It's Wearing Me Out

I hurt today; not the cruel kind of pain that stabs deeply, it's the general shallow ache and soreness that is so much a part of my everyday life. Only today it is broader in scope, deeper in nature. It starts in my fingertips, moves through my hands, into my wrists, up my arms and into my shoulders. My neck hurts. I am tired, worn out already and it is only the start of my day.

Sometimes it's hard to tell if the aches that I feel are ALS or age related arthritis. After all, I am nearly 60 years old, a time when a great many people suffer from general aches and pains. Perhaps some of it is just plain getting older. The pain in my fingers and maybe my wrists certainly reminds me of the arthritic pain I have felt in the past. On the other hand the pain in my arms and neck is muscular, not joint pain. I can tell; it's different, the kind of pain that has only started since ALS decided it wanted my upper body.

Part of the pain is simple muscle usage. I use my arms so much now; there is nothing I do that doesn't require me to put them into action. The problem is, of course, that there is no gain to go with this pain. No amount of exercise will build muscle where neurons are failing to send the proper messages. The workout has no upside; I just get to hurt from it.

Another part of the pain is "nerve" related pain. My nerves are working overtime, frantically trying to maintain current connections and even build new ones to replace failed connections. All of that work takes energy, leaving my arms, and the rest of me, exhausted even when I am not tired. My general loss of muscle tone adds to that tiredness, that inability to push myself just a bit further.

A couple of people have said lately that I am "looking good". Appearances are deceiving with ALS. They can't see inside my arms, or under my clothing. They can't see the weakening muscles, the cottage cheese surface of my skin where atrophy is actively taking place. They can't see the exhaustion, the pain. All they see is the cheerful man who isn't letting all of this nonsense stop him from living. Only it's getting harder and harder to be cheerful, especially on mornings like this.

I hurt today. I hurt yesterday. I will probably hurt tomorrow. That's just another fact of my life with ALS. It's not bad pain, it's just another thing wearing me out.