My issues started on January 3rd 2015, And here are the Symptoms:

1- My face, mouth and jaw gets stiff and tight for hours. Lay downing helps sometimes. when i am talking, sometimes i just don't know what to say and i have to stop think about what i was saying and than talk. Its like i am talking and all of the sudden i have to stop or i forgot what i was talking about. Or don't know what to say next. Its like words might be coming out a little harder or Harder to pronounce. Sometimes I notice I my face is trembling/shaking

2- My tongue has this buzzy sensation, its not twitching. Maybe more like ZAPS. Sometimes i feel like my tongue is growing in size. This way i will bring my tongue out of my mouth to see if its bigger or smaller and i try to check the movement of the tongue. My tongue feels Sore or weird. I am biting my Tongue more often, and it feels soar and has a lot of cuts on it.

3- My hands feel clumsy especially right hand and sometimes I get pain and cramps, other times it moves to left hand. sometimes this same, cramps feeling happens to my palms or wrists. Hands/fingers feel stiff and clumsy. When I am typing on keyboard i type a lot of words wrong only to hit back space and do it again, I am starting to notice this happening more and more. This clumsy/stiffness feeling just feels weird. Both my hands are Trembling and Shaking a lot sometimes

4-- I get random twitches throughout the day on different parts of my body. Sometimes its thighs,joints,calf,triceps,lips,tongue,under my jaw around throat. These twitches are real and easy to feel and see but are not persistent, so it can last for 2 minutes or 2 hours

5- I notice that the tongue makes more saliva or maybe I am focusing too much on it, but even when i don't focus on it sometimes it still makes too much saliva IMO. I am always swallowing or trying to swallow it or spit it out. I am saying words wrong and biting my tongue and inside of my cheeks a lot, And overall my swallowing doesn't feel normal


6- Sometimes Back of my head hurts, also while hurting it feels stiffness and tightness, this same feeling goes to mouth,jaw,neck and throat area

7- Feeling weakness in Legs, Joints, Arms, and pain in both legs numbness and tingling feeling in my feet, burning sensation in my feet, than at other times my feet felt so cold and numb especially around Toes. Cramps in Feet, legs, Calf and both hands

I am really worried about Bulbar Onset
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Lap work done

Clean EMG of both arms and legs. By spots i mean how many different area the needle was inserted in. The Neurologist who did the EMG has 46 years of Neurologist experience but he isn't ALS specialist. but he said he has done enough and seen enough cases of als during EMG and otherwise

4 spots on right legs
3 spots on left leg
3 spots on right arm and
5 spots on left arm

None was done around Bulbar region.

A Barium Swallow test was done and ENT said it was normal

She also put a Camera through nose to check back of throat and that was normal too. She said i have LPR(Laryngopharyngeal Reflux) Symptoms for LPR are very similar to ALS swallowing issues or bulbar issues

Symptoms of LPR from WebMD:
With LPR, adults may have heartburn or a bitter taste or burning sensation in the back of the throat. But they are less likely to have such classic signs of GERD. More often, symptoms in adults are vague and may be easily confused with other problems. The most common symptoms include:
• Excessive throat clearing
• Persistent cough
• Hoarseness
• A "lump" in the throat that doesn't go away with repeated swallowing
Other symptoms may include:
• A sensation of postnasal drip or excess throat mucus
• Trouble swallowing
• Trouble breathing
• Sore throat


Other blood work:

Vitamin D was 11.3(normal range being between 30-80)
my Vitamin B12 was 218(200-900 being normal range)
A1C(blood sugar test) 6.0(normal range is 5 to 6.4
wbc 12.3(normal 4-10.5)
RDW 16.1 H(11.5-14 normal)
segmented % 76.6 H (42-74 normal)
segmented # 9.4H(1.70-6.70 normal)
monocytes% 4.2L(4.50-12.30 normal)
bilirubin, total 1.5H(0.3-1.0 normal)
GGT(GGTP)71H(9-64 normal)
LDH 116L(140-271 normal)
(FT4 INDEX)CALE 5.1h (1.1-4.6 NORMAL)
TSH 3RD GENERATION 6.520h(.0340-5.600 NORMAL)
VITAMIN D25 HYDROXY 11.3L(30-100 NORMAL)

In total i have seen enough doctors for a lifetime

4 Neurologists in New orleans and 1 with 50 plus years of experience and his specialty was bells pasly other with 46 years of experience and 2 other in 20 plus years of experience

2 neurologists in Pakistan
1 Neurosurgeon in Pakistan(even though it wasn't his field he still did a minor physical of bulbar region and said everything is good)

4 ENT's but only one of them i saw for ALS, and she is the one who did the swallow test and put camera through nose among with physical examination

one GI doctor and been to Er twice

seen my PCP twice for als fears and once for swallowing issues

Each and everyone of them said its anxiety and prescribed medicine
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most of you read will think what can we say to convince you that the doctors who have been trained to figure this stuff out hasn't been able to do


so any feedback will be appreciated

Thanks, i recently got married on october 18th, 2014 and thought of leaving my wife has me so scared

what do you guys think?