Bad Week with ALS Suspicions

tearsneverfall

Well-known member
I am having a very bad weak "I think I have ALS day". I went to Churchill Downs Sunday and climbed several flights of steps several times and my legs did not feel weak after a long day of doing that and being in the heat. I felt pretty good Sunday night, pretty calm even. Then back to work yesterday and twitched like there is not tomorrow and then when I got home I was so tired. Dreamed a doctor told me I had a rare heart disease and then woke up depressed and worried about my twitching all over again. I have a very nervous stomach this morning. I can't figure out why I have such good days where I am convinced it's BFS and others where I go back to sqaure one. My neuro said that I didn't need an EMG in March twice on two different vists. He said I had excellen strength in all limbs and he has alwasys been able to spot ALS on the person's first visit by the time they have enought to warrant a visit. I think I am a hypochondriac because now that stomach is bothering me I feel like something is wrong there too. My poor husband needed a break from all of this worrying this morning so here I am venting. I have been twitching for 4 months and can still pick up my 30 pound child, run in the yard with her and do anything I did before this. I have days where I have the perceived weakness but then I think oh well maybe the "perceived" weakness never has gone away and I just think it has when I'm having a good day. I am so afraid that I have a slow progession kind that will get me one day. Sorry I sound like Eyore and am probably on everyone's nerves but I am beside myself today!. Remember the neuro called my worry about ALS dellusional and was adamant that I did not have it including in the letter to my PCP. Thanks for your all's support!

Karen (DONT)
 
Karen,

Believe your neuro. He isn't in the business of dismissing legitimate concerns of serious diseases. Maybe you should try some deep relaxation techniques. Meditating really helped me early on with all the anxiety.

Take care,
Gary
 
Thanks Gary. I know I need to take something but I have tried Zoloft, Wellbutrin and Pamelor and they all made me feel like I was on Speed and made a lot of my symptoms worse. Esepcially the trembling. Any suggestion of any that won't do that to me?

I know that your answer to this will be, "ask the doc for an EMG if it will eas your mind" but I really don't want to have one if not necessary. Have you seen many people on here that have not had one and go to continue to twitch and be fine.

I bet if I had one it would be abnormal anyway because my blood pressure was 163/103 just when I visited the nuero. They would probably have to sedate me if I had one to calm me down.

When I kept asking questions about whether or not this could be slow progressing he kept shaking his head with this really serious look on his face and kept repeating "you don't have ALS, it does not get better or wax and wane." Then I spent an hour on the phone with their MS nurse and she explained ALS like a lamp and how once the cord in torn into in cannot work anymore, it wouldn't come and go BUT what I don't get is these stories you read about slow progression and people who have normal EMG's and still get it. I wish I understood that. I asked the nuero why some of the stuff you read on the net says it took this or that person a year or more to get diagnosed and he said probably because they went to the wrong specialist.

Any comforting words from your nuero would help too. My hand feels clumsy as I type but my anxiety level is thru the roof today. When I got home from the nuero that first time with a BP of 163/103 my hand wouldn't work for about two hours and then it went away. Now both hands and mainly my right leg feels clumsy on an off and I am sure the tense way I sit at my desk all day doesn't help.

As you can tell I am having pretty bad anxiety about this right now (believe it or not it was worse) and I know I sound nuts but it is sooo hard!!!!! I feel like a terrible mothter but I know if my heart of hearts I love her dearly!!! I just have to get me back!
 
Dont-
I was where you were 6 months ago. I think that most of the folk here were too. We have all tested ourselves, had panic attacks, etc. I had a back and neck injury that started mine. I was testing myself with pushups making things worse wiht numbness and weakness which then fuled the "oh crap I have ALS and am going to die" panic. My neuro diagnosed anxiety and myofascial pain along with the sprains. That *beep* me off; "how dare he say I have anxiety, I am twitching!". Bottom line, ALS is a horrid NMD that should not be wished on one's worst enemy. However, it is also easy to spot and once you understand it and can work past the fear and think rationally about it, it is easier to calm down. Stories of slow onset, of people misdiagnosed, etc make an impression becuase you are scared. It is called the primacy effect; the tendency to remember the thing that grabbed your attention. How about the 600+ other people here who have been twiching for 20 years in some cases and no ALS? That is less reassuring if you are terrified than the idea of "but I read about one person who was misdiagnosed..." Primacy effect.

I have a friend, a guy I respect greatly, who has ALS and is almost to the point of needing a wheel chair. Watching the progression of the disease helped fuel my anxiety. However, he has never felt any of his twitching, has felt little pain and never felt an increase in weakness. Limbs just stopped working. No going back.

For me, understanding that the sensory events I was experiencing, the global twitcing I had, the muscle pain, the affective changes (crabby as hell to my wife and kids), the amount of time I was surfing the web looking at fasciculation, etc. all was fueling the fire. I finally went to yet another doctor (I am sticking with this one) who did indeed reiterate that I had anxiety, that I had had several neuro evals by a respected neuro, that there was no clinical weakness and that I was making things worse by perseverating and ruminating on my symptoms.

I was resistant to medication because I thougt it was a sign of weakness, was a character flaw for me. I finally got what they had all been saying. That I did not have ALS. That something was wrong, yes because I had benign fasciculations as the neuro said; but I was making things worse. I talked about my med concerns. Doc gave me a trial script for Ativan (.5 mg) PRN. I have taken it maybe 15 times in 3 months because I am still thinking I can deal with this without full meds. But bottom line is this. As I was able to calm myself, the anxiety faded (still have flareups), the fascics and pain get less, and that reinforces things. I have the luxury of having a background in mental health that helps me to do this for me. Talk to others. Talk to counselors if you are open to it. What I am saying is that anxiety, once surfaced, makes it all worse; it gets to our worst fears and starts to control us if unchecked.

If you can get the breaks somehow, use it to reinforce yourself. If it was ALS there would be no breaks. No good days. No going back. Just a downhill slide.

Like others here, I am angry at myself for wasting as many days as I have worrying about this. My daughters first christmas was marked by my worrying. Her first thanksgiving. My son's first school program. That is what helped me to put things in perspective.

Look around here. Read the stories of others. See what you have in common with them, with us. Listen to the docs. Do what you need to do to get your anxiety undercontrol before it takes you to really bad places; worse than where you are. This place has been a Godsend for me and for others. Use it. Good luck. Sorry for the length of this reply.
 
Can I ask a dumb and yet another anxiety driven question??? I thought that ALS made weakness "relentless". If your friend has never felt an increase in his weakness and he is almost ready for a wheelchair then how is he getting around at all if ALS means the limbs just stop working with no going back? To me that would have to say they stopped working gradually or he would have been in a wheel chair immediately. Please try to understand I'm not being smirky but what I am is confused because you hear one thing like the weakness is relentless and progressive and then you hear something like what you just said that he has never gotten weaker but is almost ready for a chair. Does it make sense that that is confusing to someone like me who is a very hugemongous anxiety state about this right now. I apologize if this was taken the wrong way but it's just that --- confusion----- about what I read that keeps me so anxious and scared all the time. Thanks for your response and never ever worry about how long it is. The longer the better because that gives me more info which helps! But please clarify for me if you don't mind what you meant by your friend. Thanks.
 
Karen,

There are several people on this board that have twitched for a long time that have never had an emg. I know that aaron hasn't had one, and I believe i remember jenn saying that she hadn't either. Both of them are extremely knowledgeable about bfs, and they don't have anything worse.

I think you need to concentrate on the positive things you have been told by your neuro, and his nurse. If they even remotely suspected you had als, they would have exhausted all the testing possible to find out. I didn't believe my first dr either, but I should have :confused: !

Finally, don't waste time worrying about what someone else posted on the internet about being misdiagnosed. Those stories happen, but they are rare. If you had als, you would present signs and symptoms that were unmistakable.

Good luck,
Gary

BTW, i tried wellbutrin and paxil and they both made me super nervous, so I quit taking them. I started taking remeron about a months ago, and so far it has been good. I'm only taking a very small dose, 15 mg once at night. It is sedating, so it really helps with sleep, and that is great. That sedation was also the only negative, because for the first week or so, i could barely wake up in the morning. I started taking it at 9:30 pm and that helped, now that has passed.
 
In regards to my friend - he woke up one morning and tried to cut his nails. Couldn't close the clippers. The muscles in his hands quit working. Then could not move arms, etc. In his case it was a year after "onset" that he started twitching and he did not even notice them; his wife did in his PJs. He is not in a chair yet as he has been using things like leg and back braces to compensate for some of the dead muscles. It is progressive and relentless but present and obvious. It is not, as I get it, just that everything stops at once. And for the sake of illustration, every time I see him or hear from him, I start fighting my demons again. But he is a friend and I am not gonna avoid him because of how I freak out.

Now, the more I even thought about it, I started worrying about it along the lines of "oh crud, what if I wake up and can't move my hands".. DON"T take the bait. Everything I know about this, everything posted here says, by the time you have fascics, you have the weakness and atrophy and it would show up on exam. Fascics from ALS are from muscle dying. Non-terminal causes are muscle irritation from inflamation, muscle damage, hell, even exercise. I have been to neuro 3 times, had an MRI and 3 neuro exams. No EMG as neuro saw no need. I am at peace with the fact that nothing clinically significant is showing up except for twitching, muscle pain, perceived weakness (I can work through it even though it feels like I can't), burning, tingling, etc.

Funny thing. After writing my reply to your post initially, I have had some thumpers going off in my right biceps. I have not had any there before. These are just funny things. It is like the idea of saying "don't think about yawning" and before long you yawn. The fascics are like that, the more you worry, the worse they get. Which makes sense. ANxiety and fear trigger a parasympathetic response in the brain which prepares you for the "4 Fs", Fight, Flight, Fright and Sex. Fear makes you tense, makes your muscles tense which intern causes the fascics. It is a wicked cycle.

Jenn, thanks. It was about time for me to process this for me for others. This site has helped me tons. Want to return to the community what I get from it.

Peace.
 
Great post, Kent!

I too, was like you. Anxiety was my worst enemy...it feeds off your fear, makes symptoms worse, then the dark thoughts just take over.

I'm also irritated at myself for all the time and effort I put into thinking I had ALS. The palpable fear while surfing the internet, finding everything I could to confirm my fears. It is indeed, a horrendously wicked cycle, which will control you if you let it. It took time away from my family, time which I can never recover.

However, it can be beat. And it is sites like this which help folks along the road to recovery.

All the best.

BTS
 
Karen,

Hi Karen. The truth is, we'll probably always have some anxiety here & there as long as we are dealing with these weird neuro symptoms. The trick, I guess, is to not let it debilitate us mentally for very long. I would be great for weeks or months and then feel weakness or twitching again and fall apart and go on the internet and read [which is about the worst thing you can do when you are having symptoms], and then I'd go to bed and lie there all night with my eyes open as wide as golf balls and think I have the most horrible diseases out there. And ALS is probably one of the most horrible -- and that's why everyone here gets so upset and worried at the thought.

I started taking Prozac about a month ago [when I thought I was about to be diagnosed with MS this time after having some other weird neuro happenings], and it seems to have helped me. For the first week, I felt jittery but I know that's to be expected. It has definitely calmed down now, though ... I think you have to find the right medication and this seems to be the one to help me. I definitely feel like I am not obsessing about illness now. I even had a day last week when I bought a new pair of flip flops and brought them home and tried them on and felt like I was possibly dragging my left foot -- like it felt heavy to lift it up -- even though it did lift. I started worrying like crazy -- something is wrong -- MS, ALS ... what could it be ... but luckily, this time the anxiety and worriedness only lasted about an hour or two and then I moved on mentally to some other thoughts [which were less hypochondriacal]. Sure enough, the next day, I put the sandals on again and my foot felt fine.

I go through the perceived weaknesses that you also go through. I "did" have an EMG last year -- but I can tell you this -- it made me feel better for a short time but it wasn't long before I started worrying again. The tests can all come back negative, and the doctors can sit there and stare and you and tell you "you don't have this, you don't have that" -- but at the end of the day -- it's up to you how to handle when the worried feelings start creeping back into your life. I have a 30 lb. son [he's 21 months] and I can still lift him fine, too -- as you can with your daughter. I also have felt like a crappy mom at times, when I have spent lots of time being worried that I'm going to be disabled and not even be able to lift him.

The Prozac has helped me, and I am also learning relaxation techniques. I also have taken Ambien, which is a light sleeping pill -- on those nights well over a month ago when I was so worried and freaked out that I could not sleep. I haven't needed that in weeks, though. The only reason why I did not go toward the anxiety meds is that they sometimes have a tendency to make me a little drowsy and I run my son around a lot and drive him. However, there may be some good ones out there today that don't have those kind of side effects. I'm also starting hypnosis and yoga next week -- mostly for the relaxation benefits. I also hear that meditation is great.

It certainly sounds to me that you are going to be fine and that nothing serious is wrong at all. Now the trick is for you to figure out the best way to handle your worry when it pops up so that you don't have to suffer with it too long anymore. This site, of course, is an excellent source for that.

Hope this helped.
 

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