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So, Around Christmas Time I Experienced Some Weakness In My
Question: So, around Christmas time I experienced some weakness in my left arm, and went to see my PCP to get a physical exam, and checked out. I even saw a neurologist, and he said my neurology exam was "perfect" but wanted to schedule a follow up in case he missed something. I am a runner, and upuntil about a month ago was running much slower than I'm used to, until I started getting some fitness back. Over the weekend I ran a half marathon in 74 minutes. I also have illness anxiety, and usually can get over it within a week or so, but sometimes I can't get it out of my head. Lately, I have noticed some weakness again, and also, just as concerning, some twitching, most noticeably in the joint and nerve area on the side of my knee, and also in my arms. The biggest worry for me is the fatigue in my arm, and for the past week or so the nerve right on the inside of my knee keeps twitching on and off and I’m not sure why. My family all thinks I'm crazy for worrying about this, and says I'm fine, as I'm in general very healthy, and pretty physically fit. But, as silly as it seems, my question is, do you think I could be in the beginning stages of a serious neurological or muscular condition like MS or ALS or something? My cousin suffers from MS, and I had a friend that passed of ALS at 21, and they linked it to the Gartisol vaccine which I also received about 10-15 years ago. For some reason, I can't get this out of my head, as extreme as it may seem.
So, around Christmas time I experienced some weakness in my left arm, and went to see my PCP to get a physical exam, and checked out. I even saw a neurologist, and he said my neurology exam was "perfect" but wanted to schedule a follow up in case he missed something. I am a runner, and upuntil about a month ago was running much slower than I'm used to, until I started getting some fitness back. Over the weekend I ran a half marathon in 74 minutes. I also have illness anxiety, and usually can get over it within a week or so, but sometimes I can't get it out of my head. Lately, I have noticed some weakness again, and also, just as concerning, some twitching, most noticeably in the joint and nerve area on the side of my knee, and also in my arms. The biggest worry for me is the fatigue in my arm, and for the past week or so the nerve right on the inside of my knee keeps twitching on and off and I’m not sure why. My family all thinks I'm crazy for worrying about this, and says I'm fine, as I'm in general very healthy, and pretty physically fit. But, as silly as it seems, my question is, do you think I could be in the beginning stages of a serious neurological or muscular condition like MS or ALS or something? My cousin suffers from MS, and I had a friend that passed of ALS at 21, and they linked it to the Gartisol vaccine which I also received about 10-15 years ago. For some reason, I can't get this out of my head, as extreme as it may seem.
Brief Answer:
No symptoms which point to either MS or ALS-- as before. All Clear
Detailed Answer:
Good afternoon and it's good to hear from you once again. I answered several of your questions related to similar issues in Feb. of this year and congratulate you on your recent 1/2 marathon. I calculated a 5:41 mile for you which is right up there in a pretty high category of runner (very nearly in an ELITE category perhaps?) in my opinion though I must tell you that I am not a runner so maybe I'm using incorrect terminology. All I can say is that when I was my peak condition in college as a wrestler and did a lot both sprinting as well as long distance running my best mile was 5:35 with a repeat mile 60 min. later of 5:30. Ever since then, it has been terribly downhill (I wish running were always DOWNHILL now! LOLOLOL).
At any rate, I reread my last set of responses to you and the symptoms you are worried about this time around and find them to be rather similar. It is clearly reassuring that you were examined by a neurologist. I am not in agreement with his choice of verbiage in telling you to come back "in case he missed something" in 3 months since for you obviously, that is unsettling. Not sure what he could've "missed" in a neurological examination since the things he would've done such as muscle strength testing, reflexes, measurement of muscle circumference, visualization of muscle twitches, etc. would've been pretty standard fare in order to either observe or measure and to me don't constitute things that could be missed as a reason to bring you back in 3 months.
At any rate the important part of his examination was that he apparently did not find anything having to do with neuromuscular disease such as ALS or demyelinating disease such as MS. With your level of athleticism and training that you perform in order to run half marathons in the times you do it is same to say that your muscles go through a lot of cycling between significant energy expenditure vs. recovery vs. slow burn cycles. Such fatiguing of muscle is likely and quite commonly resulting in fasciculation or TWITCHING activities that can be seen in virtually any muscle of the body without being considered abnormal. If your neurological exam did not reveal any muscle weakness of a NEUROGENIC BASIS and this was checked out by a neurologist then, I would not consternate over the symptoms at hand. These are normal physiological cycles that muscles go through as they are intensely trained, broken down then, rebuilt. The feeling of fatigue is not uncommon and the cycling process you mention is dependent upon a lot of things such as proper sleep, hydration, nutrition intake, and of course, stress/anxiety.
Your symptoms certainly do not smell of MS since the presentation is often that of focal or regional sensory symptoms which can take weeks to months to return to baseline (if they even return to baseline) with muscle weakness usually happening later. Also, the fatigue that patients feel in MS is mostly INDESCRIBABLE in the same terms as "muscle" fatigue and it is generally felt as an OVERWHELMINGLY tiredness or lethargy that can be so overpowering that it can just level people from normal and routine activities. That is not your case. Just ask your cousin. When I ask my MS patients to tell me about 1 symptom or problem with their MS that they would wish to have me make disappear if I such an ability, 95% of them say, "Doc...can you take the fatigue away?" Therefore, your description of fatigue in your arm is by no means typical, classical, or descriptive with what I would expect to hear from an MS patient.
You are also not going to convince any neurologist that you recently ran a 1/2 marathon and are now suffering from the early stages of ALS or some other motor neuron disease since the time frame, the age, and the rest of your presentation is all wrong for that sort of disease process.
I'd like to ask if you've ever considered looking into professional help with respect to counseling and therapeutic guidance for your HEALTH ANXIETY DISORDER....there are some excellent COGNITIVE BEHAVIORAL therapists who are capable of really putting you in touch with the necessary elements of your mind and body you will need to confront and beat these feelings of autoanxiety which have no evidence from a medical perspective though they are understandable given the people close to you who have obvious terrible and calamitous disease processes.
As a highly trained athlete you know how the mind and body work so intertwined and intermingled and how you can really do phenomenal things with your mind to overcome physical discomfort and pain...."getting into the zone." The exact thing can be learned and entrained into someone who is looking to overcome health anxiety and who better than to pick up on the methodolgy than someone who already trains the body to perfection and sometimes to ridiculous points of fatigue and stress doing the sorts of sports you do?
I do hope this information has given you some perspectives on your current symptoms. In other words, there is no cause for concern in my opinion given your symptoms (plus the fact you had a normal neurological examination a few months back) for either MS or ALS....Enjoy training for your upcoming race and please let me know how it goes!
Please consider closing this QUERY if I've provided satisfactory information to answer your questions. And if you could provide some positive feedback and a 5 star rating that would be most appreciated.
This query has required 75 minutes to research, investigate, and prepare a response.
No symptoms which point to either MS or ALS-- as before. All Clear
Detailed Answer:
Good afternoon and it's good to hear from you once again. I answered several of your questions related to similar issues in Feb. of this year and congratulate you on your recent 1/2 marathon. I calculated a 5:41 mile for you which is right up there in a pretty high category of runner (very nearly in an ELITE category perhaps?) in my opinion though I must tell you that I am not a runner so maybe I'm using incorrect terminology. All I can say is that when I was my peak condition in college as a wrestler and did a lot both sprinting as well as long distance running my best mile was 5:35 with a repeat mile 60 min. later of 5:30. Ever since then, it has been terribly downhill (I wish running were always DOWNHILL now! LOLOLOL).
At any rate, I reread my last set of responses to you and the symptoms you are worried about this time around and find them to be rather similar. It is clearly reassuring that you were examined by a neurologist. I am not in agreement with his choice of verbiage in telling you to come back "in case he missed something" in 3 months since for you obviously, that is unsettling. Not sure what he could've "missed" in a neurological examination since the things he would've done such as muscle strength testing, reflexes, measurement of muscle circumference, visualization of muscle twitches, etc. would've been pretty standard fare in order to either observe or measure and to me don't constitute things that could be missed as a reason to bring you back in 3 months.
At any rate the important part of his examination was that he apparently did not find anything having to do with neuromuscular disease such as ALS or demyelinating disease such as MS. With your level of athleticism and training that you perform in order to run half marathons in the times you do it is same to say that your muscles go through a lot of cycling between significant energy expenditure vs. recovery vs. slow burn cycles. Such fatiguing of muscle is likely and quite commonly resulting in fasciculation or TWITCHING activities that can be seen in virtually any muscle of the body without being considered abnormal. If your neurological exam did not reveal any muscle weakness of a NEUROGENIC BASIS and this was checked out by a neurologist then, I would not consternate over the symptoms at hand. These are normal physiological cycles that muscles go through as they are intensely trained, broken down then, rebuilt. The feeling of fatigue is not uncommon and the cycling process you mention is dependent upon a lot of things such as proper sleep, hydration, nutrition intake, and of course, stress/anxiety.
Your symptoms certainly do not smell of MS since the presentation is often that of focal or regional sensory symptoms which can take weeks to months to return to baseline (if they even return to baseline) with muscle weakness usually happening later. Also, the fatigue that patients feel in MS is mostly INDESCRIBABLE in the same terms as "muscle" fatigue and it is generally felt as an OVERWHELMINGLY tiredness or lethargy that can be so overpowering that it can just level people from normal and routine activities. That is not your case. Just ask your cousin. When I ask my MS patients to tell me about 1 symptom or problem with their MS that they would wish to have me make disappear if I such an ability, 95% of them say, "Doc...can you take the fatigue away?" Therefore, your description of fatigue in your arm is by no means typical, classical, or descriptive with what I would expect to hear from an MS patient.
You are also not going to convince any neurologist that you recently ran a 1/2 marathon and are now suffering from the early stages of ALS or some other motor neuron disease since the time frame, the age, and the rest of your presentation is all wrong for that sort of disease process.
I'd like to ask if you've ever considered looking into professional help with respect to counseling and therapeutic guidance for your HEALTH ANXIETY DISORDER....there are some excellent COGNITIVE BEHAVIORAL therapists who are capable of really putting you in touch with the necessary elements of your mind and body you will need to confront and beat these feelings of autoanxiety which have no evidence from a medical perspective though they are understandable given the people close to you who have obvious terrible and calamitous disease processes.
As a highly trained athlete you know how the mind and body work so intertwined and intermingled and how you can really do phenomenal things with your mind to overcome physical discomfort and pain...."getting into the zone." The exact thing can be learned and entrained into someone who is looking to overcome health anxiety and who better than to pick up on the methodolgy than someone who already trains the body to perfection and sometimes to ridiculous points of fatigue and stress doing the sorts of sports you do?
I do hope this information has given you some perspectives on your current symptoms. In other words, there is no cause for concern in my opinion given your symptoms (plus the fact you had a normal neurological examination a few months back) for either MS or ALS....Enjoy training for your upcoming race and please let me know how it goes!
Please consider closing this QUERY if I've provided satisfactory information to answer your questions. And if you could provide some positive feedback and a 5 star rating that would be most appreciated.
This query has required 75 minutes to research, investigate, and prepare a response.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Brief Answer:
No symptoms which point to either MS or ALS-- as before. All Clear
Detailed Answer:
Good afternoon and it's good to hear from you once again. I answered several of your questions related to similar issues in Feb. of this year and congratulate you on your recent 1/2 marathon. I calculated a 5:41 mile for you which is right up there in a pretty high category of runner (very nearly in an ELITE category perhaps?) in my opinion though I must tell you that I am not a runner so maybe I'm using incorrect terminology. All I can say is that when I was my peak condition in college as a wrestler and did a lot both sprinting as well as long distance running my best mile was 5:35 with a repeat mile 60 min. later of 5:30. Ever since then, it has been terribly downhill (I wish running were always DOWNHILL now! LOLOLOL).
At any rate, I reread my last set of responses to you and the symptoms you are worried about this time around and find them to be rather similar. It is clearly reassuring that you were examined by a neurologist. I am not in agreement with his choice of verbiage in telling you to come back "in case he missed something" in 3 months since for you obviously, that is unsettling. Not sure what he could've "missed" in a neurological examination since the things he would've done such as muscle strength testing, reflexes, measurement of muscle circumference, visualization of muscle twitches, etc. would've been pretty standard fare in order to either observe or measure and to me don't constitute things that could be missed as a reason to bring you back in 3 months.
At any rate the important part of his examination was that he apparently did not find anything having to do with neuromuscular disease such as ALS or demyelinating disease such as MS. With your level of athleticism and training that you perform in order to run half marathons in the times you do it is same to say that your muscles go through a lot of cycling between significant energy expenditure vs. recovery vs. slow burn cycles. Such fatiguing of muscle is likely and quite commonly resulting in fasciculation or TWITCHING activities that can be seen in virtually any muscle of the body without being considered abnormal. If your neurological exam did not reveal any muscle weakness of a NEUROGENIC BASIS and this was checked out by a neurologist then, I would not consternate over the symptoms at hand. These are normal physiological cycles that muscles go through as they are intensely trained, broken down then, rebuilt. The feeling of fatigue is not uncommon and the cycling process you mention is dependent upon a lot of things such as proper sleep, hydration, nutrition intake, and of course, stress/anxiety.
Your symptoms certainly do not smell of MS since the presentation is often that of focal or regional sensory symptoms which can take weeks to months to return to baseline (if they even return to baseline) with muscle weakness usually happening later. Also, the fatigue that patients feel in MS is mostly INDESCRIBABLE in the same terms as "muscle" fatigue and it is generally felt as an OVERWHELMINGLY tiredness or lethargy that can be so overpowering that it can just level people from normal and routine activities. That is not your case. Just ask your cousin. When I ask my MS patients to tell me about 1 symptom or problem with their MS that they would wish to have me make disappear if I such an ability, 95% of them say, "Doc...can you take the fatigue away?" Therefore, your description of fatigue in your arm is by no means typical, classical, or descriptive with what I would expect to hear from an MS patient.
You are also not going to convince any neurologist that you recently ran a 1/2 marathon and are now suffering from the early stages of ALS or some other motor neuron disease since the time frame, the age, and the rest of your presentation is all wrong for that sort of disease process.
I'd like to ask if you've ever considered looking into professional help with respect to counseling and therapeutic guidance for your HEALTH ANXIETY DISORDER....there are some excellent COGNITIVE BEHAVIORAL therapists who are capable of really putting you in touch with the necessary elements of your mind and body you will need to confront and beat these feelings of autoanxiety which have no evidence from a medical perspective though they are understandable given the people close to you who have obvious terrible and calamitous disease processes.
As a highly trained athlete you know how the mind and body work so intertwined and intermingled and how you can really do phenomenal things with your mind to overcome physical discomfort and pain...."getting into the zone." The exact thing can be learned and entrained into someone who is looking to overcome health anxiety and who better than to pick up on the methodolgy than someone who already trains the body to perfection and sometimes to ridiculous points of fatigue and stress doing the sorts of sports you do?
I do hope this information has given you some perspectives on your current symptoms. In other words, there is no cause for concern in my opinion given your symptoms (plus the fact you had a normal neurological examination a few months back) for either MS or ALS....Enjoy training for your upcoming race and please let me know how it goes!
Please consider closing this QUERY if I've provided satisfactory information to answer your questions. And if you could provide some positive feedback and a 5 star rating that would be most appreciated.
This query has required 75 minutes to research, investigate, and prepare a response.
No symptoms which point to either MS or ALS-- as before. All Clear
Detailed Answer:
Good afternoon and it's good to hear from you once again. I answered several of your questions related to similar issues in Feb. of this year and congratulate you on your recent 1/2 marathon. I calculated a 5:41 mile for you which is right up there in a pretty high category of runner (very nearly in an ELITE category perhaps?) in my opinion though I must tell you that I am not a runner so maybe I'm using incorrect terminology. All I can say is that when I was my peak condition in college as a wrestler and did a lot both sprinting as well as long distance running my best mile was 5:35 with a repeat mile 60 min. later of 5:30. Ever since then, it has been terribly downhill (I wish running were always DOWNHILL now! LOLOLOL).
At any rate, I reread my last set of responses to you and the symptoms you are worried about this time around and find them to be rather similar. It is clearly reassuring that you were examined by a neurologist. I am not in agreement with his choice of verbiage in telling you to come back "in case he missed something" in 3 months since for you obviously, that is unsettling. Not sure what he could've "missed" in a neurological examination since the things he would've done such as muscle strength testing, reflexes, measurement of muscle circumference, visualization of muscle twitches, etc. would've been pretty standard fare in order to either observe or measure and to me don't constitute things that could be missed as a reason to bring you back in 3 months.
At any rate the important part of his examination was that he apparently did not find anything having to do with neuromuscular disease such as ALS or demyelinating disease such as MS. With your level of athleticism and training that you perform in order to run half marathons in the times you do it is same to say that your muscles go through a lot of cycling between significant energy expenditure vs. recovery vs. slow burn cycles. Such fatiguing of muscle is likely and quite commonly resulting in fasciculation or TWITCHING activities that can be seen in virtually any muscle of the body without being considered abnormal. If your neurological exam did not reveal any muscle weakness of a NEUROGENIC BASIS and this was checked out by a neurologist then, I would not consternate over the symptoms at hand. These are normal physiological cycles that muscles go through as they are intensely trained, broken down then, rebuilt. The feeling of fatigue is not uncommon and the cycling process you mention is dependent upon a lot of things such as proper sleep, hydration, nutrition intake, and of course, stress/anxiety.
Your symptoms certainly do not smell of MS since the presentation is often that of focal or regional sensory symptoms which can take weeks to months to return to baseline (if they even return to baseline) with muscle weakness usually happening later. Also, the fatigue that patients feel in MS is mostly INDESCRIBABLE in the same terms as "muscle" fatigue and it is generally felt as an OVERWHELMINGLY tiredness or lethargy that can be so overpowering that it can just level people from normal and routine activities. That is not your case. Just ask your cousin. When I ask my MS patients to tell me about 1 symptom or problem with their MS that they would wish to have me make disappear if I such an ability, 95% of them say, "Doc...can you take the fatigue away?" Therefore, your description of fatigue in your arm is by no means typical, classical, or descriptive with what I would expect to hear from an MS patient.
You are also not going to convince any neurologist that you recently ran a 1/2 marathon and are now suffering from the early stages of ALS or some other motor neuron disease since the time frame, the age, and the rest of your presentation is all wrong for that sort of disease process.
I'd like to ask if you've ever considered looking into professional help with respect to counseling and therapeutic guidance for your HEALTH ANXIETY DISORDER....there are some excellent COGNITIVE BEHAVIORAL therapists who are capable of really putting you in touch with the necessary elements of your mind and body you will need to confront and beat these feelings of autoanxiety which have no evidence from a medical perspective though they are understandable given the people close to you who have obvious terrible and calamitous disease processes.
As a highly trained athlete you know how the mind and body work so intertwined and intermingled and how you can really do phenomenal things with your mind to overcome physical discomfort and pain...."getting into the zone." The exact thing can be learned and entrained into someone who is looking to overcome health anxiety and who better than to pick up on the methodolgy than someone who already trains the body to perfection and sometimes to ridiculous points of fatigue and stress doing the sorts of sports you do?
I do hope this information has given you some perspectives on your current symptoms. In other words, there is no cause for concern in my opinion given your symptoms (plus the fact you had a normal neurological examination a few months back) for either MS or ALS....Enjoy training for your upcoming race and please let me know how it goes!
Please consider closing this QUERY if I've provided satisfactory information to answer your questions. And if you could provide some positive feedback and a 5 star rating that would be most appreciated.
This query has required 75 minutes to research, investigate, and prepare a response.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Ok thank you for the advice. I’m sorry, just weird that the symptoms have been persistent for a week or so lately. The neurologist did schedule a follow up with me for this Friday, he did say he didn’t think it was either of those two because I’d “have much more going on”, but just wanted to follow up in case something was going on. He did not take any physical measurements of my muscles though, but performed several tests of strength and such.
Ok thank you for the advice. I’m sorry, just weird that the symptoms have been persistent for a week or so lately. The neurologist did schedule a follow up with me for this Friday, he did say he didn’t think it was either of those two because I’d “have much more going on”, but just wanted to follow up in case something was going on. He did not take any physical measurements of my muscles though, but performed several tests of strength and such.
Brief Answer:
Different facets to neurological examinations
Detailed Answer:
Thank you for your clarification of the fact that your concerns this time around seem more to revolve around DURATION of how you've been feeling (longer than usual). Again, duration of one's perception of muscle fatigue or reduction of strength in a limb can be due to a number of variables (many of which may not be easily isolated....especially in a highly trained athlete such as yourself). For this reason the neurological examination tries to rely on the most OBJECTIVE measurements of muscle strength possible along with other things that typically are independent of patient's control such as reflexes, muscle mass, and other things we look for to determine if a patient has a normal or abnormal neuromuscular system.
Also, be aware that there are many different facets to a neurological examination that each neurologist approaches differently so that if your neurologist doesn't necessarily measure the circumference of the limbs that's only because there may be other ways the examiner could be ascertaining information that goes to the same purpose for which measurements are taken.
In my particular case I'm very accustomed to taking measurements of patient's arms, forearms, thighs, and calves whenever performing a neuromuscular exam since it gives me objective numbers to show both MYSELF as well as the patient (especially if they feel they've been losing muscle mass in one limb over another) or there is a persistent complaint of feeling weakness in one limb that seems to be progressive in the absence of any changes in overall body weight, dieting, training/exercise, etc. Make sense? But taking circumferences of limbs can be time consuming when done properly and the information it yields in a normal person is minimal. Therefore, not all neurologists will go through this part of an exam when examining patients. And again, I don't do that for every patient either rather just when people come with specific complaints such as weakness, concerns over fatigue, or ongoing/progressive weakness in a limb over etc. For those folks, measurements of limbs can be useful when taken and followed over time.
For your purposes I think it is perfectly reasonable and adequate to do the muscle strength testing, reflexes, and other neurological testing that the neurologist is likely to do to rule out things such as motor neuron or demyelinating disease which I have no doubt you will pass with flying colors. I also agree that the lack of other symptoms and likely other neurological signs (which only the examiner can appreciate) help rule out the concerns you've got.
Cheers on your next race....Tis the season, no?
Once again, your evaluation of my responses with positive words of feedback and even a 5 STAR rating would be GREATLY APPRECIATED as well as CLOSING of the QUERY if there are no further questions to pose at this time.
You can always reach me on this platform by going to my URL of www.bit.ly/drdariushsaghafi and directing your questions about this or any other medical topic directly to my attention.
This query has required 102 minutes to research, investigate, and prepare a response.
Different facets to neurological examinations
Detailed Answer:
Thank you for your clarification of the fact that your concerns this time around seem more to revolve around DURATION of how you've been feeling (longer than usual). Again, duration of one's perception of muscle fatigue or reduction of strength in a limb can be due to a number of variables (many of which may not be easily isolated....especially in a highly trained athlete such as yourself). For this reason the neurological examination tries to rely on the most OBJECTIVE measurements of muscle strength possible along with other things that typically are independent of patient's control such as reflexes, muscle mass, and other things we look for to determine if a patient has a normal or abnormal neuromuscular system.
Also, be aware that there are many different facets to a neurological examination that each neurologist approaches differently so that if your neurologist doesn't necessarily measure the circumference of the limbs that's only because there may be other ways the examiner could be ascertaining information that goes to the same purpose for which measurements are taken.
In my particular case I'm very accustomed to taking measurements of patient's arms, forearms, thighs, and calves whenever performing a neuromuscular exam since it gives me objective numbers to show both MYSELF as well as the patient (especially if they feel they've been losing muscle mass in one limb over another) or there is a persistent complaint of feeling weakness in one limb that seems to be progressive in the absence of any changes in overall body weight, dieting, training/exercise, etc. Make sense? But taking circumferences of limbs can be time consuming when done properly and the information it yields in a normal person is minimal. Therefore, not all neurologists will go through this part of an exam when examining patients. And again, I don't do that for every patient either rather just when people come with specific complaints such as weakness, concerns over fatigue, or ongoing/progressive weakness in a limb over etc. For those folks, measurements of limbs can be useful when taken and followed over time.
For your purposes I think it is perfectly reasonable and adequate to do the muscle strength testing, reflexes, and other neurological testing that the neurologist is likely to do to rule out things such as motor neuron or demyelinating disease which I have no doubt you will pass with flying colors. I also agree that the lack of other symptoms and likely other neurological signs (which only the examiner can appreciate) help rule out the concerns you've got.
Cheers on your next race....Tis the season, no?
Once again, your evaluation of my responses with positive words of feedback and even a 5 STAR rating would be GREATLY APPRECIATED as well as CLOSING of the QUERY if there are no further questions to pose at this time.
You can always reach me on this platform by going to my URL of www.bit.ly/drdariushsaghafi and directing your questions about this or any other medical topic directly to my attention.
This query has required 102 minutes to research, investigate, and prepare a response.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Brief Answer:
Different facets to neurological examinations
Detailed Answer:
Thank you for your clarification of the fact that your concerns this time around seem more to revolve around DURATION of how you've been feeling (longer than usual). Again, duration of one's perception of muscle fatigue or reduction of strength in a limb can be due to a number of variables (many of which may not be easily isolated....especially in a highly trained athlete such as yourself). For this reason the neurological examination tries to rely on the most OBJECTIVE measurements of muscle strength possible along with other things that typically are independent of patient's control such as reflexes, muscle mass, and other things we look for to determine if a patient has a normal or abnormal neuromuscular system.
Also, be aware that there are many different facets to a neurological examination that each neurologist approaches differently so that if your neurologist doesn't necessarily measure the circumference of the limbs that's only because there may be other ways the examiner could be ascertaining information that goes to the same purpose for which measurements are taken.
In my particular case I'm very accustomed to taking measurements of patient's arms, forearms, thighs, and calves whenever performing a neuromuscular exam since it gives me objective numbers to show both MYSELF as well as the patient (especially if they feel they've been losing muscle mass in one limb over another) or there is a persistent complaint of feeling weakness in one limb that seems to be progressive in the absence of any changes in overall body weight, dieting, training/exercise, etc. Make sense? But taking circumferences of limbs can be time consuming when done properly and the information it yields in a normal person is minimal. Therefore, not all neurologists will go through this part of an exam when examining patients. And again, I don't do that for every patient either rather just when people come with specific complaints such as weakness, concerns over fatigue, or ongoing/progressive weakness in a limb over etc. For those folks, measurements of limbs can be useful when taken and followed over time.
For your purposes I think it is perfectly reasonable and adequate to do the muscle strength testing, reflexes, and other neurological testing that the neurologist is likely to do to rule out things such as motor neuron or demyelinating disease which I have no doubt you will pass with flying colors. I also agree that the lack of other symptoms and likely other neurological signs (which only the examiner can appreciate) help rule out the concerns you've got.
Cheers on your next race....Tis the season, no?
Once again, your evaluation of my responses with positive words of feedback and even a 5 STAR rating would be GREATLY APPRECIATED as well as CLOSING of the QUERY if there are no further questions to pose at this time.
You can always reach me on this platform by going to my URL of www.bit.ly/drdariushsaghafi and directing your questions about this or any other medical topic directly to my attention.
This query has required 102 minutes to research, investigate, and prepare a response.
Different facets to neurological examinations
Detailed Answer:
Thank you for your clarification of the fact that your concerns this time around seem more to revolve around DURATION of how you've been feeling (longer than usual). Again, duration of one's perception of muscle fatigue or reduction of strength in a limb can be due to a number of variables (many of which may not be easily isolated....especially in a highly trained athlete such as yourself). For this reason the neurological examination tries to rely on the most OBJECTIVE measurements of muscle strength possible along with other things that typically are independent of patient's control such as reflexes, muscle mass, and other things we look for to determine if a patient has a normal or abnormal neuromuscular system.
Also, be aware that there are many different facets to a neurological examination that each neurologist approaches differently so that if your neurologist doesn't necessarily measure the circumference of the limbs that's only because there may be other ways the examiner could be ascertaining information that goes to the same purpose for which measurements are taken.
In my particular case I'm very accustomed to taking measurements of patient's arms, forearms, thighs, and calves whenever performing a neuromuscular exam since it gives me objective numbers to show both MYSELF as well as the patient (especially if they feel they've been losing muscle mass in one limb over another) or there is a persistent complaint of feeling weakness in one limb that seems to be progressive in the absence of any changes in overall body weight, dieting, training/exercise, etc. Make sense? But taking circumferences of limbs can be time consuming when done properly and the information it yields in a normal person is minimal. Therefore, not all neurologists will go through this part of an exam when examining patients. And again, I don't do that for every patient either rather just when people come with specific complaints such as weakness, concerns over fatigue, or ongoing/progressive weakness in a limb over etc. For those folks, measurements of limbs can be useful when taken and followed over time.
For your purposes I think it is perfectly reasonable and adequate to do the muscle strength testing, reflexes, and other neurological testing that the neurologist is likely to do to rule out things such as motor neuron or demyelinating disease which I have no doubt you will pass with flying colors. I also agree that the lack of other symptoms and likely other neurological signs (which only the examiner can appreciate) help rule out the concerns you've got.
Cheers on your next race....Tis the season, no?
Once again, your evaluation of my responses with positive words of feedback and even a 5 STAR rating would be GREATLY APPRECIATED as well as CLOSING of the QUERY if there are no further questions to pose at this time.
You can always reach me on this platform by going to my URL of www.bit.ly/drdariushsaghafi and directing your questions about this or any other medical topic directly to my attention.
This query has required 102 minutes to research, investigate, and prepare a response.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Ok thank you for your help. I just get concerned with this, especially since the frequency of my nerve twitching seems to be increasing and is about once every 5 minutes or so now. And I read somewhere that it tends to start with one limb, and move to the same side arm or leg, and it’s the same side of my body as the arm that I’m noticing some weakness so I just worry. I mean I know I probably shouldn’t as I just finished a half marathon the other day, but I couldn’t imagine having a disease like this, and I know twitching is one of the symptoms so that’s why I’m asking all these questions
Ok thank you for your help. I just get concerned with this, especially since the frequency of my nerve twitching seems to be increasing and is about once every 5 minutes or so now. And I read somewhere that it tends to start with one limb, and move to the same side arm or leg, and it’s the same side of my body as the arm that I’m noticing some weakness so I just worry. I mean I know I probably shouldn’t as I just finished a half marathon the other day, but I couldn’t imagine having a disease like this, and I know twitching is one of the symptoms so that’s why I’m asking all these questions
Brief Answer:
You are very welcome
Detailed Answer:
I am happy to answer questions and would've told you whether or not something didn't seem right about your situation. The fact that you have noticed the twitching becoming as frequent as once every few minutes tells me that it is tied and directly related to your levels of stress and anxiety which is a very common and strong triggers for myotonic twitches. The rest of what you read is not going to impact the diagnosis since you do not have motor neuron disease based on at least this detail.
In fact, I'm going to go out a bit on a limb and say that not only is this fact of increasing frequency of twitching a big strike against anything having to do with demyelinating or motor neuron disease but so is the NORMAL NEUROLOGICAL examination you had several months ago and the one you are HIGHLY LIKELY to have this week. :)
Now, for the question of the evening if you can stand me suggesting it but again but truly I really REALLY believe that if you were act on this 1 suggestion over any other you would be taking true steps FORWARD in order to finally beat this problem that you have already identified of HEALTH ANXIETY.
You really want (and need) to REEL IN and conquer your anxieties over the unfortunate backdrops of family and friends you've seen or lost who have tragic circumstances and learn how to understand what they have WITHOUT transferring their symptoms of health troubles into your body based on normal physiological happenings which are as far removed from their problems as our solar system is removed from the next closest one in the universe that has life similar to ours! Make Sense?
Otherwise, good sir you will likely be asking these same questions and worried about the exact same symptoms in a few weeks or few months from now once things have settled down but then, for some reason get "jacked up" again (using the vernacular of some of my YOUNG RUGBY TEAMMATES! HAHA). I understand the pattern that you are manifesting because it is common and logical given how human EMOTIONS interface with the LOGICAL ANALYTICAL BRAIN. You know what I mean? It is almost a 100% foregone conclusion that unless an individual KNOWS HOW to temper their emotions and filter out what's important from what's not to one's health....that the emotional side of the equation will take over the "conversation" that the LOGICAL BRAIN is trying to suppress but eventually cannot overcome......leading to this phenomenon of "runaway" worst case scenarios that play around and around in a neverending cycle.
There are experts and methods of lassoing all of this in and giving it its due importance.
By the way, it appears that you're from XXXXXXX (great place for runners, no?) and you happen to be in the proximity of some of the greatest academicians and clinicians in the country, maybe some of the top in the world who are very capable of taking a problem such as this and helping folks such as yourself metamorphize their emotions and skills of observation into more commonly encountered inner feelings that can take care of your business IN THE BACKGROUND quietly, swiftly....without really UNNECESSARILY alerting you to anything you don't really need to know about. Does that sound like something you can resonate with....or am I just Whistling Dixie (ever hear that expression? LOL).
So, please consider what I've said and count the number of words and lines I've spent in the last group of messages to see that I probably have said more about treating the HEALTH ANXIETY component of what brought you to us in the first place than very much about disease processes that you really have no cause to worry or think too much about....UNLESS....you are simply interested in knowing details about as opposed to WORRYING about! Yes?
As always, your POSITIVE CRITIQUE of my responses with generous feedback along with a 5 STAR rating would be MUCH APPRECIATED as well as CLOSING of the QUERY if there are no further questions or comments you would like to pose at this time.
You can always reach me on this platform by going to my URL of www.bit.ly/drdariushsaghafi and directing your questions about this or any other medical topic directly to my attention.
This query has required 157 minutes to research, investigate, and prepare a response.
You are very welcome
Detailed Answer:
I am happy to answer questions and would've told you whether or not something didn't seem right about your situation. The fact that you have noticed the twitching becoming as frequent as once every few minutes tells me that it is tied and directly related to your levels of stress and anxiety which is a very common and strong triggers for myotonic twitches. The rest of what you read is not going to impact the diagnosis since you do not have motor neuron disease based on at least this detail.
In fact, I'm going to go out a bit on a limb and say that not only is this fact of increasing frequency of twitching a big strike against anything having to do with demyelinating or motor neuron disease but so is the NORMAL NEUROLOGICAL examination you had several months ago and the one you are HIGHLY LIKELY to have this week. :)
Now, for the question of the evening if you can stand me suggesting it but again but truly I really REALLY believe that if you were act on this 1 suggestion over any other you would be taking true steps FORWARD in order to finally beat this problem that you have already identified of HEALTH ANXIETY.
You really want (and need) to REEL IN and conquer your anxieties over the unfortunate backdrops of family and friends you've seen or lost who have tragic circumstances and learn how to understand what they have WITHOUT transferring their symptoms of health troubles into your body based on normal physiological happenings which are as far removed from their problems as our solar system is removed from the next closest one in the universe that has life similar to ours! Make Sense?
Otherwise, good sir you will likely be asking these same questions and worried about the exact same symptoms in a few weeks or few months from now once things have settled down but then, for some reason get "jacked up" again (using the vernacular of some of my YOUNG RUGBY TEAMMATES! HAHA). I understand the pattern that you are manifesting because it is common and logical given how human EMOTIONS interface with the LOGICAL ANALYTICAL BRAIN. You know what I mean? It is almost a 100% foregone conclusion that unless an individual KNOWS HOW to temper their emotions and filter out what's important from what's not to one's health....that the emotional side of the equation will take over the "conversation" that the LOGICAL BRAIN is trying to suppress but eventually cannot overcome......leading to this phenomenon of "runaway" worst case scenarios that play around and around in a neverending cycle.
There are experts and methods of lassoing all of this in and giving it its due importance.
By the way, it appears that you're from XXXXXXX (great place for runners, no?) and you happen to be in the proximity of some of the greatest academicians and clinicians in the country, maybe some of the top in the world who are very capable of taking a problem such as this and helping folks such as yourself metamorphize their emotions and skills of observation into more commonly encountered inner feelings that can take care of your business IN THE BACKGROUND quietly, swiftly....without really UNNECESSARILY alerting you to anything you don't really need to know about. Does that sound like something you can resonate with....or am I just Whistling Dixie (ever hear that expression? LOL).
So, please consider what I've said and count the number of words and lines I've spent in the last group of messages to see that I probably have said more about treating the HEALTH ANXIETY component of what brought you to us in the first place than very much about disease processes that you really have no cause to worry or think too much about....UNLESS....you are simply interested in knowing details about as opposed to WORRYING about! Yes?
As always, your POSITIVE CRITIQUE of my responses with generous feedback along with a 5 STAR rating would be MUCH APPRECIATED as well as CLOSING of the QUERY if there are no further questions or comments you would like to pose at this time.
You can always reach me on this platform by going to my URL of www.bit.ly/drdariushsaghafi and directing your questions about this or any other medical topic directly to my attention.
This query has required 157 minutes to research, investigate, and prepare a response.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Brief Answer:
You are very welcome
Detailed Answer:
I am happy to answer questions and would've told you whether or not something didn't seem right about your situation. The fact that you have noticed the twitching becoming as frequent as once every few minutes tells me that it is tied and directly related to your levels of stress and anxiety which is a very common and strong triggers for myotonic twitches. The rest of what you read is not going to impact the diagnosis since you do not have motor neuron disease based on at least this detail.
In fact, I'm going to go out a bit on a limb and say that not only is this fact of increasing frequency of twitching a big strike against anything having to do with demyelinating or motor neuron disease but so is the NORMAL NEUROLOGICAL examination you had several months ago and the one you are HIGHLY LIKELY to have this week. :)
Now, for the question of the evening if you can stand me suggesting it but again but truly I really REALLY believe that if you were act on this 1 suggestion over any other you would be taking true steps FORWARD in order to finally beat this problem that you have already identified of HEALTH ANXIETY.
You really want (and need) to REEL IN and conquer your anxieties over the unfortunate backdrops of family and friends you've seen or lost who have tragic circumstances and learn how to understand what they have WITHOUT transferring their symptoms of health troubles into your body based on normal physiological happenings which are as far removed from their problems as our solar system is removed from the next closest one in the universe that has life similar to ours! Make Sense?
Otherwise, good sir you will likely be asking these same questions and worried about the exact same symptoms in a few weeks or few months from now once things have settled down but then, for some reason get "jacked up" again (using the vernacular of some of my YOUNG RUGBY TEAMMATES! HAHA). I understand the pattern that you are manifesting because it is common and logical given how human EMOTIONS interface with the LOGICAL ANALYTICAL BRAIN. You know what I mean? It is almost a 100% foregone conclusion that unless an individual KNOWS HOW to temper their emotions and filter out what's important from what's not to one's health....that the emotional side of the equation will take over the "conversation" that the LOGICAL BRAIN is trying to suppress but eventually cannot overcome......leading to this phenomenon of "runaway" worst case scenarios that play around and around in a neverending cycle.
There are experts and methods of lassoing all of this in and giving it its due importance.
By the way, it appears that you're from XXXXXXX (great place for runners, no?) and you happen to be in the proximity of some of the greatest academicians and clinicians in the country, maybe some of the top in the world who are very capable of taking a problem such as this and helping folks such as yourself metamorphize their emotions and skills of observation into more commonly encountered inner feelings that can take care of your business IN THE BACKGROUND quietly, swiftly....without really UNNECESSARILY alerting you to anything you don't really need to know about. Does that sound like something you can resonate with....or am I just Whistling Dixie (ever hear that expression? LOL).
So, please consider what I've said and count the number of words and lines I've spent in the last group of messages to see that I probably have said more about treating the HEALTH ANXIETY component of what brought you to us in the first place than very much about disease processes that you really have no cause to worry or think too much about....UNLESS....you are simply interested in knowing details about as opposed to WORRYING about! Yes?
As always, your POSITIVE CRITIQUE of my responses with generous feedback along with a 5 STAR rating would be MUCH APPRECIATED as well as CLOSING of the QUERY if there are no further questions or comments you would like to pose at this time.
You can always reach me on this platform by going to my URL of www.bit.ly/drdariushsaghafi and directing your questions about this or any other medical topic directly to my attention.
This query has required 157 minutes to research, investigate, and prepare a response.
You are very welcome
Detailed Answer:
I am happy to answer questions and would've told you whether or not something didn't seem right about your situation. The fact that you have noticed the twitching becoming as frequent as once every few minutes tells me that it is tied and directly related to your levels of stress and anxiety which is a very common and strong triggers for myotonic twitches. The rest of what you read is not going to impact the diagnosis since you do not have motor neuron disease based on at least this detail.
In fact, I'm going to go out a bit on a limb and say that not only is this fact of increasing frequency of twitching a big strike against anything having to do with demyelinating or motor neuron disease but so is the NORMAL NEUROLOGICAL examination you had several months ago and the one you are HIGHLY LIKELY to have this week. :)
Now, for the question of the evening if you can stand me suggesting it but again but truly I really REALLY believe that if you were act on this 1 suggestion over any other you would be taking true steps FORWARD in order to finally beat this problem that you have already identified of HEALTH ANXIETY.
You really want (and need) to REEL IN and conquer your anxieties over the unfortunate backdrops of family and friends you've seen or lost who have tragic circumstances and learn how to understand what they have WITHOUT transferring their symptoms of health troubles into your body based on normal physiological happenings which are as far removed from their problems as our solar system is removed from the next closest one in the universe that has life similar to ours! Make Sense?
Otherwise, good sir you will likely be asking these same questions and worried about the exact same symptoms in a few weeks or few months from now once things have settled down but then, for some reason get "jacked up" again (using the vernacular of some of my YOUNG RUGBY TEAMMATES! HAHA). I understand the pattern that you are manifesting because it is common and logical given how human EMOTIONS interface with the LOGICAL ANALYTICAL BRAIN. You know what I mean? It is almost a 100% foregone conclusion that unless an individual KNOWS HOW to temper their emotions and filter out what's important from what's not to one's health....that the emotional side of the equation will take over the "conversation" that the LOGICAL BRAIN is trying to suppress but eventually cannot overcome......leading to this phenomenon of "runaway" worst case scenarios that play around and around in a neverending cycle.
There are experts and methods of lassoing all of this in and giving it its due importance.
By the way, it appears that you're from XXXXXXX (great place for runners, no?) and you happen to be in the proximity of some of the greatest academicians and clinicians in the country, maybe some of the top in the world who are very capable of taking a problem such as this and helping folks such as yourself metamorphize their emotions and skills of observation into more commonly encountered inner feelings that can take care of your business IN THE BACKGROUND quietly, swiftly....without really UNNECESSARILY alerting you to anything you don't really need to know about. Does that sound like something you can resonate with....or am I just Whistling Dixie (ever hear that expression? LOL).
So, please consider what I've said and count the number of words and lines I've spent in the last group of messages to see that I probably have said more about treating the HEALTH ANXIETY component of what brought you to us in the first place than very much about disease processes that you really have no cause to worry or think too much about....UNLESS....you are simply interested in knowing details about as opposed to WORRYING about! Yes?
As always, your POSITIVE CRITIQUE of my responses with generous feedback along with a 5 STAR rating would be MUCH APPRECIATED as well as CLOSING of the QUERY if there are no further questions or comments you would like to pose at this time.
You can always reach me on this platform by going to my URL of www.bit.ly/drdariushsaghafi and directing your questions about this or any other medical topic directly to my attention.
This query has required 157 minutes to research, investigate, and prepare a response.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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