Just met with my family doctor

[SeanR]

Let me start by saying that I have read the pinned post and I greatly appreciate the information provided here and the time you all are taking to try to provide what information you can for those of us who fear this diagnosis.

Like many posters, I have come here out of deep anxiety over my symptoms:

About 5 years ago, I lost feeling in my left arm and hand. Had an MRI and this ended up being a bulging disk. I still have a great deal of pain and tightness under my shoulder blades and in my neck on most days.

Over the past several months, however, I have been waking up with tightness in all of my limbs, especially my forearms, wrists, and hands in the morning. Additionally, my right bicep and forearm have been sore and felt heavy.

During the day, when performing actions that require fine motor skills, I sometimes feel like there is heavyness, not exactly numbness, in my thumbs and index fingers.

In the last couple of weeks, my left leg starts to get fatigued much more rapidly than my right one when doing things like going up the stairs. I feel tightness around my shin and a sense of heaviness overall.

Most troublingly, in the last week I am experiencing painful cramps in my hands, ankles, and wrists. These have woken me up from sleep.

I have not had any trouble doing basic tasks. I have not fallen down or unexpectedly dropped things. So when I when I went to my doctor today, expressing my concerns, I expected to be told that my anxiety over this was crazy. Instead, he confirmed that I have fasciculations in my right arm and ordered a metabolic blood panel and a brain MRI. He said if those came back negative he would move on to setting up an EMG. The blood panel came back completely normal this afternoon, no vitamin deficiences or anything like that. He said he certainly can't rule out ALS.

I know I just have to wait to go through the process, but I'm hoping that some of you might be able to tell me whether this sounds like any of your experiences or not.

I can't tell you how much I appreciate your time.

 

[KimT]

It certainly doesn't sound like a motor neuron disease. An EMG can look for and rule out many things so don't jump to ALS.

Do you do stretching, yoga, or any other exercise to move your limbs and strengthen them? Exercise is also a good stress reduction strategy.

 

[lgelb]

Your family doctor isn't the only one who should be following you for a disk issue and the issues you describe. For one, I'd expect your spine study to be repeated if the last one was 5y ago. Have you seen a neurologist? An orthopedic surgeon?

There are good non-surgical and interventional therapies for degenerating/herniated disks, but understanding the current status of your spine is critical to a sound treatment plan.

I agree, this doesn't sound like ALS.

 

[SeanR]

My very sincere thanks to both of you for your responses. It means a great deal to me.

I'm working to manage my anxiety and, at your suggestion, have signed up for a yoga class while I wait to get more tests.

I do have one piece of information to add and one question, based on my current presentation.

First, my left calf, which is a place that I am feeling a certain amount of heaviness and strain, is measurably smaller than my right, about an inch in circumference. Does this seem meaningful in this context?

Second: does the onset of symptoms in one leg and two arms/hands seem unlikely or atypical without first having any weakness/failure in one of those areas?

Thank you.

 

[Nikki J]

No.
Yes

 

[SeanR]

At the risk of bothering everyone with an anxious followup: I have an MRI coming up on Wednesday and a nerve conduction test next week.
In the meantime I had some very worrying symptoms today:

After doing some yard work this afternoon, my right forearm (which is where I have been feeling weakness) and hand will not stop shaking whenever I try to use them. If I pick up a can of soda, my hand shakes increasingly until I need to put it down.

Can these kinds of tremors be a sign of muscle weakness that precedes coming failure?

Thank you.

 

[lgelb]

Don't know how much soda you drink, but carbonated water leeches important nutrients out of your body over time. Maybe time to whip up a fruit /protein smoothie.

The exertion tremor you describe can come and go for no reason, relate to hydration, nutrition, sleep, anxiety -- so many things. It doesn't have to be related to either your spine or ALS. It could be a overuse injury, especially if you are only recently getting into yard work.

As you await tests/results, I would resist the temptation to cherry-pick the issues that concern you the most. Your docs are trained to look at the full picture.

 

[SeanR]

Thanks again. I definitely continue to have sleep and anxiety issues. And I drink way too many carbonated beverages. I'll try to cut those out.

 

[SeanR]

I have redacted EMG results here. The doctor's response seems to be reassuring, but I will be entirely reassured if someone could look at this, tell me it rules out ALS, and can then close this thread. With my many, many thanks .

 

[lgelb]

Yes, it does. This was a thorough EMG by a certified examiner. (for those noticing the examiner is a DPT, a couple of hundred US physical therapists have been certified in this specialty).

Apart from your disk disease, you may have an old injury that's flaring up, and/or be sitting/putting other pressure on that L lower leg. There is a reference to PT in the report and I agree that a PT eval would be appropriate, especially with your spine history.

Closing the thread as per your request, with all best wishes for your health.