Sunday, January 20, 2013

Familial Tremor

This is a note I originally wrote and published on Facebook on Sept. 8, 2010. I have not published it here to a wider audience, at least until now, because it is highly personal in nature. But, it seems I've written about plenty that is highly personal in nature, so why hold back. Certainly there are reasons to be careful exposing medical facts to the general public. It can cause all kinds of problems with insurance and "pre-existing conditions." That is no longer a problem for me since I'm now on Medicare. So, what the heck, here it is. All my faults and weaknesses revealed to everyone.

No family reunion would be complete without my comparison of the progress of our family affliction. It is called Familial Tremor, although that is a general term for many different ailments that are inherited including Bell’s palsy. Our case is a mild form of the tremor.

Tremors can affect people of any age, but are more common in older people. A familial tremor is usually a relatively benign condition, affecting movement or voice quality but seldom having any other effects. It involves a rhythmic, moderately rapid tremor (shaking) of voluntary muscles.

Purposeful movements may make the tremors worse. There may be difficulty holding or using small objects such as pens and eating utensils. Emotional stress may also increase the tremors. Over time, the tremors may affect the hands, arms, head, voice box (larynx), eyelids, or other muscles, but rarely involve the legs or feet. In children, these tremors are usually limited to the hands.

The exact cause is unknown, but the fact that it is inherited suggests a genetic cause. It is usually dominant, which means that 50% of an affected person’s children will be affected. If you inherit one copy of the gene from either parent, you will have the disorder.

I inherited the affliction from my dad. So here I am with my dad, my brother, and my sister, and we are all “a shakin’.” My grandfather had it the worst of anyone in the family. He would hold the coffee cup with two hands, and still spill more than he drank. Still, he was in his eighties, and who doesn't shake at that age?

My brother had it at an early age. I remember when I first got out of the navy and drove through Billings on the way to Spokane, Washington. I arrived at my brother’s early in the morning and we went out to breakfast at some local restaurant. His hands were so shaky he could hardly drink his coffee. Now I know how he feels. Sometimes I have to use two hands to hold the spoon when I eat soup.

My sister probably has the least impact from the disease. She is hardly bothered at all. I’m somewhere in the middle. As I’ve grown older, it has definitely gotten worse. When I’m typing on the computer, my head bobs like a bobble doll on the dashboard.  My penmanship never was very good, but it is drastically affected by the tremors, and there are times, especially under stress, when my hands shake so bad I can’t even type. (Do you notice the pattern here, I spend most of my life typing on a computer – that is what programmers do, you know!)

As is often the case, I’ve grown so used to the affliction that I hardly notice the behavior until someone else points it out. Certainly, some days are worse than others -- and then I notice. When I was in Alaska, I was trying to show something about operating systems and API’s to Chuck to explain how a GUI gets information from the basic file system API in Windows and the Mac OS. I was trying to use the terminal or text interface and show the output of Windows "dir" and Mac Unix "ls" commands and compare the output of those commands to the Windows Explorer and Mac Finder GUI screens. My hands shook so bad I could not type in my password to access my computer. Happily, days like that don't occur often.

My mother had Alzheimer’s. (Another inherited malady. Let’s hope I dodge that bullet.) Her best times were in the morning. That is typical of Alzheimer’s and is called sunrise syndrome. My palsy is just the opposite; I have it worst in the morning. That's one reason I only drink decaf coffee (and Pepsi).

Right now I’m waiting for 10:00 AM (MDT). At that time, I will be on a conference call to Boulder and presenting the monthly status of our development work on IBM software. I have good news for the meeting, but I will have to struggle not to sound like Katharine Hepburn.

Now I know we all struggle in life, and those struggles often shape us into who we are. The apostle Paul wrote of how he asked the Lord many times to remove the “thorn in his side.” But the Lord’s answer was that the affliction served His purpose, and so Paul learned to live with it. I laugh when I hear “whatever doesn’t kill us, makes us stronger” because I know it is true. Steel is tempered by the heat and the cold. I just pray Lord that I am strong enough now and don't require more temporing!

You know you have to laugh to keep from crying. Still, my life has had much more to laugh about than cry, so I am content. And now I had better get to the phone and connect to that meeting.

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