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mrpet

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Hi there,

I'll try to keep the background brief:
- Nov 2015 started twitching

- Multiple clean EMGs through Aug 2016

- One fib detected in right quad in Aug 2016 (subsequently went away)

- Had episode of ankle weakness in Oct 2016 - diagnosed as peroneal neuropathy via NCS/EMG (no fibs there any more)

- Complained of left shoulder weakness in Jan 2017. Slight weakness detected in left infra- and supraspinatus. EMG showed fibs in those two muscles as well as left deltoid and left trap. Cervical MRI showed severe foraminal stenosis in C6-c7 and mild-moderate stenosis at other cervical levels. Diagnosed with foraminal stenosis as cause of weakness, not ALS.

- No deterioration of strength in left shoulder to-date. Started to sense some subjective weakness in my right shoulder as of July 2017.

- Had my ALS-specialist neuro give me a clinical check up earlier this month (early July), where he found no objective weakness - rated me 5/5 strength on all scales (even on infraspinatus which was previously a 4+ on left hand side). Said he had zero concerns about ALS.

- I have continued to strength test when I know I shouldn't. I can hold a 20lb weight directly out in front of me (shoulder flexion) at head height for about 8s on the left hand side and about 13s on right hand side.

- Interestingly, I can only hold the same weight for about 10s on the right hand side when I lift it out laterally (shoulder abduction) while my left can hold it for about 15s. Weird that my non dominant shoulder is stronger in shoulder abduction but not shoulder flexion. This has me worried that the right hand side is losing strength! Also, my right rear deltoid has been twitching about once every 1-2 minutes non stop since the beginning of July. Seems like an uncanny concidence that that muscle is twitching right where the (relative) weakness is - the right rear deltoid, which is used for shoulder abduction.

- I'm not sure if it's normal for a man (41 years old, skinny and out of shape, never exercise or workout) to be able to hold a 20lb weight in front of him or to the side for 8-15s, or if that is particularly "weak"?

- Still worried about trap fibrillation, remains unexplained although ALs specialist doesn't care about it.

P.
 
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WendyWooG

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I am sorry but I'm not sure what you are asking us with this post? You have given a good description and been told over a period of time that you don't have ALS. Your doctors haven't found clinical weakness. You say you are not sure if it's normal or weak to be able hold a weight out in front of you for 8 - 15 seconds. I can't hold my hand out there at all let alone for 15 seconds and that's talking about the arm that still has function.

Honestly you are over analysing your body at some point you need to find a doctor that you will trust. You have been told that you have stenosis that is causing your problems I don't understand why you don't believe it, but you won't be able to control your fears until you do.

I am sorry that your problems are causing you such distress but I really don't see how we can help you as we have knowledge of als not stenosis.

Please trust your doctor, I wish you good luck.

Wendy
 

mrpet

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Thanks Wendy. I guess I have a few specific questions:
1. is 20lb "normal" for a skinny out of shape 41 year old to be able to hold a shoulder abduction/flexion for c.10 seconds (you've given your response on this - thanks)
2. If I had als would I expect to see at least some subtle muscle weakness progression over 7 months (I haven't recorded any weakness progression with my regular strength testing over the 7 months)?
3. Is the fact that my right (dominant) shoulder is subtly weaker than my left when abducting the shoulder significant?

Many thanks once more.

P.
 
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Atsugi

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MrPet,
Question 1 is answered.
Question 2 starts "if I had ALS" but you don't, so it's moot.
Question 3 has nothing to do with ALS. Best try a fitness forum.

In ALS, when we say "weak," we mean the limb becomes useless, dangling limply. A typical first sign is a foot doesn't hold you up or a hand can't button your shirt.
 
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