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.
No comments:
Post a Comment