DEAR DR. DONOHUE: My hands shake, sometimes uncontrollably and always embarrassingly. People ask me if it’s my nerves. I tell them I don’t think so. I’m really not the least bit nervous. If it’s not nerves, what is it? What can be done for it? — L.H.

ANSWER: It’s not nerves; it’s not Parkinson’s disease. Most likely, it is essential tremor, also known as familial tremor. In this instance, “essential” means “not linked to any other illness.” ”Familial” indicates that it runs in families. The tremor is most obvious when a person performs a deliberate act, like bringing a spoonful of soup to the mouth, sewing or doing anything that requires steady hands. The tremor might take place in other body parts. The head can bob, or the vocal cords might tremble to give the voice a quaver.

Emotional situations, fatigue and exhausting exercise worsen the hand tremor. Peculiarly, alcohol abolishes it for a time. Alcohol can’t be used as a treatment, since alcohol dependence is worse than the tremor.

Inderal (propranolol) is one of the first drugs turned to for control of the tremor. It works for many people. If it doesn’t, Mysoline (primidone) can be prescribed.

Some people are absolutely incapacitated by this tremor and do not respond to medicine. These people ought to consider deep brain stimulation, the same kind of therapy used for some Parkinson’s disease patients.

You should be under the care of a neurologist. You also should contact the International Essential Tremor Foundation, a source of up-to-date information and a guide to any new developments in treatment. The foundation’s website is www.essentialtremor.org, and its toll-free number is 888-387-3667

TO READERS: The subject of vaginal infections and their treatment is thoroughly discussed in the booklet on that topic. To order a copy, write to: Dr. Donohue — No. 1203, 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 foot drop. What causes it? My doctor says nothing can be done for it but to learn how to live with it. Do you know of any treatment? — V.L.

ANSWER: Foot drop indicates that something bad has happened to a nerve or nerves that keep the foot parallel to the ground when you raise it to take a step. The foot flops downward, and a person has a hard time walking.

Nerve damage that leads to foot drop is called peripheral neuropathy. It can be due to diabetes, vitamin B-12 deficiency, rheumatoid arthritis and other things. Frequently, no cause is found.

If a cause has been identified and is treatable, that cures the foot drop. If no cause is found, then things that stabilize the foot can make life livable. A brace is an example.

The doctor to see for causes of foot drop is a neurologist. The doctor to see how best to cope with it is a physiatrist, a physical medicine doctor, not a psychiatrist.

DEAR DR. DONOHUE: I am crazy about flowers and plants. I have them all over the house in winter and summer.

A neighbor informs me that I am doing my husband a disservice. He has emphysema. The neighbor says flowers and plants rob him of oxygen. Is this the case? — T.R.

ANSWER: Your neighbor is well-intentioned, but not well-informed.

Plants and flowers take in carbon dioxide from the atmosphere and give off oxygen. This is photosynthesis. Because so much of the world has been deforested, a rise in carbon dioxide results.

At nighttime without any sunlight, vegetation gives off a smidgen of carbon dioxide, not enough to be of any consequence to your husband.

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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