Tremor can be classified into two main categories:

Parkinsonian tremor

Parkinsonian tremor is a common symptom of Parkinson’s disease, although not all people with Parkinson’s disease have tremor. Generally, symptoms include shaking in one or both hands at rest. It may also affect the chin, lips, face, and legs. The tremor may initially appear in only one limb or on just one side of the body. As the disease progresses, it may spread to both sides of the body. The tremor is often made worse by stress or strong emotions. More than 25 percent of people with Parkinson’s disease also have an associated action tremor.

Resting tremor occurs when the muscle is relaxed, such as when the hands are resting on the lap.  With this disorder, a person’s hands, arms, or legs may shake even when they are at rest.  Often, the tremor only affects the hand or fingers.  This type of tremor is often seen in people with Parkinson’s disease and is called a “pillrolling” tremor because the circular finger and hand movements resemble rolling of small objects or pills in the hand. 

Action tremor

Action tremor occurs with the voluntary movement of a muscle. Most types of tremor are considered action tremor. There are several sub-classifications of action tremor, many of which overlap.

Most of the tremors I have experienced are Action tremors. Which means, they happen when I am actively trying to do something. All I need to do, to stop the tremor is to relax my hand, or leg, etc. The problem comes when I need to maintain a grip, because I am carrying something or lifting a utinsel toward my mouth, because if I relax it would result in a dropped item or spilled food. I have learned to use two hands when carrying items I would previously carried with one hand, and lay my fork down while I chew. I feel very fortunate that I am able to relax my feet, legs. arms, hands and even my chin/jaw with ease.

A tremor is most commonly classified by its appearance and cause or origin.  There are more than 20 types of tremor.  Since I don’t manifest very much resting tremors but have many non-motor symptoms, the Doctor ordered a datscan, to confirm I had a significant lose of dopamine… thus Parkinson’s instead of essential tremor

Essential tremor

Essential tremor (previously also called benign essential tremor or familial tremor) is one of the most common movement disorders.  The exact cause of essential tremor is unknown.  For some people this tremor is mild and remains stable for many years.  The tremor usually appears on both sides of the body, but is often noticed more in the dominant hand because it is an action tremor.

This information was found at:

DaTscan ordered

Pwp (people with Parkinson’s) keep telling me, if you don’t like your neurologist, fire him. I’ve been hoping third time would be a charm.

1st Neurologist said: ‘Take this medicine and I’ll see you in six months.’ The medicine made me ill (down in bed & throwing up) so I discontinued taking it.

I’d searched the internet about side effects of the medication and decided maybe I could control symptoms with exercise and mind over matter.

2nd Neurologist said: ‘Take the medicine.’ When I said; ‘no thank you. It made me ill.’ He said, ‘Then we can’t help you. Come back when you are ready to try it again.’

The 3rd Neurologist was asked to evaluate me for Myasthenia Gravis. He explained if I had energy in the morning, but lost energy as the day progressed, it would be suspect. But since I get up weary, he though I indeed do have Parkinson’s. BUT he ordered a DaTscan (possibly because I said I have ‘action tremors’ instead of ‘at rest tremors.’), although he ‘said’ he perceived at rest tremors.

People with PD will typically have a smaller signal in a part of the brain called the striatum, where the ends of the dopamine neurons are meant to be. Basically, a normal DaTscan would indicate a healthy dopamine system, whereas an abnormal DaTscan would indicate an unhealthy dopamine system.

#3 Neurologist took more time to explain WHY he felt I should try the originally prescribed medication again… also addressing strategies to minimize negative side effects.

#3 also said, “See you in three weeks“! Assuring me the visits will be frequent until my symptoms are controlled, and my life has returned to normal.

I KNOW! Sounds too good to be true. I’ve read the pros and cons… I’ve read no two PWP are alike. Some swear by the med… some swear about the med. Only time will tell which my body chooses.


On the bright side

So… I have to admit I was disappointed with how our trip to Gainsville went. Basically, the Doctor just wanted to put me on a medication that has bad side effects. When I said, no thank you, he said, “You can just be followed by your primary care doctor.”

So what we did accomplish… They have a base line for my symptoms,,, so If I return in the future, I am in the system. AND he also said, “I would change the diagnosis from Parkinson’s to Parkinsonism.” Because I have multiple symptoms, typical with Parkinson’s, but not the tremors.. plus other symptoms as seen in MSA. There is a test that could be given to determine what parts of the brain are losing the dopamine. But knowing wouldn’t change the treatment. And I don’t desire to have radioactive stuff injected into my veins, anyway.

DaTSCAN is a special technique that provides detailed images of the dopamine neurons (nerve cells) in the brain. The Food and Drug Administration (FDA) approved the use of DaTSCAN for differentiating PD from other conditions in 2011. The patient is given a radioactive agent into a vein.

I asked if I could speak with a dietician, because I am losing too much weight on the Keto Diet, but both dietician’s were in a meeting, so one is supposed to call me. (I’ve made a decision, without her call.) The thinking behind the Keto diet was to get more oil to my brain… and to increase my energy. Sadly, I do not recognize any pick up in my energy level… but when the scale said 107 Lb. this a.m., I decided to add more fruits, beans, etc… to balance my diet more. I’ll still have to say no to products with white flour or sugar, of course. Back to the matra of moderation in all things. I will also continue to focus on the gut health guidelines… Bone Broth, and fermented foods.

The bright side in my day came when I checked the mail. My Aware in Care kit had arrived. I’ll explain what that is, tomorrow.