For a long time, Don Winslow had to make apologies - for his spilled coffee, his hard-to-read handwriting and his routine fumbling of the objects he was holding.Winslow, 65, is not clumsy or sloppy; he is one of 10 million people affected by Essential Tremor (ET) at present in the United States."I try to make light of it," said Winslow. "When I'll be in a situation where I know people are going to notice it, I kind of set the stage. I say 'I have a condition, so if I throw something at you, it's not because I don't like you.'"The condition, a neurological disorder that causes primarily hands, heads and voices to shake, is experienced by four to five percent of people between the age of 40 and 60 and 6.3 to 9 percent of people age 60 and older, according to the International Essential Tremor Foundation.Young adults can exhibit the early stages of ET, but the tremors are not as noticeable and the occurrence is less common.With no known cause, ET is thought to be a genetic disorder because patients often have a family history of these pathologic tremors. Each child of a parent with ET has about a 50 percent chance of inheriting the condition, according to Dr. Shyamal Mehta, a neurologist and assistant professor in the Medical College of Georgia's Neurology Department.Winslow's tremors were first noticed by his peers when he served in the Air Force during his late teen years. He assumed at first that the tremors were an indication of a "high strung" disposition and his tendency to consume caffeinated beverages, but he later mentioned the tremors to his physician, who informed him of the condition.ET, which does not affect a patient's life expectancy, worsens and becomes more of a nuisance with the passage of time - as was true in Winslow's case."It got to a point where it was embarrassing to go out in public ¬¬- I was terrified to pick up a cup of coffee," said Winslow. "You're in constant fear of thinking you're going to spill something on yourself or someone else."Mehta agrees that the condition can significantly impair a patient's quality of life, adding that while the condition is often confused with Parkinson's disease, there are some tell-tale differences that set the two apart:* People with ET experience tremors primarily when moving but not when sitting still or sleeping. Parkinson's patients tend to experience their tremors when at rest.* People with Parkinson's disease, especially at onset, typically notice the tremor on one side of the body. People with ET usually experience a tremor that is symmetrical.* While ET patients can experience an impairment in their walking and balance at extremely advanced stages, the tremor is usually the only symptom of the condition for most patients. Parkinson's patients also present with slowness and rigidity of movement.ET can be controlled to some degree, but not cured, by medication. Propranolol and Primidone, two first line medications prescribed to curb ET, have a 50 percent average rate in tremor reduction, according to Mehta. Only Propranolol is approved for treatment of ET by the U.S. Food and Drug Administration. Specialists may prescribe one or the other, or a combination of more than one medication to yield optimum results. Because a patient would gradually build up to the ultimate dose, it could take four to six weeks for the patient to see maximum results.Winslow took Primidone, which helped some, but not enough. After careful consideration and discussion with his doctor, he opted to have a surgery called Deep Brain Stimulation, which Mehta said shows marked suppression in 70 to 90 percent of patients who undergo the surgery."What it basically involves is a minute amount of current to a particular area of the brain that is going to disrupt some of the circuitry that is responsible for causing the tremor," Mehta said.The surgery puts two electrodes into the patient's brain, connected through a wire that travels through the neck and is connected to a battery-like device put into the patient's chest. The device is programmed to determine how much current will flow through, and the patient could start or stop the tremors by holding a remote control-like device to the chest battery.Winslow opted to have this surgery last summer to stop the tremors in his dominant right hand and said that while the surgery may not be right for everyone, his decision changed his life."It wasn't a decision I made lightly. (The surgery) is not very common, and, frankly, it's very scary," he said, but added, "It's given me back the ability to go out in public."The battery device implanted in Winslow's chest has a life span of three to five years. To prolong the need for another procedure, he turns off the device at night when his tremors are at rest.A few years ago, Winslow became involved with a support group for people with ET.The group meets on the third Monday of each month at St. Paul Lutheran Church at 961 Trail Ridge Road in Aiken.The meetings begin at 2 p.m. and last for about an hour. Participants discuss the condition with one another and learn from medical professionals - like Mehta - who come in to speak with the group.To find out more information about the group, call Don Winslow at 226-0338."If you've got it, the sooner you understand what you have, the better you are able to cope with the problem," Winslow said.Contact Anna Dolianitis at firstname.lastname@example.org.
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