hello i am a 39 year old male EMT, i am having some concerning symptoms that might lead me think i could have ALS. i am having uncontrollable muscle twitching in my face on the right side under the eye, uncontrollable muscle movement and shaking of the right and left hands that at points require me to use my other hand to help control the affected hand to perform simple tasks like using a mouse. i have difficulty in swallowing and a constant feeling of choking or a blocked airway when i finish eating to the point that it often triggers my gag reflex and i vomit. severe back and neck pain most days visual disturbances, and painful eyesight, 1 syncope episode, dizziness that is chronic. and a generalized feeling of exhaustion and lack of sleep even when i sleep for 8 hours or more. i am not having any issues with the low extrimites except for pain which is present in both due to preexisting injuries.