Recent Symptoms

[Sage]

Hello, thank you in advance for taking time to read my post. I’ve also read the “read first” posting and it’s given me some reassurance but I am still worried.

About 3 weeks ago, I woke up with a tingling/numb feeling arm. (Stomach sleeper and arm was underneath me). I could use my arm although it felt weak, kinda like fatigue after a hard workout. When I went to hug my husband I had excruciating pain shoot through my collar bone and shoulder. That pain only last a few seconds. Since then I’ve had tingling, shooting pain and perceived weakness in my right arm. I’ve been to an Ortho doc who did a strength and reflex test, along with shoulder x ray and said everything appeared normal. He wrote me a script for gabapentin, said he thought it was an acute nerve injury with compression to C6/C7 nerve in my neck from sleeping on my arm wrong. I was told it would resolve in a few weeks.

Well, since then I’ve noticed twitching in that arm that is also widespread. In the mornings, my arm feels weaker but tends to improve throughout the day (I still have full range of motion although right side feels weaker) and I have pain throughout my arm and also in my hands and fingers. I’ve noticed stiffness in the middle and ring fingers on my right hand at times. I can still bend them, it’s just sometimes there is pain associated.

I know some of these symptoms (sensory) point away from ALS, but I am worried sick given that my arm is not better. I have a two year old son and my health anxiety gets the best of me sometimes. I am also in therapy for my HA.

Anyhow, since it is going on 3 weeks without full recovery I’ve asked my doc for a referral to neurology. I’m being told there isn’t a need for it and neurology offices in my area require it. I know an Ortho doc is a specialist, but I also know they are not a neuro doc and I’d really like to get an EMG test. Is there a way around a referral to be seen by a neurology specialist? I’m at a stand still and don’t know what to do at this point.

My heart goes out to everyone on this forum.

Thank you.

 

[Nikki J]

There are 2 types of referrals. There are referrals required by your insurance company and if you go without one if the doctor saw you insurance wouldn’t pay. If your pcp refuses technically you can appeal to your insurance company. You likelywould be denied and damage your relationship with your pcp in this scenario
the other types of referral is the type i think you mean. A specialist may require that another doctor says you need to see them. I don’t think you can force an appointment in this scenario.

in your place I would not be chasing an emg but asking for a pt evaluation and if no improvement after that perhaps an mri. I would also discuss this with the therapist

 

[affected]

The thing is that ALS begins in the brain and spinal cord, in nerves that don't involve feeling.
You report shooting pains and tingling when doing certain things and that couldn't be further from ALS.

You really should not direct your doctors, they are way more experienced in knowing what specialty is appropriate and Ortho sounds far more like the direction you should head.
It is kind of like hijacking the doctor while they are driving the diagnostic car in one direction.
All the very best.

 

[Sage]

Thank you for taking the time to read and reply to my post. I spoke with my doctor an he ordered a cervical spine of my MRI based on my ongoing symptoms of arm heaviness, arm fatigue and arm/shoulder/neck pain.

*MRI of cervical spine

 

[affected]

Sounds like the logical diagnostic path to take.
Do come back once you have a diagnosis so that it helps others to see how many things are diagnosed when someone worries they have ALS.

 

[Sage]

Hi, I have my cervical spine MRI on Tuesday and plan to update my post with the results. I hope to have some answers soon. I am still concerned because my arm feels weak and I’ve had several twitches in that arm today and in the same place.

 

[affected]

I hope it shows something treatable which is what they are looking for.
Remember 'feeling weak' and twitching don't mean ALS in any way at all.

 

[Bestfriends14]

"Feeling weak, heaviness, and twitches" do not say ALS; clinical weakness does. Hopefully, that gives you some relief until your appointment.

 

[Sage]

I got my MRI results this morning and they are normal. I am stunned, really thought some kind of nerve impingement would show. I believe nexts steps are a referral to a neurologist for clinical exam and possibly an EMG. Trying to stay positive.

Thank you all for your replies.

 

[affected]

Of course it might not even be neurological, so keep your mind open and come back once you have either an EMG to show us or a diagnosis. All the best with solving this!