Health Provider - Fear of ALS

[Bahbah]

First and foremost, I want to express my gratitude to the moderators for their unwavering support and guidance, especially in times of uncertainty and fear. Your dedication truly makes a difference.

Allow me to introduce myself—I'm a physician, but just like many of you here I understand all too well the challenges of battling health anxiety. Despite our training and knowledge, our minds can still play tricks on us, especially when it comes to our own health.

My journey down this anxiety-ridden road began recently, on 4-12-24, during a late-night work session. It started innocently enough with a slight twitch in the corner of my left eye. Brushing it off as fatigue, I thought little of it until a few days later when I noticed fasciculations in the tip of my tongue. As a medical professional, I couldn't help but let my mind wander to the worst-case scenario—ALS.

To make things worse, the casual off the cuff comment of a colleague only fueled my fears, “It’s probably ALS”, and I found myself immersed in a sea of internet searches and self-diagnosis. Every new symptom seemed to confirm my worst fears, and before I knew it, generalized fasciculations plagued my body, leaving me in a state of perpetual anxiety.

Despite my rational understanding of the situation, the physical manifestations of my anxiety persisted. Muscle relaxers, magnesium supplements, meditation—I tried them all, but the relief was fleeting. Even now, as I write this, the quivering of my left eye serves as a constant reminder of my turmoil.

I know deep down that I need to consult a neurologist for peace of mind, but my busy schedule presents a significant barrier. Rescheduling would inconvenience countless patients, and I can't bring myself to prioritize my concerns over theirs.

Rationally I know, if this is anything, it is benign fasciculation syndrome (BFS). I think the reassurance of those that have walked this path may help and I apologize if that comes across in the wrong way.

Thank you in advance.

 

[Nikki J]

Your colleague is an idiot. Or just a cruel jerk. What a thing to say. And wrong of course. It is probably bfs as you say.

But you need to see a doctor to get checked out. You never have a weekday off? Or a half day? No wonder you twitch.

Make an appointment and take those patients and squeeze in one a day. Come in early or stay late if need be. Tell your staff that if there is a cancel on those days don’t fill it except with your reschedule list

 

[Bahbah]

Thanks, I think I am just going to have to do what you say as until I get peace of mind, I am afraid this is just going to continue. Honestly, you probably know more about BFS than I do speaking with so many people, but does it normally occur so rapidly? I've read that there is thought that it could be due to a virus, which I am exposed to daily. I guess I just needed some reassurance before I see the Neurologist. To make matters worse, my friend that is a Neurologist, just closed his practice in town and so I'll have to go out of town to find one. I've thought about asking him about what he thinks, but I know how that feels to get a long list of symptoms text to you and you just want to respond "make an appointment." Once again thanks for your response and all that you do.

 

[Nikki J]

Absolutely bfs can come out of nowhere.

Good luck get started on the scheduling bit today

 

[Nikki J]

Should add if you are 50 plus an emg is usual even if there is nothing more than twitching

 

[KimT]

Until you are seen, you might want to cut down on caffeine and try to get more sleep. Widespread fasciculations point away from any form of motor neuron disease. Even though they're benign, you might be doing something or a combination of things that are causing them.

 

[lgelb]

Once benign eye twitches start, they can take weeks to resolve even if you do everything right as per Kim's suggestion -- and I would add hydration and nutrition to the list. And Genteal mild/moderate eye drops morning and night.

 

[Bahbah]

Nikki, I am 41, I am just on the cusp of the average age for ALS, so I know this is an unlikely diagnosis. Kim, I have SVT, so I don’t consume any caffeine or alcohol and try and stay well hydrated. Despite my efforts in this regard, last night was particularly challenging for me. I woke up at 4:00 am with my left bicep having fasciculations that then led to fasciculation over my entire body. I took a warm bath and they seemed to subside.

At times I manage to rationalize my fears, but when the fasciculations start up it seems that my body responds with intensified fasciculations, almost as if I'm gripping a live wire at times. The twitching seems to hop from one muscle group to another without warning. From my left pectoralis muscle to my right hamstring, and even the muscles of my face, the twitching appears to be spreading.

Throughout this ordeal, my left upper eyelid continues its sporadic twitching, albeit with reduced intensity. Lgelb, I use eye drops daily and have also tried magnesium and tonic water without much benefit. I recognize that these symptoms likely stem from a combination of health anxiety and benign fasciculation syndrome (BFS), although I'm not certain if research has elucidated the exact relationship between the two.

While I eagerly await my upcoming appointment with Neurology, the prospect of several more weeks of uncertainty weighs heavily on me. Despite understanding that rapid, widespread fasciculations generally rule out ALS, the grip of health anxiety is undeniably suffocating—even for someone in the medical field.

There's also an underlying perception that struggling with anxiety somehow diminishes one's ability to be an effective physician, adding an additional layer of stress to the situation. It's a vicious cycle, and I feel myself spiraling deeper into it with each passing day.

I apologize for the frequent postings; I recognize that this forum serves as my outlet during these trying times. Your support and understanding mean the world to me, and I'm incredibly grateful for all that you do.

Thank you for listening and for being a beacon of support in my journey towards peace of mind.

 

[Nikki J]

My comment about age was because the twitch first group of PALS which is tiny to begin with is almost entirely sod1 FALS and males over 50

There are a number of bfs groups around on facebook and reddit

 

[Nikki J]

You might like reading this The perils of being your own doctor | Mert Erogul

 

[Bahbah]

Nikki, I actually have read that article and it resonated greatly with me. It is almost a play by play of what I am going through.

 

[Nikki J]

I hope. You find it comforting FWIW I can recall several MDs, several med students, several nurses and at least 1 PA who have posted in this subforum. I do not remember one who actually turned out to have ALS

We have had a few PALS from these categories but they all arrived after diagnosis

 

[Bahbah]

I went to see my PCP yesterday. She does not see anything worrisome and thinks all my symptoms are anxiety driven. She placed me on a SSRI and also did some neck and back manipulations that she wants me to come and have done every day during lunch. Thank you guys for all your help and support.

 

[Nikki J]

Sounds good. Best of luck to you