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Nevadan

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I am 28 year old male and have been observing these forums due to some unexplainable symptoms that I have been concerned about.

Beginning around January 2012, I began experiencing intermittent calf pain (cramping?) in the upper center of my left calf, usually after exercising (runs of 2-4 miles 3-4x/week), although sometimes while at rest. After seeing an OD and physical therapist, they found a knot in the calf that was eventually worked away over the next five months -- however the pain never went away, even with NSAIDs. X ray and MRI of calf found nothing.

I continued running through the calf pain until I noticed my right fourth "ring" toe felt strange... numb? cramped? I truly stopped running at this point.

Over 4th of July weekend 2012, I noticed a "weakness" in my right forearm (along length of ulna) upon completing a 7 hour drive; over the next few weeks, I would later describe this as numb, painful, or burning. OD could not treat calf or arm, and ended up moving away.

Went to my PCP in early August 2012; the MD checked calf for clot with ultrasound and routine bloodwork and for RA, thyroidism (RA, hypo, and hyper run in the family) - all were negative. I returned again to PCP before getting married (wife and I had been planning this entire time amidst work).... a PA and intern examined me and checked reflexes and noticed "abnormal/absent" reflexes - PA checked again, and then said they were normal; I was referred to a neurologist for paresthesia - 5 weeks out. My anxiety upticked after that point.

During the week of the wedding, more symptoms cropped up in addition to the calf, arm, and toe issue - an odd sensation in my left thumb (again, weak? cramped? numb?) and my right ring finger (same as toe/thumb). When clenching fist, ring finger seems to "run into" my middle finger. And when I spread my fingers apart, it shakes uncontrollably. And then over-salivating on the right side - not to the point of drooling, but definately noticeable. It was at about this point I visited Dr Google to find out what was going on - MS, ALS seemed to pop up the most; anxiety now through the roof. My family and new wife say that it's a pinched nerve, however, my back feels ok, although neck is a little painful.

After returning from wedding (no honeymoon yet), return to PCP, who prescribes muscle relaxer, more Naproxin, and xanex. This seems to help up until the neurologist appointment.

Neuro does physical exam - negative Babinski, and other reflexes appear normal, however, neuro orders an EMG and MRI of cervical spine and brain. Over next two weeks up until this point, I've had the whole spectrum of symptoms on top of the original intermittent calf pain: twitching (all over), shaking, weird feeling Right ring finger, weird feeling right "ring" toe, over-salivation (but not to the point of drooling - just feels like it, or feels like I have to wipe corner of mouth), weird feeling tongue (including buzzing tongue, softly biting tongue and finding it pressed against the roof of the mouth), a choking-mucus filled swallow.... and the constant panic/fear/dread/anxiety that I have an onset of bulbar/limb ALS.

Given - I need to get my anxiety in check and still don't know results of MRI and still am waiting on EMG in 2 weeks. However, I'm curious to know, after such a long post:

*As described - is a cramped calf an onset sign?
*Is overslivation or tongue related issues an onset sign?
*Is the shaking in my ring finger cause for concern, given no other fingers are affected?
*Can all ALS symptoms strike within a narrow window, including limb and bulbar symptoms?
*If clinical weakness or atrophy aren't present with the current symptoms, could it set in later? Too soon to tell?
*If MRI, EMG, bloodwork are all clean, what else could this be?

My heart goes out to those who are fighting this terrible disease - in childhood, a family friend was struck down by this. I'm looking for what many other people on these forums are looking for - answers and understanding about what ALS is. Any answers to these questions would be greatly appreciated.

Thanks
 

Tokahfang

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Nevadan,

If you've hung around a while, you'll have noticed some trends that should reassure you - parathesia isn't a thing in ALS, it starts in one area, and doesn't cause pain. BFCS, a subtype of BFS, would be a better place to look.

Here's the tough thing though, your anxiety really has to come down to a reasonable level and stay there for a while before a doc can diagnose you. Anxiety makes all kinds of symptoms that mess up the process. They are real, uncomfortable, but completely diagnostically unhelpful.

The best advice anyone can give is to stop reading medical information on the net and sink yourself into your new marriage and life with a wonderful spouse. The more you concentrate outwardly, the better your anxiety will get, and the more clear your medical situation will become. If you don't become disabled in some way, just drop the chase for a few months, and live. You never get those first 6 months of your marriage back, and you'll regret having wasted them on worry.
 

notme

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Beky is so smart. Listen to her.

It's entirely possible you've injured something with your running. ALS wouldn't affect all those areas at once. Oh. And it doesn't cause excessive saliva.vthe excessive,saliva you have no doubt read about is really an inability to swallow normal saliva.

Congrats on the marriage! Your upcoming EMG/NCV should give you answers.
 

brooksea

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You sound like you are level headed and have taken the proper route to get to the bottom of your symptoms. I agree with the above posts. I hope you will return after your test results are in to give us an update. Good luck!

(If only others in the DIHALS forum would go to their docs to find answers like you have done!)
 

Grateful

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Just want to agree with the other posters; look upon it as an impromptu like button! And good luck, and keep us posted...
 
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