By ALLISON SCHIFANI For the Journal
Gene Clement, a 68-year-old retired Bernallio County health director, first noticed his hands shaking in 1985.
In the beginning, the troublesome involuntary movements didn’t have much impact on his working life, but as time progressed, so too did the frequency and magnitude of his tremors.
“After a while I couldn’t write at all,” he says. The shaking affected more than his work. He was forced to give up his much- loved music lessons.
“I stayed away from the piano,” says Clement.
Even social events became trying. He distinctly remembers going out to a meal and watching in dismay as a tomato flew from his wavering fork and landed on another dinner guest’s plate.
“You just kind of have to laugh at it a little bit,” according to Clement. But even that wasn’t so easy. Vanity creeps in.
What if you couldn’t sign your name on a check anymore? Couldn’t move a spoon from bowl to mouth without shaking food off onto the table? What if you had trouble holding the newspaper steady enough to read it?
More than 5 million people in the United States have trouble doing just those sorts of things. They, like Clement, suffer from a degenerative disorder known as essential tremor.
Though the symptoms of essential tremor, or ET as it is referred to by many of its sufferers, vary in severity, the disorder disrupts the professional and personal lives of those who suffer from it. Symptoms include involuntary shaking in different parts of the body including the hands, arms and head. Even the larynx, voice box and tongue can be affected, making speech a laborious endeavor.
Genetic disorder
Essential tremor is, simply put, “a neurological condition that causes tremors,” says Dr. Jill Marjama-Lyons, a neurologist and movement disorder specialist at Albuquerque’s HealthSouth Rehabilitation Hospital.
Sufferers experience these tremors when they actively move. Unlike Parkinson’s disease, which also causes involuntary shaking, ET patients’ tremors cease when people are at rest.
The disorder is genetic, though carriers of the responsible gene don’t necessarily exhibit actual tremors. Symptoms of ET can be exacerbated by fatigue and emotional distress and, because the disorder is degenerative, they can worsen over time.
The diagnosis, though, isn’t a hopeless one. Several medications can help mitigate the symptoms of ET. According to Marjama-Lyons, beta blockers like Inderal can be helpful in some patients as can other drugs like the antiseizure medication Mysoline.
Seventy-four-year-old Frankie Richardson has found medication helpful in dealing with her ET symptoms. She also attends a support group for people with ET and their families.
“I used to be so selfconscious about my head shaking,” she says. “I didn’t like to get my hair done or anything, until I started to go to the support group.”
The Albuquerque group meets about every three months at Erna Ferguson library. Among the topics discussed are ways to ease the burden of ET. Attendees learn, in addition to information about medical treatment, tools they can use to help them with daily tasks. Weighted silverware, for example, can help stabilize a shaking hand during a meal. Patients can also have a signature stamp made to make check-writing and document-signing easier. And, according to Richardson, being among people who understand the disorder truly helps.
“I think the support is something that’s important,” she says.
Brain stimulation
Support and medication, though, weren’t enough for Clement. He wanted to be rid of ET. So he spoke with his doctor and consulted with a neurologist.
The answer was deep brain stimulation, or DBS. The procedure “involves placing an electrode into a very specific part of the brain called the thalamus,” says Marjama-Lyons. The thalamus is the portion of the brain that governs muscle movement and coordination. The electrode stimulates parts of the thalamus to control the tremors. The implanted device is connected by tiny wires under the skin to a battery surgically implanted in the upper chest.
As with any surgery, there are risks. And anyone with tremors who hasn’t been diagnosed should seek a consultation with a neurologist, according to Marjama-Lyons.
For Clement and his physicians, the risks were worth taking. And the cost? Not so bad. Medicare covers the procedure for most patients.
Five months after the surgery Clement is an avid piano and organ player, though he says he isn’t very good yet.
“I shoot pool every day,” says Clement. “I drive a vehicle. I enjoy life.”
He works now with groups like the local ET support group, explaining his experience as a DBS candidate and promoting the procedure.
“If it’s broke,” he’s fond of telling people, “fix it.”
(c) 2006 Albuquerque Journal. Provided by ProQuest Information and Learning. All rights Reserved.
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