MDA Response to ALS Symptoms

Here is the response from the mdausa:

Dear Christi:

Thank you for your recent e-mail communication received through the MDA Website requesting information on ALS, the symptoms of this disease process, and information on MDA programs set up specifiically for those affected by ALS, as related to your troubling symptoms. A direct assessment by a MDA clinic physician would be in your best interest.

Fasciculations are uncommonly the presenting sign/symptom of ALS (some authors say that fasciculations as the presenting sign occurs only about 6% of the time. Much more commonly the presenting signs are weakness and wasting). According to Dr. Valerie Cwik, our MDA Medical Director, "I also don't know that there is a time point after which you don't have to worry any more. I followed one man for "benign fasciculations" several years (3-4) when I was in Canada---then he developed ALS. Fasiculations are normal---we all have them. They are increased by stress, anxiety, lack of sleep, and caffeine intake. They can also be seen in hyperthyroidism."

In the early 1950's Lou Gehrig's widow, Eleanor, who then served as Muscular Dystrophy Association national campaign chairperson, helped the Association launch the greatest private sector effort in American history to fight this baffling disease. Today, MDA is the nation's largest non-governmental sponsor of ALS research and the primary provider of services for those affected. The Association spends millions of dollars on its ALS programs annually and during the past four-and-a-half decades since Eleanor Gehrig's first effort on behalf of MDA, the Association has directed some $130 million of its resources into ALS research and patient care. MDA's current annual commitment to support ALS research is $3.6 million. MDA's support of research directly relating to ALS remains unequaled by any other voluntary health organization. MDA-supported scientists are in the forefront of ALS research pursuing promising leads that are aimed at understanding the causes of this disorder as well as developing treatment for it. MDA-funded researchers have identified two genes that, when defective, cause a familial form of the disorder, and are continuing to work further to understand the protein product involved. Although most cases of ALS are not inherited, understanding the genetic causes may provide essential clues to researchers working to develop an effective treatment for all forms of ALS.

In addition to these unparalleled research efforts, MDA believes that the comfort, well-being and medical management of those affected by ALS are of vital concern. At the present time, MDA sponsors a nationwide network of some 230 clinics -- 30 of which are designated MDA/ALS Centers -- providing diagnostic examinations, as well as annual physical, occupational and respiratory therapy evaluations. Please understand that the effects of a neuromuscular disorder vary from individual to individual. The best person to address case-specific concerns - - including providing a patient with a definitive diagnosis and answers to disease-specific questions - - is a MDA clinic physician. The only requirement to receive an evaluation with an MDA clinic is the written recommendation of a physician, in whose judgement, you may have one of the disorders encompassed by this Association. (A listing of the disorders in MDA's purview can be viewed through the attached Services brochure link). Once the referral is obtained, to learn more about MDA's clinic program or to obtain additional information regarding registering with this Association for services, may we suggest that you contact your local Health Care Service Coordinator. In the event you do not have this information, you may obtain your local office information by referring to the following zip code locator website below:

ZIP CODE LOCATOR:


Once registered, an individual is entitled to quarterly visits at the closest clinic. Additionally, registered patients would receive our monthly ALS Newsletters.

ALS is typified by weakness of the extremities. Problems with speaking and/or swallowing may occur, as well. Many have muscle twitches, cramps and spasms. Pain isn't generally associated with ALS during any stage of the illness. Control of bladder and bowel function remains intact in ALS. Along with an examination, the physician would perform an EMG to determine the health of the body's nerves and muscles. A relatively small percentage of ALS cases are hereditary. The inheritance pattern is autosomal dominant, meaning that the gene flaw is on an autosome and a person needs to inherit a flawed gene from only one parent to cause the disease.

Additional services offered by MDA include support groups, assistance with the purchase of wheelchairs and braces, and periodic educational seminars in many areas.

We're pleased to refer you to the following MDA Web site pages (containing additional ALS information). These sites can be viewed by clicking on the addresses listed below:

GENERAL MD INFORMATION:

SERVICES:

RESEARCH:


ALS SITE:


PREVIOUS ASK THE EXPERTS ;



ALS NEWS : SSDI Recipients With ALS No Longer Have Wait for Medicare

Please know MDA stands ready to assist you to the full extent of it's program while continuing its relentless efforts to conquer ALS through worldwide scientific investigation.

Thank you for reaching out to MDA and we hope this information is helpful to you.

Kindest regards...



Sincerely,



Sallie K. Bitner, MS, RRT
Program Information Coordinator
Muscular Dystrophy Association
3300 E. Sunrise Drive
Tucson, AZ 85718
1-800-572-1717
520-529-5454 - Fax
E-Mail:
Web:

P.S. The information contained in this communication is not intended to replace professional advice, whether medical or otherwise. Please consult with your own health care professional for advice concerning the matter discussed herein.
 
Ok...so this lady is not as uneducated as I thought. Her email discusses everything we already know. Here's the kicker: You might want to call and speak with Dr. Valerie Cwik. I'm very curious to know why she was "following" the man with benign fasiculations. Something must have been abnormal from the get-go.

I have seen three neuros now (not one of which did my primary doc think I needed to see in the first place). I was tested via EMG and NCV--only because one neuro knew I needed it to ease my mind--not hers.

Point being: NOT ONE of these neurologists have any desire whatsoever to "follow" my case. I have been told that I am welcome back in their offices anytime if I have any further questions--but not one of them suggested I follow up on a routine basis. As far as they were concerned, once I walked out the door--that was good-bye.

Something had to be amiss with this canadian gentleman that Dr. Cwik failed to mention. Otherwise, why would she "follow" his case? If it's truly going to stay on your mind, try to speak with Dr. Cwik and ask if this guy had EMG abnormalities early on. Also ask how old this particular gentleman was during his diagnosis. That's all I can think of for now, but I'm sure others here will be very intrigued by Dr. Cwik and might have other questions as well.

Amy
 
Amy hit it on the head, and I have to say again, NO ONE with BFS has EVER gone on to develop ALS (on record) and there are literally thousands and thousands of people with BFS.

I too think there was a reason the doctor was "following" this person. After all, if it was a "benign" condition, why would an ALS "specialist" who has MUCH more important things to do than chase around some guy that has a benign condition, do so in the first place. Was she bored or something? I mean, come-on.

I'm sure there will be the day that someone with BFS "happens" to aquire ALS, just like there have been two people (on record) that have actually been struck by meteor's, which by the way, were NOT fatal. ALS does happen, and with thousands and thousands of us having BFS, someone, sometime is bound to "aquire" ALS sooner or later, and it will have absolutely NOTHING to do with the BFS. Just as some peole with colon cancer may also get MS, It certainbly doesn;t mean cancer causes MS, and some people with heart burn will also have a heart attack, but just because they are both painful in the chest, in NO WAY means that they are even remotely related, or that one can cause the other to happen.

BFS twitches happen for an ENTIRELY different reason than ALS, and they are in NO WAY RELATED, what so ever! I can not stress that enough. Just becaue they both "seem" to be the same to some of you out there, they certainly aren't happening for the same reasons in any way. That's like comparing all headaches to brain tumors. How many people do you know that take aspirin or Tylenol for headaches and in retrospect, how many people do you know that had a brain tumor?

I'll tell you what, headaches are SO common, they have world wide TV commercials for pain killers just for headaches. Ever see any pain relievers for brain tumors? Ever see a disclaimer on any of the commercials stating that a headache can be a sign of a serious brain problem? No! So why should anyone associate BENIGN BFS twitches with twitches that have a CAUSE behind them in ALS?? It's absurd if you do!

EMG's don't lie. I suspect this guy in Canada had an abnormal EMG and that's why this ALS specialist was "following" him. We don't know all of the facts, nor do I even care to know because the OVERWHELMING data out trhere points in one direction, and one directions ONLY, that BFS is NOT associated nor causes ALS in any way, shape or form, PERIOD!

Doctors aren't precise or detailed in all of what they say sometimes. After all, they are just people like anyone else and some don't have very good communication skills while other's do, so you have to take what some say and read between the lines a little. Even the great neuro's on the MedHelp.org site say they never like to say "never", because you just never know... and ain't that the truth. They have to cover their butt's and you can't go around saying "you'll never get hit by a meteor, because you might just walk outside and get hit by one, so you can never say "never". You just have to look at the evidence and take it from there.

So far, the evidence out there today in no way shows anyone with BFS ever aquiring ALS, and even if they did (which again will probably happen sooner or later), it certainly has nothing to do with BFS "causing" it.
 
There is an article in NEUROLOGY 1986 of a man with fasciculations and no weakness for 4 years that went on to develop ALS. The important point is that his EMG was abnormal from the first time it was done. The second point is that this was so rare that it deserved an article in a prominant Neurology journal!
There is a saying in medicine that "when you hear hoofbeats it is usually horses". Occasionally, it will be a Zebra, but not likely. The point is that you need to stop wasting your time looking for Zebras. The world hasn't changed; the sun still rises in the east and sets in the west. No weakness, a normal physical exam and a normal EMG still means no ALS!!!
 
bfs and als are not related in any way. The man with als just happened to have bfs at some point in his life prior to developing als. One does not lead to the other he just happened to have 2 things going on.
 

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