Concerned about persisting symptoms

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kagbogre

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Hello all,

First of all, I thank you immensely for taking time out of your day to take a look at this thread and I'm sorry for everyone dealing with this devastating disease. I have been very reluctant from posting here because I understand that people being anxious about this and potentially not having the disease can be really annoying (I've read other posts on here). I'll try not to be! I just have reached a level of desperation that is affecting me and the people around me and so until I am able to get my checkups done I thought I might find some help here!

I'm a 22 year old male from Spain with symptoms that have appeared over the last few months (since March 23rd), and not gone away since. In Spain we have a public healthcare system, and since COVID-19 happened there are currently no in-person GP checkups, they all have to be made through the phone. Everything has slowed down. I'm thinking of going to a private entity to get my checkups done because my GP keeps dismissing this without having looked at me in person.

I'll list my symptoms in chronological order:
  • This first symptom I'm not sure if it's related to my current symptoms that have appeared over the course of weeks. This symptom I have noticed for a few years and did not give any thought to it. I would get (visible) fasciculations in the arch of my right foot, combined with cramping when they happened. The cramping was painful but it would end in a minute or so. I can trigger the cramp today by flexing my right foot into a certain position. As I said, this has happened to me for years and don't think it's related to my current symptoms.
  • On March 23rd, first symptom was tightness in the top of my throat right where the tongue ends. Swallowing and breathing was not affected, and I also had a fever and was feeling under the weather so I didn't think much of this, probably a cold. A few days passed and I was back to normal.
  • On April 8th, the same throat tightness came back, this time producing a hoarse voice and I noticed my voice would give out occasionally. This was again accompanied by fever, so I thought this was the same cold I had back in March that for whatever reason came back. But this time, since I was concerned with COVID, I went to get checked (they did a quick test on me and was negative for COVID). My GP put me on antibiotics and acetaminophen for my fever. This helped the fever, but my the sensation in my throat is, to this day, still present, with my voice giving out and hoarseness.
  • On April 22nd is when my real worrying kicked in when I was on the sofa, got up, and suddenly my right knee felt extremely awkward. No pain, it just felt stiff. This symptom persists to this day, and the knee swells a bit in the back when I walk for some time. This had never happened to me before, so I contacted my GP again about this, they did quick tests on my leg to see if mobility was affected and if I had Baker's cyst, and it was fine so they sent me home on NSAIDs. Shortly after this, I had a bad cramp in my right calf, which then led to pain when I pressed on it, and then when the pain was gone a visible dent appeared that is not visible on my other calf.
  • On April 29th, still having the stiffness in my right knee, I started feeling weakness in my whole right leg. When I walked for a bit or stretched the leg in the air, it would get get fatigued easily, as if I had done a full blown workout. I noticed that my right calf was smaller (not very noticeable) and less firm than my left one. Some days are worse than others with the knee stiffness, but I can walk the same and do not have foot drop or anything like that. When I walk for a few minutes cartilage in my foot starts making popping noises, but I insist, no pain.
  • On May 1st is when I became aware of my fasciculations. Some days are worse than others, but so far I've noticed them in my both my feet arches, both calves, chest, both arms, both hands, and glutes. I'm not sure if the pulses I see in my tongue at rest are considered fasciculations or just me being nervous. They happen most often in my feet arches (with episodes) and calves (less often than in my feet). Yesterday for example, they were constant on my left foot arch all day.
    After this, I noticed weakness in my right arm and hand in addition to my right leg. Same thing as with the right leg, it easily gets fatigued after dedicating a short amount of time to move and stretch it. One thing I've noticed with my right arm is that I "slap" it onto objects when I leave it to rest. For example, if I sit down on a couch, my arm will slap the arm rest with moderate force, unintentionally, or when I lie down in bed, my arms will hit the side of my body with more force than usual, enough to make me notice it. My mother has picked up on this and has told me that I sit down aggressively.
  • On May 2nd I noticed the throat tightness getting... tighter. I can eat and swallow without problems so far, but it feels like my throat is closing in. My voice has gotten worse dysphonia. I like to sing, and I notice I cannot hit high and low notes because my voice gives out. My voice sounds breathy and raspy. I've noticed that I'm having a bit of trouble pronouncing sounds that involve my tongue touching the roof of my mouth, like "Cheddar". My pronunciation of these sounds is getting softer. I have also noticed small pains around my body that come and go, and I believe these are smaller cramps? They've happened everywhere, can't pinpoint an exact location, but legs, neck, arms, chest (felt like on the ribcage).
  • On May 5th I noticed my tongue starting having teeth marks on the sides and looks softer than usual. I remember having a strong, meaty tongue, and it's not like that anymore. Never seen my tongue like this... Weakness and easy fatigue started happening to my left leg, arm and hand. Same pattern as with my other limbs. My left arm also slaps and drops onto objects just like my right one. I've also noticed that my left shoulder has less bulk to it than my right one, but I need to confirm this with a physician. Keeping my head up in good posture makes my neck fatigued and I need to lie down. I've called my GP to tell her about this, and she told me that I should try eating bananas for the muscle twitching and that everything else is normal because of the quarantine situation. I'm currently eating more bananas, but I believe she is not addressing anything of what I tell her.
To sum up with my current symptoms, they are:
  • Overall weakness and easy fatigue both arms, both legs, feet and neck. Dropping arms on objects with force. When applying force to objects with my hand, I notice I my arms tremble of weakness. I feel the trembling all the way to my back. I feel overall "jumpy", shaky and overalert.
  • Possible start of thenar muscle atrophy in hands and also in right calf? (Need to check this out with a physician). Image of left hand. Image of right hand.
  • Throat tightness that has been progressive, although I'm able to eat and swallow without problems. Voice hoarseness/dysphonia. I've also noticed that my yawning and sneezing reflexes are somewhat affected, sometimes depending on where my head is turned to I cannot sneeze, yawn or burp fully, which is an odd feeling I have never had before. Could this be spasticity of the throat muscles? My voice randomly gives out, seems to happen more when my head is rotated it the left, and there was this one moment when I talked and I heard like a whistle coming from my throat, never felt that before, and never again since. This has been the most longstanding symptom of mine which started back in March.
  • Jaw cracking and mild stiffness.
  • Keeping my head up in a good posture for some time makes my neck and shoulders fatigued, having to rest my back and neck on the chair or just go lie down. The best I feel is when I'm lying down in bed, except for the muscle twitches and throat sensation.
  • Fasciculations all over body, however mostly in my feet and calves (right now it's almost constant in my left foot arch). This is the most worrying symptom for me at the moment, they're just weird and don't stop, however, there are days when they are worse in my feet.
  • Teeth dents in tongue, I believe it looks smaller (as in taking less space in my mouth) and softer than usual. Pronouncing hard consonants is softer.
  • Occasional small pains around my body which I suspect to be smaller cramps.
What I believe is that, because my symptoms are coincidentally happening during this COVID-19 crisis and quarantine, all my symptoms are getting thrown into the "anxiety/lack of exercise pool" due to the current situation. However, I don't believe anxiety can cause all this range of symptoms I currently have.

I should also note that I have always lived a very sedentary lifestyle (my profession doesn't help me either, being a software developer) which I am committed to changing. I'm around 240lbs and 5'11'', although I've definitely lost weight during quarantine as I don't eat as much and have less appetite. Before quarantine I always walked to and from work which is about 2.5km away, but that was really the only exercise I had, and now during quarantine I walk inside my flat and I occasionally go walk outside, and try to do pilates although the overall weakness isn't helping.

My questions are: is anybody familiar with the progression I'm describing above? Could this indicate a motor neuron problem? Should I push for an in-person checkup (possible by going to a private entity since my GP will not do this) or wait until the COVID situation has cleared up and they are available again? What worries me is that my symptoms have gradually come in to my daily life and have not gone away since they appeared. I know that my age is not in favor of me possibly having ALS, but if my symptoms hadn't persisted then I wouldn't be worrying right now! It's also true that none of the symptoms currently impede me from doing my daily activities, but I feel like they have piled up and are getting worse by the day.

Any thoughts on this would be appreciated.

Thank you so so much for your time! :)
 
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KarenNWendyn

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Please read this if you have not already done so


It really doesn’t sound like ALS to me. I’m hoping you can get into see a primary care doctor at some point and get a good basic physical exam.

Twitching is common, nonspecific, and meaningless in the absence of muscle function failure which you have not described. Throat tightness is not ALS and neither is knee pain. The pictures of your hands look normal.

So you’re not describing ALS, but you need a good general evaluation.
 

affected

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Great news, please do read the link provided.
Overall not a single ALS symptom!
 

Clearwater AL

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Yes, please see a Primary Care Doctor.

Suggestion: Copy your post above and carry it with you when you do finally
see a PC so you don't forget anything. Or, let him/her read it... might be quicker.

You do have an accomplishment of ranking concerning previous posts though....

1,878 words - 26 paragraphs and 116 lines.

Be thankful all of that does not indicate ALS. :)
 

kagbogre

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Thank you @Clearwater AL @affected @KarenNWendyn for your time, kindness, and the reassurance! I had read that post before, and as I was writing my thread I was thinking that I was typing too many 'feels'. When I reached the end I kind of realized that it probably wasn't it and was thinking about closing the thread, however, I thought that this post might show other people in the future that post in this section. I understand ALS is about failing and not feeling. Something would fail way before noticing any of my current symptoms.
I hope I can see my Primary Care doctor soon to find out what else is wrong with me, and I'll make sure to copy and give her this exhaustive post. At least now I'll be able to sleep without much worry until then :) You guys rock!
 

affected

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Great - but may I politely suggest that before posting such a long post again you consider that our members who use eyes or a toe to operate their computer, and breathe with the assistance of machines, don't need to read such long posts when that resource we have answered you before you typed.

Please go live a great life now and stay away from here. I'm very happy for you!
 
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