Tremors II

Posted by on Mar 21, 2016 in Health | 5 comments

I know, I know. I’m supposed to be talking about polycystic ovarian syndrome (PCOS) this week. I had my follow-up with the neurologist last week, though, and wanted to tell you about that first.

The first thing the neurologist said to me was, “How’s the fibromyalgia?”

“I don’t have fibromyalgia,” I said, “I have PCOS.” We stared at each other for a beat, each believing the other was looking at the wrong file. Though I don’t know how I could have been doing that because mine’s not a file, it’s a body.

Doc decided to try a different tack. “Do you have aching in your joints?”

“Well, I’m pretty sure I’m starting to get arthritis in the top joint of this finger, but other than that…”

“Okay, so your chronic fatigue has not progressed to fibromyalgia yet.”

“I have chronic fatigue?”

“Yes. Your constant fatigue. We talked about it last time you were here. It played a major role in the packet I gave you at your last visit,” At this point, he’s beginning to suspect dementia as well.

“Oh. I thought that was a mistake.”

“No. No, it wasn’t a mistake.” I could feel the sigh he was holding back. “The spironolactone I prescribed was supposed to help with that.”

“I thought it was for the PCOS.”

He nodded, “Which is a possible cause of your fatigue.”

I’m a little embarrassed to say it never occurred to me to look at it that way. I tend to think of myself as fairly medically savvy, but I sure missed a lot at my first meeting with this doctor.

Then he asked if the medicine had helped at all with my tremors. I hadn’t realized it was supposed to. I didn’t feel too bad about that, though, because none of the other doctors I visited in-between had any idea spironolactone would help with hand tremors.

The neurologist explained that benign essential tremor is linked to blood sugar levels and insulin resistance. PCOS can cause insulin resistance, so it makes sense that getting PCOS under control would help level out your blood sugar, which would decrease tremors.

The link between blood sugar and tremors immediately rang true for me because whenever I forget to eat and get hypoglycemic, I start to shake.

I haven’t really noticed a difference in the tremors yet, so I don’t know if the medicine is working for that or not. Yet.

To figure that out, he had me do what’s called a spiral test. You draw a spiral with each hand and write a particular sentence with your dominant hand. You do that every time you come in and then compare them to see if the tremor is progressing or not. The one I did at the previous visit had not been uploaded yet, so we couldn’t compare it to the new one.

Here’s my spiral test from last week’s visit:

Reasonably steady spirals drawn on a page along with a legibly written sentence.

Reasonably steady spirals drawn on a page along with a legibly written sentence.

One of the best things the doctor told me that day was that he doesn’t expect my tremors to get significantly worse. He also said the odds of it migrating to my neck area, which would mean a vocal tremor like Katherine Hepburn’s, are very low. Imagining that it did migrate makes me wish I could show my high school choir mentor, Suzanne, that I learned to do a vocal shake without using my index finger.

We spent the rest of the visit discussing diet. He wrote out a list of things I should and should not eat, calling it the tremor diet. And the diabetes diet because it aids in managing blood sugar levels. And the eye diet because blood sugar levels that are high, but not yet in the diabetes range have been linked to myopia.

The yes list includes:

  • Almonds
  • Cucumbers
  • Olives & olive oil
  • Garlic
  • Berries
  • Cinnamon verum (true cinnamon or Ceylon cinnamon) – Doctor suggested drinking Ceylon cinnamon tea every day.

The cinnamon listed up there is the kind that’s good for you. The kind under the no list is apparently toxic to humans. Which explains why it is outlawed in Europe and the most common kind sold in the US.

The no list includes:

  • Peanuts
  • Tomatoes
  • Bananas
  • White rice
  • White bread
  • Cassia cinnamon

The last thing the doctor told me was that testosterone levels have been linked to the comparative size of the middle* and ring fingers. Since that ratio doesn’t change, they think it has something to do with the mother’s testosterone levels during pregnancy.

Michelle fingersThe doctor, Sparky, and I all looked at our hands. My middle finger towers over my ring finger, while both men have relatively even fingers. I had the highest testosterone level in the room. Sparky pointed out that I also had the highest estrogen level in the room. I totally won the doctor visit.

A few days after that appointment, I noticed that my hands were shaking up a storm. Bad enough that I couldn’t write legibly. That never happens when I consult a doctor – my hands are always rock steady when I don’t need them to be. So I did another spiral test and mailed it to my doctor for my file. Here’s that test:

Spirals with spiked lines drawn on a page along with a completely illegibly written sentence.

Spirals with spiked lines drawn on a page along with a completely illegibly written sentence.

It’s kind of like trying to draw circles with an Etch A Sketch.

*Info I found online that night indicated it was the index finger rather than the middle. I thought maybe I’d just heard the doctor wrong, but Sparky remembers him saying middle, too. I win either way.

 

 

 

 

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Technical Difficulties

Posted by on Mar 14, 2016 in Autism, Health | 0 comments

Hi. Big wind storms here yesterday. Huge. Our power was out for about nine hours, which caused much distress for Zoo Keeper. He was convinced that the power company was doing nothing to fix things. He asked us to call our ABA therapy assistant to come fix it. Sparky and I assured him that she had no control over our electricity. He insisted that she did because, the last time it was out, it came back on just as she arrived for a session. She is magic that way.

Face of a Jack Russell terrier sticking out from beneath a blanket, looking sad and ill.

Face of a Jack Russell terrier sticking out from beneath a blanket, looking sad and ill.

The lights came back on just after we put the boys to bed. Sparky and I watched some TV and went to bed at 11pm. We awoke about midnight to the lovely sound of our dog, Annie, vomiting all over the carpet. Sparky got up and cleaned up all the piles – there were several – and then came back to bed. I still had ointment in my eyes, for severe dry eyes, so I couldn’t see to help him.

Around 2:30am, Sparky woke to see that the hall light was on. BamBam was standing in the hall, so Sparky asked him what was wrong. BamBam said, “I can’t tell you,” and then threw up on the floor. Sparky got him to walk to the bathroom, so the second spew was on the tile rather than carpet. Then I heard BamBam say that he also had poop in his underwear.

Little boy in a blue shirt hunched over and holding his stomach with a pained look on his face.

Little boy in a blue shirt hunched over and holding his stomach with a pained look on his face.

I went to help, but the dog followed me, as she usually does. To keep her from interfering with the clean-up, I sat down with her at the other end of the hall. Once Sparky had BamBam in the bath, he let me know it was okay to let the dog go, so I went to comfort BamBam as he warmed up in the bath. He talked the whole time about getting sick and that he couldn’t go to school until maybe Tuesday and that he needed to rest his body. Then he started asking questions about The Phantom Menace. I’m not sure why, since he is well aware that I loathe the prequels. Plus, A New Hope is his favorite, even though I have explained that Empire is a superior film.

I dried him off and got him new clothes while he continued to talk. Somehow I convinced him to stop talking and go back to sleep while the dog stretched out on his bed. She followed me back to our room and curled up between Sparky and me when I got back in bed. I think that was around 3:15. I told Sparky that I would take Zoo Keeper to school and he could sleep until he needed to go to work. However bad I feel today, which is pretty bad, I’m sure he feels worse, since he did all of the clean-up including the vomit and pee that Annie left for him while he was changing the sheets on BamBam’s bed. Sparky really is the most awesome husband in the ‘verse. And this is a universe that includes David Tennant, so Sparky knows I really mean it.

BamBam is currently playing on his iPad. Technically I should make him stop because I have a rule that kids who stay home sick from school don’t get to play video games. I don’t have the energy, though. He has been talking since I got back from dropping Zoo Keeper at school. Much of it is running commentary on what’s going on in the game he’s playing. If I take that away, he will direct it all to me and I am way too tired to deal with the sensory overload, so letting him have it is really best for everyone’s safety.

To top things off, BamBam just told me that he thinks it might have been the pink frosted cookies he ate yesterday that made him sick. “I don’t think I ate any more than ten.” We discussed how two cookies in one day should probably be the upper limit. I think there’s a lesson there for both of us.

Oh, and it’s the spring forward part of daylight savings time today, so there’s another hour of yesterday that flew by with no sleep. Fun times.

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The Shakes

Posted by on Mar 7, 2016 in Health | 2 comments

Pink shoes stuck into chewing gum on street

Pink shoes stuck into chewing gum on street

Oh, my. I am not liking the cobwebs around this place. Not liking them at all. It probably seemed I was gone for good, but I’m like gum on the bottom of a shoe that way. Just, please, don’t put me in the freezer.

Well, in my absence, I have not been lollygagging around ducking the fog. I’ve actually been quite busy. As you will see over in the top right, I finished my National Novel Month project. I’m pretty proud of that accomplishment, and not just because I consistently surpassed my estimation of the number words I can write in a day. Though it is the part that gives me hope my dream of becoming a novelist may someday become a reality.

No, the pride I’m talking about regards facing an obstacle and, at least temporarily, overcoming it.

Dog shaking water off its fur

Dog shaking water off its fur

You see, I have the shakes.

I’ve had them for a while, years actually, but I didn’t really think about them much. Sometimes my hands would shake a little when I tried to pick things up. No big deal.

But I’ve started thinking more about neurological issues in the last few years and it occurred to me that shaking hands would definitely qualify. So, during my annual check-up with my general practitioner, I asked her about it. She said it was probably benign essential tremor and there was nothing I could really do about it, but offered me a referral to a neurologist if I wanted it. I took it, but it sat in a pile on the side of my desk for ten months. [That should not surprise anyone who has ever seen a working space I inhabit. I’m incredibly messy, but I generally know where stuff is.]

In October of 2015, I was having coffee with Marathon Girl and she noticed my hand shaking as I picked up my coffee from the counter. Here is an approximation of the conversation that followed:

MG, nodding toward my vibrating cup: So, what’s going on there?

Me: Oh, nothing.

MG: [raises her eyebrows]

Me: I asked my GP about it and she said it’s just essential tremor. Nothing to be done about it.

MG: Okay. What does the neurologist say?

Me: Er, I haven’t seen one, actually. The GP seemed pretty sure.

MG: What if she’s wrong? What if it’s the same as what Katherine Hepburn* had?

Me: Well…

MG: Okay. Here’s the number of the top neurologist within a five-state radius. I’m going to watch you call for an appointment now. Would you like me to dial for you?

*Turns out benign essential tremor actually is what Katherine Hepburn had. I looked it up when I got home after coffee.

That’s a dramatization, of course. Marathon Girl isn’t actually that pushy. Mostly. ^^And I hope she, or at least her husband, is laughing at this part because that’s my intention.

So, I called the neurologist she suggested and got an appointment on December first. That turned out to be perfect because NaNo ended on November 30th. Which brings me back to finishing my novel. You might (or might not, depending on your level of interest) ask what shaking hands has to do with finishing a novel. A lot, actually.

The initial step in writing a novel is getting the words of the story down on the page. Writing, or typing, those words while your fingers shake is extremely difficult. Therein lies the reason I hadn’t consulted a neurologist up to that point; I didn’t want to be told I would lose the ability to type. That prospect scares the living daylights out of me. The conversation with Marathon Girl reminded me that I’m not generally one to stick my head in the sand. Right now my fingers don’t usually shake when I type. When they do, it only lasts a few seconds. But, if losing control of my fingers is even a possibility for me, I need to figure out how to deal with it before it happens.

So, while I waited for my neurology appointment, I started looking in to solutions. I searched for speech to text options for when I’m sitting at my computer and for translating voice recordings made when I’m not. The voice recording hasn’t worked with respect to speech to text yet, but it did give me the opportunity to use driving time to write. I get a lot of good ideas while I’m driving.

So, my take aways from NaNo this year were that I can actually be a novelist and that I can continue to be one even after I lose the ability to type. I’m not sure what I’ll do if my voice starts to shake, but that’s a problem for another day.

Well, I got those things AND a finished novel. It’s a crappy novel, but it’s out of my head and on the page where I can work at making it somewhat less crappy.

As for the neurologist, he said the same thing my GP had said. He glanced at my hands and said, “That’s most likely benign essential tremor. What I’m more concerned with is your fatigue and daytime sleepiness.” Those are two different things, by the way. Who knew?

He did check my reflexes to rule out Parkinson’s and make me write with both hands so he could see the tremor, but most of the appointment was spent talking about sleep apnea, a breathing issue, and polycystic ovarian system (PCOS), a hormonal imbalance. Both turned out to be accurate diagnoses. Made by my neurologist.

To investigate his suspicions, he sent me for labs and to a sleep clinic. Turns out I do have mild sleep apnea, for which he sent me to a specialty dentist who is making me a night guard that will help keep my airway open while I sleep.

The labs were blood tests to check my testosterone levels, which are elevated in PCOS. I will tell you more about that in my next post, but I will ease your suspense a little by telling you the labs did show an increased level of testosterone in my blood.

 

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