DEAR DR. DONOHUE: Some time ago, you wrote about a tremor that runs in families. I have a tremor and talked to my doctor, who referred me to a specialist because he thought I might have Parkinson’s disease. My brother and I have a similar hand tremor. My sister has a shaking of her head.

When told this was familial tremor, my doctor thought the medicine for it would slow me down and I should wait until it is really necessary. I use my hands to do online taxes. Is there any medicine that would not affect me in any other way? – T.B.

ANSWER:
Many people with familial (also called “essential” tremor) believe they have Parkinson’s disease. The shaking tremor of Parkinson’s disease occurs when the hands are at rest. The shaking hands of essential tremor occur when a person makes a purposeful movement, like bringing a spoonful of soup to the lips, raising a cup of coffee or doing any fine hand work. Essential tremor does run in families – yours proves it. The head can shake in a yes-yes motion or a no-no motion, like your sister’s head does. Head tremors are not found with Parkinson’s disease. Sometimes essential tremor affects the voice and gives it a quivering quality. Another distinctive feature of essential tremor is its abolishment by alcohol. Alcohol’s effect is only short-lived and should not be used as a treatment since alcohol abuse is far worse than essential tremor.

If the tremor is a bother only in certain circumstances, then you can take medicines before those occasions take place. The two most often prescribed are propranolol (Inderal) and primidone (Mysoline). Taken in moderate doses, they should not slow you down. Botox can be effective for head tremor and for a quivering voice.

Stay away from stimulants like caffeine; they worsen the tremor.

Some essential tremor patients have a shaking so great that they cannot function. If these people don’t respond to medicine, then a device similar to a pacemaker can control the tremor. Wires from the pacemaker are placed in brain areas that produce the tremor.

Contact the International Essential Tremor Foundation at its toll-free number, 888-387-3667, or on the Internet at www.essentialtremor.org. You’ll be glad you did.

DEAR DR. DONOHUE: What are your thoughts on hypnosis for smoking and weight loss? Is it really worth a try? – M.W.

ANSWER:
I know people who have lost weight after hypnosis, and I know people who have stopped smoking after hypnosis. I also know people who didn’t lose weight or stop smoking after hypnosis. But that can be said about any weight-loss or smoking-cessation program

If the cost isn’t exorbitant and you want to give it a try, go for it. I like the “full money back guarantee” statement in the advertisement you sent me.

You also must learn proper nutrition, and you can do that from a dietitian.

DEAR DR. DONOHUE: We are a couple in our early 70s, blessed with good health and adequate energy. We are considering moving from our multilevel home to a single-story home. We are frequently advised that the stairs in our present home pose a risk and a difficulty if either of us becomes ill. We have two staircases with 13 steps each.

We are asking for your opinion. Do the benefits of climbing stairs outweigh the risk of stair-climbing at our age? – J.C.

ANSWER:
Stair-climbing is good exercise. Right now, you are managing well in your home. I would try to arrive at an answer to your question by figuring out what would be the greater loss to you – moving from your home to a new one or facing the possibility of not being able to function in your home should you become ill? If you like your home and are comfortable there, a move might be an unpleasant experience. If you think you might become incapacitated, staying where you are would be a greater downer. Me? I’d stay put.

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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