Might be time to consider a new primary. I know people talk about the difficulties in finding a specialist, but honestly I have the most trouble finding primary care. After all they're supposed to be the first stop. You really need to trust them and believe they actually care. (Most specialist you can believe they actually care about getting paid and won't waste their time if you're not in their niche market)

But a good PCP can make a world of difference. I'd take a good PCP and a terrible specialist any day over a terrible PCP and an awesome specialist. My neuro and I have a 'working' relationship. My PCP and I feel like family. About the only specialist I've ever been like that with was my pain management doctor.

Even if the PCP has been great in the past, if it feels like you're just too far over their head, it might be time for a change. I outgrew my old PCP, having far too many problems for him to keep up with. It happens. He was great for strep, bronchitis, skinned knees and even the odd broken bone, couldn't find a better doctor to explain 'healthy' living. But beyond 'healthy' individuals falling afoul of the numerous chronic diseases, disorders and various assorted dysfunctions of health, he was lost and would fall back on psychologists rather than send you to a different MD.

For him, if it didn't show on an X-ray or appear in a culture dish, it must be in your head, or you just weren't eating healthy, getting your 6 hours of sleep and/or exercising regularly. Sounds terrible, I know, but he really was great... Until he wasn't, or more to the case I wasn't... And though he liked to send patients up river to the funny farm, he never 'accused' them of being crazy, just felt that the stresses of life could be too much for some people, and what a shame it was they could become physically harmed by it.

So I found a new PCP who was more understanding beyond the 'normal' scope of 'healthy' people and cried buckets of tears when he left town. But thankfully after very few attempts and trials by fire I have my latest PCP and his wonderful nurse practitioner and we get along famously. So much so that even though my other doc has since returned back to town I haven't switched back.

So it's okay to shop around, you aren't married to your PCP, it isn't considered cheating, feel free to put yourself out there in the market and find someone new to settle down with for a bit.

I'm actually going to see my primary care doctor tomorrow. My mom actually had to go see him yesterday. She told informed him of what was going on and was stunned. He wants to see me. I have an appointment Thursday. I've been seeing physical therapy. My range of motion in my neck is back and no experiencing any burning or tightness. My hands are still a little shaky and tremory. Usually my hand or arm shakes when I go to place something back down. Sometimes I have to do it slowly. I woke up a couple of nights ago and my left arm felt like it was on fire. I shrugged it off and went back to sleep. I woke up and three of my fingers had no feeling. It scared me. After a few minutes of movement I regained feeling. Yesterday the same arm was giving me problems. Today It feels ok..my right arm feels weaker today. Although, my physical therapist said my strength in my right arm was 85% when I started back a few weeks ago. She said it's in the 90's now. Just so I don't cause any confusion.. I'm seeing two physical therapist in the same office. One for spine and one for strengthening as my orthopedic doctor told me I had tight leg and back muscles thinking that was causing some of my issues. My strengthening therapist doesn't seem to think it's all muscle.. she believed most of my issues were neck related. My spine therapist told me all of my symptoms, (dizziness, off balance, arm issues, neck range of motion, back spatial/hand coordination) was all due to neck mechanics. She practically plead with me because she I had a feeling I had a hard time accepting that. "This is very common with people who lift weights and work at a desk. You just need to change your lifestyle a bit..stretch more..watch your posture..and you'll be fine." I have VERY good posture..so I didn't believe that was the reason. I saw my muscle/strength therapist the other day and she said she was seeing very good improvement with strength. My right side was at 85% and she said now it's in the 90's range. I went last week. I did better. Dizziness was minmal..but my arms were shaking. I also did some weight machines at the therapy center with my physical therapist and my arms were shaking a little doing over head exercises. She told me not to worry. She thinks it's because I have done any overhead lifting in a few months. She tells me she think's I'm almost good to be discharged. I don't feel it. My right leg is still cramping and a little week.. occasionally my left leg gets weak. My muscle/strength therapist I could tell was originally suspecting ALS. She was asking me questions such as, Are you having issues opening doors or turning keys, are you having any issues buttoning up a shirt. She asked me to stand on my toes which I have no problem with. My last visit I told her I was starting to suspect ALS. She laughed and said, "Why?" I told her my symptoms and she said, "You have nothing to worry about." While doing some of my exercises in front of her.. I was shaking. While doing leg raises laying on my stomach I could barely do 10 with my right leg and did fine with my left. She said that, "could very well be due to lack of strength and mobility in your lower back and tightness in that leg." I'm really scared I may have the beginnings of ALS. I told my therapist I was even getting numbness and tingling in my face. She said, "That's all related to the neck nerves. You'll begin to see improvement especially since your range of motion is back." Maybe I'm just anxious and need to stay off of the internet. But I do truly believe I still have a problem. I've never felt like this is my life. When I went from being active EVERYDAY to never working out, that's a red flag for anyone. My neurologist suspected MS, but the MRI was clean. I had dizziness and facial numbing so that would definitely show up on the MRI if that was the issue. I don't know anymore.. does it sound like ALS?

Hi Dude! Could you put spaces between your text/paragraphs? For some of us MSers, it's hard to read when there are no breaks in the text. I'd like to respond and help if I can and others may feel the same way.

I'm actually going to see my primary care doctor tomorrow. My mom actually had to go see him yesterday. She told informed him of what was going on and was stunned. He wants to see me. I have an appointment Thursday. I've been seeing physical therapy. My range of motion in my neck is back and no experiencing any burning or tightness. My hands are still a little shaky and tremory. Usually my hand or arm shakes when I go to place something back down. Sometimes I have to do it slowly.

I woke up a couple of nights ago and my left arm felt like it was on fire. I shrugged it off and went back to sleep. I woke up and three of my fingers had no feeling. It scared me. After a few minutes of movement I regained feeling. Yesterday the same arm was giving me problems. Today It feels ok..my right arm feels weaker today. Although, my physical therapist said my strength in my right arm was 85% when I started back a few weeks ago. She said it's in the 90's now. Just so I don't cause any confusion.. I'm seeing two physical therapist in the same office. One for spine and one for strengthening as my orthopedic doctor told me I had tight leg and back muscles thinking that was causing some of my issues. My strengthening therapist doesn't seem to think it's all muscle.. she believed most of my issues were neck related. My spine therapist told me all of my symptoms, (dizziness, off balance, arm issues, neck range of motion, back spatial/hand coordination) was all due to neck mechanics. She practically plead with me because she I had a feeling I had a hard time accepting that. "This is very common with people who lift weights and work at a desk. You just need to change your lifestyle a bit..stretch more..watch your posture..and you'll be fine." I have VERY good posture..so I didn't believe that was the reason. I saw my muscle/strength therapist the other day and she said she was seeing very good improvement with strength. My right side was at 85% and she said now it's in the 90's range.

I went to the gym last week. I did better. Dizziness was minmal..but my arms were shaking. I also did some weight machines at the therapy center with my physical therapist and my arms were shaking a little doing over head exercises. She told me not to worry. She thinks it's because I have done any overhead lifting in a few months. She tells me she think's I'm almost good to be discharged. I don't feel it. My right leg is still cramping and a little week.. occasionally my left leg gets weak. My muscle/strength therapist I could tell was originally suspecting ALS. She was asking me questions such as, Are you having issues opening doors or turning keys, are you having any issues buttoning up a shirt. She asked me to stand on my toes which I have no problem with. My last visit I told her I was starting to suspect ALS. She laughed and said, "Why?" I told her my symptoms and she said, "You have nothing to worry about." While doing some of my exercises in front of her.. I was shaking. While doing leg raises laying on my stomach I could barely do 10 with my right leg and did fine with my left. She said that, "could very well be due to lack of strength and mobility in your lower back and tightness in that leg." I'm really scared I may have the beginnings of ALS. I told my therapist I was even getting numbness and tingling in my face. She said, "That's all related to the neck nerves. You'll begin to see improvement especially since your range of motion is back."

Maybe I'm just anxious and need to stay off of the internet. But I do truly believe I still have a problem. I've never felt like this is my life. When I went from being active EVERYDAY to never working out, that's a red flag for anyone. My neurologist suspected MS, but the MRI was clean. I had dizziness and facial numbing so that would definitely show up on the MRI if that was the issue. I don't know anymore.. does it sound like ALS?


There ya go

Thanks!!!

First of all, I'm glad to hear your MRI was normal. That's a good sign.

Nerve irritation doesn't sound too far off and may possibly be what is going on. It can take a while for things to calm down. So give yourself some time and don't try to rush it. Work SLOWLY to going back to your normal activities. Maybe find another form of exercise other than weight lifting for the time being since that seems to irritate things for you.

Muscle spasms and tightness can irritate the nerves as well and visa versa. Your muscles or nerve may not be ready for the strain that you are putting on them.

Have you tried heat and ice? Alternating? Any kind of muscle rub/arthritis cream? A nice soak in an Epsom salt bath may help as well and they make Epsom salt cream that you can buy that works well too. The magnesium can help relax the muscles.

Also, have they used a TENS unit on you to see if that brings relief? (I love, love my TENS unit.) There are medications that can help bring relief as well. I'm not sure what you have tried. For nerve pain, there is not much that helps. I take gabapentin for nerve pain and have had success with it. Others have tried Lyrica and other meds used for epilepsy.

Are you still doing the massages? I get what is called the MS hug. My intercostal muscles spasm due to nerve damage caused by a lesion in my spine. I started getting gentle massages 2 to 3 times a week. It took a year for things to calm down and for me to get the full benefits of relief.

As for posture, when we're in pain, our posture is always off. We tense up areas to compensate for the area that is hurting trying to protect it, as I think Starz mentioned. I can shrink a couple of inches when I am in pain. My gait can be off when I am in pain. My shoulders, neck, etc all tense up and create posture issues and more pain when I am hurting. It's just part of being human. Try learning some breathing techniques for relieving pain. Well, they may not take all the pain away but they can help you refocus and by doing so it can lessen our perception of pain.

Give yourself some time to heal. It really can take a few months to heal from an injury to the body.

Let us know how it goes at the doctor tomorrow.

Wow... Take a deep breath.... You have a lot of fears, and yes the Internet is a great place to fuel them... ALS would have shown on the MRI, it has a very distinct butterfly type pattern that would not have been missed or confused.

And yes, your PTs are correct, many of your symptoms appear to have known causes. It'll be okay, even if it isn't, you are being proactive in your care. However, you should listen well to the PTs concerning increased stretching and a slight modification to your current lifestyle.

Also posture is probably one of the few things that PTs will harp on their patients about whether they're there for a back issue or a sprained pinky. And many times what we think of as good posture (we don't slouch, we stand up straight...) isn't always the indicator. As a weight lifter I'm sure you've been reminded numerous times about your center of balance. Good posture is the ability to carry that over into everyday tasks and activities. Not leaning forward to read from the computer screen, desk and chair heights properly set to ensure arms can hang comfortably and properly while typing.....

So take a deep breath again, calm down, we're hear for you if you need some reassurance.

Thank you Starznight. I was under the impression that ALS doesn't show up on an MRI. I've read an EMG will give you a definite diagnoses. (As an clean MRI doesn't necessarily mean you don't have MS..but since I had head symptoms.. that would show on the MRI.)

You might have misread about the EMG. EMG tests are checking for PNS (peripheral nervous system) disorders, while MRIs of the brain and spine are checking for CNS (central nervous system) disorders.

While it may not seem it, there's a huge difference between the two even if the symptoms appear identical. And it's more than simply peripheral nerves being those that run throughout the body, and the central obviously being the 'hub' through which they communicate.

The central nervous system has one additional factor being the blood/brain barrier which is supposed to protect it. Outside of traumatic injury, almost all CNS disorders are autoimmune.

The PNS doesn't have any protection so to speak, aches from a cold are in a way a PNS disorder, but so are pinched nerves, scarring and the like, and it does have some of its own autoimmune diseases.

But for the CNS, it pretty much has to be autoimmune, trauma or spinal meningitis and like viruses to cause, nervous system issues stemming from the CNS. If it's autoimmune the only way to dx a CNS disorder is through MRI, CT scan and/or blood tests including the ever popular spinal tap.

It's next to impossible to dx PNS disorders from an MRI or CT scan, so doctors use EMG tests to see the health of the muscles and the strength of their signal to the CNS.

ALS, MS, Parkinson's, even Alzheimer's are CNS disorders and will likely show on an MRI, sometimes small lesions in MS can hide between the cuts or are only present in the spine, but still can be found on MRIs.

Hope this helps some

ALS affects both upper and lower motor neurons. The three people that I have know that have had it all started with difficulty with their hands and speech and/or swallowing. Weakness and spasticity were also symptoms they had. For one, it was the slurring speech that finally made him go to the doctor. I think that your neuro would have identified some abnormalities during the neuro exam that would suggest ALS. There is an ALS forum on NT that you can check out and ask questions about the initial symptoms they had.

http://neurotalk.psychcentral.com/forum6.html

Thanks for the insight everyone. I guess since my MRI waz good I shouldn't worry. After doing more research (I swear to god google is going to drive me insane) it seems like my leg symptoms may be BFS. I can see the twitches in my legs. From what I've read..with ALS you cannot see the twitches. I have twitching in both legs..my left leg is slightly weak/achy and ny right leg is twitching like crazy and weak/achy. Can anyone confirm that? I'm no longer having any serious range of motion issues in my neck after doing my therapy exercises for a week.