I Have a Tremor in my Left Arm

[Johnny Angell]

I’ve had it several years, my PCP (which was 3 different doctors) have seen it and said no big deal. But on my last visit to my PCP (in which I was complaining of constant exhaustion since November), he said it was time to check into it a little further.

Last week I saw a neurologist and he gave me a thorough physical and verbal exam. His verdict was that it looked like Parkinson’s but was not accompanied by other symptoms so he does not think it iS Parkinson’s. Because it’s not causing any problems he did not prescribe any medication. Since it could be a couple other things (a rubral tremor or vascular tremor) he is prescribing an brain MRI and that will happen tomorrow.

I’m going to beat you to the punch. I’ve had Stacy look through my right ear and she cannot see through to the other ear, which means somethings in there. So there will be no “we took a picture of your brain and found nothing” results.

This caused me to reflect the organ that makes us what we are, is the least examined. At any moment, we know the least about it.

As for the exhaustion, I’m seeing a pulmonary cardiologist. I’ve already had a lung capacity test (no results yet) and later this month will have a stress test and electro-cardio gram. I hope we can discover the cause of the exhaustion. As a reminder I have asthma and a paralyzed right diaphragm. That’s been going on for 5 years and it ended my running career.

 

[usrunnr]

Does Essential Tremor run in your family?

 

[Johnny Angell]

Does Essential Tremor run in your family?

My mother had Parkinson’s late in life. What’s Essential Tremor?

 

[usrunnr]

It is a generally hereditary disease, different than Parkinson's. It is progressive, sometimes involves limbs, neck.

"Essential tremor is a nervous system (neurological) disorder that causes involuntary and rhythmic shaking. It can affect almost any part of your body, but the trembling occurs most often in your hands — especially... mayoclinic.org "

 

[Sam Posten]

Johnny, best of luck. I've had neurological issues since I was 18 (I've mentioned here before that I have a pituitary adenoma, a prolactinoma to be precise) and they are a quick way to make you question everything you know about life and your part in it. The good news is that medicine and treatments continue to improve as we learn more. I know Parkinsons itself is a serious bitch of a disease, so hoping it's not that for you or that if it is that it is manageable for many years to come.

 

[Johnny Angell]

Johnny, best of luck. I've had neurological issues since I was 18 (I've mentioned here before that I have a pituitary adenoma, a prolactinoma to be precise) and they are a quick way to make you question everything you know about life and your part in it. The good news is that medicine and treatments continue to improve as we learn more. I know Parkinsons itself is a serious bitch of a disease, so hoping it's not that for you or that if it is that it is manageable for many years to come.

Well the doc really thought it wasn’t Parkinson’s and the brain MRI is to rule out a couple of other things. Thanks for you wishes.

 

[Josh Steinberg]

Johnny, wishing you the best - I’m glad to hear that the doctors are being proactive about trying to figure it out and I’m glad you’ve kept us in the loop. I’ll be keeping you in my thoughts.

 

[jayembee]

I hope things work out, Johnny. Whatever the results, my thoughts are with you.

 

[Clinton McClure]

Best of luck, Johnny. Parkinson’s runs in my family, on my dad’s side. His mother had it and so did one of his brothers.

 

[John Dirk]

This caused me to reflect the organ that makes us what we are, is the least examined. At any moment, we know the least about it.

Hope it turns out to be too much caffeine or some other benign and easily dealt with condition. You're right about our brains. Least examined and least understood.

Best of luck, Johnny. Parkinson’s runs in my family, on my dad’s side. His mother had it and so did one of his brothers.

Come on, Clint. What are you doing in the Rocket Science Department if you can't offer some protracted explanation to at least reduce Johnny's state from serious apprehension to general malaise.

 

[jayembee]

Come on, Clint. What are you doing in the Rocket Science Department if you can't offer some protracted explanation to at least reduce Johnny's state from serious apprehension to general malaise.

Well, if he's in the Rocket Science Department, he's obviously no Brain Surgeon...

 

[Johnny Angell]

I’m really not that concerned about the brain mri. What I am concerned about is not finding a cause and then cure for my constant state of exhaustion.

 

[John Dirk]

I’m really not that concerned about the brain mri. What I am concerned about is not finding a cause and then cure for my constant state of exhaustion.

A lot of potential factors in play there and also, we're in unprecedented times. I always say, "no one knows You like You." If this has just begun to happen [post COVID] then I would suspect a concrete and identifiable cause. If it roughly coincides with the pandemic then it may very well be stress related. In pretty much any situation, the best we can do is rule out the obvious [proper diet, sufficient rest, etc] and then let the professionals do their work.

I certainly hope and pray it's nothing serious.

 

[Johnny Angell]

A lot of potential factors in play there and also, we're in unprecedented times. I always say, "no one knows You like You." If this has just begun to happen [post COVID] then I would suspect a concrete and identifiable cause. If it roughly coincides with the pandemic then it may very well be stress related. In pretty much any situation, the best we can do is rule out the obvious [proper diet, sufficient rest, etc] and then let the professionals do their work.

I certainly hope and pray it's nothing serious.

It started mid November, pre-covid.

 

[John Dirk]

I reread your initial post. It sounds like your care team believes you are in good overall health. Having been a runner, that figures. I believe your overall prognosis is likely excellent, despite the known chronic issues you mentioned.

 

[Mysto]

I just thought I'd chime in. Even though we're not posting, I'm sure a lot of us, like me, are just reading the mail to see how you are doing, and wishing you well.

 

[Johnny Angell]

I reread your initial post. It sounds like your care team believes you are in good overall health. Having been a runner, that figures. I believe your overall prognosis is likely excellent, despite the known chronic issues you mentioned.

Good overall health except that: 1) I have a paralyzed right diaphragm; 2) Asthma; 3) hypertension medically under control; 4) chronic exhaustion since mid November. And I’m an old fart. There’s nothing the screams “your gonna die!” But items 1 & 4 and drastically changed my life for the worse. If they tell me I’m stuck with 4, that’s going to be bad.

 

[Johnny Angell]

I got my brain mri results a short time ago. The doctor’s nurse called and said “you have a normal brain for a man your age.” My wife tends to be a “glass if half empty” gal and immediately presumes that must mean I have Parkinson’s. I tell her no, the mri was looking for a couple other things. I don’t have them, nor do I have the other symptoms to receive a Parkinson’s diagnosis.

She’s not convinced, so I’ve got a call in to the doc. Talked to the nurse and explained the issue. Waiting for a call back. I know what the doc said, I don’t have the big P.

 

[David Norman]

I'm going to play House -- see that, leading with a bad pun to put the patient at ease which is a House specialty

It would seem a tremor in on arm that doesn't sound like it's changed much, progressed, and no other P symptoms over several years would seem to lead against PD.

Tremor -- does your wife see it when you're sleeping, is it just when you are tired or worse when you are tired, mostly (or least) right after waking up, just when you are not doing something with the hand/arm or only when you are trying to do something (resting vs intention tremor) or does it seem to be there all the time,

Just your hand/fingers or includes forearm, elbow, upper arm too. If you're lefthanded does it cause trouble writing? or in general trouble doing things with your left hand -- holding knife/fork, tools, just holding things at all


Fatigue -- it would be nice to put both symptoms together, but sometimes 2 things is more likely than one
New medications in the last 6-9 months?
I'm assuming Iron and Blood counts are too easy and almost certainly have been checked.

Change in sleep -- more snoring, more night awakening, sleepwalking. Have you been checked for sleep apnea or similar sleep issues? Very common in 50-60yo+ though a bit odd to show up suddenly for no reason

Skin changes -- more/easier bruising, extra sensitivity to sunlight, rashes, darkening of skin over your elbow/knuckles that makes you think they're dirty all the time. Thinning or accelerated hair loss -- or odd change in color

Were you sick with a fever, flu, or similar illness 3-6 weeks prior to the fatigue being noticeable? Mono in a 60yo isn't unheard of, but is a bit unusual, in Arkansas ticks are pretty common though and it started at the end of the summer/fall season.

Thyroid numbers -- not just a simple TSH since that's commonly mistaken esp in non men and non 15-35yo

Adrenal/Cortisol issues - mild Addison's can be exceedingly hard to diagnose and the test is at best a crap shoot as anyone watching a dozen episodes or HOUSE will learn. Lupus and Addison's seem to be in the differential for everything and of course it's never those except when it is

 

[Johnny Angell]

Were you sick with a fever, flu, or similar illness 3-6 weeks prior to the fatigue being noticeable? Mono in a 60yo isn't unheard of, but is a bit unusual, in Arkansas ticks are pretty common though and it started at the end of the summer/fall season

In mid November, 2019, I was sick with the flu and when I came out of it I had the exhaustion and it’s stayed with me since.