Stressing and could use some advice

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guyerj698

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Hello all,

I have lurked on this website for the past few weeks and just would like to express how incredible this community seems to be. I wanted to discuss my with this community to get some thoughts on what I’ve been experiencing. I will apologize on the length of this post but will try and be as brief as possible.

I am a 30 year old male with no medical issues. For the past 3 weeks or so I’ve been experiencing a wide range of symptoms that have me stressed out. I would welcome any

- Numbing/weakness on my entire right side.I would describe the sensation as a hybrid between numbness and weakness, but it is hard to put into words (it is something I’ve never quite experienced)
- This numbing/weakness would then alternate sides (right to left and vice versa) virtually on a daily basis
- While the numbing/weakness feeling seems to have subsided, my left forearm and hand have been cramping for the past few days (I would describe this as cramping but it’s not as painful as a thigh or calf cramp)
- During this time I think I have been much more conscious of my day to day actions. I do not feel any weaker (though I know this is perception), have not been dropping anything, have not had any issues with my normal activities, no issues walking/climbing stairs, etc.

I have had two appointments (one with a general doc, the other with a neurologist). Unfortunately both were telehealth because of COVID. The neuro did do a pseudo physical exam, though I assume it was more limited in nature due to the fact it was remote. This consisted of walking, lifting a few things, touching fingers/noses, etc.

The general doc brushed off ALS (appointment lasted all of 10 min). The neuro also did not seem to think this was ALS either, but wanted to do an EMG regardless. This fact concerned me.

My questions that I would love any feedback on:

1.) Would ALS symptoms appear this quickly? I know each case is different but just generally speaking.
2.) In terms of symptoms onset, where does the hand/cramping begin? My hand/forearm cramping have been bothering me quite a bit. Does cramping usually proceed weakness?
3.) How painful are hand/forearm cramps? In general, I would describe these as painful, more of a nuisance. Regardless, they have definitely elevated my concern level.

Thank you again for your time! It really amazes me the support this community provides for one another.
 

lgelb

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1=no. 2/3 the short story is ALS doesn't begin with "cramping" per se unless function is also impaired in the same time frame. Nor does numbness factor in.

Neuros get paid for doing EMGs and sometimes sued if they don't. Don't be concerned just because one was ordered. Even transient numbness, for example, can suggest a treatable cause, like a disk problem, blood clot, MS, etc., so I'm not shocked at this. The EMG will show if the nerves that are responsible for sensation, for example, are damaged.

While waiting for this, I would really dig into sleep, stress, diet, exercise and hydration. These can all be powerful levers for alleviating your issues.

Best,
Laurie
 

guyerj698

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Thank you Laurie - I was hoping you would be one of the ones to respond.

I have not experienced any functional impairment yet (that I am aware of). One other question - is it normal/typical for the cramping to begin in the forearm?

Thank you
 

lgelb

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Normal/typical for what? Again, ALS does not typically begin with cramping per se. Most often forearm pain is a pressure injury, repetitive use injury, or ergonomic/positioning issue.
 
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guyerj698

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Thank you Laurie. I guess the feeling is a cross between cramps and spasms. They are painless so I am leaning towards spasms?

Is this a normal symptom? I’ve read conflicting things online so wanted to gauge how concerned I should be. I’ve never really felt anything like this so I’m quite nervous and can’t stop thinking about this.

I don’t seem to be any weaker (not dropping anything, normal grip strength, no issues waking, etc.).

Thank you again.

Sorry if I could bother with one final question - how would you describe the difference between weakness and soreness? I can’t tell if what I’m experiencing is more “weakness” or “soreness” and how concerned I should be.

Thank you!
 

guyerj698

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Happy (early) Thanksgiving all.

If I could ask one other question - how would you describe the difference between soreness and weakness? I am still confused as to what I am feeling right now and how concerned I should be. I am nervous right now so any guidance is appreciated.

Thank you in advance!
 

lgelb

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Clinical weakness is not a feeling. It's a fact.

If you have to ask, you don't have it. If you fall and bruise your knee, it's sore. If you can't walk, whether it hurts or not, that's weakness.
 

guyerj698

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Thank you Laurie! So to summarize - no issues performing normal day-to-day activities means no weakness? I haven’t had issues yet but just wanted to know what to look for. I’ll assume what I have is more soreness/numbness.

Thank you!
 

lgelb

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Yes, that is correct.
Your mind is very powerful and can trick you into thinking you're weak when you're not. But flat-out inability to do something can't be mistaken for anything else.
 

guyerj698

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Thank you Laurie. I am feeling better today so I am hoping it was more just soreness than weakness as I believe weakness does not come and go. Thus far I also have not had any issues doing anything so I will hope and pray this is more soreness.

My forearm and hand do seem to cramp from time to time though which makes me nervous. This all just scares me so much but this forum has been a great place to share thoughts and I truly appreciate it.

Happy Thanksgiving!
 

guyerj698

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Hello all,

I hope everyone has been staying safe during these trying times. I just wanted to provide an update on my continuing symptoms. My EMG is still a few weeks away so I’ve been quite nervous.

- I have noticed continuing and persistent hand pain. This pain is not constant, but rather is noticeable when I am using it (ex: I was using a screwdriver earlier putting something together and as I twisted it there was a sharp pain in my hand and wrist).

- I also notice this pain when I squeeze a fist or curl my wrist. The pain seems to be most noticeable on the top of my hand and thumb and I have no issues making the fist, but it is painful when I do so

- While I know pain typically points away from ALS, I also have read stories of differing symptom onset, including difficulty performing day-to-day tasks.

- I still can lift/carry items (and thus far haven’t been dropping anything), but I also noticed my right arm and shoulder tire quite easily now

- Occasional twitching (not specific to any part of the body), and most noticeable at night. Again, after reading the stickies I know twitching is non-specific but I wanted to highlight this symptom as well so it could be taken into account with my other symptoms.

I certainly would welcome any feedback as to these symptoms are consistent with ALS onset. There is a lot of information out there and while I try to avoid going down the rabbit hole with Google, it is becoming increasingly more difficult to avoid.

Thank you in advance for any thoughts.
 

lgelb

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It's not hard to avoid at all. Just stay off Google. Block it from your browser.

As you will expect us to say, pain isn't failure, widespread twitching points away as well, and anxiety can cause muscle tension that makes you more likely to feel pain when you turn a screwdriver. Maybe whatever you were turning needed some oil...sometimes a cigar is just a cigar. Our fingers are poorly padded, and keyboarding/holding phones not uncommonly causes hand/thumb pain.

Pretend you pulled a muscle. What would you do to feel better? Try a heating pad, stretching, walking, doing things that you enjoy.
 

guyerj698

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Laurie - thank you as always for the prompt response. In summary - would you consider these symptoms indicative of ALS onset?

As I mentioned my EMG is still weeks away but was wondering if I should try and make it sooner.

Thank you
 

lgelb

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No and no. It's fair to say that you are likely more functional than those scheduled ahead of you.
 

guyerj698

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Thank you Laurie. I will continue to monitor. Some days the pain is worse than others (today has been one of the worst though especially how yesterday was completely pain free). I will continue to hope this is nothing too serious but this all has me extremely stressed.
 
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