New to site and a bit scared

[ohioprof]

I would like to start by thanking the amazing physicians on here for lending their service. I teach in a medical school and it's wonderful to see that those wonderful students become such great docs.

40 year old male . . . very healthy . . . religiously lifts weights and does cardio.  Felt fantastic prior to the scenario I'm about to present.

While in the gym, suddenly lost strength in my right arm, but had absolutely no indication it happened (that is no pain or strain felt) other than losing strength for the next exercise.  Left the gym thinking I was fatigued from the cold virus I had the week before.
Returned to the gym two days later to find that I was indeed weaker by about 25% in my right arm (again, feeling absolutely no pain in the neck or arm whatsoever).
I stopped going to the gym to "rest" and 2 weeks later, I'm sitting on my couch and I felt a twitching sensation in my left shoulder and within 30 seconds, I felt my left arm get weak (as if someone had sucked the life out of it). Now both of my arms are weak.
I went for a walk the next day and found that my right leg was very weak/fatigued (not exactly sure if the loss of strength was that day or prior to that).  The very next day my left leg became weak too.
I am now getting fasciculations in all of my limbs and also in my upper, right chest area. I have been losing sleep over this and am extremely worried, so I guess that could be part of the cause of the fasciculations.  I have had them before but nothing like this.
I teach physiology so immediately I'm thinking the worst: MS, ALS (especially because of the fasciculations and the lack of sensory problems), Guillain Barre, etc.  I'm also aware that a herniated disk could have caused spinal cord compression and could very well explain the symptoms, but I thought I would still feel some pain in my neck or somewhere.  Is it possible that I wouldn't feel pain?  Can ALS present itself so quickly . . . to have spread from one limb to another to another to another in a matter of 2 weeks.  I am a little unsteady on my feet, my hand dexterity isn't what it was just 2 weeks ago and I fatigue much more quickly.
I would appreciate any insight you can give to me. Thank you so very much for your time.  

[ggreg]

Dear Ohio,
Just a reminder, this part of the forum is patient-to-patient.  The link for the pay Ask The Doctor forum is to the left of this forum.  But I will give a shot as to what I think might be going on, as I have experienced a similar problem in the past, lost all strength in my left leg out of nowhere at the top of the stairs, took several years to find out why, that it came from my back.

Some simple things to get out of the way are:  Since you are considering dramatic causes for your muscle weakness, I'm just guessing, but snowballing thoughts often happen to people who are stressed.  I used to do that.  Just a tip.  Also, since you recently had a cold, you may have been too wore out to continue with your weight lifting, and so you've gone and tore up your arm muscles.  I did some pushups after a layoff in my 40s, and for months my left arm hurt.  I am still afraid of doing pushups.

Some more tangible ideas are:  When you had your cold, if you were taking Sudafed or if you had diarrhea, those can cause magnesium depletion, which can increase those muscle spasms you were having before your cold, which bananas and nuts will fix that.  Also, your muscle spasms in the past can also come from too much exercise and dehydration.

As for your unexplained arm muscle weakness, when I lost all strength in my leg that time, I had just put it down on the first step of the stairs, went to shift weight, and it went.  No warning, no pain.  I was hanging onto two railings, so I didn't fall.  But ever since then, I am careful on stairs.  Well, I wondered what caused that, too.  My neurologist said I had no neuropathy, etc., etc.  But turns out, a few years later, they discovered I did indeed have nerve problems in my lower back, just didn't show up in a normal exam.  So, I'm thinking your disk bulge in your neck may now be impinging on the nerves to your upper extremities, the way my low back nerve damage took the strength out of my legs.  Your doctor can advise you ways to help that.

This, of course, does not explain your lower legs feeling weak.  Perhaps your cold was more than a cold, could be some bloodwork would rule out any stubborn infection that might be making you weak all over.  You did not say what caused the bulge in your cervical spine, but you could also consider having your back evaluated for other abnormalities, including a good look at the problematic disk you have now.  This is expensive, though.  A plane black & white X-ray would be better than nothing, much less costly, and might give your learned self some clues as to whether or not your back is goofing up your extremities.

In any case, reevaluate your exercise programme, you're 40 not 30, best favor I ever did for myself was slack off in ALL things.  I made myself walk slower, think slower, and was more careful when I did my exercises.  You don't have to jump off the merry-go-round, but you can shift gears.  I became aware of and accepting of all the fool stuff I did in my 20s, we pay for all that later.  So, in general, for all people who are past the halfway mark of three score and ten in their lives, give yourself a break, everyone loses some body perfection, except for a few miracle people, like an 80-year-old woman I read about who still climbs mountains.

But take of this what you want, and leave the rest, as a friend of mine often says.  I'm just giving you my two cents in an effort to help.
GG

[ohioprof]

Thanks for taking so much time to answer my question.  I think I've calmed myself enough to think that it is indeed a disk problem.  Compression of the spinal cord itself (not of the nerves) at the cervical can actually cause bilateral weakness in the arms and legs.  I am actually going to have an MRI on Monday and am hoping that it shows a disk herniation in my neck.  And yes, you're right, I probably do need to slow down.  But as I'm sure you know, ego's and vanity and wanting to show the younger guys that you're still king of the gym, gets in the way.  This was definitely a wake-up call for me.  Again, thanks for taking the time to reply.  I'll keep you posted.