My Left Arm Looks Different

It's probably been about three months since my left arm started to decline down the path to paralysis. I say "probably" because the beginnings of this process are infinitesimally small, almost unnoticeable except by those in the throws of the disease. The first signs for me were increased clumsiness; not a lot, just enough to recognize that it wasn't "normal" clumsiness.

My left arm is still working but I can feel the increasing weakness in it. It will keep working, harder and harder, as the weakness in the bicep continues to become more pronounced. Already I am compensating for it, favouring my right hand, using my right arm to complement my left when pulling myself across the bed, pushing harder with my right as I lift myself out of my wheelchair. It is the extra work on my left bicep and wrist that make it hurt. If I did nothing there would likely be no pain; the problem is that doing nothing is not something I can do.

I have noticed a weakened shaking of that arm as I use it to hold or push, that mild shaking I used to get when my legs were tired and I had to sit down, back when I could still stand and walk. It's barely visible and stops immediately once I rest my left arm. We are early in the game. I know how this will go; it will follow the pattern of my legs, declining more rapidly on the left at first, then showing up on the right. In the end, perhaps a year or so from now, I will lose most of my arm strength.

This morning I noticed the first real, visible change in my left bicep. I was pulling myself across my bed, using both my left and right arms. I saw that the shape of my left bicep was different that the shape of my right bicep. When you flex your muscles in your arm, that muscleman kind of thing, your biceps are supposed to make this nice, fairly symmetrical lump. My right arm looked just like that.

My left arm, on the other hand, if you will forgive the pun, was misshapen. There was no smooth, round lump. The bicep was flattened, almost as if the muscle was sliding into the crook of my elbow. There was no rise to the center, no roundness, or at least not much. It is a clear sign that I am past the beginning of this part of ALS.