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fitzroy

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Nov 28, 2011
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Learn about ALS
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AU
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VIC
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Mel
I wanted to give a short update from my first thread and possibly get some additional insight.

As way of background, I have a confirmed Dx of Ankylosing Spondylitis and a working Dx of Rheumatoid Arthritis. I am under active care of a GP and Rheumatologist and am being treated with prednisolone, methotrexate and adalimumab with adjunctive supporting meds and pain killers. This has all happened within the last 15 or so months. Basically from complete health to being on temporary disability leave.

My subjective sense that something was wrong with my hands beyond joint issues began about seven or more months ago, but it's hard to say as I've had so many other things that took higher priority health-wise earlier this year. Objectively, my rheumatologist identified the atrophy and weakness about three months ago during a regular appointment.

I've seen both my GP and Rheumy in the last week and the wasting in my hands has accelerated as has the weakness. It is most apparent on the palms of the hands in the big muscle leading off the thumb. Big "divots" are missing. Amongst other stuff, there is also now flattening of tissue on the back-outside of the hands leading from the base of the ring and pinky fingers back.

The left is "leading" the right by a couple of months and I'm starting to have issues with function in a couple of fingers and the thumb on the left side (I'm left handed as well, which adds to the adventure). The earlier NCV study and other clinical exams have pretty much ruled out entrapment-type conditions. There are no indications that there is a medial nerve problem.

The good news is we have a plan. My Rheumy has ordered an MRI of the hands and a referral to a new Neurologist for a complete workup (different from the NCV dude I saw two months ago). If there is synovitis or other frank inflammation, then I win a confirmed Dx of sero-negative Rheumatoid Arthritis to go with the Ank Spond and we'll assess whether the type of wasting I have could be due to under use.

The Neuro consult will likely lead to another NCV and an EMG (my first).

For what it's worth, I have something similar happening in the feet, but with the more advanced issues on the right fore-foot and toes with the left foot following. The right fore-foot isn't particularly controllable, it cramps frequently and my toes like to, on occasion, wave at me of their own accord. Similar with bouts of pronounced finger jerks and muscle twitches in the left hand

The appointments, testing and imaging workups will happen in late January / early Feb. I'm fine with that as time has a way of clarifying things as much as tests and procedures do. I'm not happy about the symptoms, but I'm getting used to my body not cooperating with me at this stage.

In any case, I'm looking forward to spending time with family over the holidays much more so than undergoing more diagnostic exams. I'll drop another update once there are any particular findings.

Best of wishes to all of you and I hope you are surrounded by loved ones and joyous times through the New Year.
 
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