ALS concerns

I am a female i just turned 32 last month. I am a mother of one and i exercise regularly. My diet is prety good i eat a variety of health foods and a very minimal amount of junk food. I dont drink and dont smoke. I had surgery in mis september to remove a fibroid from my uterus. I opted for a spinal and a sedative instead of general anisthesia( pardon my spelling). Just a couple of days after my surgery..(3 or 4) i began having cramps in my left claf. It does not seem to be agrivated by my exercise at all. My doctor refered me for Phys. Therapy where i had massage therapy. It felt as if there was a wad of broken glass shards in the area that was crampy when she massaged it. After 3 sessions it felt alot better but not completely well. Iam now having cramps in right leg  also, they started shortly after the left leg cramps but has never been sore when handled like the left. I had a few but not many twitches in my left leg it progressed from my left leg to my entire body. I would say i have alot of them but not 24\7 like some people. 60% of them are in my legs but the rest are all over my body (not my tongue). They always occure at rest never while a muscle is being used and i dont seem to have any weakness as my exercise does not seem to be lacking at all. I do have a panic anxiety disorder and i am very anxious so my twitching has been increased. I am going to a follow up with my PCP but what are the odds of this comming up ALS?, how long after twitching begins should i be expeirienceing some kind of weakness?  Thanks so much. You people are god sent.

[CCF-Neuro-M.D.-JT]

ALS is NOT the first (second or third) thing that comes to mind here. In typical cases of ALS, muscle twitching usually comes on after there has been symptoms of progressive weakness. However, it sounds like you do need some evaluation starting with routine bloodwork to check for electrolytes such as magnesium and calcium, as well as muscle enzymes CK and aldolase to see if there's any signs of muscle damage, and thyroid. If there's an abnormality, then you may need to consider a neurological consult and possibly an EMG to further assess you for muscle disease.

In the meantime, simple things you can do is try some calcium (TUMS at the drug store) and soda water which contains small amounts of quinine, a medication that helps with cramps.  Now in larger amounts, quinine can make you sick if you have underlying heart disease. But the amounts in club soda are not enough to do so. Start with your primary care physician. Good luck.