New and concerned

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New and concerned

Postby twitchette on October 28th, 2002, 12:26 pm

Hello all... I am a 24 year old new mother. My son is now 5 months old (23 weeks) and I am having extreme fatigue! I am curious as to what is causing it. I am twitching mainly in my left toe, however they come from every place, most strangely my backside and the other day even a stranger more personal place! :shock: I do seem to feel as though my calves are extremely tight, as well as numbness in my toe. I can still feel it as well as feel when someone touches it, but there just seems to be a strange blah feeling in it. I am starting to feel as though my left hand is slightly weak in the fingers. Mainly because of what feels like clumsiness. I do seem to be dropping things, but I am able to do the normal things with my fingers. I am constantly testing there strength, and so far they seem normal. I can still type at a normal pace. Today the twitches seem to be gone, so now I am scared that they are gone. I am petrified of ALS. MS doesn't really alarm me, maybe it should. I had a Sinus infection for 12 weeks before all of this began, and at first my MD did a CAT scan just to ensure that there was not a tumor. There wasn't. I went back to my regular doctor and asked and she said that living in a new place with a baby I am taking care of with out help except when my husband is home, could very well be enough to make me tired and twitchy. She took a ton of blood work and said it was nothing and perscribed Paxil. Should I be worried about ALS? My husband thinks I am nuts. My doctor apparently thinks I am nuts, so am I??? She said that a neurologist would probably laugh at me, but I am going CRAZY! My son NEEDS his mother. I cant even imagine leaving him or my husband. The thought alone makes me want to vomit. I swear sometimes I feel like I am losing strength, though no one seems to agree when I ask if I can squeeze their hands to compare my strength. Anyway, I will stop rambling. Do any of you have any thoughts?? Thanks for your help. Rebecca

Postby Davidd on October 28th, 2002, 1:54 pm


It seems like a number of things are going on with you.

1. You're tired and your worried about it. How has your sleeping been? Sometimes the stresses of life (from all sources) cause sleepless nights which turn into sleepy days.

2. You mentioned that you have twitches in your toe and some other places...but then you said that the twitches are gone? If they're gone, don't be worried, be happy! I hope I can have even one day where I have no twitches!

3. The tight calves and numbness are also strange sensations that you're concerned about. If it makes you feel better I have had that same "blah" feeling in my toe. In fact I had it in my whole foot which is one of the reasons I first went to see a neurologist this past July.

I am no doctor and am clueless when it comes to these things...and it is all probably nothing...but, here's my opinion regarding your doctor's comment when you asked to see a neurologist---your doctor said the wrong thing. First, a neurologist is not going to laugh at you. Second, with the variety of symptoms that you are experiencing, what's the harm in getting checked out by one? Third, when the neuro exam turns up nothing serious this may make you feel better and perhaps your anxiety regarding ALS will go away. To me, seeing a neurologist is a much better choice at solving these problems.

That said, I am a 28 year old who can be very opinionated! You have to do what's best for you. My bet is that your perfectly fine...but if the symptoms don't go away in a reasonable amount of time, you should see a's your life and the choice is up to you. If you need a referral (insurance reasons) and your doctor won't give you one, then find a better doctor who will. Part of being a good doctor is dealing with the emotional side of people and some doctors obviously forget about this part of their profession.

Good luck and let us know how things work out!

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Postby Twitchette on October 28th, 2002, 2:43 pm

Thanks for your reply. I do think that going to a neurologist may be the thing to do, but my husband does not want to spend the money on what he calls rediculous tests. I guess if I press it he may reconsider, but there is a part of me that is scared to go. I know that sounds crazy and oh so immature, but I am just frightend. I still wake up in the night with a difficulty breathing, rapid pulse, sweating, twitching, etc. I just think the wait to get in would kill me alone. Anyway, I am working at talking myself into it. SLOWLY but steadily. Thanks again for your reply.

What to do?

Postby Davey on October 28th, 2002, 3:06 pm

Rebecca -

As a new parent, you are under tremendous stress. I am not a doctor, but what you are describing sounds like acute and generalized anxiety disorder (GAD). I was a GAD sufferer just after my first child was born 8 years ago too, so I have personal experience. I woke up in the middle of the night, heart pounding, sweating, etc. I've been there!

First, the average age of onset of ALS is 55 years. The disease is rare (1 in 100,000) and even rarer is the onset in the 20's. Most cases of early onset are familial ALS and caused by a genetic problem. If you have no prior history of ALS in your family, then it is unlikely.

Second, the presenting symptom for ALS is profound weakness. Fasciculations are late symptoms. It is about a one-in-ten million occurrence for fasciculations to occur before weakness (like winning the lotto, except you don't want that ticket! :) ).

Third, ALS typically starts in a hand or foot and spreads, asymmetrically. Generalized, widespread twitching is not indicative of ALS.

If you had ALS, your doctor would have picked it up in the routine neurologic exam (reflex testing, strength testing, etc.) that they do. However, you sound like you need reassurance, and hopefully this will help. If not, try to see a neurologist. Even if you don't have an EMG, having an "expert" on the nervous system examine you can still be beneficial to providing the reassurance you need. Good luck and God bless.

Now, stop obsessing about this and get back to your baby and husband and give them a big kiss! :D

Remember: Do not fear death tomorrow so much that you forget to live today!
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Postby Twitchette on October 28th, 2002, 3:28 pm

Thanks, you made me feel a little bit better. I did not know that most people with early onset had familial ALS. That does make me feel atleast a small sense of relief. One other question does ALS ever go from left side to right? Mine is centered right now in both my left hand and left foot. Thankfully I don't notice any weakness yet anyway. I do appreciate your response. Any reassurance is definently helpful.

I can relate...

Postby fellowfasciculator on October 28th, 2002, 5:27 pm

Your symptoms sound so familiar to what I have been experiencing off and on for several years now. Things definitely get worse when I'm dealing with a lot of stress. My husband took a new job last year that required him to be out of town very often. Not only was this generally stressful, but I also had the added responsibility of taking care of the house and our two children. This type of stress made my twitching - varied in place and intensity - increase. My MD says stress and fatigue commonly increase these types of twitching. He ruled out ALS without any significant test for several reasons - twitching was the first symptom (very rare), no weakness other than associated with fatigue (profound weakness as Davey says for ALS), and no increased problems over time (I had twitching with nothing else for several months before even seeing him). ALS is very progressive and unrelenting. It doesn't come and go. It starts in an area and progresses systematically. Some of the other people here may have more to say. I never write anything, but your story sounded so similar to mine. I understand your worries and I hope you understand many of us have your symptoms with no major health problems. I'm mad because I can't get my MD to give me any happy drugs. Sure would help sometimes with two kids running around.


Postby Davey on October 28th, 2002, 7:49 pm

ALS progression is typically asymmetric, starting on one side and then going to the other.

:arrow: That said, my BFS started on my left side and spread to the right. It is also more severe on my left side. The parasthesias and twitching are much more pronounced on my left side. Is this a normal progression in BFS?????? I would gather a resounding YES :!:

You need to relax, take a deep breath, and then be thankful that you have a benign, (albeit extremely annoying) illness. :lol:

Paxil is a "happy drug" and should help to reduce your anxiety. However, your response to it might warrant a higher dosage or even a change to Celexa, Zoloft, Wellbutrin or other SSRIs. Beware, though, that during the initial 8 weeks of taking SSRIs your anxiety typically GETS WORSE before your body adjusts to the medicine. Your BFS can even be exacerbated during this period. I was on Celexa and even though it is one of the better tolerated SSRIs, I still had the nasty adjustment period. :shock:

Also, remember that if you are nursing, some medications can pass through the milk to the baby. :!:
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Postby SusanSid on October 29th, 2002, 3:18 am

After reading these series of postings, I just had to respond. As like everyone else, I am not a doctor, but I am a nurse and have worked in maternal child health for more years than I'm willing to admit. :lol:
What strikes me as curious with your post Rebecca, is that you have the classic symptoms for post partum depression and/or hypothroidism. The post partum depression is common following birth, but can be more serious for some moms. Many get by without any intervention, while others may need therapy, some need a mothers group, some need
Something that many people don't realize is that new moms are at much higher risk for thyroid problems. We aren't sure why that is, but the rates of hypothyroid are about 18%, some feel higher, the first year after giving birth. Many times this is contributed to "post partum blues" and anxiety, when in fact their thyroid levels are out of wack. INSIST on a TSH, T4 and a thyroid antibody level. Any current, up to date doctor, will do this in a second given your symptoms. I'd try your GYN first...just to rule it out.
So where am I going with this? Abnormal thyroid production, especially hypothyroid can cause muscle cramping, anxiety, depression, poor sleep, fatigue, muscle weakness on and on.
Hope this helps. Just get this ruled out before jumping to the neuro. Not trying to be a know it all, just trying to help a new mom.
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Postby Guest on October 29th, 2002, 11:15 am

Thank you all for your responses. I really appreciate the reassurance. I hope if everything does in deed turn out to be benign that in time maybe I can give others a sense of calm as you have extended to me. Though the worry is always there, it does feel good to hear from people with my symptoms and no major disease!
Susan, I thought at first it sounded like thyroid too. Unfortuneately, I have already been tested for it, and no such luck. That one would be an easy fix, but my levels are normal. As for depression, I think my problem falls more on anxiety than depression. I don't feel sad. I have never felt happier than when holding my baby. Some people are born to be doctors, lawyers priests, etc. I was born to be a mother. I love it. Not to say that it is the least bit easy, but I LOVE IT. I too am a nurse(well I was until my son was born), and have seen quite a bit of post partum depression. It is very common, I think I may have had the "baby blues" my first couple of weeks while my hormones were evening out, but now feel very content at the exception of the anxiety that I have some horrible disease. My husband simply thinks the term nuts covers me pretty well. I make him do neuro exams on me constantly. He says he thinks he should convert from a lawyer to a doctor. :)
Davey, I do appreciate your time, and do feel calmer. Not totally but better, by the way, you would be amazed how few people I have had tell me to watch out for the drugs passing into my son. I think that is great. My doctor didn't even tell me to wean. Fortuneately because I was a nurse, I knew that SSRI's and nursing don't mix, but that is helpful information. I really appreciate you bringing that up.
Fellowfasciculator, I can not imagine having my husband out of town with two children. I would kill him. I have the upmost respect for you. I truly love being a mother, but when you don't feel good and have very little help, you feel as though you are being drug through the dirt. Thank you for your response. I appreciate all of you!



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