all shook up

yesterday was a low point in my war against the tremors- and trust me, the tremors are definitely winning. in fact, they are trouncing me. i have been dealing with action tremors (also called intention tremors, depending on the literature) off and on for over a year now, but since December there has been a dramatic spike in their intensity and frequency. yesterday was a prime example. everything i touched proved to be an exercise in frustration- i couldn't button my shirt, i was unable to turn the pages of a book, my fingers slid off the keys as i tried to type, my handwriting was illegible, i couldn't slice an apple. the shaking and jerking got so bad that i finally squeezed both hands into the tightest balls possible, my knuckles white and my fingernails jabbing into the palms of my hands.

i have a friend in DC who has an extreme case of tendinitis which has rendered her unable to perform even simple tasks without pain. you don't realize how much is done with your hands and fingers- being an electronic focused society, most of us automatically think of the computer/keyboard. but many more of our necessary daily actions are done unconsciously! they are so ingrained in us- squeeze the toothpaste onto your toothbrush, unscrew the lid off a diet coke bottle, uncap your chapstick, tie your shoes,put on earrings. at my low point yesterday, i wanted to call fran and scream "i am SO feeling your pain right now!" then we could laugh and go have martinis.

after awhile, the moment passed, and i resigned myself to the old "grin and bear it" phrase my grandfather would say (at least i think it was he who said it. sounds like something a grownup would say, right?) my neurology/MS team is aware of the tremors and i just have to learn to adapt. but i happened to be at Geisinger Hospital (where all my various doctors seem to be- in theory that would make things more convenient, but in practice not so much) meeting the newest recruit to join Team Meg with a focus on my insomnia. he's an internist that specializes in sleep medicine- which will require a separate blog detailing my adventures in the Sleep Center (you have to spend the night! hooked up to machines looking into your brain waves!) it's quite the science actually, and he was incredibly thorough. (can't really take a joke tho, quite the serious bloke- yes, i borrowed some of Britney's british slang) i mentioned to him that my tremors had increased significantly, which he saw first hand since it was blatantly obvious, and asked if i could talk to a PA or nurse practitioner about what was going on.

i was basically asking (in a very PC manner)- "look, do i really need to tell my MS doc about this b/c he's just going to blow me off again..." i think that this need for validation is common among people who deal with chronic diseases or conditions. for me, i find that the line frequently blurs- i find myself doubting my own ability to see my suffering objectively. i worry that i lost that along the way, because so many physical problems really are tangled up in my MS in some shape or form.

end result of this situation is that i did get validation from Dr. Zzzzzzz (get it? sleep doctor? catching some zzzzzzz's?). he did a brief neurological exam (squeeze my finger, push against my hand, stick out your tongue, touch my fingertip, hold your arms outstretched, walk to the door, drop it like it's hot- HAH i'm just making sure you're paying attention!) he was honest with me. he looked me in the eyes and said "i'm concerned. you need to make an appointment with your neurologist as soon as you can. i'm concerned that you have muscle atrophy in various places, that your right side is significantly weaker than your left, and you are having significant tremors. you need to make an appointment with your doctor." that meant a lot to me, it really did. it gave me the confidence i needed to go into today's appointment with the MS team and say "this is a serious problem. it's interfering with my life too much for me to handle."

long story short, Neuro 1 switched me to a drug called remeron, which has proven effective in lessening action tremors in patients with Parkinson's as well as MS. she emphasized that the medication is not going to eliminate the tremor 100%- it will always be present, but hopefully we can control it to the point where i am able to use my hands for basic functions. another perk of the drug is that it is very effective for controlling migraines, and i can swap out an existing drug i'm already taking to cover that, so we're not adding more medications onto my proudly lowered drug/toxins intake. i asked how soon i would be able to tell a difference, and she said it might take a few weeks, as the dosage will be increased on a sliding scale. so hopefully i will be blogging tremor-free (ok, tremor-lessened) in a month's time!

btw, i tried to find a good reference to better explain the role of tremors in people with MS (or similar conditions) and more specifically, how remeron has been used to lessen the severity... but wasn't entirely successful. i seemed to get more results by looking into the two independently of each other. however, the MS Society's Library information is good for basic facts, along with Friends With MS. (here is one on intention tremors specifically.) at this point, i feel that i should at least address the controversial role of marijuana in patients with MS. in the majority of cases, the drug is being used specifically to abate tremors. (any Law & Order fans? there was an SVU episode that touched on this last year.) to be honest, the research tends to be split down the middle as far as results are concerned. (and no, i'm not growing weed in the backyard! so don't even go there!!) apparently there is an elderly woman that is a patient in the neurology clinic who finds that a shot of whiskey is just as effective in calming the tremors. on that note- Bottoms Up!

remember, you can view these postings directly on kit katchat's blog
http://meggerv2.blogspot.com/