DEAR DR. DONOHUE: I am 63 and have had shaky hands since I was 45. They’re getting worse now. I won’t eat soup because I make a spectacle of myself. My wife says this is Parkinson’s disease. Is it? – H.D.

ANSWER: I’d say its essential tremor, which also goes by the name of familial tremor since it runs in families. People with the tremor find it difficult to do anything that requires controlled hand and arm movement – bringing a spoonful of soup to the mouth, taking a sip from a full cup of coffee, turning a screwdriver or writing by hand.

The tremor of Parkinson’s disease is a rest tremor, seen when the hands are lying in the lap. Essential tremor comes on with use of the hands. It often worsens as the years pass. Sometimes the head develops a shake, something that doesn’t happen in Parkinson’s disease. The voice can take on a trembling quality.

Alcohol often abolishes essential tremor for a short time. Alcohol can’t be used as a treatment, but it does serve as a test for essential tremor.

Inderal, a medicine used to regulate heartbeats, and Mysoline, a seizure-control medicine, are two drugs prescribed for this tremor. There are other medicines for it. If the tremor gets so bad that it incapacitates a person – and that can happen – and if it doesn’t respond to medicines, then deep brain stimulation is another way of abolishing it. An electrode stimulates the part of the brain that controls movement. It’s connected to a small generator put in the chest, like a pacemaker.

Call the International Essential Tremor Foundation at 1-888-387-3667. The foundation supplies information that lets you know the latest treatment for this condition. Its Web site is www.essentialtremor.org. All those with essential tremor, and that’s a lot of people, ought to take advantage of the foundation’s many services.

DEAR DR. DONOHUE: The doctor found a small tumor in my lung on an X-ray. It’s less than an inch in diameter. I have no symptoms. The chest surgeon feels it would be to my advantage to have the tumor and part of the lung removed. I don’t know if I’ll be able to function with a part of my lung missing. I have trouble breathing as it is. What would you do if you were me? – D.M.

ANSWER: I am positive that the doctors will go over you with a fine-toothed comb before any surgery. Part of the examination will be a determination of how well your lungs function. The results of those tests will enable your doctor and you to judge if part of your lung can be safely removed.

If the tests indicate surgery is not an option, there are other treatments. Picking the right one depends on the kind of lung cancer you have and checking to see if the tumor has spread. Radiation and chemotherapy are two nonsurgical treatments.

Since the doctor suggested surgery for you, surgery is probably the best choice for your particular cancer. There are four different kinds of lung cancer.

DEAR DR. DONOHUE: What effect does alcohol have on vitamins? I take my vitamins in the morning. At dinner, I have two beers. My wife thinks that the beer interferes with the absorption of vitamins from food and from the capsules I take in the morning. That sounds ridiculous to me. – F.S.

ANSWER: Two beers at dinner won’t affect vitamin absorption from your food or the absorption of vitamins you took in the morning. The morning vitamins have been absorbed well before you drink any beer.

Drunk in large amounts, alcohol can affect a person’s vitamin status. For example, excessive amounts of alcohol can block the absorption of the B vitamin thiamine. Furthermore, it hastens thiamine’s breakdown.

The result of chronic alcoholism, when it creates a thiamine deficiency, is known as Wernicke’s encephalopathy – a destruction of brain cells. People with the condition lose control of eye muscles, and they see double images. They are unsteady when walking, even when they aren’t drinking. If they develop memory problems and make up stories to cover their memory lapses, then the disorder is called Korsakoff’s syndrome.

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. Readers may also order health newsletters from www.rbmamall.com


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