Question: I have a condition both annoying and embarrassing. My hands shake when I lift a coffee cup to my mouth. I also spill food when I use a fork. I must write extremely slow to make it legible. My doctor has ruled out Parkinson's disease. Please advise medication other than a beta blocker. I tried it. It did not work.
- L.L.Question: My daughter has essential tremor. I cannot find much information on it. Is it hereditary? Is there any medicine for it?
- V.M.
Answer: Both writers inquire about the same condition, essential tremor. It is a shakiness of the hands, most noticeable when you make a purposeful hand movement, such as drinking a cup of coffee or writing.
Two things are peculiar about essential tremor: It worsens under emotional stress and alcohol abolishes it for a short time, although alcohol has no place in its treatment.
Essential tremor does run in families.
On the bright side, it does not indicate any serious or progressive nervous system disorder. On the dark side, the tremor can be so pronounced that some patients lead a hermit's existence to avoid public embarrassment.
The beta-blocking drugs such as propranolol quiet the tremor for most patients, although L.L. had no luck with them.
There are other drugs effective for tremor control. Primidone is one. Have you tried that, L.L.?
Both of you can find a wealth of information by writing the International Tremor Foundation, 833 W. Washington Blvd., Chicago, IL 60610.
Question: I have bubbles in the urine. I once read something about it, but I can't remember what it was. Please tell me if I have to worry about it.
- H.P.
Answer: Bubbles in the toilet water after urinating generally indicate no serious problems.
On rare occasions, the bubbles result from protein in the urine. Urinary protein can be a sign of serious kidney disease.
On even rarer occasions, they are due to infection of a fistula, a tunnel formed between the intestinal tract and the bladder.
If you are having no symptoms, you need not rush to the doctor. But on your next visit, mention the bubbling to the doctor. A simple urine test can put the significance of the bubbles to rest.
Readers with questions about the urinary tract can order my report on the subject by writing to: Dr. Donohue - No. 48, Box 5539, Riverton, NJ 08077-5539. Enclose $3 and a self-addressed, stamped (55 cents) No. 10 envelope.
Question: Just what is a myocardial infarction? I feel silly and ignorant to ask such a question. But a relative recently died. I was told the cause of death was a myocardial infarction. I was not sure what that meant, but I was too flustered to ask.
- K.K.
Answer: "Myocardial infarction" is the official medical term for a heart attack. It's an expression couched in Latin words - "myocardium," for heart muscle; and "infarctus," for tissue death due to lack of blood supply.
A myocardial infarction comes about when blood flow through heart arteries is blocked by a buildup of plaque on the artery wall. Plaque is a slurry of cholesterol, fats and blood platelets that acts as a dam to blood flow.
Heart attacks are the leading cause of death. It's gratifying to know that the number of heart attacks is actually decreasing. The public has become more conscious of cholesterol and fat and is exercising more than it did in the past. Also, the number of cigarette smokers has plummeted. Nicotine is a huge factor in heart-attack occurrence.
Heart-attack pain is described as a severe crushing or squeezing chest pain that lasts for 30 minutes to an hour. The pain might spread from the chest to the neck, jaw or left arm.
In a small number of patients, no pain is felt. The heart attack is silent.
Actually, a silent heart attack is more dangerous than one that causes pain. The person remains blissfully unaware of a serious condition. No treatment is sought. No changes are made in diet. The patient does not get to benefit from balloon angioplasty or bypass surgery.