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taoquix

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Hello,
I appreciate your time in reviewing my issue. I'm 42 years old with lots of recent stress/anxiety over the past 6 months or so.

Around September 1st after a stressful day at work I noticed I was getting some mild chest pains. I decided to take my BP and found that it was pretty high for my usual (145/95). Most of the time I'm around 120/80 unless my anxiety is ramped up. My wife told me to relax and go to bed. That night in bed I started getting a weird pin like pain in my left lower triceps area close to the elbow. Didn't last long but it happened several times that night. The next day I started feeling a 'pulsing' type feeling on the outside part of my elbow above the joint in the muscle. Didn't think anything of it and went about my business for the next few weeks. In those next few weeks I was feeling fatigued more in my legs and just generally speaking.. with little aches and pains that would come and go in various parts of my body. I figured maybe it's just all due to my stress and anxiety.

In about the 3rd week in I realized that the 'pulse' in my elbow was actually a muscle twitch that was nearly constant. (I know, I know.. muscle twitching doesn't matter) I also noticed around my elbow that the muscle in my triceps and biceps felt like they were 'pulled'. Very vague feeling.
In this time I mentioned to my mother how I had been feeling and she brought up something called MS. I had no idea what this was, so I decided to finally jump on Dr. Google and see what it was all about. In finding out what it was, I ALSO found out what ALS was. Of course I freaked out thinking the worst and the very next day I started having muscle twitching all over my body. To this day I am plagued with the twitching, mostly at night. I am also getting big jerks in all of my limbs during rest. Again, I don't know if this is all due to the anxiety or not.

Decided to go to my GP and get the ball rolling on dealing with anxiety and any other possible issues going on. This was the beginning of October. BP was normal and she checked my reflexes which I guess were all normal: she said "Your fine" even though my left leg about shot through the ceiling when she tapped it. She also did very basic strength tests which all were normal. I had mentioned that I was concerned about my symptoms and ALS or MS and she said not to get carried away and let's check the bloodwork as well as getting set up on Lexapro/Therapist for the anxiety.

My labs came back normal except for having 10.2 Total calcium. This kinda concerned me because for the last 3 or 4 years my levels have always been in the low to mid 9's. I've also researched that anyone over 40 should not have calcium above 10. I know you can have very mild levels of high calcium and still have Hyperparathyroidism. I explained this to my doctor at that time and she blew it off.

A few weeks ago I started noticing some stiffness in my left thumb, this of course was after my GP appointment. I can still do everything I could before, I can make a pincer like I've always been able to do. However, for the past week and a half I've noticed that my left hand in the first dorsal web space has started to get smaller on the top of my hand. On the palm side, I've noticed that the muscle there in that web space has also turned to fat and is wrinkling there. So I'm thinking this is definite atrophy going on and I've shown it to multiple family member and wife and they seem to agree. I certainly hope this isn't the beginnings of 'split hand'. I called my GP and they told me that they will get me set up with a neuro.

So my first question is... should I possibly pursue the high calcium thing first and have my PTH levels checked possibly for Hyperparathyroidism? I'm not sure if ALS presents with high calcium at onset?

And my second question: With how I've described my symptoms in the way they've occurred... does this make sense at all for ALS? Twitching 1st, Atrophy in hand but no weakness yet? I'm at a loss to understand this disease as it affects so many people differently and I've thoroughly read many posts on this site trying to convince myself that I do not have this disease based on the usual onset of symptoms.

Thank you so much for your time involved in reviewing this post, I sincerely appreciate all of you.
 

KarenNWendyn

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Please read this if you have not already done so: Important - READ BEFORE POSTING! Answers to common concerns about possible symptoms!

ALS does not present anything close to what you’ve described. You mention sensory symptoms. ALS is a disease of motor neurons, not sensory. Twitching is common, nonspecific, and meaningless in the absence of muscle function failure which you have not described. Anxiety can make twitching worse.

Only a doctor can diagnose atrophy, so see your doctor if you’re concerned. Chances are you don’t have atrophy. People worried about ALS tend to be hyper-aware of every little symptom and start looking for atrophy when really they’re probably noticing some benign asymmetry that’s been there for months or years.

And ALS does not affect your calcium levels.

I don’t see ALS in your post, but I do see anxiety. Please get help for it.
 

taoquix

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Thank you for your response Karen. I do realize that I have anxiety and that I am indeed hyper-aware of my symptoms right now based on my symptoms for the past 2 months. I should have mentioned that my PT even told me that my hand looks to be atrophied in that area as well. My fingers feel like they have onset arthritis going on at the same time as everything else. Even in my right hand. Each night no matter what position I put my arms in, the fingers and hands tend to go numb. Sometimes my shoulders will go numb as well. My left elbow since the start of all this has had some very mild discomfort so I'm wondering if maybe there is a nerve trap or something. (Praying) I know this all points away from ALS but I'm just trying to be sure before I go through all the diagnostic testing with a neuro. I cant get an appointment until January where I live. I asked them what I should do if I lose function in my hand and they said to just go to the ER. I guess its all a waiting game. Any other suggestions? Thank you again.
 

KarenNWendyn

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Very likely you could have some musculoskeletal issues going on. I wouldn’t worry about ALS. Work with your doctors. It’s not the role of this forum to provide general medical advice.
 

taoquix

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Thanks again Karen. I will not post anything further until I follow up with my doctor. Your time is most appreciated!
 
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