Monday, 19 May 2014

Pain In My Left Hand

In the fall of last year I began to notice a persistent pain in the bicep of my left arm. It wasn't a lot of pain, nor was it widespread. In fact I could point to the location of the pain. The pain was there at a low level almost all the time but became especially apparent when I made heavy use of my left arm. After a while I noticed a similar pain in my right bicep, only at a lower and weaker level. Just as with my left, the pain in my right arm increased when I worked the muscle hard.

A couple of months after the pain started I went to the ALS clinic and the neurologist noticed a loss of muscle strength in my left arm, but not in my right. ALS had started to affect my upper arm muscles. Since then I have probably lost about 25% of the strength in my left arm. My right arm is beginning to show signs of muscle loss as well although the weakness, while there, is not yet as apparent as my left arm.

I am coming to learn that the pain I feel in the muscles is a precursor to actual muscle loss. It is the harbinger of the loss of nerve connectivity, the warning that something is about to happen. Like dark clouds warn of rain, this pain warns of loss to come. The pain is not difficult to manage. I take nothing for it. It's just enough to tell me that, in a few months, things will begin to change. After the change begins, the pain doesn't go away immediately, just eventually.

It is important to know that this pain is not consistent with all ALS patients although pretty much all PALS suffer from some sort of pain associated with this illness in spite of what the literature says about it being a painless disease. Nor can this pain be dismissed as "arthritis" or "just getting old"; it is specific and related to the advancement of ALS. I know this to be true.

This morning I got up and noticed that same pain in my wrist and at the base of my left thumb. It's not the aches and pains of aging, nor have I overworked my hand or wrist or thumb. It is a warning, telling me that ALS has decided where to go next. I have a few months, maybe less, when weakness in the thumb will be measurable, when dexterity will begin to fail, when my grip will weaken and I will become even clumsier. I hope I am wrong; I am probably not.

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