DEAR DR. DONOHUE: My husband, age 51, has extremely shaky hands that are a source of embarrassment to him. He won’t eat out. On top of this, he refuses to see a doctor. I think he’s afraid he has Parkinson’s disease. I try to get him to relax, and that drives him wild. He says he is relaxed. One more thing: A cocktail or a can of beer makes the shakiness vanish. — H.O.

ANSWER: Let me take a guess. I bet your husband has essential tremor. “Essential” has a different meaning, in this context. It means that no other body condition contributes to the process. Essential hypertension is the most common cause of high blood pressure. “Essential” there means the same thing. Essential tremor is also known as familial tremor because other family members often show it.

Postmortem examination of the brains of people who had essential tremor doesn’t show consistently abnormal areas in those brains. This kind of tremor isn’t Parkinson’s disease, and anxiety isn’t responsible. Anxiety, however, worsens it.

Tremulous hands make writing difficult. Tremor makes difficult any motion requiring the slightest dexterity. Bringing a spoonful of soup to the mouth is all but impossible. Not only do the hands shake, but often so does the head. The larynx, the voicebox, can be affected. When it is, the voice quavers. Jaw, lips and tongue also might tremble.

Alcohol often abolishes the tremor. It can’t be used for treatment because of the threat of alcoholism. Two prescription medicines, propranolol (Inderal) or primidone (Mysoline), often are able to stop or lessen the tremor. In a few instances, when medicines fail or the tremor is so bad that it disables a person, deep-brain stimulation can suppress it.

March is Essential Tremor Awareness month. The International Essential Tremor Association sponsors it.

You or your husband can contact the association at 888-387-3667 or online at www.essentialtremor.org. The association can provide the latest information on this problem. Your husband also needs to see a doctor for treatment.

DEAR DR. DONOHUE: My brother dropped dead suddenly at age 50. He looked the picture of health and didn’t smoke or drink. He stayed physically active.

We were told he died of a heart arrhythmia. We don’t understand what that is. Is it common? Please elaborate and let us know if anything could have been done to save him. — P.L.

ANSWER: “Arrhythmia” is an all-inclusive word that covers all abnormal heartbeats, from the innocuous extra heartbeat to the lethal kind of heartbeat called ventricular fibrillation. I believe that’s what your brother had.

It’s an extremely rapid, chaotic and weak beating of the ventricles, the two lower heart chambers, the ones that pump blood. With ventricular fibrillation, little to no blood circulates. It’s as though the heart had stopped working.

V. fib, as it is called, can happen out of the blue. More commonly, it happens when the heart faces a particular challenge, like a heart attack. The fibrillation has to be converted to a normal heartbeat, quickly, or death results. If your brother was in a place where defibrillators are within reach, he might have been saved. Those areas are few and far between.

I want to make it clear to readers that ventricular fibrillation is not the same as the much more common and less deadly atrial fibrillation.

DEAR DR. DONOHUE: I have smoked heavily for 25 years. I am going to stop. How much weight does the average person gain when they stop smoking? — P.L.

ANSWER: Not all who give up smoking gain weight. Those who do, gain, on average, five to 10 pounds.

Even if you gain 10 pounds, that’s not a deterrent to stopping smoking. You’ll greatly improve your health and chances for a long life by doing so.

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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