Fasciculations and weird symptoms

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Sanji81

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Hello, everyone, and nice to meet you all.

I'm aware I'm one more person asking for advices and suggestions as many other here, so I'd like first to apologize in advance for this. I’d like to share my symptoms started a few months ago.

First of all, a tiny bit of self-introduction: my name’s Daniele, I’m 40 years old and I’m from Rome (Italy). I’m currently living in Tokyo, where I’ve moved 5 years ago for a working experience abroad. During this period as an expatriate luckily I didn’t have any particular health issue (I’m trying to follow a lifestyle as healthy as possible, given that I’m basically alone all the time and I don’t have any friends, apart from a few colleagues with whom I rarely meet due to the COVID situation and the remote work policy of my company), apart from a bad hip infection I had last year, caused by an awful bacteremia and because of which I underwent a surgery. The health care in Japan, from the pure physicians’ competence point of view, is a hard matter to discuss: in my experience so far, I’ve often met doctors whose only objective is to maximize the hospital/clinic’s “patient visited per unit of time” throughput and to prescribe as many medicines as possible, while giving very poor diagnoses (which 9 times out of 10 consist in “it’s just stress” or “you should rest for a while”). I’ve often found myself changing hospitals/clinics so many times since finding a good and competent physician or specialist is like playing bingo (plus the burden of keep paying the additional “first visit” fee every time). At the beginning I’ve learned (just in case, you never know!) a lot of the Japanese medical jargon (Medicine is one of the things I love the most) and this has been a great help in all the visits I had so far (hospitals with English speakers are fairly rare, although recently their number is increasing). Yet the times I’ve actually been the one guiding the doctor to a diagnose (no jokes!) are quite many. On the other hand, the medical facilities are very well-organized, the staff is usually amazing, kind and prone to help you in any possible way and you usually don’t spend too much time for a visit, even without any appointment.

Putting that aside and fast forward to March 2021, one morning I woke up and I’ve noticed that my left eyelid was twitching. This phenomenon lasted a couple of weeks, so I’ve decided to go to a neurologist in one of the hospitals close to my apartment (here there are either big hospitals or small private clinics, typically run by one specialist and a few nurses: the cost for a visit, no matter the place, is reduced to 30% of the total if you are covered by a health insurance program, which is usually provided by the employer) where I got an MRI of the head, which was normal. The twitching spontaneously disappeared after a few weeks. One month later I started waking up with my right arm completely numb and my wrist was also in slight pain. Payed another visit to the neurologist, got an MRI, a CT and an echography of the wrist (since, for each clinical test performed, the facility gets a refund from the government, usually the more the better) and it turned out I had carpal tunnel syndrome (maybe because of the posture when working on the PC). I wore a wrist brace for a couple of weeks and this issue too disappeared.

At the end of June 2021, both my calves started twitching badly and I got pretty scared: I’ve never experienced such a thing at all. I'm used to go to the gym almost everyday and part of my exercise is fast walking for 30 minutes on a treadmill with 10% slope, so I thought that I was somehow overdoing it but I didn’t stop (I know, I’m a moron), since I didn’t have any cramps or pain yet. I’ve also thought that it could be due to some dehydration and electrolyte imbalance, but no matter how much water I drank, this phenomenon was still present. During the day the frequency of the fasciculations was barely noticeable but, when I was asleep and for a while after getting up, it increased drastically. So I said "Ok, let’s go back to the neurologist": he ordered some blood tests which came out with no abnormal values, apart from the creatinine-kinase which was slightly above the upper limit (I didn’t care too much, since I’ve had probably more than 30 blood tests in the past two years and every time the CK was high, very likely due to the exercise done the day before the test). He just said to rest. I didn’t, of course. Looking for a second opinion, I went to another neurologist, who just “liquidated” me with a Vitamin E supplement prescription (which didn't change the situation).

In July 2021 I’ve noticed that, when I bend my hands up and down (as if I’m trying to “blow out some fire” with a towel), they make some weird jerky movements. Same thing happens to my back and ankles (if I try to pick something up from the floor, my torso bend with the same jerky movements and similarly, if I try to bend my feet, they don't move "smoothly"). Plus, I’ve noticed a slight tremors in both hands. The fasciculations in the calves were still there. I went to another neurologist, who focused just on the tremors and he diagnosed me with “essential tremor” and gave me some medicine to reduce it.

At the beginning of August I went to Italy to visit my family for a week and, as I came back here, I had to stay 2 weeks in self-isolation. Being forced to rest for 20 days, the fasciculations became barely noticeable (but I don’t know if restraining from exercise and the reduction of fasciculations are related). At the end of these 20 days, I started again to go to the gym and the fasciculations gradually reappeared. At the same time, I was noticing that my stamina on the treadmill was constantly decreasing and that I was short of breath almost immediately. I also began to have fasciculations at random places in my body, although barely noticeable and not continuous (on my cheek, shoulders, arms, back, chest, all over: fast twitches lasting for a few seconds, once every 10/20 minutes). That was the first time I began to grow really scared, so in September I went to another neurologist and he ordered an MRI of the head, clean as the previous one. Again, "Just rest!" he said. And I didn’t, of course.

During September and October, I kept exercising while this overall fatigue was growing stronger and stronger. I didn’t and I don’t have (yet) any muscle weakness, at least in my upper limbs: I can lift the weight I could since a few months ago, with no difference in both limbs, although my legs feel "shaky" (when doing some upper limb exercise with a bar, they start shaking after some time). Nevertheless, since November 1st I stopped doing any walking/running exercise, since my calves started to be in pain after that and I’ve decided to take a break at least from that. I went again to another neurologist and I’ve explained him my fear of ALS: he performed a thorough examination (reflexes, Babinsky sign, postures and so on), a nerve conduction study and an EMG, all of which were clean (some fasciculations popped up in the EMG of the gastrocnemius and the tibialis anterior, though). Unfortunately he only explained me the results without giving me any report (which is something very common in Japan and it is pretty much annoying). I’ve also been to another neurologist, explaining her my fears and my condition but she said that, apart from fasciculations and “general fatigue”, without any evident signs of ALS, she couldn’t do that much (maybe she has a point, I guess). On Saturday I’ve reserved an MRI of the spine and next Monday I’ll have another EMG at a different medical institution. Let’s see.

As of now, I still have fasciculations in both calves, stronger and more frequent at night, and diffuse, random, temporary twitching here and there, plus an overall fatigue and a weird feeling in the legs, as if they are somehow weaker, shaky and “burning” after walking long distances. I also feel a light pain in the back of my knees, as if I had a tendinitis, just above the calves and my right foot is slightly "numb".

The reason I’ve started thinking of ALS is that, over the past 4 years, I’ve consumed a huge amount of fruits and vegetables everyday (which is something I was doing in the past as well, by trying to follow a healthy diet as much as possible), especially broccoli and pumpkins (I love them, so I've consumed A LOT of this stuff) and I’m afraid that I’ve ingested so many pesticides that may have led to this condition. So yes, because of my gluttony (and stupidity), I’ve been so masochist to harm myself this much. And I’m even more scared, since I’m living on my own with basically no friends and relatives here, but I need to keep lying to my family and saying “It’s all right here, I’m perfectly fine!” in order not to make them worry too much and keep visiting doctors in the meanwhile.

That’s it. I hope I didn’t bother any of you readers too much. I wanted to share another proof that there’s always someone so stupid that can harm himself up to this point for his gluttony and, what’s worse, not even by eating comfort food but something which is supposed to be healthy.
 

lgelb

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Your conclusion is the problem, not eating produce. Do I really have to point out that if eating produce was an ALS trigger, most people in farming communities the world over would have it? And many likely use way more toxic pesticides than in Japan. If you rinse your produce, as we all should, I can't imagine what your fears are based on.

After four years and countless tests, there is no reason to think of ALS at all. At worst you might have a slowly-progressing motor neuropathy or myopathy, except there is no evidence of either on EMG. Presuming they have physiotherapy/tai chi/ballet/Pilates/swimming and other forms of exercise that elongate the muscles and stretch the connective tissue in Japan, that might be something to try, to test the assumption that a systematic, supervised regimen can improve what you feel.

Otherwise, I don't know what to say. Maybe it's worth asking a friend or family member [or your rational self] if they think you seem anxious and/or depressed about all this, and seek counseling if so. Chasing up causes of symptoms that don't impair your daily function can be a long, hard pursuit that takes up energy that could be spent in things that are much more enjoyable.

Best,
Laurie
 

affected

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I couldn't even read all that, so I read lgelb's reply to get an overview.
You really need to let this go, like REALLY.
Please don't continue here.
 

Sanji81

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Thank you very much for your replies and your time, I've really appreciated it. Indeed this situation is taking a huge toll on my body, all alone bouncing back and forth from clinic to clinic and with this constant fear.
 

Bestfriends14

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Stop bouncing back and forth between doctors or as we call it "doctor shopping". Stick with one you connect with the most and stay with that one for a while. If the doctors in Japan were so incompetent, they would not be regarded as some of the best and brightest in the world, nor would the Japanese be among the healthiest in the world. I, too, lived in Japan for a few years, my husband had a neurologist in Japan for several weeks, shortly after his ALS diagnosis, so I'm familiar with the system.

Your symptoms are such a far cry from ALS that you should let this fear go immediately. Keep working with a doc and take Laurie's advice

Good luck to you.
 
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