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Your Anxiety

Searcher,

Perhaps if you quit searching on the subject of ALS or MND's in general, your anxiety might subside. I'm serious. You've been on this run for over 20 years according to your own testimony.

Are you obsessed with the subject? If so, why? It seems to me (and probably to several others) that you have an obsession and a sad one. I truly feel sorry for you.

If you stay on this kick for too much longer, you may wind up with no one to talk to as some may (if not all) find your obsession offensive and very bothersome.

Just some thoughts...

Zaphoon
 
Well let's look at what is required to diagnose ALS versus what you have.

Upper motor neuron degeneration - you don't have that.
Lower motor neuron degeneration as shown by EMG - you haven't had one.
Progression of symptoms from one area to another - nope.
Nothing such as neuropathy that might explain the symptoms as shown by an EMG - you haven't had one.
No other evidence from MRI to explain symptoms - you haven't had one.

You have none of the criteria required to support a diagnosis of ALS and haven't been tested for anything which might cause those symptoms if in fact those symptoms exist and yet you assume ALS. Sit back, take a breath and think about that for a minute. That's like saying the house is on fire because a warm breeze came in the window.
 
Searcher,

Perhaps if you quit searching on the subject of ALS or MND's in general, your anxiety might subside. I'm serious. You've been on this run for over 20 years according to your own testimony.

Are you obsessed with the subject? If so, why? It seems to me (and probably to several others) that you have an obsession and a sad one. I truly feel sorry for you.

If you stay on this kick for too much longer, you may wind up with no one to talk to as some may (if not all) find your obsession offensive and very bothersome.

Just some thoughts...

Zaphoon

Zaphoon,

I have not been obsessed with having ALS for all that time; just at times when symptoms seemed worse. Whatever the course of symptoms in the past, there is now clear visual evidence (pictures of tongue from 2 years ago) that tongue has more wearing, correlated with what is becoming rather consistent problems with mild articulation difficulty and swallowing difficulty (including coffee coming up through nose once recently). The rheumatologist noted less tissue on one side of the tongue and that side being slightly weaker and wrote in her note a question of atrophy of the tongue (atrophy?). This in a tongue that once had +2 fibrillations on an EMG at the best EMG lab in the world (Mass General), albeit long ago.

BTW, are you not also worried about having ALS? And isn't this forum precisely for people with symptoms who are worried they may have ALS? If so, what's the problem? I am not just one of those who has twitches, then reads of the possible association with twitches and ALS and starts obsessing about having ALS, as some here and on other forums are.

I am not searching about MND or ALS; since having been around this subject a long time, already have known a lot about it for a long time now. I am searching for what might be going on with my worsening symptoms and functioning and what might be causing it, and have become aware of a range of possibilities.

Hope you find what you are looking for.

Searcher
 
Well let's look at what is required to diagnose ALS versus what you have.

Upper motor neuron degeneration - you don't have that.
Lower motor neuron degeneration as shown by EMG - you haven't had one.
Progression of symptoms from one area to another - nope.
Nothing such as neuropathy that might explain the symptoms as shown by an EMG - you haven't had one.
No other evidence from MRI to explain symptoms - you haven't had one.

You have none of the criteria required to support a diagnosis of ALS and haven't been tested for anything which might cause those symptoms if in fact those symptoms exist and yet you assume ALS. Sit back, take a breath and think about that for a minute. That's like saying the house is on fire because a warm breeze came in the window.

Thanks for the comments. I actually have had one, maybe 2, EMGS showing lower motor neuron degeneration. Also have signs of upper motor neuron disorder, though not conclusively so (like a positive Babinski). I also have symptoms in several muscles, though none have definitely progressed EXCEPT for possibly the speech and swallowing, which goes along with the tongue twitching, slight atrophy (progression over time) and slight weakness. I've had MRIs and many other tests in the past; just didn't list them all. In fact, Rheumatologist is suggesting that I have an MRI repeated. I've been told various things by different neuros, includng Mitochondrial Myopathy and possible Myotonic Dystrophy 2. The 2 neuros who suggested these have changed their minds. Another once said he thought I had a spreading peripheral neuropathy, but also changed his mind when a repeat EMG was essentially normal (after being very abnormal and suggesting widespread denervation).

My question remains, though - what else causes tongue atrophy and weakness with fasciculations besides ALS? Can, for instance, MMN do this? Can Mitochondrial Myopathy? Maybe this is not a place I'm going to find such answers, but you do learn interesting things from others with such mysterious, unresolved problems; like learning that APS can be associated with weird muscle weakness problems.
 
Searcher,

No, I'm not worried I have ALS. I already know thats not what I have with 2 clean EMG's behind me. Initially, yes, I was worried but after the clean EMG's, I know its something else. In the meantime, while awaiting a final diagnosed, I have opted to call this a pinched nerve.

I refuse to obsess about a fatal disease that the neurologists have confirmed I don't have. It is my opinion that you bring a lot of unnecessary anxiety on yourself by doing all you can to convince yourself of having ALS if not now, in the near term.

Your reasoning and logic are beyond me. But, for your sake, I hope that you are able to be satisfied by eventually coming down with ALS. I feel this will sate your appetite for the disease and perhaps lesson your anxiety (in a sick sort of way). I say this in kindness, not malice. I truly believe you will be happier once the diagnosis of ALS is made for you.

As for me, its a pinched nerve (non-life threatening and much less anxiety).

You are perfectly free think as you may. I just believe it is sad.

Cheers!:-D

Zaphoon
 
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I really do not understand what you are searching for, Searcher, if it isn't reassurance that you do not have ALS or just to commiserate. I completely appreciate the people on here who try to calm me down on the days that I am freaking out. And, yes, so many of us have fears when we have similar symptoms to ALS, how else did we get here?

I think you are over-analyzing and you just need to calm down. Zaphoon obviously has PNS as most of us probably do who have not received that ALS diagnosis and I'm on a real rampage today because I have PMS and PNS and that may be TMI.

Try to chill out and every appointment that you hear that you do not have ALS, celebrate because it would be one hell of a dark day/night if you received that diagnosis. I would assume.
 
Hi Searcher,

I was reading down through your earlier posts and found that you are assuming that your problems are autoimmune in nature. You were also told at one point by a neurologist that you had something wrong with your motor neurons, but then you had improvement not only with symptoms, but subsequent EMG's were normal, where as the earlier ones were not.

Since having the normal or improved EMG's have you then again had problematic ones?

It sounds like you've been dealing with this for a very long while. Other than the new bulbar/ mouth tongue related weakness, fasciculations, etc, has everything else stayed within the same area of "same" . i.e. with fluctuations, but never a dramatic turn for the worse that you've then recovered from ~ or has that happened too?

It is known that autoimmune can infiltrate the nervous system. Lupus and Sjögren's are at the top of the list ~ and obviously MG, but I kind of feel that goes without saying, as it is an autoimmune condition of the nervous system.

Are you on immunosuppressants, and do they improve your symptoms?

It is true that there are many on here that have had some unusual symptoms. Angelman Florida (I think is his name) was one that I read about when first joining, and he did receive a diagnosis. I don't think what he had going on sounds at all like what you've experienced at all. I just remember him because he was so sick and it was a relief for me (that hadn't even posted yet) for him to learn that he had a treatable condition after all.

I'm not experienced enough with the search function on the forum to explain to you how to look for similar cases, other than just searching by key word.....

I understand (I think) that you're hoping to draw out discussion from others that have had similar problems, or gone similar routes to attempt treatment.

There are a few on here that I happen to know are being treated for some form of autoimmune condition (suspected or definite) and perhaps they will see your posts and respond.

take care, :)
 
Searcher,

No, I'm not worried I have ALS. I already know thats not what I have with 2 clean EMG's behind me. Initially, yes, I was worried but after the clean EMG's, I know its something else. In the meantime, while awaiting a final diagnosed, I have opted to call this a pinched nerve.

I refuse to obsess about a fatal disease that the neurologists have confirmed I don't have. It is my opinion that you bring a lot of unnecessary anxiety on yourself by doing all you can to convince yourself of having ALS if not now, in the near term.

Your reasoning and logic are beyond me. But, for your sake, I hope that you are able to be satisfied by eventually coming down with ALS. I feel this will sate your appetite for the disease and perhaps lesson your anxiety (in a sick sort of way). I say this in kindness, not malice. I truly believe you will be happier once the diagnosis of ALS is made for you.

As for me, its a pinched nerve (non-life threatening and much less anxiety).

You are perfectly free think as you may. I just believe it is sad.

Cheers!:-D

Zaphoon

First, I believe I saw some posts from you in which you were very concerned about your symptoms.

Second, for you to wish me to eventually get ALS because you think it will satisfy me is a) absurd and b) sick. Wishing anyone to have ALS FOR ANY REASON WHATSOEVER is sick!

Why is there a forum for people wondering and worrying that they may have ALS if you object to my posts? I have raised various other possibilities of things I'm hoping I might have; things which may mimic or maybe even cause ALS. I still think there is a decent chance that I have some autoimmune problem that is causing these symptoms, even if they are evolving into ALS.

If you are not concerned about having ALS why are you on this forum?

Searcher
 
I really do not understand what you are searching for, Searcher, if it isn't reassurance that you do not have ALS or just to commiserate. I completely appreciate the people on here who try to calm me down on the days that I am freaking out. And, yes, so many of us have fears when we have similar symptoms to ALS, how else did we get here?

I think you are over-analyzing and you just need to calm down. Zaphoon obviously has PNS as most of us probably do who have not received that ALS diagnosis and I'm on a real rampage today because I have PMS and PNS and that may be TMI.

Try to chill out and every appointment that you hear that you do not have ALS, celebrate because it would be one hell of a dark day/night if you received that diagnosis. I would assume.

Well, yes, I am here to commiserate with others having troublesome, unexplained symptoms or those who have been diagnosed with ALS or something else. In asking about other possible things which can cause or mimic ALS or which might account for my symptoms I am also seeking reassurance in a way. Just having someone here tell me that I don't have ALS wouldn't be very reassuring. If this is evolving into ALS than I am looking for support and how others cope with the progression of deficits, the anxiety, trying to live life as best one can with all of this, etc.

Searcher (for many things)
 
Hi Searcher,

I was reading down through your earlier posts and found that you are assuming that your problems are autoimmune in nature. You were also told at one point by a neurologist that you had something wrong with your motor neurons, but then you had improvement not only with symptoms, but subsequent EMG's were normal, where as the earlier ones were not.

Since having the normal or improved EMG's have you then again had problematic ones?

It sounds like you've been dealing with this for a very long while. Other than the new bulbar/ mouth tongue related weakness, fasciculations, etc, has everything else stayed within the same area of "same" . i.e. with fluctuations, but never a dramatic turn for the worse that you've then recovered from ~ or has that happened too?

It is known that autoimmune can infiltrate the nervous system. Lupus and Sjögren's are at the top of the list ~ and obviously MG, but I kind of feel that goes without saying, as it is an autoimmune condition of the nervous system.

Are you on immunosuppressants, and do they improve your symptoms?

It is true that there are many on here that have had some unusual symptoms. Angelman Florida (I think is his name) was one that I read about when first joining, and he did receive a diagnosis. I don't think what he had going on sounds at all like what you've experienced at all. I just remember him because he was so sick and it was a relief for me (that hadn't even posted yet) for him to learn that he had a treatable condition after all.

I'm not experienced enough with the search function on the forum to explain to you how to look for similar cases, other than just searching by key word.....

I understand (I think) that you're hoping to draw out discussion from others that have had similar problems, or gone similar routes to attempt treatment.

There are a few on here that I happen to know are being treated for some form of autoimmune condition (suspected or definite) and perhaps they will see your posts and respond.

take care, :)

Hi Rose,

Thanks for your responsive post

The most recent EMGS (the most recent was in 2005) were considered normal, though some had hints of possible MMN (some slowed conduction velocities). Except for the tongue/speech/swallowing, which seems to clearly have progressed some, all other symptoms have remained essentially the same or fluctuated from mild to normal or near normal - hand weakness, foot, and leg weakness, shoulder weakness, neck weakness, etc.

I have never been on immunosuppressants, but the Antiphospholipid antibody (APS) specialist I saw last week wants me to go on Plaquenel; both to reduce risk of a clot and to see if it might help the muscle problems. No one has ever suggested any immunosuppresant treatment other than this.

Just curious, do you know what Angelman Florida ended up having?

Yes, I would be interested in hearing about anyone who may have some autoimmune problem or is being treated for one, in relation to definite ALS or other muscle symptoms. I am not assuming that my problem is autoimmune in nature, but it is one of the few things from what I know that seem to make any sense, given my unusual symptom history and test results. And, of course, I hope it would be something autoimmune that might be treatable, rather than ALS.

The grossly abnormal EMG I had in 86 also had signs of MMN, but this was before MMN was even identified, or was only recently identified. Dr. Munsat, a world-renowned ALS expert, told me that I have something wrong with my motor neurons based on that EMG. He didn't think it would progress or evolve into ALS and so far, I guess, he has been right. However, with aging, normal loss of neurons, maybe whatever was wrong then and all along has evolved into a different stage, something else going on with motor neurons. I have read of cases and communicated with a few others who had long-standing symptoms which at some point evolved into frank ALS. Maybe it's not the typical situation, but it apparently does happen. I sure hope Munsat was right then.

Thanks again,

Searcher
 
Wow! You really do have some high anxiety there, questioner. Calm down! If after 27 years its not obvious to you that you've obsessed, it will never be. So, moot point!

Of course, at one point, those of us who have suffered spreading weakness, spasticity and fasciculations, atrophy and such were very concerned regarding ALS and to a lesser degree, still are until the diagnosed comes (whether its PNS or not).

I'm on this forum because I started out with multiple, mirroring symptoms (throw in a little muscle atrophy to boot) and was looking for answers and support. I plan on returning those answers and support once I know what it is I've got that's been doing the mirroring. In other words, for people like you with high anxiety (for which you take beta blockers?), I can report I had similar symptoms but it turned out to be "PNS". Are you getting my motivation here?

I am also enjoying the fine company of so many excellent people.

This forum has greatly helped to calm the concerns of many regarding their symptoms. Most folk on this forum experience their anxiety being lessened. I still think you will not be satisfied until you are given a diagnosed of ALS and I only wish you to be satisfied in your quest. No malice intended - just happiness and smiles.:mrgreen:
 
My point in all this was that to post multiple questions of similar natures in various forums before getting answers to the last batch is a pain in the butt for some. Besides Wright, most of us here aren't rocket scientists so if you have technical questions it may be better to PM him directly so that people looking just for support don't have to read through half a page of postings before realising they really don't care about what is being discussed. You've been playing around for 26 years. Some of us don't have that luxury. Some one mentioned another forum is more medically inclined. We talk about things medical but don't obsess about it. We're more a hey Rose, how are you today?, kind of a forum. That's how it's been since start up and it took me a while to type this with just 1 finger so you're barking up the wrong tree here.

AL.
 
Al,

I thought the purpose of this particular forum was "Have symptoms? Not sure if you have ALS, or what ALS is? Would you like to ask a general question about ALS symptoms? Please post all related questions to this forum."

Well, I think I fit in that category and think my posts on this forum have mostly been in line with this purpose and the concerns others have raised. There are other forums for those with diagnosed ALS to share their experiences, how they are doing, etc., right? But look, I don't have the luxury of time either, so I'm not interested in posting that simply draws critical comments for what I'm posting; including, perhaps, by some who have ALS (though don't know why anyone with an ALS diagnosed would object to any such posts on THIS forum, since it is for people wondering about ALS, not those who have it).

As for posting several things in a short time frame, on many forums, after a day or two, with other posts coming in, posts can easily get buried. Yes, I have a lot of questions, concerns and thoughts about these things, but if people don't want to read them or don't want to respond or don't know what to say in responsse, then fine, they can skip over them.

I'll try, if I continue to post here at all, to confine my questions and concerns to what you think are appropriate questions and concerns about possibly having ALS, e.g. general questions about ALS symptoms. Okay?
 
Wow! You really do have some high anxiety there, questioner. Calm down! If after 27 years its not obvious to you that you've obsessed, it will never be. So, moot point!

Of course, at one point, those of us who have suffered spreading weakness, spasticity and fasciculations, atrophy and such were very concerned regarding ALS and to a lesser degree, still are until the diagnosed comes (whether its PNS or not).

I'm on this forum because I started out with multiple, mirroring symptoms (throw in a little muscle atrophy to boot) and was looking for answers and support. I plan on returning those answers and support once I know what it is I've got that's been doing the mirroring. In other words, for people like you with high anxiety (for which you take beta blockers?), I can report I had similar symptoms but it turned out to be "PNS". Are you getting my motivation here?

I am also enjoying the fine company of so many excellent people.

This forum has greatly helped to calm the concerns of many regarding their symptoms. Most folk on this forum experience their anxiety being lessened. I still think you will not be satisfied until you are given a diagnosed of ALS and I only wish you to be satisfied in your quest. No malice intended - just happiness and smiles.:mrgreen:

Zaphoon,

I did not say I am not obsessed about possibly having ALS or just the fact of a seeming progression of symptoms and findings; just that I have not been obsessed continuously over these 27 years. I am more in an obssessed mode now, obviously, as apparently are many who come here, judging from the posts. I don't quite get your point - if people aren't worried that they have or might have ALS, why would they have come to this particular forum at all?

I also don't get this point: "In other words, for people like you with high anxiety (for which you take beta blockers?), I can report I had similar symptoms but it turned out to be "PNS".

Are you saying that you hope to be able to tell worried people who come to this forum (like me and yourself at one point, apparently) to not worry or worry so much because your troubling symptoms turned out to be something benign, e.g. "PNS?" If so, that is a nice wish, which I share (for both of us), but you don't have a diagnosis yet if I understand what you've written. Is this correct?

I'm a little befuddled by your implied criticism of my posts; as if I don't belong here. Like you, I also came here recently for answers (if available and support). Like you and like, I presume, most who come to THIS forum, I am worried about my symptoms and concerned that they could mean ALS. Hence some of the questions I've asked, like whether tongue atrophy could be due to things other than ALS.

Is your criticism that my anxiety has not seemed to be lessened by the responses I've got so far? If so, what, specifically should allay my concerns, other than the long history of my symptoms? Yes, that long history does lessen my anxiety, in the sense of giving me hope that this is something else besides ALS, or if ALS, perhaps there will be atypically slow progression. Indeed, many of my questions were precisely to seek answers as to the possibility of some other alternative causes of these symptoms, even including progressive tongue atrophy, if I definitely have this.

Seeking and getting answers may not always allay anxiety. Indeed, it may sometimes increase anxiety. I think what I want even more than reassurance and having my anxiety allayed is for the truth- honest answers about people's actual understanding and experience. I don't expect people here to have more convincing answers than the neurologists for questions about whether this or that symptom or history is likely to be ALS.

Perhaps I should just stop posting on these forums and wait until I see the speech therapist and neurologist, or see if the PLaquenil makes any difference. On top of all else that I'm dealing with, I certainly don't want to be writing unwanted posts and to be in a place where, rather than feeling wanted and supported, I'm feeling that my beliefs should change and my writings (and therefore my presence, as I present myself) are unwanted. Too bad, though, as I thought this forum, by its description and many of the posts on it, is uniquely a safe haven for those with these ALS anxieties; anxieties I've long ago learned are not welcomed almost anywhere else, unless and until one is diagnosed with ALS.

Moreover, to be consistent, I suppose you will also tell others who come here with such concerns that they shouldn't be concerned or shouldn't express them in the way they are expressing them or that their anxiety-tinged posts are, one-way-or-the other, inappropriate.

Even though you still say you hope I eventually get ALS to be satisfied, I continue to wish that you have PNS or some other benign cause of your symptoms.

Searcher
 
Searcher,

I hope it is not anyone's goal to make you feel unwelcome. This forum is for those that have questions about the health problems they are experiencing.

Sometimes there will be a poster that has had a minor event, and the more they post and read the forum, the more scared they become ~ In other words, the forum serves to feed their fears, rather than being that safe haven. This does not appear to be the case with you.

What's more, I understand the signs such as tongue atrophy which isn't just your perception, but noted by your doctor is reason enough for anyone to be concerned as to the cause.

I, for one, will be interested to learn if the Plaquenil has a positive effect for you. It was very frustrating for me when I was on this and the other immunosuppressants. I never had any improvement, no matter what the dosage change with combination of the three different meds. Each time something would be increased, or added, my doctor would assure me that it was going to help, that I would get better, and I just didn't. I don't think you can possibly notice a difference right away, but I'm really hoping that eventually you will see an improvement.

I agree that being evaluated by a speech pathologist will give you some valuble information as to not only how major or minor your problems are, but also as to the mechanics behind why you're having trouble.

take care, :)

BTW, If you can avoid hitting the "quote" button, and just addressing who the post is addressed to, it makes it easier for those that have limited use of their fingers to scroll down through the thread.
 
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