DEAR DR. DONOHUE: My hands shake something terrible. People say it’s my nerves. It isn’t. I am not the least bit nervous. The shaking bothers me when I eat and when I have to make public speaking presentations, which my job requires. During the presentation, I use a small, laser-beam light to underline important points on my projected slides. The light shakes with my hands. It’s mortifying. My wife says I have Parkinson’s disease. I am only 47. Is that possible? What can be done about this? – B.F.

ANSWER: I don’t believe you have Parkinson’s disease. I believe you have essential tremor. It’s a tremor that occurs when you’re using your hands, as in eating or pointing with a laser light. It’s a common problem, afflicting 5 percent of the population. It usually worsens with age. Essential tremor is also called familial tremor, because half the people who have it can find the same kind of tremor in some of their close relatives.

This tremor is seen mostly in the hands and forearms, but it can affect the head and rarely the legs. Even the voice might be involved and take on a trembling quality; the vocal muscles are shaking.

One peculiar aspect is the abolition of the tremor by alcohol. Alcohol can almost always stop the shaking for a time. It can’t be used as a treatment. Overuse of alcohol has consequences of greater severity than essential tremor.

Medicines are effective in quieting the tremor. Inderal (propranolol) is one, and Mysoline (primidone) is another. There are others. You don’t have to take medicine on a regular basis if you prefer not to. You can take it only before your presentations or when you are eating out.

Sometimes essential tremor is disabling, and sometimes it doesn’t respond to medicines. In those cases, a deep brain stimulator – an affair much like a heart pacemaker – can be implanted. Wires are connected to the part of the brain responsible for tremor messages, and the stimulator suppresses activity there.

DEAR DR. DONOHUE: I got a chest X-ray this past week, and my doctor sent me a copy of the report. It says my lungs are “hyperinflated.” What does that mean? I’ve never smoked. My doctor says it means nothing. What do you say? I am 77. – L.F.

ANSWER: It indicates emphysema. In emphysema, which is one of the two chronic obstructive pulmonary diseases, the lung’s air sacs – the alveoli – are destroyed, and the lungs have more air in them than normal. They’re hyperinflated. Unfortunately, the air’s oxygen can’t get into the blood because of air sac destruction.

Most chest X-rays of men your age show a touch of emphysema from aging. I go along with your doctor. Don’t worry about this. An X-ray is not the best test for emphysema. Breathing tests are.

READERS: Asthma is an often-asked-about pulmonary disease, and the booklet on this topic describes asthma and its treatment. Readers can obtain a copy by writing: Dr. Donohue – No. 602, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.

DEAR DR. DONOHUE: I have some acne, but not very bad. My mom thinks I don’t scrub my face hard enough or wash it enough. I wash twice a day, in the morning and again before going to bed. If I washed more, would the acne go away? – E.C.

ANSWER: No, it wouldn’t.

Twice a day is more than enough washing for you and for anyone with acne. And it’s wrong to scrub. Scrubbing irritates the skin and causes more pimples to break out.

You’re doing things right. Stick with it. Use a mild kind of soap, not a harsh one.

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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