Essential Tremor

CdaleJekyll · Sep 22, 2008

I have essential tremors. 20 years ago in the Army Medical Corp, my hands shook so bad whenever I held a needle that I gave up on ever making it as a medic or nurse. I've always known that my mother and aunt who have the condition take beta-blockers but I was to proud and considered that to be a last resort. So I beacame an electrician instead (No, I'm not about to tell you to stick your finger in a lamp socket.)

Well, this past spring after seeing the construction industry collapse all around me, and being almost 40 now and tiring of manual labor I started thinking about nursing again. I decided it was time to beat these tremors before they got any worse as they do with age.

Beta-blockers really do work for tremors, I am taking Propranolol 20mg. and they only cost @ $4.00/ month and I have no side effects other than a slight blow to my pride. I've found out that a LOT of people use them to treat performance anxiety too ( public speaking, entertainment ).

Another thing I'm doing is target shooting. I bought an air rifle and built a shooting range in my basement. This has exactly the same effect as meditation but with more sense of purpose. I feel immediately rewarded when I see shot after shot go through the same hole, which of course requires stready hands. As a result I am now becoming very proficient at steadying my hands by thought alone.

And finally, I went to the pharmacy and bought myself a few 5cc syringes to practice with at home. Just practicing sticking that needle through an 18 gauge hole over and over. I'm very certain now that I'll be fine in nursing school and in my future career.

You'll be fine

Thornbird · Oct 12, 2008

I have essential tremor and have learned to get by. It is wose if I'm nervous, so nursing clinicals were terrible. Now that I'm comfortable with all nursing skills, I rarely have any issue. Also, I find that as the needle makes contact it somehow steadies. I've never injured anyone and am even successful starting IV's. No one ever told me about beta-blockers. I was always told to "live with it". I take Cymbalta for depression and that seems to have improved my tremor.

peoplenurse rn · Oct 12, 2008

Thanks to Turtleherder and Thornbird! I actually did try propranolol and, I think it was mysoline, but unfortunately I had side effects that were not tolerable, so I can no longer take either. The propranolol was wonderful, I didn't shake at all!!

Anyway, I'll just keep trying. I want to wish the best to both of you in your ongoing nursing careers!

lbyrda · May 14, 2010

Hi Thornbird,

I have googled "nurses with essential tremor" may times within the past year and this post is always at the top of the search. Your reply is ultimately what gave me the courage to enroll in nursing school to get my RN certifcation and degree. I start in a couple of weeks but I am very nervous because I have also been diagnosed with Essential Tremor and my biggest fear is that I will spend the money on this education and then not be able to apply it in a real job because of my shaking. Within the past year I have been to the doctor several times going through different trials and methods of combating this medicine. My most recent prescription, which I have only been taking for a week now is, primidone (mysoline) at 25 mg/day. In another week, once my body has adjusted to this medicine, I will also begin taking Lexapro (an anti-anxiety pill with a mild anti depressant) which will help with when I am nervous or stressed, which seems to be when this tremor is most prevailant. I am writing to see if you could shed any light on what I may face as a nurse while dealing with this handicap. Do you know of any other nurses with ET? Will a mild shaking be excusable in this field? The medicine that I am on has helped tremendously and while my hands are, for the most part, steady, there is still a bit of shaking going on. Like I said, Im just worried and dont know quite what to expect with my clinical trials as well as a career in the nursing field. Any tips?

CrunchRN, ADN, RN · May 14, 2010

I can relate to performance anxiety! Jeez. However, if you practice something enough to become confident then that alieves 80%.

I don't have tremor, but stress always gives me that shake. You just have to force yourself to do thigs over and over and then the problem goes away.

I have pwrked with people in the past that had Essential Tremor and they did just fine. Humor is great. If you are having a bad day a great way to reassure the patient is to tell them you have done this a million times and you are not shaking from fear, you just have a chronic condition......

Do NOT let it stop you.

lbyrda · May 14, 2010

Thank you for the very comforting and encouraging advice crunch. I have really taken up a passion for nursing and pray that it is in my cards to be my professional career one day. I am a very stubborn woman in the fact that I have never let anything stop me from anything that I have really wanted to accomplish in life before this. It's just a very new and scary life change when I throw this ET into the mix. Thank You so much for your encouragement. It really does help!

Idduna · May 29, 2010

I'm glad to see I'm not alone. I have had ET since I was a child and it has always affected my life, mostly with people asking me why I'm so nervous. When I went to nursing school, I realized I would have to go on medication. I was unable to use inderal, because it was making my asthma worse, so I went on mysoline. I'm now up to 250 mg BID. I have become use to it and don't experience any side effects, but my tremor continues, especially when I'm rushing around (like we nurses do a lot) or when my body is stressed out (like I haven't eaten or slept well). I feel very sensitive to people's comments. My tremor is very fine now, but people will still notice. I have developed a system where I do most of my tasks that require fine motor skills with one hand (like drawing blood or starting IVs) but I am still really effected by this condition. Has anyone noticed problems with focus or memory with this condition?

Josephine61 · Aug 5, 2010

I am a nursing school graduate with essential tremor that I've had since childhood. I tried propranolol, doc put me on 60 mg extended release, and although they were moderately helpful with tremor, it was tremendously helpful with issues like public speaking. Unfortunately, it gave me terrible activity intolerance....walking up a flight of stairs would leave me sweating profusely and short of breath. I tried a lower dosage which just seemed ineffective, then I discontinued the med.

I am looking for work now and am very concerned as to how the tremor will affect my work.

I am now considering Primidone.

cubelle · Nov 11, 2010

Awesome to see there are others I can relate to that are nurses with essential tremors. Almost everyday a pt or cg asks "Are you nervous?" I say that I have a hereditary tremor, but it does not affect my job. Normally they say "Oh" and that is that. What do ya'll say when people ask about your tremor?

shakyinohio · Jan 15, 2011

Hi everyone:

I am a 43 year old male with ET. I used to be on meds but stopped due to no insurance. I am starting my pre-reqs for nursing and although my tremor is mild still I have been wondering if I should peruse a career in nursing. I am worried about being able to draw blood or put in IV's. I can't help but wonder if employers will hire me due to my ET. What do you think? Should I pursue a nursing career? I'm presently a CNA and an AMAP and my ET doesn't interfere with my job. Thanks.

Mark

The-Duece-Is-Loose · Mar 6, 2011

Hey, Mark! I have dealt with ET my entire life and am quite happy to report I am in my 16th year as an RN. In fact, the past ten years have been spent in a Hemodialysis unit in which I spend the majority of the day cannulating patients with 15g, 1 inch needles. Many have wondered why any patient in their right mind would allow me near them bearing a needle with such tremulous hands! First of all, after having been on the unit for ten years, I am fairly confident and rarely get nervous. When I do, biofeedback helps ALOT. Secondly, I always make sure I have stable blood sugar levels and don't over do the caffeine. Finally, I have found I can minimize a majority of the tremors by resting my pinky on the patient while I advance the needle using my thumb and forefinger. The same technique works for injections. (Side note, one patient with a significant amount of scar tissue over his fistula is always happy to have me cannulate him. He has nicknamed me "The Jackhammer" and believes the tremors help to advance the needle through his toughened skin with less pain than when the other non ET nurses do it!)