DEAR DR. DONOHUE: I am 85 and have had angina since 1982. I take atenolol, Norvasc and aspirin. I have had essential tremor for the same amount of time. I have the tremor when writing or lifting a cup or fork. I have no tremor when at rest. Is there a medication for this? I have been told to try taurine. What do you suggest? – A.S.

ANSWER: Two percent of North Americans share essential tremor with you. It is just as you describe. When people with this tremor lift a cup, a fork or a spoon to their lips, the tremor kicks in, and the food or drink does not always make it to the mouth. Threading a needle is a herculean task.

Yes, there are medicines that can keep it controlled. One family of medicines, the beta blockers, is quite successful at eliminating the tremor. Inderal is one of those medicines. So is your atenolol. You might ask your doctor if a slightly larger dose would be safe for you as a control for your tremor.

If not, don’t fret. There are other medicines that can be quite effective in steadying the hands of a person with essential tremor. Mysoline and Klonopin are two examples. Botox – a diluted form of the toxin that causes botulism, the most serious kind of food poisoning – can be injected to block the nerve bombardment of hand muscles that occurs with this condition.

For extreme cases, when the shaking disrupts a person’s life and when no medicine controls it, deep-brain stimulation is a newer technique that can often accomplish what medicines can’t. The stimulator is much like an artificial pacemaker for the heart. By way of wires implanted in the brain, it delivers electrical impulses that stop the shakiness of essential tremor.

Taurine is a byproduct of an amino acid. I don’t think it will help your tremor.

DEAR DR. DONOHUE: My pulse rate jumps all over when I am not active. It can rise suddenly from 58 to 110. Is this important? – R.E.

It’s a matter that ought to bring you to your doctor’s office. If you have any symptoms, such as fatigue, dizziness, shortness of breath or a feeling that you are on the verge of fainting, it should bring you to your doctor’s office quickly.

You could have sick sinus syndrome. In this case, the sinus is a small island of special heart cells that activates every heartbeat by generating a blip of electricity. The syndrome is also known as the brady-tachy (slow-fast) syndrome. It would be a good idea to have all your heartbeats recorded for two or three days. You can do that by wearing a portable heart monitor.

If you have this syndrome, a pacemaker keeps the heart beating at a normal tempo.

Abnormal heartbeats are a frequent problem for people. Atrial fibrillation, for example, happens to a large segment of the older population. Heartbeat irregularities are discussed in the pamphlet of that name. Readers can obtain a copy by writing: Dr. Donohue – No. 107, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.50 U.S./$6.50 Can. along with the recipient’s printed name and address. Please allow four weeks for delivery.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475.

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