Wednesday, November 25, 2009

This could get complicated. . .

I went to my primary doctor last week or so, and told him about the tremor and rapid eye movement and other things that may not end up being related to HNA, since he really can’t talk about that in particular. I demonstrated the tremor, and told of the muscle strength fluctuation. I mentioned my guess at Myasthenia Gravis as being a possible cause. By now he is not surprised by my suggestions anymore. He thought it might be possible, but that the specific type of rapid eye movement may suggest something else too. He did not want to speculate. Instead he ordered a bunch of blood tests, an EMG test, and a brain MRI.

What I find that may be related is called Meniere's Disease, which can cause rapid eye movement, vertigo and balance problems. It can also cause tinnitus of at least one ear. I can see why he did not want to speculate. As much complaining as I have done previously about the ability of doctors to know what I have- there are so many things out there that I am surprised anyone ever really knows what may be going on in their body.

I have had at least one attack of vertigo, one attack of rapid eye movement and I have slight tinnitus in my left ear. I sometimes feel as if my balance is off a bit. Who knows at this point if any of this is related?

He mentioned one thing to me during my visit that could pertain to anyone trying to figure out what is happening to them. He suggested that my increased level of focus on any new symptom may or may not really be helping. As Freud eventually said about dream imagery, sometimes a cigar is just a cigar. Maybe in my case, all of these other things are just random passing things, and not related to any long term issues. Due to my increased sensitivity of focus, I am concentrating on things that may not really be there- or my focus is making them appear to be more than they are.

One note though, I do know that I have a brain. The MRI at least proved that. My parents would be happy to finally know that. There was a brief time when I was younger that I would have liked to have this proof. For a time they wondered if I really had a brain in my head. . . And according to the MRI Technician it was the largest one they had seen that day. I do have a rather large head. It is nice to know it is not empty.

Friday, November 13, 2009

Myasthenia Gravis- another possiblity

I have been accepting of my diagnosis of Neuralgic Amyotrophy in the past. Of course I have kept looking just in case something else popped up of interest that may be a closer match. I may have found that. Myasthenia Gravis (MG) is an autoimmune disease (what isn’t an autoimmune disease anymore?) that explains quite a few of my current symptoms, including the weakness in my eyes and my fluctuating muscle strength. If you search “fluctuating muscle function” you will only come up with the one disease; Myasthenia Gravis.

From Wikipedia http://en.wikipedia.org/wiki/Myasthenia_gravis Myasthenia Gravis “is a neuromuscular disease leading to fluctuating muscle weakness and fatigability. It is an autoimmune disorder, in which weakness is caused by circulating antibodies that block acetylcholine receptors at the post-synaptic neuromuscular junction,[1] inhibiting the simulative effect of the neurotransmitter acetylcholine. Myasthenia is treated medically with cholinesterase inhibitors or immunosuppressants, and, in selected cases, thymectomy. At 200–400 cases per million it is one of the less common autoimmune disorders.”

They go on to say that it can be difficult to diagnose due to subtle differences in presentation of symptoms and similarities to other diseases, and that it tends to run in families that have other autoimmune diseases.

One thing that always perplexed me about my condition was that it seemed that my eye problems started about the same time as my most recent attack. MG would explain that. It can cause double vision and blurriness of vision. I had this very suddenly only a few months after my eyes had been checked and were said to be OK. I am not sure I had mentioned that before all this started, I also had an episode of rapid eye movement (while totally awake). And MG would also explain the intermittent return to strength followed by weakness again after intense exercise, as mentioned earlier when I quickly worked up to 25 pushups done twice in one day, followed by a collapse of strength the next day, and for a few weeks after. By the way, I am now up to 16 pushups. As much as my muscles were shaking when I tried last week to get to 14, I have been able to do 16 once since then.

So, this is something else to consider. I know that there were a few of you out there who had issues with your eyes as I have also had. I am going to ask my Doctor if MG could be the underlying cause of my problems. Of course, nothing says I could not have NA and MG. I may have to start another blog yet.

For more Myasthenia Gravis information, see this site:

http://www.ninds.nih.gov/disorders/myasthenia_gravis/detail_myasthenia_gravis.htm

They point out the common symptoms listed here from the site:

"In most cases, the first noticeable symptom is weakness of the eye muscles. In others, difficulty in swallowing and slurred speech may be the first signs. The degree of muscle weakness involved in myasthenia gravis varies greatly among patients, ranging from a localized form, limited to eye muscles (ocular myasthenia), to a severe or generalized form in which many muscles - sometimes including those that control breathing - are affected. Symptoms, which vary in type and severity, may include a drooping of one or both eyelids (ptosis), blurred or double vision (diplopia) due to weakness of the muscles that control eye movements, unstable or waddling gait, weakness in arms, hands, fingers, legs, and neck, a change in facial expression, difficulty in swallowing and shortness of breath, and impaired speech (dysarthria)."

Thursday, November 5, 2009

Push-ups near topping out at 14

I thought it might be time for a push-up update. I am now up to 14, but I think it might be near a topping off for now anyway. I know I can do more- as I have stated elsewhere I can do 25 twice in a day under the right circumstance. It just feels like my strength does not want to increase like that again. Of course, being able to do 25 twice in a day seemed like it might be a fluke at the time, and it turned out to really be a fluke.

What happens now as I try to push towards 14 is that the rest of my body starts to protest. Everything else starts to shake under the stress starting on number 10 or so, and it is all I can do to keep going. It is hard to think I can get higher than 14 unless the rest of my strength can improve a bit, and I am not sure it will yet.

Other strength issues have surfaced since I switched to heavier bedding for winter. It usually has taken only a day or so to adjust to the heavier blankets at this time of year even since the 2006 attack. This time though, it continues to be a struggle to turn over a couple of weeks after the switch. Something may eventually have to give here. Either I will live with it, or have to go to different blankets. Or, I guess my strength may still recover a bit. I still hope for that, and I try to work towards it, but at this point I have to say I wonder how much I will get back when it still feels like certain muscles are getting weaker instead of recovering.