So how is someone, knowing that someone has something like PD, going to ask “how in the world” something that person did took so long? All I have to say is are you dense? Do you honestly think that I don’t know that I’m more of a hindrance than a help out there on the floor? Why do you think that I put in a bid on a less physical position? Why do you think that my staying employed depends on this position?
Let me explain the entirety of the situation. One particular resident had to have a shower today. This isn’t so bad, but he took me forty five minutes to shower before I started showing symptoms of PD. Plus, I had to get his weight before showering him. Add in some permanent progression from the cold that turned into severe bronchitis to mild pneumonia, and what you have is a patient who takes extra long being taken care of by someone who is extra slow. I have to be slow. I’ll hit the floor otherwise, and that linoleum is hard. This shower took me an hour and fifteen minutes to accomplish.
To further complicate the matter, I was on the second lunch. The first lunch goes at eleven, the second at eleven-thirty. It is the responsibility of the person on the second lunch to fill the water pitchers with ice. This is usually done while the first lunch is away, but it’s not something set in stone, and I was still showering this resident. I started him at ten-thirty, and finished at quarter to twelve.
This particular coworker feels that this ice passing time is set in stone. She was very upset—not descriptive enough—ready to crucify me that the ice had not yet been passed. The way I see it, I was there till three, and as long as it got done before three, then my job had been done. The encounter went down like this,
Her: You didn’t pass ice?
Me: I just got done showering my guy.
Her: I’m not doing it, it’ll be waiting.
Me: Did I ask you to do it?
Her: No you didn’t ask. How in the world did it take you till quarter to twelve to shower your guy when you started at ten-thirty?
Me: I had a choice to make here. Do I rip her a new asshole? Do I tell her to politely kiss my ass? Do I ask her to take a wild guess as to why it took me so long? What I said was, “ it just did.”
The thing is, I fake being okay when I’m at work. I have to. Who wants to know that the person taking care of them is himself sick? There are very few residents who know or have known that I have PD. It’s only those who I feel that it’ll help to know that I have an idea what they’re feeling, because I often feel the same things. (I will never say, dear reader, that I know what they feel, but only an idea of it.) I’m someone who will listen, and for those few, it helps.
Thing is, I’m tired of faking being okay. I’m not. When I say that my employment depends on this position, I don’t mean that I’d quit because I’m pissed off that I didn’t get the position. I’d have to leave because I’m no good to anyone doing floor work anymore. I’m too damned slow.
To my coworker, who will probably never read this, but that means nothing right now, you need to try something. It’s real easy, I promise. You need to remember that I am not you. I don’t move at your speed. I don’t think like you do. I don’t reason like you do. I don’t run according to your schedule. As long as everything’s done before I leave, I don’t believe it matters when I do it. So the next time you need to open your interminable trap, try thinking first. Chances are, the person you’re talking to is fully aware already of his or her shortcomings. I tell you the truth, I really don’t need reminded.
Showing posts with label stress. Show all posts
Showing posts with label stress. Show all posts
Monday, November 1, 2010
Tuesday, October 26, 2010
Siloam
Another Tuesday night during the fall program at church. This year is a program that we’re calling Transformational Tuesdays. This is essentially a program where we gather together for a meal and then our rector gives us a talk based on the fruit of the Spirit. Today’s lesson was on peace.
Here’s a lesson I sorely needed given the past week. The funny thing is, I realized, before the end of the week, that God had my back the whole time. He let me go through my worries, the whole time carrying me to that point of realization. And then for that to be the topic of the night just floored me (not literally, dear reader, but you get the point). Now, dear reader, if you are not of the Christian faith, you may take a look at what happened the past couple of days and say, “huh… coincidence.” I have to say count the coincidences. How many does it take before a coincidence stops being coincidence?
The talk she gave was really good, and the reading we did, which I will get into later since I don’t want too much from the talk to seep in to my post. Some is okay, but not as much as will be if I do it in this post. It ended with an exercise in meditation, just sitting in Christ’s presence. That, to me, was the best part of the evening. This meditation thing is something that I need to do more often.
The perfect end to what has been a horrible seven days. When my cold hit my chest, it knocked me down and out. My Parkinson’s symptoms reached levels that I had never before experienced. Naturally, the first thing that crossed my mind was, “will this cause a permanent progression of the symptoms?” The unfortunate answer to that is yes, it did, but not so bad as they were during the height of my illness. I’m stiffer, I’m slower, my hand shakes more, but not so much as it could have been.
Even so, it makes me question how safe it is for me to be transferring people from bed to wheelchair. I’ve described the events of the meeting at work twice now, so I won’t be going into detail of it. But when I called last Friday to request a meeting, it was with a heavy heart that I did so.
I don’t know why I called it. I believe that there was something in the back of my mind that’s tired of fighting this damned thing. How about that, I’ve only been dealing with it for the past year, and I’m already tired of fighting it. Every time I seem to get ahead, I seem to lose something else. I lose a little balance, or a little muscle strength. This beast keeps taking, but only a little.
We talked about peace, and then, even now, I want to cry out from the depths of my soul. My eyes are not dry as I write about it, either. I’m not in full blown water works, praise God. Nevertheless, I want to say screw it. Something deep in me wants to let this bastard do what it’s going to do. That something wants to ask, “Why fight it? It’s going to win anyway.”
Now how did a posting starting with peace turn into a lament? Probably because I need to say it and don’t want to make someone listen to my whining. The blog is safe. If I were to say this out loud to someone, face to face, I can’t be certain that I won’t lose it. I haven’t lost it over this yet, and I definitely don’t want to start now. I can put my heart into the blog and never go past having some wet eyelashes. It’s safe here.
Plus there’s the knowledge that if you’ve gotten this far, dear reader, then I can be sure that you want to hear it. When I’m among people, my instincts are to not show weakness. What people can see—what I want them to see—is someone who accepts what’s happening to him and just plods onward. I don’t want someone to see me frustrated because I’m struggling to open the milk carton, or I knocked over something else because I have no concept of how much space is between my hand and an object. I don’t want someone knowing that I’m ready to scream I HAVE HAD ENOUGH at the top of my lungs.
This is where I need the peace that transcends all understanding that we’re promised in Ephesians 4:7. I long for that peace. I yearn for that peace. I’ll make you a deal, dear reader. Pray for me and I’ll pray for you (I’ll do that anyway). Then maybe we both can experience that kind of peace.
Here’s a lesson I sorely needed given the past week. The funny thing is, I realized, before the end of the week, that God had my back the whole time. He let me go through my worries, the whole time carrying me to that point of realization. And then for that to be the topic of the night just floored me (not literally, dear reader, but you get the point). Now, dear reader, if you are not of the Christian faith, you may take a look at what happened the past couple of days and say, “huh… coincidence.” I have to say count the coincidences. How many does it take before a coincidence stops being coincidence?
The talk she gave was really good, and the reading we did, which I will get into later since I don’t want too much from the talk to seep in to my post. Some is okay, but not as much as will be if I do it in this post. It ended with an exercise in meditation, just sitting in Christ’s presence. That, to me, was the best part of the evening. This meditation thing is something that I need to do more often.
The perfect end to what has been a horrible seven days. When my cold hit my chest, it knocked me down and out. My Parkinson’s symptoms reached levels that I had never before experienced. Naturally, the first thing that crossed my mind was, “will this cause a permanent progression of the symptoms?” The unfortunate answer to that is yes, it did, but not so bad as they were during the height of my illness. I’m stiffer, I’m slower, my hand shakes more, but not so much as it could have been.
Even so, it makes me question how safe it is for me to be transferring people from bed to wheelchair. I’ve described the events of the meeting at work twice now, so I won’t be going into detail of it. But when I called last Friday to request a meeting, it was with a heavy heart that I did so.
I don’t know why I called it. I believe that there was something in the back of my mind that’s tired of fighting this damned thing. How about that, I’ve only been dealing with it for the past year, and I’m already tired of fighting it. Every time I seem to get ahead, I seem to lose something else. I lose a little balance, or a little muscle strength. This beast keeps taking, but only a little.
We talked about peace, and then, even now, I want to cry out from the depths of my soul. My eyes are not dry as I write about it, either. I’m not in full blown water works, praise God. Nevertheless, I want to say screw it. Something deep in me wants to let this bastard do what it’s going to do. That something wants to ask, “Why fight it? It’s going to win anyway.”
Now how did a posting starting with peace turn into a lament? Probably because I need to say it and don’t want to make someone listen to my whining. The blog is safe. If I were to say this out loud to someone, face to face, I can’t be certain that I won’t lose it. I haven’t lost it over this yet, and I definitely don’t want to start now. I can put my heart into the blog and never go past having some wet eyelashes. It’s safe here.
Plus there’s the knowledge that if you’ve gotten this far, dear reader, then I can be sure that you want to hear it. When I’m among people, my instincts are to not show weakness. What people can see—what I want them to see—is someone who accepts what’s happening to him and just plods onward. I don’t want someone to see me frustrated because I’m struggling to open the milk carton, or I knocked over something else because I have no concept of how much space is between my hand and an object. I don’t want someone knowing that I’m ready to scream I HAVE HAD ENOUGH at the top of my lungs.
This is where I need the peace that transcends all understanding that we’re promised in Ephesians 4:7. I long for that peace. I yearn for that peace. I’ll make you a deal, dear reader. Pray for me and I’ll pray for you (I’ll do that anyway). Then maybe we both can experience that kind of peace.
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.
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.
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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