Hand Tremor

This forum made possible through the generous support of SDN members, donors, and sponsors. Thank you.
Members don't see this ad :)
FiveOVicryl said:
Classic Kidsfeet.
Click to expand...

You know, people here give me a hard time about being condescending and posting things to inflame, yet when a student does the same thing, no one gets up in arms. Interesting.

Just btw, we have now provided the OP with several good pieces of literature to perhaps comfort him on his search for help for his issue. I think this thread went rather well in that regard, even though dtrack and I can't agree.
 
But what if a surgeon has stress related tremors AND wears glasses!!!!!
 
Wait Kidsfeet, don't you and Dtrack agree now that he's shown beta blockers are effective in surgery?
 
Did anyone else laugh out loud at the comment about checking and tightening glasses screws previous to performing surgery?
 
podo trest said:
Did anyone else laugh out loud at the comment about checking and tightening glasses screws previous to performing surgery?
Click to expand...

Hey!! Last thing you want is for one of those little screws to fall into your surgical field!!! :eek:
 
Members don't see this ad :)
podo trest said:
Did anyone else laugh out loud at the comment about checking and tightening glasses screws previous to performing surgery?
Click to expand...

Actually, I did. I can just picture a pre op toolbelt, to have all the tools you may need for an upcoming surgery.

I personally ALWAYS pick my nose clean prior to a surgical case. You NEVER know when a booger will fall out of your nose, slip through your mask and land in the surgical field. I HATE when that happens.

I also check for loose eyelashes and eyebrow hairs, because it's ALWAYS possible one of those hairs can float down into the surgical field.

AND I always walk into the O.R. with a large mop to clean the ceilings prior to a case. You never know if there may be some small spider hanging out up there ready to spin down and drop into the surgical field.

I'm sure everyone does this prior to surgery, it's just not ME is it?:shrug:
 
Is the tremor in one or both hands? sorry I'm swamped and was too much text to read. If the tremor is worsened by alcohol in one hand consider that it could be a Jacksonian seizure and you may follow up with a neurologist. If it is entirely anxiety related you are correct in thinking that low dose beta blockers will usually provide relief as this is a treatment for stage fright type of anxiety. Propranolol 10 mg about 1 hour prior to the anxiety provoking situation. This can usually be monitored by your family physician. Make certain you don't have seriously low blood pressure. Another quick pharmacologic solution is to try a mild relaxing antihistamine, chlorpheneramine maleate 4 mg works well and is of short duration. If the dose is too strong, you can try brompheneramine at a much lower dose by dosing a liquid like Dimetapp Children's liquid.
A good way to know if any medication will work is to schedule some kind of stressful situation such as a public speaking engagement for practice. If successful, chances are likely that you'll have greater success with a repeat dose in other stress provoking situations.
Anxiety related problems, including panic attacks, can be pharmacologically managed in many people. There are other nonpharmacologic therapies available too but if you're in a pinch it's good to have a back up plan. Best of luck in the OR doctor! :xf:
 
Just a follow-up.

The advice is appreciated. I've seen 2 neurologists recently and have been told by both that I have a VERY mild case of Essential Tremor. It's nothing that affects the way I eat or get along with daily activities, but manifests itself when i'm nervous or under pressure. One of the neurologists suggested I shouldn't worry about it and that my "hands would steady" with surgical experience and basically not to worry about it. But, frankly, all my original concerns about "performing" well in the OR continue. The 2nd neurologist prescribed 20mg of Propranolol and suggested I take the medication a couple times before trying it in the OR to ensure it didn't make me faint. It didn't, so earlier this week I took a dose before going to a case at my current rotation. I was even 'lucky' enough to be asked to tie a few sutures in the OR. My hands were steady as a rock. No shaking at all. I couldn't believe it. In a situation that usually makes me look weak, I was strong as ever.

But, that lends itself to the question and debate discussed previously. I still feel like it's a crutch. Is this a medication I can take while I'm learning early in residency until some of the 'pressure/stress/social concern' of being in the OR is relieved or am I signing up for a lifelong daily dose of propranolol? I know the propranolol is not an addictive medication, but I could see how I could become dependant on it, and that concerns me. I guess I have some big decisions to make. If anyone has had experience taking this medication with similar circumstances, please PM me as I feel like I could really benefit from your experiences.

Once again, thanks for all the responses, I appreciate the articles and friendly debate.
 
I think that the fact you were evaluated by two neurologists was great and can at least alleviate any concerns regarding a serious underlying problem.

At this risk of getting blasted, did you ever think that MAYBE the propanolol had a slight placebo effect? It is possible that because you knew you were taking the medication, everything would be ok?

Sometimes the actually thought/anxiety preceding an event is much worse than when actually put in that situation. There is always the possibility that you would have performed just as well with no medication. My only concern at this time is that if for SOME reason you forget to take your medication prior to a potential stressful situation, will you automatically believe you will start the tremors??

I think that the medication is great if and when needed. But nothing will every be better than gaining the confidence that you MAY not need the meds. Just a thought.
 
In addition, when you are a trainee and are under someone's watchful scrutiny it's easier to get the shakes simply by knowing someone is standing there evaluating your performance. When it's just you it's easier to relax and do the work.
 
You must log in or register to reply here.
Next unread thread

Similar threads

Jummy Biffett
How to Handle Post Ops when Leaving Job
Replies
8
Views
618
icebreaker32
icebreaker32
F8T
Best affordable handheld ultrasound for podiatrists
Replies
9
Views
889
Feli
Feli
M
Can podiatrists handle basic internal medicin issues?
Replies
11
Views
5K
GypsyHummus
G
MaxillofacialMN
Hand Surgery?
Replies
5
Views
3K
flyhi
flyhi
DrRock44
"Good with your hands"
Replies
8
Views
4K
Creflo
C
Top