ALS or Anxiety

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Chesterx2

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Jul 1, 2024
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Learn about ALS
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US
State
NY
City
Rochester
Hello Everyone,

Reaching out to see if I can get some more clarification on the ALS symptons what to expect. I am 35y Male with a recent history of health anxiety these past 6 months that have worsened over time. In April I was having some issues with vision, concentration, memory, and various cognitive functions, before my MRI one sympton that everyone asked is if I was experiencing was muscle weakness which at the time I did not but I feel like the inquiries planted a seed because as soon as the MRI results came back clean the cognitive symptoms dissipated and I started to feel some tingleness/weakness in the right hand (I am left handed) the last couple days of May. When I say weakness I mean they felt heavy and I perceived things were more difficult but no evidence that anything has weakened.

I went to primary doctor in mid-june and he ran a basic relfex and strength test and didn't find anything and concluded it was anxiety related. He prescribed some anxiety medication and said lets wait and see before taking and additional steps. Shortly after this visit I felt some tingling and weakness in the left hand as well as muscle spasms everywhere, I escalated to primary care doctor and he ordered an EMG which is scheduled for 8/4 (I think he did this to appease my anxiety).

Forwarding to today, the weakness in right hand has gone away and left hand feels very weak and sore as well as left bicep and shoulder (approximately 2 weeks of left side pain/weakness). I bought a dynamometer to guage if grip is weak and no evidence though it did hurt my left hand quite a bit more than right. My question is can brain/anxiety be strong enough to create the illusion of weakness and muscle spasms? Can muscle weakness come and go as it did in the right hand? And what does muscle weakness actually feel like and is there any test at home to see if I am actually experiencing this?

All feedback is appreciated. I plan on updating this once EMG results come in.

Best,
 
Hello there-

Please make sure to read here: Read Before Posting. It answers many of the questions that bring people here. Your thread title states ALS or anxiety- what you report here is not how ALS starts, as you will read in the linked post. You do clearly have anxiety and it is time to address that. However, that is not to say you don't have some sort of post viral issue or some other thing affecting your health.

Reassurance seeking in places like an ALS forum is counterproductive, as it serves to continue your focus on something that frightens you despite showing no signs of it. Anxiety can cause profound physical symptoms, yes. It can also amplify existing ones and muddy the waters for a doctor who is trying to figure out a pattern and look for cause. While you wait for your next appointment, please consider working with someone to reduce anxiety and find some stress reducing tools.

Please take care
 
Besides anxiety, sleep, nutrition/hydration, and exercise also can also play key roles in "heaviness." It is also pretty much the norm that one hand has more strength than the other. Nor does weakness or pain migrate from place to place in ALS.

That said, anxiety does not pop out from nowhere -- it has roots that need to be addressed -- and popping some pills is generally not the entire answer, in fact, often not the best approach. I would encourage you to seek counseling to evaluate whether that approach could help you, since it's less invasive than drugs that have multiple side effects.

As to your question about clinical weakness, a doctor can appreciate this if it exists, but it does not appear that your doctor perceived it. There is no point to repetitive self-testing at home, which is more likely to skew results than yield new data.

You seem to recognize the lack of rationale for an EMG, so before and after it's negative as I expect, I hope you find time to take a look at alternative explanations that are much more under your control. For the vast majority of the "could it be" posters here, your health is in your own hands.
 
Thank you for the reply, it is much appreciated. For additional context I have started seeing a therapist a couple weeks ago and contemplated ending the medication that was prescribed to me because it has drained me of my energy. I also have a newborn that was born first week of June so sleep and diet are temporarily way off course.

As noted the weakness that I have experienced may be purely fiction as I have no benchmark of how strong I was prior to a month ago, I only perceive things being more difficult up to now. Like when I hold my phone are glass of water I feel like I’m going to drop it and it’s slipping out of my hand even though it never does.

The one symptom that I can see with my own eyes is the muscle spasms that occur almost everywhere. I know anxiety can cause these but I’m not sure to this extent (probably 1 spasm every 30-45 minutes). That and the pain I’ve been feeling in my left side fingers, wrist, arm, and shoulder but per your feedback this isn’t a normal correlation to ALS.
 
Chesterx2,

*You also have a newborn that was born first week of June... that says so much.
(I'd be surprised if the therapist doesn't address that too or has.)

Neuro ordered an EMG which is scheduled for 8/4 (I think he did this to appease my anxiety).
( I think he did this to appease my anxiety ) That says so much too.
Continue to work with your therapist.

As for the scheduled EMG...

Why not? EMGs/NCS are are expensive - profit structured for the Neuro who is paid
very well and the Neuro facility too.

Being just 35 I hope this all gets resolved soon so you can spend another happy 35 years
with your new born. The child deserves a happy healthy Dad. And the critical next year or so
too.
 
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Update on this thread, had appointment with primary care doctor to discuss symptoms regarding weakness, muscle atrophy, and spasms. His feedback observations were the following:

Weakness: performed some basic strength and reflex test and did not find any abnormalities

Muscle atrophy: I pointed out some indents and areas where the skin/muscle looks sunken in and he stated it’s not atrophy

Spasms: this was the only symptom that prevented him from canceling the emg. The spasms are mostly sporadic and random all over the body but the frequency increases with physical activity and becomes more focal to the muscles that are being exerted. To say the least he is not sure what to make of the pattern and we will discuss further if emg provides abnormal results but he is betting that this too is anxiety related.

Emg is scheduled for 8/5. Will provide results on this thread when they become available.
 
Concerning Twitching and Health Anxiety. And others…

As I have written before to the very young posters (you 35)…
We have no idea of your personal habits and for others.

Do you drink energy drinks,
Do you vape,
Do you smoke pot,
Do you drink too much coffee,
Stress from sports activity.
Gambling… anxiety over losses
Too much sugar intake from sodas, many also have caffeine.
Do you have a conflict with friend, something at work,
someone on social media.
Too much time on the Internet in general seeing things that
subconsciously bother you.

And accelerating the cycle… any combination of above.

Finally, Dr. Google… who not a doctor but has led millions
into Health Anxiety, some severe Health Anxiety.

I hope the EMG finally gets you onto the path out of the
concern of having a rare terminal disease for 35 more
years
 
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Regarding lifestyle my answer would be no across the board to energy drinks, vape, pot, coffee, soda, gambling, alcohol, sports or strenuous workouts (just light cardio), excessive stressors in relationships, work, financial situation's etc.

With the exception of good sleep due to new baby I am pretty close to living the text book healthy life-style and no history of any form of anxiety prior to this year which I believe is the reason why my doctor isn’t completely dismissing my claims. We have already discussed that if emg comes back clean this case is closed and we will shift all energy to getting this anxiety under control.
 
EMG came back normal with zero abnormalities. Going to direct energy towards anxiety mitigation and start enjoying life again.

Thank you all for the feedback and know going forward I will be a monetary donar to my local ALS chapter
 
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