[41F] With progressive muscle weakness and spasms post-hysterectomy

What might be happening

Based on the symptoms and history you've provided, there are a few potential diagnoses that could explain your condition. It's important to remember that these are just possibilities, and you should seek care from a real health professional for a formal diagnosis and treatment.

Most Likely Diagnoses

1. Amyotrophic Lateral Sclerosis (ALS)

   • Rationale: ALS is a progressive neurodegenerative disease that affects nerve cells in the brain and spinal cord. Symptoms often include muscle weakness, involuntary muscle jerks, difficulty speaking, and trouble swallowing, which align with many of your symptoms.
   • Typical Treatments/Testing: Diagnosis typically involves a combination of electromyography (EMG), nerve conduction studies, MRI, and blood tests. Treatment focuses on slowing disease progression and managing symptoms, often involving medications like riluzole and edaravone, as well as physical therapy.

2. Multiple Sclerosis (MS)

   • Rationale: MS is an autoimmune disease that affects the central nervous system. Symptoms can include muscle spasms, weakness, coordination problems, and cognitive issues, which match many of your symptoms.
   • Typical Treatments/Testing: Diagnosis usually involves MRI scans, lumbar puncture, and evoked potential tests. Treatment may include disease-modifying therapies like interferons, glatiramer acetate, and monoclonal antibodies, as well as symptomatic treatments.

Unifying Diagnoses

1. Myasthenia Gravis

   • Rationale: This is a chronic autoimmune neuromuscular disease that causes weakness in the skeletal muscles. Symptoms can include muscle weakness, difficulty swallowing, and speech difficulties, which align with your symptoms.
   • Typical Treatments/Testing: Diagnosis often involves blood tests for antibodies, EMG, and nerve conduction studies. Treatment may include medications like anticholinesterase agents, immunosuppressants, and plasmapheresis.

2. Parkinson's Disease

   • Rationale: Parkinson's disease is a neurodegenerative disorder that affects movement. Symptoms can include muscle stiffness, tremors, and difficulty with balance and coordination, which could explain some of your symptoms.
   • Typical Treatments/Testing: Diagnosis is primarily clinical but may involve MRI to rule out other conditions. Treatment often includes medications like levodopa, dopamine agonists, and MAO-B inhibitors, as well as physical therapy.

What you can do

Weakness in Limbs and Muscle Spasms

• See a Neurologist: Given the severity and progression of your symptoms, it's crucial to consult a neurologist as soon as possible. They can perform the necessary tests to diagnose conditions like ALS, MS, or Myasthenia Gravis.
• Document Symptoms: Use MDandMe to journal your symptoms, track progress, and share longitudinal medical notes with your provider. This can help in diagnosing and managing your condition.
• Physical Therapy: Engage in physical therapy to maintain muscle strength and flexibility. Your neurologist can provide a referral.
• Medication Review: Discuss your current medications with your doctor to see if any adjustments are needed.

Difficulty Swallowing and Hoarseness

• Speech Therapy: A speech therapist can help you with swallowing techniques and exercises to improve your speech.
• Dietary Adjustments: Consider softer foods and thickened liquids to make swallowing easier. Avoid foods that are difficult to chew or swallow.

Constipation and Urinary Issues

• Hydration and Diet: Increase your fluid intake and consume a high-fiber diet to help with constipation.
• Pelvic Floor Therapy: A specialist can help you with exercises to improve urinary and bowel function.
• Medication Review: Discuss with your doctor if any of your current medications could be contributing to these issues.

Cognitive Issues and Aphasia

• Cognitive Therapy: Engage in cognitive therapy exercises to help with brain fog and aphasia.
• Medication Review: Discuss with your doctor if any of your medications could be affecting your cognitive function.

What you should look out for

Given the severity and progression of your symptoms, you should seek medical care as soon as possible. Reasons to seek care even more urgently include:

• Severe Muscle Weakness: If you experience sudden or severe muscle weakness, especially if it affects your ability to breathe or swallow.
• Severe Difficulty Swallowing: If you are unable to swallow food or liquids, or if you are choking frequently.
• Severe Cognitive Changes: If you experience sudden or severe changes in your cognitive function, such as confusion or memory loss.
• Severe Pain: If you experience severe pain that is not relieved by your current medications.

Remember, while I can provide information and suggestions, it's essential to consult with a