Yet Another Post About Bulbar Concerns

Sam80

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Hi everyone,

I’ve been a lurker here for a few months ever since last October when I developed some strange symptoms. I’d really appreciate any feedback about my symptoms below. My family thinks everything is tied to anxiety but I’m just not sure. I’m concerned and wondering whether I should ask my Neuro for an EMG.
  • Male in mid 30s. Fairly unremarkable medical history until fall 2018. Since then, my throat has felt tight on the left side and swallowing feels more labored.
  • Intermittent pain around left side of chin during day-to-day activities. Feels similar to a cramp but I never have the painful onset associated with a cramp nor is the pain as severe/intense. More like a low-level annoyance. This symptom concerns me the most because I’ve read it may be a UMN sign.
  • No slurring and I can still drink water and other liquids, but I notice that swallowing water isn’t as effortless as it used to be. Feels like it takes more work because the left-center side of my throat has a strange “bulge” in it when I swallow and the left side frequently feels tight behind soft palate.
  • At times I feel pain in “the bulge” and in my chin when I swallow.
  • I went to an ENT in late 2018/early 2019 who recommended a swallow study. Normal result. Also went to a Neuro in February who ordered MRI. Results were normal again. Neuro mentioned that bulbar symptoms usually progress quickly and that I would have likely noticed deterioration in 6+ months. That was somewhat reassuring but my symptoms haven’t gone away. Newest symptom is the chin pain. Everything else has plateaued or gotten slightly better. No complete resolution, though.
  • One other thing- The Neuro mentioned my reflexes were brisk during the exam but said it was “nothing ominous”. That still scared me. I was able to do all of the other things he asked me to do (stand on toes, press against arms). He said tongue was fine and noted no voice abnormalities. I have looked at my tongue too many times to count and I don’t see twitches at rest. It definitely shakes and the sides twitch when it protrudes out of my mouth. I need to stop looking at it. Tongues are gross.
Thanks in advance!

Sam
 

Chuckdobro

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Pain is not a precursor to ALS. Functional loss of muscle movement and fine motor skills is. May be some other disorder that I am not familiar with.
 

Sam80

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I am a male in my mid 30s who started having swallowing issues last fall. Went to a Neuro in April and thought I was in the clear (normal exam except for brisk reflexes) but I recently noticed that I am coughing after eating or drinking.

By coughing, I mean that I may cough once or twice anywhere from 10 seconds to a few minutes after eating/drinking. I occasionally cough when eating but it doesn’t feel like I’m choking. Just feels like I need to cough. I admit that the coughing started about 2 weeks ago after I had a sore throat and likely a virus, but it hasn’t gone away. I seem to mainly cough now after eating/drinking.

My fear is that this is bulbar onset and I am aspirating. I am going to the doctor soon but wanted to know if this is appears problematic to anyone.

Sam
 

KarenNWendyn

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Coughing can linger for weeks or even months after a respiratory infection. I would give it more time. Also if you have any post nasal drip (coming down from the sinuses), that can trigger a cough.

Your symptoms do not suggest ALS to me. There are numerous conditions that can trigger a cough after eating and drinking. ALSis at the bottom of a very long list because it is so rare.

So it’s good to get things checked out by the doctor, but I wouldn’t fear ALS here.
 

Sam80

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Thanks for the reply. I went to the doctor yesterday and he said it sounded like a cough after an infection to him. I mentioned the coughing during and after eating but he wasn’t too concerned. I am also coughing in the morning before eating/drinking and throughout the day, especially if I laugh or exercise. That gives me some hope that this isn’t related to bulbar issues but i’m still very concerned. I’ve never coughed for three weeks before!
 

codyclan

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This should completely alleviate all concerns with ALS. Seriously! Your symptoms don't sound like ALS at all. I have coughed for 3 weeks after an infection. There are a myriad of reasons for coughs and a myriad of ways to address them, but your doctor examined you, found no cause for concern with regard to a terminal disease, so it is time for you to put aside the worries about ALS, move on from this site and live your life! No need to reply.
Best wishes,
Tracy
 

Sam80

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Thanks. I’m still coughing but I am trying not to worry too much. I’ll go back to the doctor if things don’t get better and i’ll try to stop viewing the forums and seeing if anyone’s experience matches mine.
 

Sam80

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Update: Bulbar issues subsided. That’s great but I have noticed a lot of pain the last 3 weeks in my left arm. Bicep hurts after picking up things. Forearm hurts. Area around elbow hurts a lot too. Doesn’t feel like cramps. More sore and achy. Sometimes a little sharp. Not debilitating.

I see the Neurologist next week and I will bring up my concerns. I’m worried that my left arm is weak but i’m still able to do things with it. Just hurts. I read the stickies and understand that pain is an atypical presentation, but I am still scared. Anyone see reason for concern?
 

KarenNWendyn

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No reason for concern about ALS.

Your coughing and swallowing issues resolved. ALS doesn’t improve like that. It just keeps hammering away and getting worse. Now it seems like you’re looking for other symptoms to justify your fears and your continued presence on this forum.

Stop! That’s not ALS. That’s health anxiety. Please work with your doctors to address your concerns and seek help for your anxiety. And pain is not a presenting feature of ALS.

I’m leaving this thread open in case you want to post an update after you see your neurologist. Otherwise there’s no reason for you to be here.
 
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