Should I be worried?

[Canadianguy85]

(photo of dog bite removed)

Hi everyone, sorry to bother you all I just need some help. Hopefully just my anxiety playing tricks on my mind.

I’ll start back on September 20th 2022. Everything was normal up until this point. While I was at work I was helping a client when his dog snuck up behind me and but the back of my left leg through my jeans. I don’t know if it was bad or not because I’d never been bit by a dog. Dog was about 70-80lbs, mix of some sort. My leg took about a month to heal up. I still have scars but I thought everything was normal. Occasionally the leg felt odd but I shook it off. Being that this was at work I had to report everything to workers insurance.

Workers insurance sent me for a few tests which took a bit to get into. But I went for an ultrasound that showed nothing and then I was sent for an EMG. Everything looked normal until he said I had potential damage to a nerve. He put the needle in the back of my calf and it didn’t make the noise it did on the rest. I should add that this test was May 2nd 2023. See the doctors notes below.

“Needle EMG Examination:
• Needle MG studies ot theleft tibialis anterior, medial gastrocnemius, and biceps femoris short head showed slightly increased amplitude and duration polyphasic units with overall reduced recruitment.
• Left tensor fascia lata needle study was unremarkable.
• Left biceps femoris long head needle study was normal.
Interpretation:
These are abnormal electrodiagnostic studies. On MG needle studies there is evidence ofa chronic possible sciatic or peroneal plus tibial neuropathy localizing to the distal posterior thigh/popliteal fossa as evidenced by increased duration polyphasic units observed on needle studies to the left tibialis anterior, gastrocnemius, and short head of biceps femoris with sparing oft h e long head of biceps femoris suggesting peroneal greater than tibial involvement. Due to the normal sensory studies and normal motor amplitudes it appears this injury is mild in nature and has already shown evidence of recovery.”

He stated that nerves heal slowly and I should have seen some improvement by now. He said it just may be taking longer than usual.

Fast track to today, may 18th 2023. I had to visit another doctor for another assessment for insurance. This doctor notices atrophy on my left calf. He gets me to do some walking and squatting tests but says everything looks fine but the atrophy. So of course this send me down the internet rabbit hole. I deal with anxiety and depression and take regular medication but this just spins me.

The way my leg feels sometimes is as if it’s not really there, I wouldn’t say numbness just as if nothing is there. I can move my toes, I still have most of my strength, but I’m worried and stressed out. Could this turn out to be more? The doctor said to me today he was 100% sure it’s not ALS, he stated he’d been a doctor for 36 years and could confidentially say it’s not ALS. I just heard the word atrophy and panicked because of what was also found on the EMG. Could this be just from a dog bite so many months ago?

I’ve been thinking back and I’ve also been slurring my words and biting my tongue the last little bit. My wife says she doesn’t notice, she says I’m probably tired.

What do you all think? I’m really sorry to come here but I’m desperate, I need to try to put my mind at ease. What should I do?!

A little about me.

I’m 37
5’8”
Weight was about 206lbs about three weeks ago. I weighed myself today and I’m 196lbs.
I’m fairly healthy besides what’s going on here. Maybe not as active as I should be and probably could eat less junk food.

 

[ShiftKicker]

Hello-

Please make sure to read here: Read Before Posting

You report sensory issues, and your test results indicate possible neuropathy, which explains this. You had a dog bite, which seems to have caused nerve damage. Damage to nerves and tissue can cause atrophy. The emg appears to support this- per the conclusion on the report.

Your doctor straight up said "No ALS" to you today, which should be very reassuring- that's good news. As to what you should do? Speak with your medical care provider about next steps. Likely some sort of rehab to help with your injured leg would not go amiss.

Please take care

 

[lgelb]

+1 everything ShiftKicker has said. I would imagine you will be referred for physio if you ask.

As for feeling tired and garbling words a bit, with all respect, you are overweight and that can sap your energy as well as degrade your sleep. Junk foods in place of real food also deprive your body of the fuel it needs to function at its best, even if you take vitamins.

If you are at risk of dozing during the day, or wake up feeling unrefreshed even after enough sleep, those are signs (and you can also video your sleep to look for abnormal movements, gasping, choking, gaps in breathing) that you may have sleep-disordered breathing, for which there are very effective treatments. Sleep studies can be done at home these days.

Best,
Laurie

 

[Canadianguy85]

Thank you for the response, I really do appreciate it. I also do apologize for coming to this conclusion. My mind just goes to a very dark place hearing atrophy and nerve not working… it’s very scary. It’s hard for me to understand how something that happened almost 9 months ago can still be effecting me today and hasn’t healed. To me the bite didn’t seem so bad.

I can’t imagine what anyone with this terrible disease goes through.

 

[Canadianguy85]

Can I just add this for you to review as well please? Still trying to ease my mind.

“Canadianguy85 is a 37 year old male who presents today with left dorsal foot numbness after being bit by a dog on September 20, 2022 in the posterior thigh/knee. On clinical examination he w a s found to be neurologically intact with the exception of a mild s e n s o r ydisturbance
in the dorsum of the left foot following the peroneal nerve distribution. On electrodiagnostic assessment his nerve conduction studies were unremarkable when comparing to the contralateral side.On M G needle studies he was found to have chronic changes suggestive of reinnervation in the peroneal and tibial distribution suggestive of a likely distal sciatic neuropathy. An alternative localization may involve both the peroneal and tibial nerves after dividing from the main sciatic nerve in the distal posterior thigh/posterior knee. There is no evidence of ongoing or acute enervating changes”

 

[Nikki J]

It is saying no signs of ALS. That is what the last sentence means in relation to mnd. Your emg does not support ALS and the doctor who examined you said no ALS. You have a little old nerve damage nothing that requires any intervention

 

[Canadianguy85]

So with all the information I have given your saying I should stop worrying. If it were ALS the EMG findings would be a lot different? I’m just trying to understand. Thank you for your reply.

 

[Nikki J]

There is nothing in the emg to suggest ALS. ALS emgs have more and different findings. Correct. Your doctor also said so based on your exam

 

[lgelb]

Yes, that is correct on both counts. Live the life that others here can't. Consider both physio and a dietician consultation to feel your best.

 

[Canadianguy85]

I do apologize again. Im trying to put this to bed and move on. I spoke with the doctor they preformed the emg today and he stated he didn’t see anything that would typically point to als because I had no weakness. He stated if I feel like I’m getting weak or something else is happening I should see my family doctor to request a repeat again if needed.

I unfortunately spent many hours going down rabbit holes and the scariest thing I’ve been reading about is the “suggestive of reinnervation” part. He states I shouldn’t worry about that because he didn’t see anything else with it? Isn’t
reinnervation part of it because the body is trying to fight to grow back the nerves?

I also wanted to touch base on my sensory issues again. The feeling of hot, cold, and a picking of a pin are still there. It’s just the feeling as if the control of the leg isn’t there sometimes? If that makes sense. Is that what numbness is considered? That left leg is also 1/2” smaller at the base than the other side of my body. My dominant side is my right side.

I’m trying to get this off my mind I’ve spent the last few days (5) riding a stationary bike and went on a couple walks with my family… beside the part of it kinda feeling like I don’t have total control of the limb, as if it’s not there… I still could do these tasks. Maybe with a little more effort because I’m out of shape, but I did them. I should also note that since the start of the month I have lost 10lbs.

 

[ShiftKicker]

Hi, can you please re-read the pinned post? Sensory issues point away from a motor control issue. If you have further questions, they are for your doctors to answer. You've been cleared of ALS by a neuro and have been provided answers for your symptoms. If the anxiety about ALS is preventing you from addressing the nerve injury from your dog bite, it's time to deal with that anxiety while you work with your doctor to mitigate symptoms.

I am closing this thread. Please do not open another.

Take care.