet.

The strange thing is, for a month my fasciculation's had stopped almost entirely, and after the EMG they came back with a vengeance along with all my limbs constantly going numb to the point where I can't really sleep at night. As well I've been dealing with extreme abdominal pain and a deep aching pain in my scrotum (go figure, sigh).

I have no Clinical weakness of which to speak of with no UMN signs (Babinski) or brisk reflexes. Just a bit worried about my EMG report and it's findings. I find comfort in this forum knowing that there are such amazing people with such incredible perseverance.

My symptoms have put me at a complete loss, but I'll be sure to post the results of my tests as soon as I get them. If anyone has any specific questions about my symptoms/reports please feel free to ask. Thanks for listening =)

Warm regards,
Ali
 

Toto's Dorothy

Very helpful member
Joined
Jan 31, 2012
Messages
1,033
Diagnosis
11/2008
Country
US
State
Kansas
City
Emerald
Dear Ali, welcome. Unfortunately, I don't have advice to give when it comes to antibodies.

I just wanted others to know of a friend of mine's Son. He graduated from high school - Valedictorian. Graduated college one year early - Valedictorian. Applied to many med schools - turned down. Why, might you asl? His lack of people skills! What is the area he plans to practice? The kicker - PATHOLOGY, his patients are dead! Basically, the people he would be dealing with are other doctors. So he is also being educated in the islands of the Caribbean. Best of both worlds!

Now back to you, Ali, did you have this before you went to the islands? If not, is it possible you could have contracted something there? I will go and go og le the anti bodies even though that's a no-no!
 

trfogey

Very helpful member
Joined
Jan 31, 2008
Messages
2,043
Reason
PALS
Diagnosis
07/2007
Country
US
State
NC
City
Raleigh
You did take your extreme abdominal pain to a doctor, didn't you? What turned out to be the cause of that? How about the deep aching pain in your scrotum? You do realize that you're in one of the prime age cohorts for testicular cancer, don't you?

No offense, but it is extremely difficult to take someone seriously when they use adjectives like "extreme" and "deep aching" to describe pain that they haven't bothered to consult with a real doctor about. That you say you are a medical student -- reminds me of an old joke about what you call the medical student who graduated last in his medical school class.
 
Last edited:

Toto's Dorothy

Very helpful member
Joined
Jan 31, 2012
Messages
1,033
Diagnosis
11/2008
Country
US
State
Kansas
City
Emerald
Trfogey, I'll bite. Doctor's? I didn't notice before the extreme medical pain, have you eaten any exotic foods or raw foods. Did you have these pains in the states or the Caribbean? I gather they have dissapated since you haven't seen a doctor. If your back to school, go to the nurse and list your symptoms. I remember reading where people have eaten uncooked foods and have gotten strange things growing inside ie. Worms (or worm like creatures). Go to doctor and come back with results. We would like to know.
 

Toto's Dorothy

Very helpful member
Joined
Jan 31, 2012
Messages
1,033
Diagnosis
11/2008
Country
US
State
Kansas
City
Emerald
Okay, I let my voice do the walking and found that ANA is used for autoimmune diseases. Thought it sounded familiar. Mine were negative. Well, clicking through the we b si te, I came across the one A I D and noticed symp toms of Primary Bilary Cirrhosis. Have you looked that up? It would make sense on the stomach problems. The fevers, muscle aches etc point to the A I D or Lu pus. With BFS added into the mix. The BFS you said had stopped and came back after the EMG, you also went back to school, correct? Is it possible, that stress could be controlling the fascic u lations but you still may have the AIDisease. When is the next time your back in the states? You are going to med school there, do you not trust the doctors there and have them give you a check? Good Luck in your med choices and good luck in med school.
 

kmendsley

Distinguished member
Joined
Feb 19, 2010
Messages
434
Reason
PALS
Diagnosis
04/2011
Country
US
State
CA
City
Highland
Hmm..okay, Ali. Let me tell you where my thought process was while reading your post. When I first read that you were in your first term of medical school in the Caribbean...the Place where you were didn't throw me off. It was the first term of medical school. There is an old saying/theory that 1st year medical students will sometimes get what is called "medical student's disease or disorder" This is when the diseases you study cause a fear within you subconscsiously which leads to pyshcogenic symptoms. You are not consciously doing this or 'making it up'. It is literally your brain's coping mechanism to deal with the symptoms and diseases you are studying. Something to think about...did it come on all of a sudden?

Obviously...the rest of the post throws me in another direction because you can not have pyschogenic EMG problems...that I know of anyway. Paralysis and tremors yes...EMG tests....no. Although...you don't know the results yet...could be the dr. just wants to be extra thourough...which is a wonderful thing.

Something is going on ...whether it be pyschological or something else...either way...keep following up with the tests, dr, and maybe check yourself into a little therapy. Couldn't hurt. Good luck to you.
 

FirstTermMed

Member
Joined
Dec 6, 2011
Messages
12
Reason
Learn about ALS
Country
US
State
MI
City
East Lansing
Thank you all for the replies! I suppose I should be a bit more thorough in my explanation. I'll start with my school, St. Georges University, situated on the lovely Island of Grenada (yes we do get spoiled living on a tropic Island, but to be fair I spend 95% of my time cooped in the library). As of currently I have taken this term off to stay in the states, as getting oneself sorted out in Grenada is, well, lets just say you don't want to get sick down there. If I had to say when all my symptoms started, it would have to be within a month of when I moved down there. Had a Centipede (one of the big ones crawl up the side of my bag on campus and take a nice sized chunk out of my right leg (yeah I know, it sounds really corny, but anyone who's been down South American/Carribean territory knows to watch out for these buggers!). The venom caused excruciating pain in my right leg with a fever lasting approximately 4-6 hours. Shortly after I developed a constant twitch in my left deltoid, funny enough one of my classmates noticed and commented "that can't be good" to which I responded "hmmmm, yep, must be the Island". The twitch spread to most of my left arm, trunk, right arm and heck pretty much everywhere else save my hands and face (along with abdominal pain I still have to this day). I of course had the school doctor run a CBC, Metabolic panel, chest X-rays, Liver Enzymes, tests for Parasites, Dengue, EKG, Ultrasound of my lower abdomen, and so on. Everything came back clean, so it was BFS and I moved on.

Over my summer break, I developed a productive cough that stuck with me for about a month (used to love smoking my hookah, but had to stop as my lungs could no longer tolerate it). As well I developed burning sensations/numbness in my left arm, which spread to my right arm. As well as a change in perception (a brain fog of sorts). I promptly made a trip to the emergency room, and after a battery of tests (including a CT of my head), was sternly lectured by the ER doctor since I was not dying, I should not have come in, and this was a place for serious etc. etc. etc. I made an appointment with a Neurologist (an old friend of the family) and paid him a visit. He performed the usual tests for Neurological disorders, and I passed with flying colors (yay!). Just to be on the safe side, an MRI was done of my Brain (with CSF study), C-spine, and T-Spine. My Brain was all fine and dandy and there were no visible obstructions in CSF flow. However, a syrinx cavity was located at (C6-7) along with two mild disc herniations at C4-5 and C6-7. As well as some mild degenerative changes in my T-spine.

So I assumed, yep, BFS along with some possible Syringomyelia (do another MRI in 6 months and make sure the syrinx hasn't gotten bigger, no problem). I said thank you to my Neurologist, and wen't on my merry way back school. I'd say my first month and a half of school was great (though I still had body wide fasiculations, which I mostly ignored). Then something hit me, it felt like a ton of bricks, every joint in my body ached and popped. I had night sweats, a mild rash on my trunk, and yet never produced a fever. This passed within a span of 3 weeks (of course I wen't back to the school doctor and had everything retested, still looking great on paper). Then one night, every inch of my skin began to itch, and I developed a terrible migraine. In the morning the itching passed, but the migraine stuck around, and along with it came the worst nausea/sore throat I've ever experienced. My symptoms would abate at night, and begin anew every morning. This continued for a month, and then I can clearly remember the day when it happened. Every muscle in my body hurt as if someone had taken a bat to me, and my muscle fasciculation's amped in frequency. It felt weird to walk, to hold a pencil or type. Just moving around was extremely fatiguing.

I made a decision to withdraw from the term and take a leave of absence for the next term. This is almost as good as committing career suicide, but I was in no shape to keep up with my class loads. I did one final round of tests with the school doctor (once again all clean) and I wen't back home. I underwent new MRI's (with no noticeable changes), a full body CT scan with nothing notable to be seen (save for a mildly enlarged Prostate). Testing for MG, Kennedy's disease, and etc. (all clean). I was referred to a Neuromuscular specialist who wanted to perform an EMG on me (not due to anything she saw clinically, but just for thoroughness).

During this time, before my EMG, a Rheumatologist who was another old friend of the family requested an ANA test for me. It came back positive (1:640 Homogenous), and he put me on Prednisone and Plaquenil. Diagnosing me with MCTD or possible Lupus. Ironically I had worked with this Rheumatologist for two years, and new all about AI diseases. So I made the necessary lifestyle changes and so on (no noticeable changes from taking said drugs, but it has only been three weeks).

However, during this time (along with the abdominal/groin pain), I have noticed increasing dysphagia, as though no matter how much I swallow there is always fluid remaining, along with a lump/tightness in my oro-pharygeal area. I attributed this to GERD and began taking Pepcid AC (to no avail alas). As well I've begun feeling burning/stabbing sensations in my feet and my toes. A sensation that my tongue is too large for my mouth, numbness, and teeth imprints on the outer edges. Strangest of all, is the ease with which my limbs will fall asleep (become numb) with only mild pressure (i.e. sitting for several minutes=numb legs). The thought of ALS being the culprit had never been considered as a possibility to me, until my EMG. Though I haven't yet received the report yet, I find myself worried by the behavior of the Neuromuscular Doc, as I've spent a fair amount of time around Physicians and have a pretty good idea of when somethings up. I should know the answer though within a week, just figured I'd share my experiences with others in the meantime.

Here are the tests I got lined up or have results pending -

EMG
ENA panel (for specific auto antibodies i.e. Lupus)
MRI of C-spine and L-spine
Prostate Exam (PSA tested came back 0.9)
Skin Biopsy (probably looking for Small Fiber Neuropathy).
Endoscopy/Colonoscopy
Sleep Study (not that I need it, just wanted to give it whirl once =) )

Sorry for the lengthy, somewhat convoluted story, but I've always enjoyed reading clinical vignettes and trying to decipher symptoms into a helpful clinical diagnosis. I just happen to be the patient this time around =)
 

wright

Very helpful member
Joined
Jan 12, 2008
Messages
1,160
Country
US
State
xx
City
xxxx
Could you please share with us what on earth has led you to a possible self-diagnosis of ALS, because I for one am just not seeing it.

P.S. Taking a year off from medical school is not career suicide. Where did you hear that? It happens all of the time for a slew of different reasons. As long as you come back and perform, then all will be completely fine. You are not even close to starting your career. Taking a leave of absence your first year (or second or third or fourth) is not going to affect your placement into a residency . . . I assure you.
 

kmendsley

Distinguished member
Joined
Feb 19, 2010
Messages
434
Reason
PALS
Diagnosis
04/2011
Country
US
State
CA
City
Highland
BTW, I would definately go to a parasite specialist...here in the U.S. to make sure that bite didn't transfer something. Centipedes are poisonous! And it sounds like your symptoms began after this event. Good luck.
 

FirstTermMed

Member
Joined
Dec 6, 2011
Messages
12
Reason
Learn about ALS
Country
US
State
MI
City
East Lansing
Could you please share with us what on earth has led you to a possible self-diagnosis of ALS, because I for one am just not seeing it.

P.S. Taking a year off from medical school is not career suicide. Where did you hear that? It happens all of the time for a slew of different reasons. As long as you come back and perform, then all will be completely fine. You are not even close to starting your career. Taking a leave of absence your first year (or second or third or fourth) is not going to affect your placement into a residency . . . I assure you.
Well I can't say I've self-diagnosed myself with ALS, heck I've actually never even considered ALS, as my fasciculation's are present in the absence of atrophy or weakness. It's simply the behavior of my neuromuscular doctor that I find suspicious in regards to my EMG I suppose, and I was hoping to seek some general advice on the forum. As far as the career suicide, that would be the general advice from the Dean of Students at my school, however I'm assuming it was in regards to a competitive residency. Thank your for the reply =)
 

FirstTermMed

Member
Joined
Dec 6, 2011
Messages
12
Reason
Learn about ALS
Country
US
State
MI
City
East Lansing
BTW, I would definately go to a parasite specialist...here in the U.S. to make sure that bite didn't transfer something. Centipedes are poisonous! And it sounds like your symptoms began after this event. Good luck.
I'll definitely do that! I had heard stories of them before I landed on the Island, but I never expected to have one chow down on my leg! I must have tasted good b/c it didn't wan't to let go, but on the positive side I gave the local Grenadians a good laugh while I hoped around trying to pry him off. :)
 

wright

Very helpful member
Joined
Jan 12, 2008
Messages
1,160
Country
US
State
xx
City
xxxx
EMG's can be dirty for a gazillion different reasons, but I'm sure you know that. Furthermore, please don't try to gauge what a physician is thinking, based solely on a "gut feeling" and his/her behavior based upon what you think you see.

With all due respect, your Dean is mistaken. Please ask him/her for even one instance when a student who took a leave of absence, failed to get into a residency of his/her choice because of that leave of absence. If they failed to get into a competitive residency, it was because they didn't perform well in school and/or in their rotations and/or on their boards . . . not because of a leave of absence.

P.S. If you don't think you have ALS, why are you here? Don't get me wrong, we welcome you . . . but I don't get it.
 

FirstTermMed

Member
Joined
Dec 6, 2011
Messages
12
Reason
Learn about ALS
Country
US
State
MI
City
East Lansing
EMG's can be dirty for a gazillion different reasons, but I'm sure you know that. Furthermore, please don't try to gauge what a physician is thinking, based solely on a "gut feeling" and his/her behavior based upon what you think you see.

With all due respect, your Dean is mistaken. Please ask him/her for even one instance when a student who took a leave of absence, failed to get into a residency of his/her choice because of that leave of absence. If they failed to get into a competitive residency, it was because they didn't perform well in school and/or in their rotations and/or on their boards . . . not because of a leave of absence.

P.S. If you don't think you have ALS, why are you here? Don't get me wrong, we welcome you . . . but I don't get it.
Thank you for the advice! I tend to have a bad habit of thinking the glass is half full, but it wasn't until recently that I considered ALS. I explained everything away as being Autoimmune related, I assumed my EMG would be clean, but it wasn't (still waiting on results). By posting on this forum, I was hoping to see if anyone had a similar onset of symptoms, as well as share my story. I agree that I shouldn't try to read btw the lines and taking a step back would probably be the best thing to do. I think I'll take "Kmendsleys" advice and try out some therapy, it's actually a free service through my school (which is pretty awesome) and I'll see if that will help. Thank you again for the response and the welcoming =), it's greatly appreciated! I'll be sure to make a donation to the forum as well.
 

Toto's Dorothy

Very helpful member
Joined
Jan 31, 2012
Messages
1,033
Diagnosis
11/2008
Country
US
State
Kansas
City
Emerald
Dear first,

As I believe I started with that centipede bite. Is there a confectious disease control building near where you live.you might want to visit some place like that. If not, go to GP and explain the bite and everything that has happened after the bite. It's highly possible you were infected with some type of neurotoxin.

Good Luck to you and finish school.
 

FirstTermMed

Member
Joined
Dec 6, 2011
Messages
12
Reason
Learn about ALS
Country
US
State
MI
City
East Lansing
Dear first,

As I believe I started with that centipede bite. Is there a confectious disease control building near where you live.you might want to visit some place like that. If not, go to GP and explain the bite and everything that has happened after the bite. It's highly possible you were infected with some type of neurotoxin.

Good Luck to you and finish school.

Hey TD =)

I've made an appointment with an Infectious Disease Doc for mid March (still have nightmares about the little buggers, they have a nasty habit of sneaking in to bed with you, bleh!). I have a Uro appointment tomorrow to rule out Prostate/Testicular cancer. A skin biopsy for my Neuromuscular doctor, and Endo/Colonoscopy with GI the day after. My ENA panel looking for specific antibodies (auto-immune) all came back clear, which is good or bad depending on my EMG report :) which I will receive this Wednesday (I could have called in for the results, but I figured why bother, and went ice fishing this past weekend instead.)

Regardless of my outcome, I've decided to become as active as possible in the ALS community, donating/volunteering/promoting (especially at school)! And thank you for taking the time to respond =)
 
Status
Not open for further replies.
Top