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mch1972

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Hello,
This is my first post. I've read so much on this forum over the past couple of weeks, and I am impressed by the comradery, love, and professionalism here. I worry about my symptoms and am going in to see my PCP next Monday about my concern.

Here's a bit of my history: 43 year old male, veteran, moderately active.
JUNE
I began to lose muscle feeling in my left outer leg. I still have skin sensation but the deep muscle is numb. Docs had different possible ideas (pinched nerve, maralgia parasthesia, IT band syndrome...) The numb area has spread maybe a couple of centimeters since June.
JULY
After a run, my left leg on-and-around the muscle felt like it was a charlie horse on fire. I refrain from long runs now to avoid that pain. However, long walks can create this pain. I consider this a weakening of that muscle and am not as active. I favor my other leg and have a slight limp to my gait detectable only if you are looking for it.
SEPTEMBER
I began getting severe pain in my Coccyx area, but is resolved itself within the month. Some pain is in my upper back now though along and near the spine creating some muscle spasms of which I took relaxants and narcotics so I could get a decent night's rest.
OCTOBER
I began getting widespread fasciculations (legs, arms, shoulders, buttocks, back, eyelids, and cheek today for the first time). These are most common when I'm at rest. Usually right when I wake up in the morning and late in the evening I notice them every few minutes, sometimes none for 20 minutes, and sometimes 3 or 4 in a single minute. They usually last between one and eight small twitches. I read that I shouldn't worry about it too much and it will often resolve itself within a few weeks.
DECEMBER
Well, it's been two months now and I still have the fascics, the numb muscle, and painful back. My concern is the loss of nerve to the leg muscle combined with current constant fasciculations. It has prompted me to make an appointment with my PCP and have a full check up.

I have read that some PALS started with fascics, others with denervation, others with footdrop, so there doesn't seem to be a clear symptom progression. Many PALS testimonies contradict the Stickies post. I had my wife -who used to be in medical- do a reflex test and found that my reflexes were normal and I was negative for Babinski's. I can walk on heels and toes, push and pull against resistance, etc. but still the fascics worry me.

Does a negative Babinski's test rule out ALS?
What are some pointed questions I should ask my PCP?
Are my symptoms too early to start looking towards ALS?

I will respond with the doctor's findings next week.

Thank you so much!
 

lgelb

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1) No.

Questions for you: are you still taking drug for pain? Do you have a history of back trauma? Did you try therapeutic massage or acupuncture for the numb area? Do you stretch morning and night?

2) Questions for PCP: do I have clinical weakness? Do I have visible fascics? Any other signs/sx of neuropathy as you see it? Do I need to see a neuro/ a spine study to rule out myelopathy? Any other differentials come to mind?

3) ALS isn't in the top 10 differentials from what you describe. Let your PCP begin the diagnostic process for you. I suspect you have something much more treatable.
 

GregK

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You imply you've read the Sticky and yet:
The bulk of your symptoms involve "feelings" (numbness, burning) not "failing". ALS attacks the motor neurons not the sensory ones.
Twitching is far too common to be diagnostic of anything.

So, yes, it's too early to start looking toward ALS.
 

affected

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Many PALS testimonies contradict the Stickies post.

We put an awful lot of time and effort and wide experience into creating that sticky. It is our official position and we don't move from it - that's why it is up the top as a sticky.

If your symptoms are outside what the sticky says, and you read other things elsewhere, then maybe you should be asking advice of those others.

I'm sorry if that sounds harsh, but that is why we wrote the stickies, otherwise we have to say the same thing over and over.

Good luck when you finally get a doctor to check you over, that's the first place you should start rather than internet research as you are not a doctor and can't tell fact from fiction.
 

mch1972

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Thank you so much for your quick responses.
affected, it doesn't sound harsh. And I agree, Dr. Google is probably the scariest doctor in the world. I don't know why I keep returning.

Here are some answers to lgelb's questions:
Are you still taking drug for pain? Only as needed and only one pill before bed.
Do you have a history of back trauma? No. This is the first time my back has ever felt this bad.
Did you try therapeutic massage or acupuncture for the numb area? I did not, but my wife sometimes massages it and I sometimes put a hot compress on it.
Do you stretch morning and night? Not in the morning, and half of the time at night; not as often as I probably should.
 

Atsugi

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MCH, I read your posts twice, and I still don't see ALS in there anywhere.

Lgelb said: "ALS isn't in the top 10 differentials from what you describe."
GregK said: "The bulk of your symptoms involve "feelings" (numbness, burning) not "failing". ALS attacks the motor neurons not the sensory ones. Twitching is far too common to be diagnostic of anything."
Affected also didn't see ALS in your description.

We're not doctors, but we know ALS pretty well. You didn't describe it. You may certainly have something non-fatal going on though. Enjoy your holidays.
 
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