How many pushups should you be able to do?

I was never much for physical activity when I was young. Don’t get me wrong. I tried. I was just always behind my PE classes. My muscles would not respond to being pushed. I was lucky if I came out at the average according to the numbers on this chart, courtesy of Physical Living- http://physicalliving.com/how-many-pushups-should-i-be-able-to-do/

Push Up Test Norms For Men

Age	17-19	20-29	30-39	40-49	50-59	60-65
Excellent	> 56	> 47	> 41	> 34	> 31	> 30
Good	47-56	39-47	34-41	28-34	25-31	24-30
Above average	35-46	30-39	25-33	21-28	18-24	17-23
Average	19-34	17-29	13-24	11-20	9-17	6-16
Below average	11-18	10-16	8-12	6-10	5-8	3-5
Poor	4-10	4-9	2-7	1-5	1-4	1-2
Very Poor	< 4	< 4	< 2	0	0	0

Push Up Test Norms for Women

Age	17-19	20-29	30-39	40-49	50-59	60-65
Excellent	> 35	> 36	> 37	> 31	> 25	> 23
Good	27-35	30-36	30-37	25-31	21-25	19-23
Above Average	21-27	23-29	22-30	18-24	15-20	13-18
Average	11-20	12-22	10-21	8-17	7-14	5-12
Below average	6-10	7-11	5-9	4-7	3-6	2-4
Poor	2-5	2-6	1-4	1-3	1-2	1
Very Poor	0-1	0-1	0	0	0	0

 

You know what? If I had seen this information before I started my return of strength recently, I may not have pushed it as fast, or as far as I have. My muscles, I knew, were not very good at responding to exercise. As it is, it took a number of months of daily exercise to get a response that would have been in the consistently “Good” range for a 60-65 year old male. Now, at 50 twice a day, I am close to “Excellent” for a 17-19 year old and way above “Excellent” for my age.

My goal for now? No limit. I will keep doing pushups as long as my body allows me to. My appetite is way better than it has been. My stamina is increasing for the first time is years. And my weight is increasing. Why limit it?

Avoid long term magnesium use- Push-ups now up to 40?

For those interested in my magnesium use, it would probably be best to warn you to keep it at a minimum, ongoing, or stop it all together as soon as you can do so.

In fact, I had stopped my magnesium supplements from time to time, only to restart when I felt suddenly worse overall. Now, I have no plans to ever use it again.

My primary doctor agrees that anyone with a neuromuscular disorder should limit use of magnesium or any other long term muscle relaxer. There is, as it turns out, a possible long term use detriment.

My own update as far as strength is this: Last night, and again earlier today, I did 40 pushups.

Yep. That is still a bit hard for me to believe, since at the height of my magnesium use, I almost never did more than 5 at any one time, and 5 was a hard stretch.  
 
Now, the 40th one is a hard stretch. But it is 40!!!! When did I ever do 40 push-ups in my life? Never, that I can remember. So much for my friends suggesting that I was unable to do push-ups because “We are just getting too old. Face it”.

Four months in, and still going strong- minus the magnesium

I still have been doing better- now four months after stopping the magnesium supplements. It is true they helped in the initial time after my attacks, but ongoing, they only made me worse.

Push-ups have remained in the 15-20 range, so my overall strength is still limited to what is available with this disease. But, I feel much healthier without that supplement.

Pushups return, and did magnesium cause weakness?

Hi again to anyone that sees these posts.

I have been absent. Other things take precedence, at times. One thing I have talked about in the past is that magnesium has helped me, at least during and right after the attacks. It, for me anyway, helped to tone down the twitches and leg jerks that I had. I am going to suggest now that you watch out about taking it long term. Do breaks from it from time to time, to see if it is still helping or like I think happened to me, started to cause me more harm than good.

I have talked about my ongoing weakness. Some HNA sufferers report ongoing weakness and breathing difficulties. I had all of that. I never even thought about it at a certain point. It had become part of who I was. The weak guy over there who sits around while everyone else moves on with their lives. That was me. Maybe you are that person too. Or maybe you know someone like that. 

Since my attack, I have taken magnesium religiously. I have taken my own advice from time to time, and have stopped it for a week or two, until I would start to feel those familiar twitches start up again. Or I might feel tightness in general as my muscles tensed up. Magnesium is good to ease those things. It made them go away for me. And I could never stop taking it for long. It did seem to help. But, I had no idea that it also could be adding to my weakness even at the dose I was taking. I had no clue until the most recent time that I stopped.

It has been about a week now since I stopped my morning magnesium pill. And I feel so much better now. I fell less shaky in just doing everyday tasks. My breathing has improved. A couple of days ago, I tried to do some pushups. And I was amazed that on the first try, I could do 10.

Those 10 pushups were a bit shaky, but I was amazed that it was 7 more than I had been able to do for the longest time. So a half hour later, I tried again and did 20 with no shakiness. A half hour later I tried again and did 20 more. The next morning I did 15 and a bit later did 25 more. And now, for the first time in a very long time, the muscles in my arms are actually sore from that exertion. It feels amazing. I have to admit, I thought my doing any sort of exercise ever again, was a pipe dream. I felt like I was aging in an accelerated way with this disease to blame. And now I feel like I have part of my life back. Maybe because that magnesium is getting out of my system.

I know it has its place. I may use it again if I am in an attack. But, I feel like I will never just blindly take it just because I think it has helped in the past. After a while, at least in my experience, that help goes sideways and becomes more of a hindrance.

So, take it but watch out for possible problems of long term use. It might make you feel better at first, but it also can have opposite impacts in the longer run.

And maybe, it is all a coincidence and at some point my return of strength will go away, magnesium or not. 

I will let you know.    .  

And more push-up stuff

In the last week or so I have found that I can do between 10-15 push-ups every 2-3 days.  I am definitely not pushing myself this time. And I have not been able to increase the count past 15. I guess that is one thing about HNA. There definitely is not any muscle growth past what you have at any given time.  I am only trying every 2-3 days. I will not do this every day for anything. I have already seen how over exercise does not work in the long run.

Push-ups already gone again and balance issues resurface

Well, this was a very short-lived improvement as these things go.  Just now, I tried again to see if my strength was still at the level it had been when I wrote last. Nope.  I already could tell prior to the attempt that my strength was not there. I was shaky again. That seems to be the key here. If your muscles feel shaky just existing, it is not likely that they will have the extra required to do heavier exercise.  Back to a shaky 3 on this attempt then.

What else is in the mix? Well, through the last few years I have had episodes of dizziness, and vertigo associated with Nystigmus.  Generally, this is confined to nights in bed- specifically getting out or into bed.  Lying down is worse than getting up. But I have a bit of trouble walking straight after I feel I am OK to stand.  Lying back down can be quite exciting as well, and I am thankful that at these times, I have no place to fall to.

I see that I am not alone in issues related to balance.  It is a known that HNA sufferers particularly do have problems with the inner ear and hearing.  Again, it is listed as “rare”.  And again, I just hope that my doctors have not missed something I will eventually have worse problems with.

Some return of strength again. . . Push-ups coming back

For more than a year now, I have not been able to do any push-ups.  This has been due to my frozen right shoulder, and extremely tender muscles and tendons in my right arm/shoulder area.

The time had come a couple of days ago to see if this part of my arm weirdness had passed again, and maybe a bit of strength had returned.

A couple of days ago, I tried and I did 10 a bit shaky push-ups.  Compared to recently when I could barely hold my body in the position to try, I will count them.  Just now, I was able to do 15 with no shakes.  Maybe I am on the mend again. Do not let me over do this.  No need to get greedy and try to do 30 next.

“Low-D” update

I have been taking a daily supplement of vitamin D for the last couple of weeks, and there are early indications that this 5000 IU daily supplement is helping a number of issues that I had earlier attributed to NA.

The biggest thing is the reduction of nerve/muscle fatigue.  During my regular physical therapy sessions, I had been asked to exercise using an arm exercise style “bike”.   This is on a machine that has an arm crank that you turn using different settings to achieve goals of reconditioning your upper arms and shoulders.  While initially doing this exercise prior to my taking the D3, I had trouble turning this for more than a couple of minutes with very little to no resistance.  As the Borg would have said, “Resistance was futile.”  A couple of times I had to stop before reaching the preset goal of only ten minutes, and it felt extremely hard to go past 5 minutes.

Now since taking D3, the last few times I have had no sensation of fatigue in the early going, and this is with the settings now on what they call “constant work.”  This setting really is weird in that if you maintain a certain speed you do not really feel the resistance. If you go too slowly, the resistance sets in.  But the key is that you have to go faster. Before the addition of vitamin D supplement, when I finished the 10 minutes, I could usually end up around 1.0-1.1 miles on a good day and usually in the .9-1.0 mile range, with no resistance set.  Since the addition of vitamin D, I have been regularly hitting 1.3-1.4 with a high of 1.5 miles using resistance setting as constant work.  And at the end of 10 minutes, I now feel as if I could go on for a longer time.  It is true that I feel like my muscles are getting tired during this, but I can tell that they recover while still exercising and the strength is not negatively impacted.  This has made a real difference in my physical therapy.

My therapists had been concentrating on having me do stretching exercises and including the exercise bike if my arms would tolerate it.  Now my therapy is being geared to a more active use of my arms.  Instead of passive stretching, I am actively using my arms within my achievable range of motion with a ling term goal of increasing strength.  This is closer to what my arms would be doing in the real world.

A few days ago, I also tried to do a pushup.  I was not successful.  My shoulder still has too much pain with certain actions.  But my left leg feels stronger at my hip, and my right leg just above my ankle is much stronger when driving around town.  That had been getting worse and I had been getting a bit more worried that my ongoing weakness would impact my ability to do necessary driving; like to doctors for me and my significant other, grocery shopping, etc.

But you still do not look sick. . .

I have posted about this link (Funny, you do not look sick- Spoon Theory) previously.

I hear this quite often, and it is true. I really do not look as bad as this can feel at times.  I find I have to keep reminding some people anyway, that just because it appears I am OK does not mean that I am totally fine.  On the contrary, I am not fine, and it really appears at this point that any recovery I may have now, or at some future speculative date, will only be a partial recovery at best. And probably will not last very long.  I hope I am wrong.

This is a common problem for many with a disease that makes one just feel worse than they may look to the untrained and some trained eyes as well.  There is an acquaintance of mine, who has spoken to others about my condition saying to the effect, “I do not get this.  He looks OK to me. What is up?”  Even my current Physical Therapist who has had a prior patient with PTS/NA and knows at least some of the limitations, had appeared to forget recently that I may not be up for any exercise right now even of a fairly low-key type.

I had to re-explain to him that my muscles do not respond at this point, to any physical “training” that other PT patients may be expected to do at this stage of treatment.  I told him that there may have only been one time in my life when my muscles really felt normal, and that at that time it all felt so good to me that I over-exercised and set my recovery back quite a bit.  I mentioned that currently my body feels extremely shaky with almost all movements.  True, there are some days it is a bit better, but overall it is way out of any normal muscle response to exertion.  All my muscles fatigue easily.  What I can do is limited by this fatigue.  They warned me my muscles may feel stiff after exercise.  I said I really doubted that since to be stiff, they would have had to do some work- beyond what the basics of my mobility currently.

I think that maybe now they get it.  I hope so anyway.  I may be the last PTS patient they see in there practice, but I am there now.   There are things I just will never be- and one main thing is, that I will never be muscular to any normal degree.   I no longer seem to be wired that way, if I ever was.

Leg pains and forget what I said years ago

I have to say that I am not enjoying this anymore.  Not that I ever was. But, recently my legs have been bothering me.  It is hard to even sit here typing. They both ache. Walking sometimes is hard. If I have managed to fatigue either of them it is like walking with the proverbial rubber crutch.  I must look like one of those poor people that folks see tottering along in old age. Well, I am old, but not that old yet.  This certainly is a new wrinkle in something that is supposed to only impact shoulders.   So- We have weakness to the point of falling, but not quite yet.  Luckily this usually is only one leg or the other. If both went at the same time, I would be down for the count.  Pain is bearable, but a constant reminder of something that is not right down there.  It starts at lower back almost to my butt and runs down to hips and knees.  Standing makes it worse. Usually sitting is better unless it is as I am now with a desk chair and arms extended to keyboard.

And the arm still bothers me at night trying to sleep.  Actually now that I say that, turning from one side to the other is harder again, and staying any time on my back irritates that achiness.  Oh well.  It is not like I Have to get up and go to work. But, it is harder to get around and stay out doing anything at this point.

That brings up another issue.  I ran into someone recently who asked me if I thought I identified with the disease too much.  I know I mentioned here before that I was trying not to do that- some mumbo-jumbo about not “being the disease.”  I think it is good to try to keep that attitude.  It is very hard to do it with a condition that is chronic, or that is constantly evolving as it cycles through you.  Sure, I do not go up to someone and introduce myself “Hi I am Joe Blow and I have HNA.”  But, there are few times in a day that I am not thinking about it in some way.  If not in a cycle of pain, it finds other ways to remind me it is there.  If I get complacent and forget about it for a while, I usually end up dropping something or hurting myself trying to pick up something that is way too heavy and I should know better than to attempt at this stage.  So, to that person (if you ever make it to the blog and read this) I guess I do identify with it a bit too much- maybe more than I would ever admit.  But, it makes itself hard for me to ignore it.  Now, I really do have to go. Sitting here just is no fun anymore.

Just a bit on legs. . .

In the beginning, I may have had shakes in the legs a bit, and some early fatigue below the knees noted while walking. This is still the case, but I notice even more weakness now. That and weakness particularly to the Jambier anterior- at least that is the one it appears to be.  My neurologist had noted that muscle was particularly atrophied in that areas of my leg a few years back.  I had not noticed problems related to that at the time. But now I notice while driving that my leg gets shakes in the region of that muscle. This was when driving in San Francisco with much stop and go and hills involved.  I was happy when I got back to freeway and could rest my leg by way of cruise control.  Since then, I have noticed leg weakness on the left, early in the morning to the extent it feels as if I could fall if I do not concentrate.

And that may be the biggest concern with this disorder.  It is not that it completely stops you, but that it limits you by requiring concentration to do even simple maneuvers most folks take for granted.  Pay attention, or you drop things. Pay attention or you could fall.  As I age, falling takes on an entirely new level of potential worry. I may be fine otherwise and I fall. I break something, and end up in bed. Lack of movement follows, and then pneumonia. . . It happens all the time.

Neuralgic amyotrophy by Nens van Alfen

I have added a document to my list of links- Neuralgic amyotrophy - Nens van Alfen.  If the name seems familiar, he has written quite a few things I may have already referenced. This appears to be his thesis of 150 or so pages with a section in Dutch if you prefer.  I have only scratched the surface of reading it myself. 

Short Updates

Well, where am I, you may ask. It has been a while. 

Push-ups:  I still seem to be stuck at being able to do 5, and that is with a lot of shaking. Some things do not ever change.

DHEA: I have started DHEA again at 50 mg a day.  This is a 25 mg tablet twice a day.  Why? Well, I thought I would give it a try since every eye doctor I have asked about it says DHEA had nothing to do with my eye pressure spike of a few years ago.  I see that 50 mg is a suggested daily amount that may be beneficial for aging types, which includes me. So far, I really have noticed a decrease of my fine motor tremor since going to 50 mg a day.  It does not seem to help much on shaking, as noticed on almost anything I do requiring any strength.

Prednisone: There have been a couple of times since the last entry where I have experienced pain in both scapulas, and some pain in my right hand. This was noticed when I made a fist. I took a 10 mg prednisone a day for a few days, and that stopped that. 

Cause and effect or coincidence: I just note what appears to have helped me. Recognize that it all may be coincidental that I notice DHEA helping tremor, since it is not one of the probable benefits as listed in the literature of DHEA. Ditto that for prednisone helping scapula and hand pain. Your mileage may vary.  

Why is the shoulder the most common first complaint in NA

http://www.umcn.nl/Informatiefolders/7130-Neuralgic_Amyotrophy__id-i.pdf 

If you are like me, you may have wondered why it is that the shoulder is the most common first noticed complaint in Neuralgic Amyotrophy attacks. Maybe it never crossed your mind after all.  I figure, if there is a causal agent in the bloodstream, and it finds the shoulder plexus site to attack, it is just as likely to find other nerves at other plexus sites.  It may be clever, but is it really smart enough to be that specific?  If you listen to most doctors, they would suggest “yes”, it is that specific.  If you have any other issues in other areas with weakness, it is either all in your head, or you have something else they can charge thousands of dollars to test for, and come up with nothing.  “Oh well, nothing wrong with you- got to scoot”.   

If you read the document (linked above), there are two things talked about which suggest a reason for the shoulder being the most common joint impacted with NA.  It begins with overall muscle loss, and ends with the efficiency of muscles to do work with impeded nerve connections.  The author first speaks of muscle loss, stating that

“In daily life, people generally do not notice that they are losing muscle strength

until they have lost around 30% of their maximum strength. The strength that lies

between 70% and the maximum of 100% is, as it were, ‘extra’ in case heavy exertion

must unexpectedly be made.”

So, you could have an attack of NA that leaves you with a gradual loss of muscle strength to say 75% of normal, and not even notice it.  I think this actually happened to me, looking back. I had had an attack that impacted my right hand and left my arm weak. But otherwise, I had no clue what was going on, except, on a long car trip, I noticed a bit of shaking at times getting into or out of the car.

Time passed, and one night I woke up on my right side and noticed that my shoulder popped, and collapsed a bit. There was no pain, just the sensation of settling that did not feel normal at all.  Why would this be important? Look to the document again. 

“For most of the muscles, one can say that they function well in daily life

once they have regained 70% of their former strength. However, some muscles

must truly be nearly 100% recovered before they can function normally again.

The muscle that, when it fails, causes a protruding shoulder blade, (the serratus

anterior) is the most important example of this. Because this muscle needs its

maximum strength and endurance in order to work well, it sometimes seems as

if recovery of the nerve to this muscle takes much longer than the recovery of the

other nerves.”

It would seem possible that the muscles surrounding the shoulder are a bit more sensitive to nerve loss than other sites in the body. So that may explain why the shoulder is the first noticed spot that NA impacted, when truly, it is everywhere to some extent.  They go on to say:

“With neuralgic amyotrophy, the strength in the affected muscles is often decreased

to (much) less than 50% of the maximum. It is often not even possible

anymore to carry – or lift – the weight of the arm itself, let alone an extra weight

(for example, a purse or bag). It also becomes difficult to maintain movement or

postures. It is sometimes possible to make a specific movement once (such as

extending the arm or putting something in the cabinet above your head) but it is

not possible to do that a number of times or to keep doing it for a specific period

of time. Both the loss of strength and the difficulty with maintaining movement

are serious impediments for NA patients in their daily work, sports or activities at

home.”

Add to that that any regained strength may be to a lesser amount than what existed prior to the attack. For HNA sufferers, this is augmented by having many more attacks over a lifetime.

Speaking of returning strength. . . Do not do as I did and force it to get better.  Heavy exercise prior to complete healing can lead to further nerve damage and make that nerve even more susceptible to further attacks in the future.

“If, within a nerve bundle, no more than two thirds of the axons are damaged, then

the remaining axons will take over the work of the damaged cables within three

to four months. This mechanism is called: ‘collateral reinnervation’. This repair

mechanism works well because the muscle can then again be completely controlled.

However, this is at the expense of some load endurance. That means that the

muscle can certainly provide maximum strength once but cannot maintain it well

or keep it up for long. In daily life, patients often notice that, after a time, they can,

in principle, carry out all of the movements with the arm, but that the arm becomes

heavy and tired after being used for awhile and they must stop and rest before

they can continue with what they were doing.”

“If the nerve has been affected a number of times, the chance of recovery decreases.

Also, nerves are not able to tolerate everything: If they become even more

damaged, they will be ‘broken’ for good. In practice, this means that the function

of, for example, the arm after an initial period of painful loss of function will still

recover for the most part, but that, after a second or third time, will not recover as

completely and, ultimately, will not be able to recover at all. The loss of strength,

but also the disorders in sensation and blood supply to the skin, then become

permanent.”

Let me repeat- This is great information- A must read for NA sufferers or caregivers

From : [1] Information on hereditary and non-hereditary Neuralgic Amyotrophy for patients and caregivers
http://www.umcn.nl/Informatiefolders/7130-Neuralgic_Amyotrophy__id-i.pdf 

One thing clear in reading this paper is that my weakness is explained totally by Neuralgic Amyotrophy. No other undiagnosed disease is necessary. It states in other words, that as nerves re-grow, it is possible to regain movement of a previously lost arm function, for example. But, the nerve re-growth may not be complete, allowing for one use or maybe a couple, before having to take a rest. The stamina to have multiple “reps” of an exercise for example, is reduced. The muscles used fatigue very easily.  Maybe, this is what my neurologist was attempting to tell me a few years back. He just did so very badly.  This guy nails it. 

One other thing relates to balance (inner ear) function and hearing losses.  I have had a bit of changes to particularly my left ear. I have constant tinnitus. I have on at least two occasions had vertigo type sensations. One of those was with Nystigmus. Again, I thought these symptoms may be related more to other diseases than Neuralgic Amyotrophy. This paper explains that although it happens rarely, NA can impact hearing and balance. My ears were not impacted this way until after my NA attacks.  

My mind is a bit more at ease since reading this paper. 

Overall, if there is only one document you ever read about the causes and impacts of Neuralgic Amyotrophy, this one would be among the best. It has a lot of information and is very easy to understand.  I have included a permanent link in my Links section of the blog.  

Weakness continues

Weakness is a strange thing after a while. I still find myself wondering if the source of all of my weakness is NA.  It fluctuates a bit from time to time but is always there at this point.  Yesterday seemed to be a peak in the weak category as I found it almost impossible without extreme effort, to stand from a seated position.  Shaking and straining all the way, I was able to stand.  Does that sound like anything you read about on NA/PTS sites?  Not really. Weakness is a part of this, but how much is NA/PTS related is still not nailed down for me.  What else could it be?

I still go back to the possibility that part of this weakness could be related to Myasthenia Gravis. But I know that what I feel is not text book for MG either.  Sure, I have had double and blurred vision, particularly prior to my shoulder issue in 2006. But when I see how those symptoms relate to MG sufferers, my eye issues seem small by comparison.  My eyes when tested, do not droop, and do not seem to suggest to doctors that MG could be an issue. But, 20 minutes into reading can make my eyelids shut down, and vision go double. 

I see where MG can present as leg weakness impacting ability to stay standing, and that does sound like me.  I start a task that has me bent over at the waist and within minutes, I can feel my back not supporting me, and if I push, I have to get down before I fall down.  It could be NA, but also MG?  Who knows? 

When I am able to do sit-ups, and I pause for a minute and try to do more, it does not happen.  The muscles just do not want to work again that quickly.  Is that more MG than NA?  I wish I knew. 

tremor causes shift to right hand trackball use and other updates

The tremor with my left hand is now at the point I have had to change back to using my right hand for my trackball. And quite frankly, the left hand feels like it is not mine right now even typing this. It seems as if it is taking a bit more concentration than usual to type. I have been using my left hand for trackball use ever since 2001 or so when my right hand was subject to my first documented NA attack. Recently I have had increasing difficulty getting my fingers of the left hand to cooperate and smoothly move the pointer. Also, if I have to select text in this way, it is almost to the point of being an impossible task left handed. Now, after ten years of left handed trackball use, it is very odd to see that thing over on the right again, and even seeing it there it is hard to stop reaching for it on the left side. I guess I had the same trouble initially when I switched from the right side to the left. I will get used to it. I am not sure I will ever be used to the tremor though.

And this tremor is not just on the left. It is also on the right, built the right side tremor is a bit less invasive in everyday tasks. It is interesting that I even now at times think I am getting better as far as the tremor goes. Then I try to do some simple task requiring both hands and it is all I can do to keep them steady enough to come close to doing it. The trackball is one thing. Using a nail clipper is getting a bit hard if I use the right hand to clip the fingers of the left. Oh well. There are worse things out there to deal with.

Pushup strength is still way down.

I tried to do a yard related painting project the other day. And I was able to do it, but slowly. I had to reach out in front of me and upward to stain wood on the underside of a roof. After a couple of seconds of brushwork, I had to drop my arm. Then after a sort rest, I would apply more stain and then a few more seconds of brushing and I would have to drop my arm again. There is no pain associated with this action, even if I push it with all my strength. What causes the arm to drop is simple muscle fatigue. There is just not enough muscle stamina to hold my arm out and do something with it. It has been like this for close to ten years. It never gets any stronger.

push-ups gone again

Oh well. I am now back to 4-5 push-ups. One of these days I will work back through the dates and figure out the cycle of strength, or lack of it. No, I probably won't. If I thought it mattered I would. I guess it is fine for me now just to know that whatever strength I feel one week will be gone after a week or two.

Update update

Well, it goes on.

A few weeks ago, I noticed that my tremor had been going away a bit. Corresponding to this time span, my strength had returned a bit. I noted earlier that I was able to increase my push-ups to 25 or so. Now the last few days I see my tremor returning again, and as you might guess by now this also has corresponded to a decrease in the number of push-ups I can do- which has now returned to around 10. Also in this time I have noticed my left leg has been weaker again up near the hip. I have had brief stabs of pain in my left knee and foot. Prednisone has helped this left leg issue. Oh, and if that is not enough, my left arm also had some pain in the shoulder area followed by more weakness. Again the prednisone has helped this feel more normal.

This left leg issue is curious. I know in the past my doctors have been quick to point out that my right arm was weak because I did not use it as much as I used to, favoring my left arm instead. And then my left arm was growing weaker due to over-use. Well, the leg issue sort of shoots this theory down. It is not as easy as they may think, to favor a leg over the other one- even giving them that it might be possible to do this with the arms. If you walk on two legs, other than hopping on one foot, how would you favor one leg?

Recently I had to walk fairly quickly at least a quarter mile if not more. About halfway into this I felt my left leg start to fatigue a bit but kept on at a slightly slower pace. My left hip and upper thigh never recovered from that. The muscles still feel fatigued. My right leg feels much the way it usually did, except it still shakes when I try to exert it for long periods of time. People can see that I have a slight limp as I walk. Doctors especially, think that this limp is caused by pain. They assume it anyway. Nobody has asked me how it feels. There is not really pain as I walk anyway. It is just that the muscles of my left leg do not work the same as those on the right. This causes a bit of an extra swing of my left leg to make it go. That swing makes up for the lack of muscle control and makes me look a bit lopsided as I walk. Not all limps involve pain. This one is just to compensate for lack of muscle control in upper leg.

now back to 25

Well, I just did 25 pushups. The last time I tried, it may have been around ten just a few days ago- and those were shaky. Just now, I did not get any shakiness until the last couple. I may have been able to push it to 30, but why bother? It is not like a PE instructor is breathing down my neck. I would like to consistently hit 25 at least. I am not sure why I could do more just now, but I have noticed a bit of improvement in my tremor in the last week or so. Maybe they are connected.