pocanii
11-15-2001, 08:16 AM
Hi, all. I have a resting tremor in a finger on my left hand (one side only, definitely a "resting tremor" after my exhaustive research!). Needless to say, I am now concerned about young onset Parkinson's, although I currently do not exhibit any other symptoms. It is my understanding that this is often the first symptom, however. I know, too, that hyperthyroidism, brain tumour, Shy Drager, etc. can also exhibit this symptom, although I have no other indications of those conditions either.
My question is on the occurence rate of resting tremor. I have "had" it for 2-3 months now. For awhile, it was almost "regular" in that it happened several times a week, always when propped up in bed watching TV with my hands on my lap in the middle of the night. Yes, activity makes it ultimately stop. And yes, I may have been a little stressed during this period of time, though nothing drastic. However, the last three weeks, it is not "as regular" (and I am less stressed) but has popped up three times: in public for the first time when I was at a beach relaxing in a chair, hands in lap once again. The other two times were in the morning. Once it actually started in the last two minutes of my dream and I woke up to realize it was no dream and the other time was about a minute after waking up. Everything I had read thus far indicated resting tremors (perhaps tremors in general) disappear during sleep, however I found this cryptic passage on the net regarding, "Effects of Sleep on PD": Motor abnormalities during sleep include....persistence of tremor in the lighter stages of sleep, or its re-emergence in the transition between sleep and wakefulness and on awakenings."
Should I be concerned? Could one have a rest tremor for simply no reason at all? In the beginning stages of PD, does anyone know the frequency of a tremor? (NOT the mhz, but how regularly/irregularly it might occur)?
Any feedback would be much appreciated.
Thanks greatly in advance!!
P.S. I do know of other causes of tremor, i.e. caffeeine issues, alcohol withdrawal, drug toxicity, etc - none of these apply to me.
My question is on the occurence rate of resting tremor. I have "had" it for 2-3 months now. For awhile, it was almost "regular" in that it happened several times a week, always when propped up in bed watching TV with my hands on my lap in the middle of the night. Yes, activity makes it ultimately stop. And yes, I may have been a little stressed during this period of time, though nothing drastic. However, the last three weeks, it is not "as regular" (and I am less stressed) but has popped up three times: in public for the first time when I was at a beach relaxing in a chair, hands in lap once again. The other two times were in the morning. Once it actually started in the last two minutes of my dream and I woke up to realize it was no dream and the other time was about a minute after waking up. Everything I had read thus far indicated resting tremors (perhaps tremors in general) disappear during sleep, however I found this cryptic passage on the net regarding, "Effects of Sleep on PD": Motor abnormalities during sleep include....persistence of tremor in the lighter stages of sleep, or its re-emergence in the transition between sleep and wakefulness and on awakenings."
Should I be concerned? Could one have a rest tremor for simply no reason at all? In the beginning stages of PD, does anyone know the frequency of a tremor? (NOT the mhz, but how regularly/irregularly it might occur)?
Any feedback would be much appreciated.
Thanks greatly in advance!!
P.S. I do know of other causes of tremor, i.e. caffeeine issues, alcohol withdrawal, drug toxicity, etc - none of these apply to me.
Sponsor
Bruce
11-15-2001, 11:10 AM
I have had parkinsons for twelve years and am not a doctor.The best advice I could give you is make an appointment with a movement disorder specialist,because their seems to be a myth out there that parkinsons is a disease found only in old people and people like yout self are frequently misdiagnosed.10 per cent of parkinsons is found in younger people.
I am not implying you have parkinsons, but frequently people have a wide range of symptoms that they may not be aware of.
We have MSD doctor on this forum and he would be more qualified to answer your questions than I.
Bruce
I am not implying you have parkinsons, but frequently people have a wide range of symptoms that they may not be aware of.
We have MSD doctor on this forum and he would be more qualified to answer your questions than I.
Bruce
pocanii
11-15-2001, 03:45 PM
Thank you so much for the reply. Yes, I gathered early on to not exclude myself as a PD candidate because of my age (31).
I am not in the US presently and have no insurance, etc. in the country where I am (Greece) - or in the US - so I am having to approach this rather cautiously. Don't necessarily want the diagnosis if it is PD until I am covered, as you can imagine. And most of the policies I am now reviewing don't even cover "palliative conditions." Right now I will simply try to get an MRI to rule out other possiblities and a simple test for hyperthyroidism and hope that transatlantic sharing of medical records can be avoided :) I did at least look into the cost of meds, if there ends up beign a need, and I'm hearing estimates of $150-$200 a month. Taking into account that one's dosages/drug use will vary, does that sound about right to you? If so, it is not as God-awful as I might have anticipated. $0 would always be better, of course :0)
In any event,thanks again for the reply. After 12 years, I see you're still active on the net. My craft is web design so that's promising - ha!ha! Regardless of my personal outcome, I wish you the absolute best!!!
I am not in the US presently and have no insurance, etc. in the country where I am (Greece) - or in the US - so I am having to approach this rather cautiously. Don't necessarily want the diagnosis if it is PD until I am covered, as you can imagine. And most of the policies I am now reviewing don't even cover "palliative conditions." Right now I will simply try to get an MRI to rule out other possiblities and a simple test for hyperthyroidism and hope that transatlantic sharing of medical records can be avoided :) I did at least look into the cost of meds, if there ends up beign a need, and I'm hearing estimates of $150-$200 a month. Taking into account that one's dosages/drug use will vary, does that sound about right to you? If so, it is not as God-awful as I might have anticipated. $0 would always be better, of course :0)
In any event,thanks again for the reply. After 12 years, I see you're still active on the net. My craft is web design so that's promising - ha!ha! Regardless of my personal outcome, I wish you the absolute best!!!
Bruce
11-15-2001, 07:31 PM
I hope I don't ruin your day,but eventually you end up tsking a lot of different drugs and higher doses of those drugs if you have Parkinson. I buy generics, if I can get them, and a few days ago the drugstore substituted the brand Parlodel for the generic and that one prescription cost me $435, about a hundred dollars higher than the generic. I once calculated my annual cost for prescription drugs and it was about $16,000.
My neurologist, soon to be ex neuro, started experim enting on me ant told me I had to switch from Parlodel to Requip, because the Requip was a "newer" drug, I tried taking some samples he gave me and then he wrote up a prescription. It cost me over $200 and then I figured out the Requip was causing side effects and I am now stuck with a full prescription that I couldn't take. His nurse called me and told me I had to immediately switch to Mirapex. Her first mistake was to tell me to make an abrupt switch, because you are supposed start wirh a lower dose and gradually work up to the desired dose to help prevent side effects. I refused to buy a Mirapex prescription for the same reasons.
I found a reference on the NPF website www.parkinson.org (http://www.parkinson.org) that said their have never been any clinical trials proving that any drug in this class is better than any other drug in this class (agonists). I sent itto my neurologist.
I think you "pulled my chain."
Bruce
My neurologist, soon to be ex neuro, started experim enting on me ant told me I had to switch from Parlodel to Requip, because the Requip was a "newer" drug, I tried taking some samples he gave me and then he wrote up a prescription. It cost me over $200 and then I figured out the Requip was causing side effects and I am now stuck with a full prescription that I couldn't take. His nurse called me and told me I had to immediately switch to Mirapex. Her first mistake was to tell me to make an abrupt switch, because you are supposed start wirh a lower dose and gradually work up to the desired dose to help prevent side effects. I refused to buy a Mirapex prescription for the same reasons.
I found a reference on the NPF website www.parkinson.org (http://www.parkinson.org) that said their have never been any clinical trials proving that any drug in this class is better than any other drug in this class (agonists). I sent itto my neurologist.
I think you "pulled my chain."
Bruce
pocanii
11-16-2001, 02:42 AM
Ouch! Slight ruining of my day, yes http://www.healthboards.com/ubb/redface.gif) No worries, though. Not at my regular PC right now but later will send you the URL of the study I saw on PD drug costs. Obviously it was w-a-y off!
Anyway, I will try to find a movement disorder specialist here where I am (and I've since read you guys' thread on why you all recommend one over a neurologist - very helpful stuff indeed!), but in the meantime will hope that the one who frequents this message board is kind enough to answer my question about the frequency of the tremors. I'd love to especially know about hyperthyrpoidism, in case I'm lucky enough to have that instead. Not too much is written about resting tremors and hyperthyroidism, though, but there are a couple of references to it. I guess I'm curious if the resting tremor presented in early Parkinson's is very similar in nature/characteristic to that presented in hyperthyroidism or if there might be distinct differences that will allow me to rule out one or the other.
Thanks again for your wealth of knowledge and taking the time to reply! Though I'm already in acceptance mode if it comes to pass that this is what I have, it is still a bit of an anxious period for me not knowing so this is a nice forum to have found :-)
Anyway, I will try to find a movement disorder specialist here where I am (and I've since read you guys' thread on why you all recommend one over a neurologist - very helpful stuff indeed!), but in the meantime will hope that the one who frequents this message board is kind enough to answer my question about the frequency of the tremors. I'd love to especially know about hyperthyrpoidism, in case I'm lucky enough to have that instead. Not too much is written about resting tremors and hyperthyroidism, though, but there are a couple of references to it. I guess I'm curious if the resting tremor presented in early Parkinson's is very similar in nature/characteristic to that presented in hyperthyroidism or if there might be distinct differences that will allow me to rule out one or the other.
Thanks again for your wealth of knowledge and taking the time to reply! Though I'm already in acceptance mode if it comes to pass that this is what I have, it is still a bit of an anxious period for me not knowing so this is a nice forum to have found :-)
Bruce
11-16-2001, 05:45 PM
A description of the parkinson tremor is it is like rolling a pill with your fingers, but here is what separates the specialist and the non spspecialist. From discusions on the forums to researching the internet, I have learned that every patient is different and you will see a wide variation of that one symptom, tremers. We are all unique and what works for me may not work for you.
By the way, what country do you live in?
Bruce
By the way, what country do you live in?
Bruce
Googy
11-16-2001, 06:24 PM
My daughter had hyperthyroidism many years ago,she had a goiter removed.She never had tremors.Lost a lot of weight had a rapid heartbeat and high pulse rate of over a 100.Bulging eyes.I dont think myself it even resembles PD.My husband has that.The tremor can be very disabling among other things.
Blessings in you search,
Googy
Blessings in you search,
Googy
md1817
11-17-2001, 09:00 PM
Hello. I am a board certified neurologist with fellowship training in movement disorders. I am not offering a diagnosis.
Speaking in general terms, a tremor due to hyperthyroidism is a very fast and small shaking of the fingers and is not restricted to a resting position. It occurs with sustained posture and movement. The tremor associated with Parkinson's disease, as Bruce has pointed out, is quite variable from one person to another, but it tends to intermittent and more evident at rest, including, sometimes, during lighter stages of sleep.
Tremor alone does not establish a diagnosis of Parkinson's disease. You ask whether you should be concerned, but, correct me if I'm wrong, it appears you are already concerned. See a neurologist competent in movement disorders. Not knowing is often more anxiety provoking than knowing what the problem is (or isn't).
Best wishes.
Speaking in general terms, a tremor due to hyperthyroidism is a very fast and small shaking of the fingers and is not restricted to a resting position. It occurs with sustained posture and movement. The tremor associated with Parkinson's disease, as Bruce has pointed out, is quite variable from one person to another, but it tends to intermittent and more evident at rest, including, sometimes, during lighter stages of sleep.
Tremor alone does not establish a diagnosis of Parkinson's disease. You ask whether you should be concerned, but, correct me if I'm wrong, it appears you are already concerned. See a neurologist competent in movement disorders. Not knowing is often more anxiety provoking than knowing what the problem is (or isn't).
Best wishes.
Pelicangirl
11-18-2001, 01:49 AM
Hi Pocanii,
Listen to the doctor and go see a movement disorder specialist. That's the only way you are going to find out.
------------------
Pelicangirl (aka Ruth)
Listen to the doctor and go see a movement disorder specialist. That's the only way you are going to find out.
------------------
Pelicangirl (aka Ruth)
pocanii
11-18-2001, 03:29 PM
Hi, guys - thanks again Bruce, Googy, Mr. MD and Pelicangirl for the responses.
I am fairly confident I do not have hyperthyroidism, as NONE of the other symptoms and/or telltale signs apply to me. Of course, I am only exhibiting one "lonely" symptom of PD, as well...still, it seems like one of the more ominous and earliest to exhibit. Actually, that is not true...I did experience for 7 MONTHS a "circadian rhythm" problem, in that my wake-sleep cycle was completely backwards.
I was going to sleep between 5 and 8 AM and waking up at 2-5 in the afternoon (makes you feel like a slacker, though I'm not!). I tried NUMEROUS times to "adjust" but to no avail. I began to prefer the schedule, actually, and since I was working remotely from my PC, I did not have traditional office hours to contend with. However, I recently took some PT work with kids that requires me to be up at 7 AM and my schedule has recently returned to normal. The "problem" was very real, but my new job seems to have cured it, so I have to wonder whether that can even be considered an additional "sign", as I have read that circadian disorders can also be existent with PD (OK - I had no idea what it was called - I kept calling it permanent jet lag! I came across sleep disorder issues in all my research of PD and found most - or at least a lot - can be due to side-effects of meds, which obviously would not apply to me).
So Doc, what say you about my sleep issue?
And yes, you are right - I am already concerned :) I was not initially - what a silly thing to have, right? A finger twitching all on its own. Not until I tried out of curiosity to see what possibilities the net offer did I grow increasingly concerned, especially as I learned the distinction between types of tremors and realized mine was definitely of the resting variety.
I do NOT have pill-rolling going on, though. It twitches exactly the same direction each time, and in the same rate of rhythm. Moving my hands or engaging them in an activity makes it temporarily stop but it resumes if I stop right away. If I continue to engage in activity, it eventaully stops altogether. Left to "be on its own" with no action of my hands on my part initiated, it generally lasts about 20 minutes.
I will seek out a movement disorder specialist/neurologist-in-the-know here in Greece, if I can figure out what word they go by here :) (I'm in the land of Zorba, Bruce!). It seems to be the only thing to do at this point, eh?
I sound like a broken record, I know, but I greatly appreciate everyone taking the time to reply.
I am fairly confident I do not have hyperthyroidism, as NONE of the other symptoms and/or telltale signs apply to me. Of course, I am only exhibiting one "lonely" symptom of PD, as well...still, it seems like one of the more ominous and earliest to exhibit. Actually, that is not true...I did experience for 7 MONTHS a "circadian rhythm" problem, in that my wake-sleep cycle was completely backwards.
I was going to sleep between 5 and 8 AM and waking up at 2-5 in the afternoon (makes you feel like a slacker, though I'm not!). I tried NUMEROUS times to "adjust" but to no avail. I began to prefer the schedule, actually, and since I was working remotely from my PC, I did not have traditional office hours to contend with. However, I recently took some PT work with kids that requires me to be up at 7 AM and my schedule has recently returned to normal. The "problem" was very real, but my new job seems to have cured it, so I have to wonder whether that can even be considered an additional "sign", as I have read that circadian disorders can also be existent with PD (OK - I had no idea what it was called - I kept calling it permanent jet lag! I came across sleep disorder issues in all my research of PD and found most - or at least a lot - can be due to side-effects of meds, which obviously would not apply to me).
So Doc, what say you about my sleep issue?
And yes, you are right - I am already concerned :) I was not initially - what a silly thing to have, right? A finger twitching all on its own. Not until I tried out of curiosity to see what possibilities the net offer did I grow increasingly concerned, especially as I learned the distinction between types of tremors and realized mine was definitely of the resting variety.
I do NOT have pill-rolling going on, though. It twitches exactly the same direction each time, and in the same rate of rhythm. Moving my hands or engaging them in an activity makes it temporarily stop but it resumes if I stop right away. If I continue to engage in activity, it eventaully stops altogether. Left to "be on its own" with no action of my hands on my part initiated, it generally lasts about 20 minutes.
I will seek out a movement disorder specialist/neurologist-in-the-know here in Greece, if I can figure out what word they go by here :) (I'm in the land of Zorba, Bruce!). It seems to be the only thing to do at this point, eh?
I sound like a broken record, I know, but I greatly appreciate everyone taking the time to reply.
Bruce
11-18-2001, 10:46 PM
Okay "Zorba" I will give you one more consult. In my opinion,searching the net to diagnose your self is not a good idea. You will get a variety of opinions, and that is all they are, and you will end up a very confused person. Most of us are not experts, but are just trying to point you in the right direction. You must be a little skeptical about what you read, because their are some strange people out there who claim to have the perfect cure for parkinsons.
People like that or those who seek to profit from a person's illness, is one thing that really gets me fired up and I have exposed a few of these parasites.
How do you like living in Greece?
People like that or those who seek to profit from a person's illness, is one thing that really gets me fired up and I have exposed a few of these parasites.
How do you like living in Greece?
md1817
11-19-2001, 01:10 AM
Although sleep disorders occur commonly in Parkinson's disease, this is a nonspecific symptom that can arise from any number of causes, including anxiety.
Googy
11-19-2001, 06:36 PM
For you DR.and our many friends.
A quote I believe from Shakespeare !
"Sleep, perchance to dream."
I still say this after all these years.
Happy Thanksgiving,
Googy
A quote I believe from Shakespeare !
"Sleep, perchance to dream."
I still say this after all these years.
Happy Thanksgiving,
Googy
pocanii
11-20-2001, 04:00 PM
All -
Have begun the search for a movement disorder specialist, but no one is quite familiar with that term here. I THINK I've located a Parkinson's expert, however, so even if it is not what I have, hopefully he'll we well-informed on the alternate possibilities. It's a little odd here, though - you bring your MRI to the doctor of your choice for review AFTER getting it done somewhere else independently. I don't visit doctors much in the US, but that is not how it's normally done, is it? In any event...as the good doctor said, just knowing/finding out is going to be better than wondering. I still have that pesky lack of insurance issue, though....hmmmm :)
The sleep thing happened after my very first day of arrival here and continued on (why I always joked about it being jetlag)...I was certainly happy and excited to be in a new country, but I would not categorise it as anxiety. Probably just a strange coincidence, eh, more than anything...I'll not yet chalk it up to a sign of PD!
Bruce, thanks for the advice on self-diagnosis. I consider myself a fairly savvy web user and often use the net for research, but one must still be reminded of its limitations and what it is not a substitute for, so thanks. I have tried to not only read online literature for PD patients, but also material written FOR doctors about diagnosing things. Anywho, I've exhausted it silly and need to go see someone now I suppose. And by the way, Greece is sooooooo great - trying to learn the language, learn as much as I can about the culture, etc....really fun place!!
Happy Gobble-Gobble Day/Week, All!
Have begun the search for a movement disorder specialist, but no one is quite familiar with that term here. I THINK I've located a Parkinson's expert, however, so even if it is not what I have, hopefully he'll we well-informed on the alternate possibilities. It's a little odd here, though - you bring your MRI to the doctor of your choice for review AFTER getting it done somewhere else independently. I don't visit doctors much in the US, but that is not how it's normally done, is it? In any event...as the good doctor said, just knowing/finding out is going to be better than wondering. I still have that pesky lack of insurance issue, though....hmmmm :)
The sleep thing happened after my very first day of arrival here and continued on (why I always joked about it being jetlag)...I was certainly happy and excited to be in a new country, but I would not categorise it as anxiety. Probably just a strange coincidence, eh, more than anything...I'll not yet chalk it up to a sign of PD!
Bruce, thanks for the advice on self-diagnosis. I consider myself a fairly savvy web user and often use the net for research, but one must still be reminded of its limitations and what it is not a substitute for, so thanks. I have tried to not only read online literature for PD patients, but also material written FOR doctors about diagnosing things. Anywho, I've exhausted it silly and need to go see someone now I suppose. And by the way, Greece is sooooooo great - trying to learn the language, learn as much as I can about the culture, etc....really fun place!!
Happy Gobble-Gobble Day/Week, All!
Bruce
11-20-2001, 08:06 PM
Nothing wrong with being well informed. Like I posted elsewhere, the Medscape web site is loaded with up to date info.
A friend forwarded me a message today and this woman said her doctor resented the fact that she was knowledgeable about her disorder as result of searching the net and she had to play dumb. I have a similar problem.
Sorry MD, but I don't believe all doctors think that way.
Bruce
A friend forwarded me a message today and this woman said her doctor resented the fact that she was knowledgeable about her disorder as result of searching the net and she had to play dumb. I have a similar problem.
Sorry MD, but I don't believe all doctors think that way.
Bruce