Concerned about Bulbar jALS

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concerned_guy

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Learn about ALS
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IT
Hello everyone, I would like to anticipatedly thank you for your patience in reading this (hopefully needless) post. I would like to also point out that I ve read all the pinned posts and I have basically exhausted every other resource, so I know that 99.9% it is my anxiety that is causing my symptoms, but the same anxiety makes me worry about that .1%.

I am a 19 year old (from the start chances of having this insidious disease are slim) that s currently studying in a foreign country. I have had body wide twitching from the start of May. At first I thought nothing of it, until that unfortunate google search. I tried everything from diet changes, limiting the use of caffeine, to supplementing for the past months with Bs, D, Magnesium and Potassium. Nothing has worked, yet i find somewhat of a correalation with stress and/or sleep and the intensity and duration of the fasciculations. Additionally, before observing the twitching, I have also noticed that my left tricep is "popping" - like the muscle gets shortcircuited and tangled, ambigous description yet I have none better- whenever I flex it hard. It doesnt happen at the joint (more in the middle of the longhead of the muscle), it is painless, but I feel it whenever I try to do pushups or stand in planks or simply flex it(I dont think I have any real weakness, yet this issue has been persistent for many months) After countless panic attacks, I ve tried to ignore the twitching, but other symptoms keep popping up and I am quite scared that it is not a coincidence.

Two weeks after the twitches first occured I had a week of incredibly tight neck muscles (thrapezoid, and suprahyoid) It was almost unbearable, yet it didnt interfere with swallowing or speech(only the muscles got more fatigued and strained after talking for long). Got checked for my thyroid that could also cause the twitching and strain, but bloodtests and ecography were perfectly normal.

Fast forward some months of crippling anxiety as I was leaving for college and my situation didnt seem to improve, nor did my parents find me a neurologist. I recently (a week before) experienced the same spasticity in the suprahyoids. It was bilateral and just as horrible as the last time, yet this one time, after they relaxed, I feel as if thin liquids and small bits of dry food remain stuck in the back of my throat. I havent choked (nearly did once), but I have to swallow twice every sip. Also my tongue is strained, achy and sometimes extremly tense(rarely get pins and needles - thought they were due to TMJ/TMD but aside from the suprahyoids i dont have a closed jaw, or problems with the other tempomandibular muscles) I perceived some speech problems, yet they are mild (problems pronouncing r's and s vs sh), and they havent been pointed out by anyone else, thus I didnt make much of it. Along with the double swallows (it doesnt feel like Globus, nor do I have the other symptoms of GERD), I ve noticed liquids sometimes get in my nose, even if i dont fully regurcitate them.

Along with everything mentioned before, I get random numbness in my pinky fingers and big toes, tibias and other areas, yet they dont really persist for too long (I know that they are not an ALS symptom)

Other than for some reassurance I am writing this post wondering if seeing a neuro and potentially getting an emg would be the only way to clear my concerns (it is very expensive, it would cost me more than half of my monthly allowance). Also for context, before the twitching started I had a constant, unrelentless headache for over a month, along with dizziness, and facial parasthesia, but I did an X-Ray and MRI that came back clean (started in March after I had Covid for the second time, and got rid of them in May)

I know that I am a severe hypochondriac, I used to be in a good place mentally, and I try to stay surrounded by friends, family, meditate and keep myself busy with learning, but I feel as I have never felt before and also that something terribly wrong is happening with me. All i want is to study in peace, yet Im torn by these degrading symptoms and thoughts. Again, thank you for your time, and patience.
 
Hello-

We always advise people to read this thread first. It contains a fair amount of information. Twitching, pins and needles, numbness, muscle tightness, etc, are all incredibly common things and don't really point towards ALS. You also state shoulder "spasticity", but this is something only a doctor can diagnose. Spasticity is not tension, cramps or stiffness- it is abnormal muscle response to certain stimuli. You can't diagnose that in yourself.

You ask if seeing a neuro will be the only way to clear your concerns- Only you can know that. You appear to think you have something neurological going on, but the doctor (s?) you have already seen don't think so or they would have referred you already. Your admitted anxiety and hypochondria might be more productive to address if your day to day function is being severely compromised.

I hope you will be able to get some help with your severe health anxiety. Working with a counselor or other professional will help you tease out what is a symptom of anxiety and what, if any, other symptoms may indicate there is need to explore further. It is also to be noted that even mild COVID can cause a myriad of symptoms well past the acute phase of the illness and you may be experiencing lingering post viral issues there.

Please take care
 
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