Tremors affect on a Surgeon's practice

[Knight_MD]

I'm almost sure I'm gonna shoot for a surgical residency once I complete my internship year, but I have a mild case of essential tremors in my hands... and I fear it could affect my performace in surgery.

Mild essential tremors is a very common condition in any age-group. But how does it affect the surgeons practice?

Some doctors at my Uni told me that many of their colleagues take 2 pills of Inderal early in the morning before an operation... well is that enough?

Is that even needed? And worst case scenorio if I don't comply with Inderal well, will the Tremors affect my surgical performance? Or is surgery more about macro-movements and far less about fine manipulations?

A word from surgical residents/attending could help a lot.

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[Jocomama]

This forum will offer opinions. Unless one of us has this exact disorder, you are best seeing a neurologist and getting official work-up and options.
As a surgeon, I cannot advise you. Essential tremors are not in my scope of knowledge as an expert

I'm almost sure I'm gonna shoot for a surgical residency once I complete my internship year, but I have a mild case of essential tremors in my hands... and I fear it could affect my performace in surgery.

Mild essential tremors is a very common condition in any age-group. But how does it affect the surgeons practice?

Some doctors at my Uni told me that many of their colleagues take 2 pills of Inderal early in the morning before an operation... well is that enough?

Is that even needed? And worst case scenorio if I don't comply with Inderal well, will the Tremors affect my surgical performance? Or is surgery more about macro-movements and far less about fine manipulations?

A word from surgical residents/attending could help a lot.

 

[Knight_MD]

Thanx for replying, however, I wasn't seeking a medical opinion. Mild essential tremors is as common as some ppl sweating a bit more than others.

It's a very tiny 'shaking' of fingers, esp when ur anxious, and noticable only if u concentrate into it. You know how ppl have tremors when they're low on potassium... its very much similar.

I was wondering if this 'phenomenon' would interfere much in a surgeons' profession. And whether or not Inderal is sufficient to control it.

Here's a some info on it: http://www.postgradmed.com/issues/2000/10_00/evidente_tremor.htm

 

[FliteSurgn]

A minor intention tremor should not preclude a surgical career. I've known plenty of surgeons that didn't have rock-steady hands, me included. With most macro-movements (for example, closing fascia), the tremor is more of a nuisance than anything to worry about. With micro-movements where precision and accuracy are important (for example, vascular anastamosis), the key to overcoming the tremor is to rest your hand or forearm on something stationary like the patient, the retractor system, etc. Laparoscopy will really make the tremor go away because your instruments are fixed at the trocar site. Have no fear, a minor tremor is nothing to worry about. I worked with a pediatric urologist in medical school that had a terrible tremor and he could still place very precise stitches by resting the back of his suturing hand on the patient.

 

[Knight_MD]

Thanx a lot that's exactly what I needed to hear. And u didn't even mention Inderal 🙂

It's funny u mention Urology and Laparoscopy, these are the 2 surgical fields I'm mostly interested in.

Only in Laparoscopy, my fear was these minor tremors causing me to injure a ureter for instance. I didn't know Laparoscopy was actually better for me, I though open surgery was easier (movement-wise)

 

[factoid]

i probably have the worst hand tremor imaginable (to the point that the whole OR would talk about it) but I still got awesome evals and got the job done. there're a lot of things you can do about it so don't let that make the decision for you.

i have to say though that the resting of the hand on the patient didn't really help me. it actually made the tremor worse in some situations. i did great with big movements, but when it came to the more finer things, like skin closure or thyroid surgery, (or following 6-0 suture) etc, things got a bit more complicated; but never stuck anything i wasn't supposed to 🙂

 

[Knight_MD]

Great great great. Thanx a lot factoid.

Now how do u control/limit the tremors? Medication (Inderal)? Or With the aforementioned resting-hand-on-body technique?

 

[factoid]

mainly deal with it via mental exercises; trying not to focus much on it when working, etc. at this point, i have not been in need of medical intervention as I can do everything; i just create a great bit of distraction for everyone else who can't believe i can do what i'm doing with all that shaking going on 🙂 propranalol is definitely an option; i've thought about it often and may consider it in the future.