Shall I seek out Nuero

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Bragger

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Good afternoon

Thank you all for what you do. 34 yo male. I have read sticky but curious the communities thoughts.

I have had Phlegm in my throat for 2 months now causing coughing and hacking. Cant really get anything up and its clear when I do but seems like it is always there.

Recently developed twitches all over legs as well as arms, shoulders, etc...

Recently noticed numbness under left eye and jaw discomfort causing a twitch on left side of face.

Saw PCP and he did initial strength test and dismissed me. I can walk on toes and heels and dont see any signs of atrophy or weakness

Should i seek the opinion of a nuero?

Thank you
 

KarenNWendyn

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What did your PCP advise?

Your symptoms don’t suggest ALS. Phlegm in the throat for a couple months could be a sign of chronic sinus inflammation or gastroesophageal reflux.

Twitching in and of itself
is common, nonspecific, and meaningless.

The numbness ounder the eye might suggest some pressure on one of the facial nerves, and you might consider seeing a neurologist about that if it persists. It could also be a sign of a sinus problem.

Otherwise I’d go with your PCPs recommendations and not be concerned about ALS.
 

Bragger

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Thank you for the response Karen.

He did not really advise anything. Set up a follow up for 6 months. Just for normal physical.

I did not know that since he seemed so dismissive if i should seek a second opinion
 

Nikki J

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Suggested nothing to try for the phlegm issue? Or did you focus on the twitches/ concern for ALS? If you went in and reported symptoms without trying to direct the visit I am surprised he did not address thd phlegm which as Karen says makes one think sinus/ allergy or GERD
 

Bragger

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Good question. I mainly directed the visit to the twitching and ALS concerns. I have a documented sliding hiatal hernia, but to be honest i did not know that could cause phlegm. I was not aware that phlegm could be a symptom of ALS either.

When I read that on this forum is why I wanted to seek you alls opinions
 

Nikki J

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Increased phlegm is not an ALS symptom.phlegm is a big issue because PALS often can not handle phlegm due to inability to swallow, cough effectively or blow their noses.

Any time any of us go to the doctor with undiagnosed symptoms the proper question is what is wrong with me. Presenting a question such as is this ALS allows the doctor to say no and close the visit
 

Bragger

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Thank you Nikki.
 

Bragger

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I have read several stories about PALS that had to constantly clear their throat. Is that correct or is there alway something else that accompanies it?
 

Atsugi

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Bragger, you don't have ALS. Stop asking about it. Your doctor was dismissive because you need to dismiss this idea.

The people who answered you in this thread were politely telling you that you don't have ALS. That's pretty much the end.



This forum is for people with ALS. So I invite you politely to satisfy your snot questions elsewhere. Follow your PCPs advice.
 

dldugan

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Bragger, I suggest you contact your PCP about the twitching in your face. Ask him to refer you to a neurologist who may want to do a brain MRI. This is a symptom I had 3 years ago and they did a brain MRI to check for Bell’s Palsy which I did not have. But they did find a couple of things that I had since birth and did not think that was causing the issue. Was this a sign of ALS? I have no idea, but I tend to believe it was among the first signs. As to the phlegm, there are medications your PCP can prescribe.

I will never know enough to be able to tell you that you don’t have ALS. You are responsible for your health and if you still have concerns make another appointment with your PCP, or go to urgent care. If your PCP does not want to see you, fire him/her and get another.
 

Bragger

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Hello all,

Wanted to give a quick update. I saw the nuero today and a couple of things i would like to share and get input on.

1.) hyperreflexive in my ankle and knee. Not up top.
2.) passed strength tests

Ordered EMG for a time TBD of upper right and lower rightz would that show bulbar?

Im very worries about the hyperreflexia, am I just to the point where i need to hope for a clean emg?
 

KarenNWendyn

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Bragger, with normal strength, you don’t have ALS. It doesn’t matter if your reflexes are hyper. A lot of normal, healthy people have hyperactive reflexes, and they don’t have ALS.

If someone had bulbar onset ALS, the EMG would show abnormalities in the limbs.

You don’t have ALS, so your EMG should be primarily for reassurance.
 

Bragger

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Thank you Karen. Great insight. One last thing I forgot to add was that I had a negative Babinski sign. I know that is a good thing although im not sure why
 

Atsugi

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Stop. Asking. Questions.

Believe. Us. The. First. Time.
 

Bragger

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So sorry to ask another question but I searched hundreds kf threads and could not find an answer.

I recently had blood and urine analysis work done and my urine creatine level came back low. 16.6mg/dl. Normal range is 27-260.

Has anyone heard of this test beinf effective way of lookong at what is going on? Is anyone knowledgable to what it may mean?
 
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