Today was not a good day. Today, I had to let my employers in on what’s happening with my being treated for PD. There’s no way around telling them this. The meds I’m on have side effects, some of which could affect being able to do my job. I am experiencing three: dry mouth, postural dizziness—essentially, I get dizzy whenever I change direction or position—and falls. Since I started on this med, I have eaten dirt more than a few times. I haven’t fallen at work because I can feel it coming and there’s almost always something to hold on to. Home’s a different story. That’s where all the good falls occur.
I started this process by talking to a union rep. She told me that I must let them in on it, that if I don’t disclose my condition and a resident gets hurt, then I could lose my job. She offered to go in with me to talk to the administrator. This was something that she didn’t have to do. The support was nice.
So there I stood, on the verge of tears, telling the administrator and the DON that I am being treated for PD. Time of my life, joy joy, and all that other happy horseshit. I didn’t stay standing for long; a chair seemed excessively inviting. I was slightly proud of myself that I never made it into full-blown waterworks. I managed to hold myself together. I was glad that my union rep was there. I almost wasn’t able to speak.
It sucks, having to do these things. There’s a bit of finality to telling your employer that you have such a staggering problem. Now it’s for real. This is actually happening. I can’t live in denial of it any longer. For their part, my administrator and DON were understanding and full of nothing but kindness. They handed me paperwork for intermittent FMLA just in case I need it and told me to get it in as soon as possible.
Then there’s the problem of falling. It’s bad enough when you’re on your own. When there’s a witness, however, that’s a different story. Laughing is good, except that dizziness thing kicks in and I wind up on the floor, which everyone in my bible study group got to witness. I laughed it off, but it was particularly embarrassing. Of course, I joked about it. “I’m down,” I said sprawled out in the middle of the floor after slipping off the couch. After we closed out the bible study, though, I took my nine pm meds and ran out for a cigarette. My arm was jumping all over the place. I needed to get calmed down.
Tuesday, March 9, 2010
Friday, March 5, 2010
Off the Deep End.
Let me apologize to my readers. I wound up being up in the middle of the night, despite being incredibaly tired. At this point, I still haven't been to sleep, and it's 8:30 in the morning. I made the mistake of looking too far ahead. Way too far ahead. Couple that with a strong urge to write, and what you get is a little wacky-crackyness. Then again, if I'm don't publish when I'm a bit wacky-cracky, then what the hell am I doing? I can assure you, reader, that these things don't happen often, and I'll be okay.
Thursday, March 4, 2010
The Doldrums
And I was determined that the next couple of posts would deal with something other than PD. That is until I started experiencing insomnia. Now I’m sitting in a completely silent house with nothing but my thoughts. This is rather irritating. This gives me plenty of time to hit the doldrums.
That’s a real issue. I don’t know if I fall into depression often enough to require happy pills, but I’m not too happy tonight. Looking to the future is bleak business, but once again, I can’t seem to help myself. They come, my thoughts, in waves of unscrupulous misery. Knowing that I’m not going to just slow down, but I won’t be able to do anything on my own in that future.
It’s a future of wheelchairs and frequent trips to the bathroom. It’s a future where I can’t open a milk carton, button a shirt, open a pill bottle. As for picking up my guitar and playing it? It’s difficult now, let alone when my left side becomes affected. Most likely by 45, I’ll be walking with a cane. By 55, with a walker—if I’m having a good day.
Yes, the depression hit. Or maybe it’s more like mourning. What am I mourning? My independence. My ability to do for myself; without having to rely on someone else. I’m a caregiver by trade. This is what I do. This is who I am. This is who I’ll no longer be.
With the passing of time. Yes, with the passing of time I’ll be less of myself. I’ll be slower, unsteady, ready to fall at any time. I do enough of that now. With the passing of time, it’ll get worse. No miracle drug is going to change that.
So, I have to ask, did the insomnia bring on the depression, or the depression bring on the insomnia. Does it really matter? Not especially, I think. The facts are in: I’m awake, and I’m not feeling chipper about anything right now. Then again, tomorrow’s always a new day. I look forward to the sun.
That’s a real issue. I don’t know if I fall into depression often enough to require happy pills, but I’m not too happy tonight. Looking to the future is bleak business, but once again, I can’t seem to help myself. They come, my thoughts, in waves of unscrupulous misery. Knowing that I’m not going to just slow down, but I won’t be able to do anything on my own in that future.
It’s a future of wheelchairs and frequent trips to the bathroom. It’s a future where I can’t open a milk carton, button a shirt, open a pill bottle. As for picking up my guitar and playing it? It’s difficult now, let alone when my left side becomes affected. Most likely by 45, I’ll be walking with a cane. By 55, with a walker—if I’m having a good day.
Yes, the depression hit. Or maybe it’s more like mourning. What am I mourning? My independence. My ability to do for myself; without having to rely on someone else. I’m a caregiver by trade. This is what I do. This is who I am. This is who I’ll no longer be.
With the passing of time. Yes, with the passing of time I’ll be less of myself. I’ll be slower, unsteady, ready to fall at any time. I do enough of that now. With the passing of time, it’ll get worse. No miracle drug is going to change that.
So, I have to ask, did the insomnia bring on the depression, or the depression bring on the insomnia. Does it really matter? Not especially, I think. The facts are in: I’m awake, and I’m not feeling chipper about anything right now. Then again, tomorrow’s always a new day. I look forward to the sun.
Arguments and Sunshine
If you and your spouse think that your marriage might be in trouble, then you need to watch this new show called “Marriage Ref.” They took two couples and recorded some of the most ridiculous arguments. Being male, I do have some level of feeling for the men in these altercations. What man out there has never argued with his wife about wanting to do something stupid and rather ludicrous? That being said, these guys took things over the limit as to what they were arguing about. I have to say, before I describe any of this, come on guys, dealing with women is hard enough as it is. Don’t go on TV arguing with your wife about these things. Isn’t dealing with women hard enough? We’re already considered idiots by the fairer sex. Why would you reinforce that stereotype?
The first one, dude wanted to keep a stuffed bulldog. No, not one of those fluffy little toys you but for children, but a real one that took a visit to the taxidermist after it died. I understand that you watch scrubs. I understand that you think Turk’s dog is a riot and the arguments with the woman(sorry, I’m not remembering the character’s name) are a riot. While I laughed my ass off throughout, I have to wonder if dude stopped to listen to himself before he agreed to do this show. It’s funny on TV, but to do in real life is rather… shall we say… foul. Makes me wonder if he’ll stuff his wife when she dies thinking that funeral expenses would be a lot less.
The next one wasn’t much better. He was trying to argue his wife into installing a stripper pole in their bedroom. I’ll pause for a moment while you take your hand, place it in the middle of your forehead, and proceed to shake it. Go on, you know you want to, I’ll wait…
Are you finished? Good. To this man I must say, are you dense? What woman in her right mind would consider allowing that to happen? Quit reading Penthouse Forum. We’re talking about real life here. Those stories in that magazine are as fictitious as Stephen King’s novels. Women don’t dance around a pole unless they’re paid well to do so. An unwilling participant just ain’t sexy. Consider yourself lucky that she gets naked with you. You’re trying to spice up your marriage? Go to the closest adult book store, walk past the Penthouse Forum—that one is giving you horrible ideas—and buy one of those sexy games. Those are fun and will spice things up without going overboard. Yes, the stripper pole is overboard numb nuts.
The sun is out today. It’s about damn time. A person can get tired of gray, overcast skies every day. Some sunshine does a parkie good. It gives a little vitamin D. I’ve been rather enjoying my trips outside to smoke today. The only problem is that snow is white. If it were blue, then there would be no problems. Alas, its whiteness only reflects the sun making it hard to look at.
And speaking of snow, I have to throw my sarcasm around again. Will everyone out there please realize that you are not meteorologists? You have training in the field, yet you want to practice what you don’t know, have no hope of knowing. Every week I am bombarded with people who are saying, “there’s another storm coming in. Two systems are supposed to collide. We’re supposed to get another eleven to eighteen inches.” What? The last time that was “supposed to happen” was last night. We didn’t get one snowflake, let alone another eleven to eighteen inches.
I’m aware that a powerful snow storm blew through here. I’m aware that it dumped two feet of snow in an area that only gets a couple of inches at a time and isn’t used to this. But the reputable source called the weather channel (come on… you know that one… they employ trained meteorologists… broadcast the weather predictions on the television) said that a “winter powerhouse” only really blows through every fifteen years or so. This means that we’re not due for another dumping like that until 2025. So will everyone PLEASE STOP PANICING!
On a sadder note, we at Trinity Episcopal Church were struck with a great loss yesterday afternoon. A friend, choir member, and all-around good guy passed away. Since this is over the internet, and I do not have permissions from his wife, I cannot in good conscience put his name for any old person to see. Those who are members of the church and reading this, you know who I’m talking about. May God grant him rest as he brings him into the company of heaven.
The first one, dude wanted to keep a stuffed bulldog. No, not one of those fluffy little toys you but for children, but a real one that took a visit to the taxidermist after it died. I understand that you watch scrubs. I understand that you think Turk’s dog is a riot and the arguments with the woman(sorry, I’m not remembering the character’s name) are a riot. While I laughed my ass off throughout, I have to wonder if dude stopped to listen to himself before he agreed to do this show. It’s funny on TV, but to do in real life is rather… shall we say… foul. Makes me wonder if he’ll stuff his wife when she dies thinking that funeral expenses would be a lot less.
The next one wasn’t much better. He was trying to argue his wife into installing a stripper pole in their bedroom. I’ll pause for a moment while you take your hand, place it in the middle of your forehead, and proceed to shake it. Go on, you know you want to, I’ll wait…
Are you finished? Good. To this man I must say, are you dense? What woman in her right mind would consider allowing that to happen? Quit reading Penthouse Forum. We’re talking about real life here. Those stories in that magazine are as fictitious as Stephen King’s novels. Women don’t dance around a pole unless they’re paid well to do so. An unwilling participant just ain’t sexy. Consider yourself lucky that she gets naked with you. You’re trying to spice up your marriage? Go to the closest adult book store, walk past the Penthouse Forum—that one is giving you horrible ideas—and buy one of those sexy games. Those are fun and will spice things up without going overboard. Yes, the stripper pole is overboard numb nuts.
The sun is out today. It’s about damn time. A person can get tired of gray, overcast skies every day. Some sunshine does a parkie good. It gives a little vitamin D. I’ve been rather enjoying my trips outside to smoke today. The only problem is that snow is white. If it were blue, then there would be no problems. Alas, its whiteness only reflects the sun making it hard to look at.
And speaking of snow, I have to throw my sarcasm around again. Will everyone out there please realize that you are not meteorologists? You have training in the field, yet you want to practice what you don’t know, have no hope of knowing. Every week I am bombarded with people who are saying, “there’s another storm coming in. Two systems are supposed to collide. We’re supposed to get another eleven to eighteen inches.” What? The last time that was “supposed to happen” was last night. We didn’t get one snowflake, let alone another eleven to eighteen inches.
I’m aware that a powerful snow storm blew through here. I’m aware that it dumped two feet of snow in an area that only gets a couple of inches at a time and isn’t used to this. But the reputable source called the weather channel (come on… you know that one… they employ trained meteorologists… broadcast the weather predictions on the television) said that a “winter powerhouse” only really blows through every fifteen years or so. This means that we’re not due for another dumping like that until 2025. So will everyone PLEASE STOP PANICING!
On a sadder note, we at Trinity Episcopal Church were struck with a great loss yesterday afternoon. A friend, choir member, and all-around good guy passed away. Since this is over the internet, and I do not have permissions from his wife, I cannot in good conscience put his name for any old person to see. Those who are members of the church and reading this, you know who I’m talking about. May God grant him rest as he brings him into the company of heaven.
Wednesday, March 3, 2010
Did I Really Complain?
Was that me who was complaining about the price of Azilect? Was it truly I who threw a fit about how much the co-pay was on it? While I stand that $60 is ridiculous, it works so well. No stiffness at all. My back doesn’t hurt, the top of my calf up through the back of my knee isn’t cramping. My right foot isn’t killing me. This morning took some time to get out of bed, but once I got my meds in me, everything seemed to diminish. My worst problem is some cotton mouth with no good hallucinations to go with it. The advantage to that is it keeps me drinking the water.
Now I’m not trying to sell anyone on the Azilect. I’m just trying to write down my own experience with everything. While for those whom this drug works, it really works. It can be a really nasty event for some people, too. I know I guy for whom Azilect was prescribed and he’s had speech problems ever since. For confidentiality’s sake, I shall not give a name for that. It’s something I have to be incredibly careful with. I need to follow the instructions on not only that, but also the dietary restrictions that it comes with—so I don’t have to follow the dietary restrictions, but see my last post for why I plan to anyway—and I need to start reading the warnings of everything over the counter that I take. I can’t even start a dietary supplement without checking with the doctor anymore.
The problem I’m faced with isn’t that the treatment option is working, but it’s working too well. This only makes the probability of this being Parkinson’s Disease(PD) more likely. Some would say, “you’re young… you have a lot of time left before this gets exceedingly bad.” And those fine folks would be right. I do have a long time before that happens. PD is a progressive disease, and it tends to progress even more slowly in those with young onset PD. On my days where I’m taking it one day at a time, this is how I consider things. Plan for the future, but don’t forget to live for today either.
I don’t always do that. PD deals with a shortage of dopamine producing cells. Any time you mess with brain chemicals and enzymes, you have a short-circuiting brain. This is why depression happens in around 50% of PD patients. I can’t say that I’m having any kind of depression issues, but I have my moments where I look too far ahead, and that looks rather bleak.
Today I’m okay. That’s half the purpose of doing this blog. To help me in keeping my thoughts on the here and now and not on what’s coming. There’s a lot for me to learn about my condition, and as I learn things, I can pass them along. Like the new research into PD. It seems that some researchers are starting to believe that it’s an immune system disease. They even claim that a vaccine can stop progression in people with advanced PD and reverse the symptoms in those in the early stages of the disease. There’s hope out there, but I’ll have a level of skepticism until there’s some kind of hard evidence. Not only is there no definitive test for this out there (with the exception of discovering lewy bodies in the brain during an autopsy), but I’ve already seen people trying to take advantage of hope for a cure too many times.
Now, I sit here praising my meds, but they haven’t been put to the test as of yet. I’m on vacation until Monday. It’s easy to say that it’s working wonders. I’m not under any kind of stress. While I’ve got some things I want to accomplish, I only need to put in two or three leisurely hours per day to accomplish those things. The rest of my day is spent relaxing, playing on the computer, playing on Facebook, trying to figure out this thing they call blogging, all the while, especially right now as I put these words onto the screen, listening to some classic rock. Today, it’s The Dark Side of the Moon. The true test of this stuff will be when I go back to work on Monday and add my normal daily stress. I’ll let you know how that goes.
Now I’m not trying to sell anyone on the Azilect. I’m just trying to write down my own experience with everything. While for those whom this drug works, it really works. It can be a really nasty event for some people, too. I know I guy for whom Azilect was prescribed and he’s had speech problems ever since. For confidentiality’s sake, I shall not give a name for that. It’s something I have to be incredibly careful with. I need to follow the instructions on not only that, but also the dietary restrictions that it comes with—so I don’t have to follow the dietary restrictions, but see my last post for why I plan to anyway—and I need to start reading the warnings of everything over the counter that I take. I can’t even start a dietary supplement without checking with the doctor anymore.
The problem I’m faced with isn’t that the treatment option is working, but it’s working too well. This only makes the probability of this being Parkinson’s Disease(PD) more likely. Some would say, “you’re young… you have a lot of time left before this gets exceedingly bad.” And those fine folks would be right. I do have a long time before that happens. PD is a progressive disease, and it tends to progress even more slowly in those with young onset PD. On my days where I’m taking it one day at a time, this is how I consider things. Plan for the future, but don’t forget to live for today either.
I don’t always do that. PD deals with a shortage of dopamine producing cells. Any time you mess with brain chemicals and enzymes, you have a short-circuiting brain. This is why depression happens in around 50% of PD patients. I can’t say that I’m having any kind of depression issues, but I have my moments where I look too far ahead, and that looks rather bleak.
Today I’m okay. That’s half the purpose of doing this blog. To help me in keeping my thoughts on the here and now and not on what’s coming. There’s a lot for me to learn about my condition, and as I learn things, I can pass them along. Like the new research into PD. It seems that some researchers are starting to believe that it’s an immune system disease. They even claim that a vaccine can stop progression in people with advanced PD and reverse the symptoms in those in the early stages of the disease. There’s hope out there, but I’ll have a level of skepticism until there’s some kind of hard evidence. Not only is there no definitive test for this out there (with the exception of discovering lewy bodies in the brain during an autopsy), but I’ve already seen people trying to take advantage of hope for a cure too many times.
Now, I sit here praising my meds, but they haven’t been put to the test as of yet. I’m on vacation until Monday. It’s easy to say that it’s working wonders. I’m not under any kind of stress. While I’ve got some things I want to accomplish, I only need to put in two or three leisurely hours per day to accomplish those things. The rest of my day is spent relaxing, playing on the computer, playing on Facebook, trying to figure out this thing they call blogging, all the while, especially right now as I put these words onto the screen, listening to some classic rock. Today, it’s The Dark Side of the Moon. The true test of this stuff will be when I go back to work on Monday and add my normal daily stress. I’ll let you know how that goes.
Azilect
The trip to the movement disorder specialist (who will henceforth be referred to as the MDS) wasn’t encouraging. To be fair, it wasn’t absolutely discouraging either. I came forth from her office without a diagnosis as to why I’m so shaky, but with a new pill, Azilect, nonetheless. The running theory is it looks like a fish and smells like a fish so we’ll treat it like a fish, even though we can’t call it a fish without another cardinal sign. Right now we have to say that it’s more of a salamander, but it’s more likely than not that you have a fish there.
The Azilect is good stuff. It works (am I supposed to be encouraged by that? I’m not sure) really well. It’s encouraging that my arm is steady as a rock, but the idea that the treatment regimen that’s working is the treatment for early PD kind of sucks in its own right.
There’s other problems with this particular drug, too. Price is the biggest. The co-pay for this is $60. They told me that at the pharmacy and I about fell over. Of course, I paid for it, I have to, anything that can help is worth it. But I get generics for all of $5 and all my other meds have generics. The Azilect doesn’t. Not only is it without a generic form, but my insurance company says that it’s a “tier 3 medication.” This means, they consider it too new and are unwilling to pay out too much for it. I’d like to know who comes up with this crap. Although, with a cash price of $384, I can see why the insurance company feels that way. This is price gouging that we let drug companies get away with. It probably only costs them ten cents to make one pill and they want more than ten dollars per pill. It’s out of control.
Next problem, this is an MAO-B inhibitor. What’s that mean? It means that every medication out there—and there’s a lot of them I can assure you—that says, “do not take if your taking a MAOI” is now off limits. That means my colds are going to really suck because that describes every cold medicine out there.
Then there’s the food restrictions. Oh goody! There is both German and Slovakian blood in my veins. I swear there’s some genetic predisposition to loving all things cabbage. Sauerkraut is out. Salami is out, as are aged cheeses. Bologna, salami, pepperoni, sausage, jerky, bananas, canned meats(tuna, Spam), any aged meat of any kind(fresh is okay); none of these can I eat. They’re all high in an enzyme called tyramine. Tyramine in excess could cause me to have a sudden, dangerous, and even life-threatening spike in blood pressure. To be fair, I also read that this is not necessarily the case with the Azilect. But after reading the previous literature to this, it’s like putting a bowl of sauerkraut at the other end of the swimming pool filled with alligators. You can tell me that the alligators have all just been well fed so they won’t attack me while they’re digesting. All I have to do to get that bowl of deliciousness is cross the pool without paying any mind to the gators. I’m going to miss my kraut.
The Azilect is good stuff. It works (am I supposed to be encouraged by that? I’m not sure) really well. It’s encouraging that my arm is steady as a rock, but the idea that the treatment regimen that’s working is the treatment for early PD kind of sucks in its own right.
There’s other problems with this particular drug, too. Price is the biggest. The co-pay for this is $60. They told me that at the pharmacy and I about fell over. Of course, I paid for it, I have to, anything that can help is worth it. But I get generics for all of $5 and all my other meds have generics. The Azilect doesn’t. Not only is it without a generic form, but my insurance company says that it’s a “tier 3 medication.” This means, they consider it too new and are unwilling to pay out too much for it. I’d like to know who comes up with this crap. Although, with a cash price of $384, I can see why the insurance company feels that way. This is price gouging that we let drug companies get away with. It probably only costs them ten cents to make one pill and they want more than ten dollars per pill. It’s out of control.
Next problem, this is an MAO-B inhibitor. What’s that mean? It means that every medication out there—and there’s a lot of them I can assure you—that says, “do not take if your taking a MAOI” is now off limits. That means my colds are going to really suck because that describes every cold medicine out there.
Then there’s the food restrictions. Oh goody! There is both German and Slovakian blood in my veins. I swear there’s some genetic predisposition to loving all things cabbage. Sauerkraut is out. Salami is out, as are aged cheeses. Bologna, salami, pepperoni, sausage, jerky, bananas, canned meats(tuna, Spam), any aged meat of any kind(fresh is okay); none of these can I eat. They’re all high in an enzyme called tyramine. Tyramine in excess could cause me to have a sudden, dangerous, and even life-threatening spike in blood pressure. To be fair, I also read that this is not necessarily the case with the Azilect. But after reading the previous literature to this, it’s like putting a bowl of sauerkraut at the other end of the swimming pool filled with alligators. You can tell me that the alligators have all just been well fed so they won’t attack me while they’re digesting. All I have to do to get that bowl of deliciousness is cross the pool without paying any mind to the gators. I’m going to miss my kraut.
Welcome to My World
One day, you’re good; life is going at least semi-decently, your young, full of pep, at the top of your game. All of a sudden, with no warning at all, a friend, maybe a coworker notices you’re shaking. It’s been a stressful day so you remove yourself from the stressor for a few minutes, taking some time to drink a cup of coffee. The coffee break makes you feel better. You go back to doing your thing. A few days later, you’re still shaking, except you haven’t been under any kind of stress that day. There’s absolutely no reason to be shaking. Mentally you don’t feel yourself. You haven’t felt all week, in fact.
Off to the ER you go, worried that you might have finally cracked, that you’re losing it. Your heart’s racing, you’re dizzy, and you want checked as soon as possible. The good doctors, I use “good” loosely, call it an anxiety attack. They take a CT of your brain to be sure. They obviously never gave you a good visual assessment, because they miss the fact that only one of your arms is shaking. The other one is as steady as it gets. But you notice that the next day. You also notice that the arm stops shaking when you move it intentionally.
Now instead of just deciding to go to the doctor’s office, which you have already decided because one sided anything is never good, you become a fool. You hop on the computer and look up “shaking in one arm” on Web MD. Who doesn’t do this kind of idiocy anymore? That’s what the internet is for, right: information that you wouldn’t have access to otherwise. The first result that shows up gives you a problem. You’re only 30 years old. That one’s impossible. You click on it anyway you numbskull. The thought is, this is so ridiculous that I’m just going to read it and rule it out. The problem is, you can’t rule it out. A lot of the symptoms in the list fit you too well.
Now don’t get me wrong, I know how trying to self-diagnose works. You read a list of symptoms and you can claim most of them at one time or another in your life. Who hasn’t experienced dizziness after getting up out of a chair? Or how about tripping over something and losing balance? No one goes through life without doing that one. None of those things are the ones that scare you. It’s the obscure problem that is more rare and you can never say, “that’s me,” unless you actually have that problem. That’s what makes you hang your head and say, “Shit… I can’t rule it out after all.” The real kicker is that you find out that being 30 does not necessarily disqualify you from this either. Now you’re worried.
So to your PCP’s office you go. You have no idea whatsoever that this is the first of many trips to that paper covered, beige table that you quickly learn to hate. Let’s face it folks, those things are not comfortable; not in the least bit. Your PCP comes into the room in my case I’ll be singing next to the same guy in two days at choir rehearsal at church and gets a slightly worried face when he examines you. Not only is your arm shaking, but it’s much weaker than the other arm. He gives a prescription for a low dose of Propranalol and orders blood work and an MRI of your neck. He also has his office people make an appointment with a neurologist for you. They can’t get one for you for at least two months. Right now, your doctor is calling this a “resting tremor.” The PCP wants to see you back in two weeks.
A few days later, you have your MRI and a few days after that the PCP’s office calls you to say that they’re sending you to not only the neurologist, but a neurosurgeon as well. Apparently, you have two bulging discs. Your blood work also shows that you’re slightly deficient in Folic Acid and Vitamin B12. You pick up another prescription for Folic Acid. You’re happy though, you have a pretty solid explanation for the tremor. A little rehab and you should be good. You’re ready to go back to the PCP’s office to hear the official good news. No more worrying about that silly little thing that you read on Web MD. As a side note, I would say to avoid Web MD at all costs. It never does any good for you to dwell on this stuff. I learned the hard way.
So you head back to the PCP’s office in a much better mood than you were in the first time. That beige table with the thin, white paper doesn’t feel so hard this time. There’s a cause that can be easily corrected. Bulging discs cause pinched nerves which can cause tremors. Your PCP’s first statement breaks your bubble like a tank firing a round into a glass building. The discs are bulging to the left. Your tremors are in your right arm. They explain your occasional left shoulder pain nicely. But your right arm remains a mystery. The PCP calls you his “interesting case.” You don’t want to be his interesting case, thank you very much and good day. Someone else can have that fine honor. How about a rain check on that, huh?
Such foolery does you no good. This is happening, it’s for real, and there’s nothing you can do. There’s an unknown problem of unknown origin. All the reading your doctor has done hasn’t given him any kind of answers. He now orders a nerve conduction study with EMG and an MRI of your brain. Off to the neurosurgeon’s office you go, but the neurosurgeon tells you that he can help you with the bulging discs if they ever get too painful, but as for your tremors, you’ll have to see the neurologist. There’s nothing he can do for that.
You get into the neurologist’s office, and once again you sit on one of those damned tables again. It’s even harder this time. The MRI of the brain showed that there was a brain, but nothing out of the ordinary. The nerve conduction study and EMG also showed nothing abnormal. According to all the tests, you’re healthy. The problem is being that it’s been three months to this point and the only time your arm stops shaking is when you’re asleep. There’s something else to tell him too. You have been tripping too easily, often over your own feet, you get dizzy when you walk too fast, change direction, bend over, sit down, and stand up. You also have been experiencing a good amount of fatigue. You just can’t pull off the twelve hour shift like you used to.
He checks you out. Moves both of your arms, has you push and pull against his hands and squeeze his fingers. He also has you walk heel to toe, which you can’t do very well, and then he says to close your eyes and stand with your feet together. When did we get in the middle of the ocean, you think as you keep having to step to your side to catch balance. They come back in and tell you that your right arm, the one that shakes, is a lot stiffer than your left. They mention that horrible thing you saw on Web MD but say you’re too young for that. They call it a stress reaction tremor, give you a prescription for an anticolinergic called Artane and we’ll see you in two months. He also has his office make you an appointment to see another neurologist, this one with a subspecialty in movement disorders.
After two months have gone by, you go back to the neurologist. You haven’t seen the movement disorder specialist yet, but the appointment is made for the first of the following month. You ask him what you’re looking at. The neurologist isn’t a bad guy. He has a dry sense of humor, but you get it. Your sense of humor is just as dry as his. The first thing he does is he takes in a sharp, hissing breath and says the word that two months ago he said you’re too young for. And then, as an aside, he says that there’s still a chance that it’s a benign tremor. You know as well as he does that it’s bullshit, but he says it to keep some hope out there.
I see the movement disorder specialist tomorrow morning. My symptoms have gotten worse in the past couple of weeks. I’m a lot stiffer, especially in the mornings. Yesterday in Walmart, I walked through the store leaning heavily on the cart. I didn’t do this because I thought that it was a good idea. I had no choice. It was either that or get one of those motorized carts, and people look with contempt at a thirty-year-old using one of those, without stopping to think that someone my age wouldn’t even think of using one unless it was absolutely needed.
Off to the ER you go, worried that you might have finally cracked, that you’re losing it. Your heart’s racing, you’re dizzy, and you want checked as soon as possible. The good doctors, I use “good” loosely, call it an anxiety attack. They take a CT of your brain to be sure. They obviously never gave you a good visual assessment, because they miss the fact that only one of your arms is shaking. The other one is as steady as it gets. But you notice that the next day. You also notice that the arm stops shaking when you move it intentionally.
Now instead of just deciding to go to the doctor’s office, which you have already decided because one sided anything is never good, you become a fool. You hop on the computer and look up “shaking in one arm” on Web MD. Who doesn’t do this kind of idiocy anymore? That’s what the internet is for, right: information that you wouldn’t have access to otherwise. The first result that shows up gives you a problem. You’re only 30 years old. That one’s impossible. You click on it anyway you numbskull. The thought is, this is so ridiculous that I’m just going to read it and rule it out. The problem is, you can’t rule it out. A lot of the symptoms in the list fit you too well.
Now don’t get me wrong, I know how trying to self-diagnose works. You read a list of symptoms and you can claim most of them at one time or another in your life. Who hasn’t experienced dizziness after getting up out of a chair? Or how about tripping over something and losing balance? No one goes through life without doing that one. None of those things are the ones that scare you. It’s the obscure problem that is more rare and you can never say, “that’s me,” unless you actually have that problem. That’s what makes you hang your head and say, “Shit… I can’t rule it out after all.” The real kicker is that you find out that being 30 does not necessarily disqualify you from this either. Now you’re worried.
So to your PCP’s office you go. You have no idea whatsoever that this is the first of many trips to that paper covered, beige table that you quickly learn to hate. Let’s face it folks, those things are not comfortable; not in the least bit. Your PCP comes into the room in my case I’ll be singing next to the same guy in two days at choir rehearsal at church and gets a slightly worried face when he examines you. Not only is your arm shaking, but it’s much weaker than the other arm. He gives a prescription for a low dose of Propranalol and orders blood work and an MRI of your neck. He also has his office people make an appointment with a neurologist for you. They can’t get one for you for at least two months. Right now, your doctor is calling this a “resting tremor.” The PCP wants to see you back in two weeks.
A few days later, you have your MRI and a few days after that the PCP’s office calls you to say that they’re sending you to not only the neurologist, but a neurosurgeon as well. Apparently, you have two bulging discs. Your blood work also shows that you’re slightly deficient in Folic Acid and Vitamin B12. You pick up another prescription for Folic Acid. You’re happy though, you have a pretty solid explanation for the tremor. A little rehab and you should be good. You’re ready to go back to the PCP’s office to hear the official good news. No more worrying about that silly little thing that you read on Web MD. As a side note, I would say to avoid Web MD at all costs. It never does any good for you to dwell on this stuff. I learned the hard way.
So you head back to the PCP’s office in a much better mood than you were in the first time. That beige table with the thin, white paper doesn’t feel so hard this time. There’s a cause that can be easily corrected. Bulging discs cause pinched nerves which can cause tremors. Your PCP’s first statement breaks your bubble like a tank firing a round into a glass building. The discs are bulging to the left. Your tremors are in your right arm. They explain your occasional left shoulder pain nicely. But your right arm remains a mystery. The PCP calls you his “interesting case.” You don’t want to be his interesting case, thank you very much and good day. Someone else can have that fine honor. How about a rain check on that, huh?
Such foolery does you no good. This is happening, it’s for real, and there’s nothing you can do. There’s an unknown problem of unknown origin. All the reading your doctor has done hasn’t given him any kind of answers. He now orders a nerve conduction study with EMG and an MRI of your brain. Off to the neurosurgeon’s office you go, but the neurosurgeon tells you that he can help you with the bulging discs if they ever get too painful, but as for your tremors, you’ll have to see the neurologist. There’s nothing he can do for that.
You get into the neurologist’s office, and once again you sit on one of those damned tables again. It’s even harder this time. The MRI of the brain showed that there was a brain, but nothing out of the ordinary. The nerve conduction study and EMG also showed nothing abnormal. According to all the tests, you’re healthy. The problem is being that it’s been three months to this point and the only time your arm stops shaking is when you’re asleep. There’s something else to tell him too. You have been tripping too easily, often over your own feet, you get dizzy when you walk too fast, change direction, bend over, sit down, and stand up. You also have been experiencing a good amount of fatigue. You just can’t pull off the twelve hour shift like you used to.
He checks you out. Moves both of your arms, has you push and pull against his hands and squeeze his fingers. He also has you walk heel to toe, which you can’t do very well, and then he says to close your eyes and stand with your feet together. When did we get in the middle of the ocean, you think as you keep having to step to your side to catch balance. They come back in and tell you that your right arm, the one that shakes, is a lot stiffer than your left. They mention that horrible thing you saw on Web MD but say you’re too young for that. They call it a stress reaction tremor, give you a prescription for an anticolinergic called Artane and we’ll see you in two months. He also has his office make you an appointment to see another neurologist, this one with a subspecialty in movement disorders.
After two months have gone by, you go back to the neurologist. You haven’t seen the movement disorder specialist yet, but the appointment is made for the first of the following month. You ask him what you’re looking at. The neurologist isn’t a bad guy. He has a dry sense of humor, but you get it. Your sense of humor is just as dry as his. The first thing he does is he takes in a sharp, hissing breath and says the word that two months ago he said you’re too young for. And then, as an aside, he says that there’s still a chance that it’s a benign tremor. You know as well as he does that it’s bullshit, but he says it to keep some hope out there.
I see the movement disorder specialist tomorrow morning. My symptoms have gotten worse in the past couple of weeks. I’m a lot stiffer, especially in the mornings. Yesterday in Walmart, I walked through the store leaning heavily on the cart. I didn’t do this because I thought that it was a good idea. I had no choice. It was either that or get one of those motorized carts, and people look with contempt at a thirty-year-old using one of those, without stopping to think that someone my age wouldn’t even think of using one unless it was absolutely needed.
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