Essential Tremor and Dermatology

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Shaky-NotStirred

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Hey all, I'm a third year osteopathic medical student that is hoping to pursue dermatology. I've been very interested in the field for a while now. I love all the aspects of the field, including the variety of procedures that are involved in dermatology. However, I have an inherited essential tremor that I'm starting to notice already (26 y.o.). I have not tried any medication for it (I.e primidone/propranolol), but am aware that many of those medications only help ~50% of the patients and only reduce the tremor, not resolve it.

I was hoping to get an opinion from any current dermatologists or residents in the field on whether or not it would still be a good idea for me to pursue this career. I've read other blogs about ET and pursuing surgery, however I haven't found one that talks about tremor in the field of derm.

I know derm isn't restricted to only procedures, however some of the procedures I feel require fine motor skills, and am wondering if this tremor would significantly impair my future ability to practice.

Any advice would be greatly appreciated!
Thanks

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Hey all, I'm a third year osteopathic medical student that is hoping to pursue dermatology. I've been very interested in the field for a while now. I love all the aspects of the field, including the variety of procedures that are involved in dermatology. However, I have an inherited essential tremor that I'm starting to notice already (26 y.o.). I have not tried any medication for it (I.e primidone/propranolol), but am aware that many of those medications only help ~50% of the patients and only reduce the tremor, not resolve it.

I was hoping to get an opinion from any current dermatologists or residents in the field on whether or not it would still be a good idea for me to pursue this career. I've read other blogs about ET and pursuing surgery, however I haven't found one that talks about tremor in the field of derm.

I know derm isn't restricted to only procedures, however some of the procedures I feel require fine motor skills, and am wondering if this tremor would significantly impair my future ability to practice.

Any advice would be greatly appreciated!
Thanks

I'm sure it depends how bad the tremor is. I haven't met anyone whose ability to practice general dermatology was restricted by a tremor.
 
I have essential tremor although relatively mild. I have not had too much trouble thus far on derm rotations (starting derm residency in July). Avoiding caffeine, alcohol, and stress helps a lot as well as using an object or your other hand to stabilize. I think it should be less of an issue in derm than in many other surgical specialties (although my sister has it as well and still manages to do opthalmology).
 
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Thanks for your input, helps put my mind at ease some. Now just have to worry about/focus on acceptance into a program haha
 
Hey all, I'm a third year osteopathic medical student that is hoping to pursue dermatology. I've been very interested in the field for a while now. I love all the aspects of the field, including the variety of procedures that are involved in dermatology. However, I have an inherited essential tremor that I'm starting to notice already (26 y.o.). I have not tried any medication for it (I.e primidone/propranolol), but am aware that many of those medications only help ~50% of the patients and only reduce the tremor, not resolve it.

I was hoping to get an opinion from any current dermatologists or residents in the field on whether or not it would still be a good idea for me to pursue this career. I've read other blogs about ET and pursuing surgery, however I haven't found one that talks about tremor in the field of derm.

I know derm isn't restricted to only procedures, however some of the procedures I feel require fine motor skills, and am wondering if this tremor would significantly impair my future ability to practice.

Any advice would be greatly appreciated!
Thanks

I am an attending anesthesiologist and have an essential tremor.

I imagine in derm if you miss your mark, you have to re-excise something (positive margin in MOHS?) or you make a scar. If I miss my mark with intubation, people can die. If I miss a peripheral nerve block or thoracic epidural people cry in pain. If I miss on a central line, can cause a pneumo.

My point being, I chose (potentially) a more consequential field in terms of outcomes from a possible tremor and didn't hesitate going into Anesthesiology. Propranolol has worked great for me and have only gone up on dose once in five years. Was diagnosed when on neurology doing an LP as a student and the upper level resident said, "You can do that procedure better than I can, but you do shake more than normal." Dad has it. Gets better when I drink...

I will say, though, do NOT apply for disability insurance until residency. You can read more about how I got denied disability insurance as a medical student on my website. Literally cannot get it now because of it.

TPP
 
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I am an attending anesthesiologist and have an essential tremor.

I imagine in derm if you miss your mark, you have to re-excise something (positive margin in MOHS?) or you make a scar. If I miss my mark with intubation, people can die. If I miss a peripheral nerve block or thoracic epidural people cry in pain. If I miss on a central line, can cause a pneumo.

My point being, I chose (potentially) a more consequential field in terms of outcomes from a possible tremor and didn't hesitate going into Anesthesiology. Propranolol has worked great for me and have only gone up on dose once in five years. Was diagnosed when on neurology doing an LP as a student and the upper level resident said, "You can do that procedure better than I can, but you do shake more than normal." Dad has it. Gets better when I drink...

I will say, though, do NOT apply for disability insurance until residency. You can read more about how I got denied disability insurance as a medical student on my website. Literally cannot get it now because of it.

TPP

does propranolol completely stop the tremors or just reduce the severity? do your hands shake at all when you're around patients? and if they do how do patients usually react? As a patient if my physician was trying to treat me and had shake hands, I'd think they were nervous or unsure of what they were doing... that's my main concern... I also have ET and am starting medical school in August so trying to get a good idea of how to deal with it moving forward
 
does propranolol completely stop the tremors or just reduce the severity? do your hands shake at all when you're around patients? and if they do how do patients usually react? As a patient if my physician was trying to treat me and had shake hands, I'd think they were nervous or unsure of what they were doing... that's my main concern... I also have ET and am starting medical school in August so trying to get a good idea of how to deal with it moving forward
You can't notice my tremor at all when I take propranolol. Been on a stable dose for past three years. Humble brag... But I do procedures all day and often get complimented on how efficient I am with my blocks from CRNA, fellow attendings, etc.

So unless I mention it, you wouldn't notice. Now on the days I forget to take it... I don't have to tell you I have a tremor, it's noticeable when I forget to take the propranolol.

If you have one, try it out, and see how it works for you.

Sent from my XT1710-02 using Tapatalk
 
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