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Ask Dr. D. Love Your Own Question
Dr. D. Love
Dr. D. Love, Doctor
Category: Neurology
Satisfied Customers: 17514
Experience:  Family Physician for 10 years; Hospital Medical Director for 10 years.
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I am not sure how this works. I, like others on this thread,

Customer Question

Hello, I am not sure how this works. I, like others on this thread, have a fear of als. Currently my fear is of bulbar. I honestly think it is anxiety related, but could use some reassurance today...
Submitted: 15 days ago.
Category: Neurology
Expert:  Dr. David replied 15 days ago.

Hello, this is Dr. David. I am reviewing your question now and will be with you momentarily.

Expert:  Dr. David replied 15 days ago.

ALS is a very rare neurological disorder.

why are you worried about ALS

many patients who have anxiety symptoms can have benign fasciculations and twitching which in 99.999% of the time is not due to ALS.

are you getting treatment or medications to help with anxiety symptoms?

Customer: replied 15 days ago.
I should add... body wide muscle twitching for 4 months. Clean emg two months ago. Seen two neurologists have both said not als. I know it's a fear and likely unfounded.Had two major flare ups of acid reflux in the last two months. Obsessive swallowing. No issues swallowing food or drink, just saliva. Left Ear feels plugged. Hear a clicking in throat sometimes.
Customer: replied 15 days ago.
I am seeing a therapist for anxiety and am going to speak with dr about starting some meds for that soon. Did not have anxiety issues until after twitching started. (Neuros both say present as classic bfs). Just concerned about swallowing issues now as these started after neuro visit.
Customer: replied 15 days ago.
I'm not sure if you're getting these.... (again, not sure how this works or if I'm doing it right)
Expert:  Dr. David replied 15 days ago.

you should talk to your doctor about medications which could help decrease your anxiety symptoms.

your symptoms don't sound like ALS

Customer: replied 15 days ago.
Ok thank you. I know... als swallowing issues would present differently, correct? And usually speech issues first...Trust me, i realize I sound ridiculous... just need as much reassurance as I can get.
Expert:  Dr. David replied 15 days ago.

it sounds like your anxiety symptoms are out of control.

you should talk to your doctor about medications which could help decrease your anxiety symptoms

ALS progresses and takes away your speech and motor functions and walking

you are letting your anxiety symptoms get out of control with worry here.

Customer: replied 15 days ago.
ok. Thank you
Expert:  Dr. David replied 15 days ago.

let me know if you have other questions.

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you can always reach me directly with "a question for Dr. David" in the medicine or oncology categories if you have other questions

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Expert:  Dr. D. Love replied 15 days ago.

The system says that you have requested another answer.

What additional information are you seeking?

Customer: replied 15 days ago.
I would like some more specific info as to how my issues don't point towards ALS....
Customer: replied 15 days ago.
Looking for something to help ease my anxiety, rather than just telling me that anxiety is my problem. (Which I am aware)
Expert:  Dr. D. Love replied 15 days ago.

While I agree that ALS is rare and that the symptoms are not the typical presentation for ALS, the greatest reason why I do not think that it is ALS is that there was apparently no findings on neurologic exam by two different Neurololgists that was worrisome for ALS and the EMG was normal.

Customer: replied 15 days ago.
MAkes sense. I did not have the swallowing issues (I believe brought on by my bad acid reflux flare ups???) until after those appointment.... but that wouldn't make sense for neuros to clear me and then suddenly something else flare up that was als related, correct? One said that with body wide twitching, I would display a whole host of other symptoms that I did not have...
Customer: replied 15 days ago.
In the span of a few weeks things keep changing. One symptom gets better and then another pops up.... I am guessing anxiety related again.
Customer: replied 15 days ago.
Ie. ball in throat and classic reflux symptoms, then sore throat, then throat feeling tight, then clicking noise and popping ears, now some nasal drip....
Customer: replied 15 days ago.
One will go away and then other starts. Not all on top of each other. If that makes sense
Expert:  Dr. D. Love replied 15 days ago.

Yes, the Neurologist referencing the other usual symptoms is the same as the above statement that the symptoms are not the typical presentation, but the Neurologist also has the advantage of being able to perform a neurologic exam to also indicate that it is not the usual presentation.

Yes, it is common anxiety symptoms can fluctuate frequently, so yes, it makes sense from the perspective that anxiety is causing your symptoms.

.

Customer: replied 15 days ago.
Ok thanks...
Expert:  Dr. D. Love replied 15 days ago.

You are most welcome.

Please remember to provide a positive rating so that I am credited for assisting you.

Customer: replied 5 days ago.
Hello again. I have more to ask... I have noticed my uvula is hanging to one side. Is this of concern???
Customer: replied 5 days ago.
When I say "ahh" it doesn't really move at all...
Expert:  Dr. D. Love replied 5 days ago.

It is probably not a concern, but to be able to definitely answer that question, it would require an examination. Did your doctor look at this?

Customer: replied 5 days ago.
Hasn't yet. Gag reflex on both sides is fine...
Customer: replied 5 days ago.
What else would you examine?
Expert:  Dr. D. Love replied 5 days ago.

If the gag reflex is fine, then it is even more likely that the palate and uvula are not a concern.

I would do a neuro exam, which assesses each component of the nervous system.

Customer: replied 5 days ago.
Anything I can test myself? also, is it possible that this is caused by my LPR (likely) sore throat and irritated mouth?
Expert:  Dr. D. Love replied 5 days ago.

No, not really. A neuro exam would need to be done by a doctor.

It is common for LPR to cause mouth and throat irritation and inflammation, and this can cause the uvula to deviate to one side.

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