In some people, too much stress simply results in irritability. In other people, too much stress can cause or worsen health problems, including Essential Tremor. Learning to relax is the key to reducing stress.
Below are a few relaxation exercises. Be sure that you have a quiet location that is free of distractions. Make sure that you are in a comfortable body position and a good state of mind. Try to block out worries and distracting thoughts.

• Rhythmic breathing: If your breathing is short and hurried, slow it down by taking long, slow breaths. Inhale slowly and exhale slowly. Count slowly to five as you inhale, and then count slowly to five as you exhale. As you exhale slowly, pay attention to how your body naturally relaxes. Recognizing this change will help you to relax even more.
• Deep breathing: Imagine a spot just below your navel. Breathe into that spot, filling your abdomen with air. Let the air fill you from the abdomen up, then let the air out like you are deflating a balloon. With every long, slow exhale, you should feel more relaxed.
• Visualized breathing: Find a comfortable place where you can close your eyes and combine slowed breathing with your imagination. Picture relaxation entering your body and tension leaving your body. Breathe deeply, but in a natural rhythm. Visualize your breath coming into your nostrils, going into your lungs and expanding your chest and abdomen. Then, visualize your breath going out the same way. Continue breathing, but each time you inhale, imagine that you are breathing in more relaxation. Each time you exhale, imagine that you are getting rid of a little more tension.
• Progressive muscle relaxation: Switch your thoughts to yourself and your breathing. Take a few deep breaths, exhaling slowly. Mentally scan your body. Notice areas that feel tense or cramped. Loosen up these areas. Let go of as much tension as you can. Rotate your head in a circular motion once or twice, but be sure to stop any movements that cause pain. Roll your shoulders forward and backward several times. Let all of your muscles completely relax. Recall a pleasant thought for a few seconds. Take another deep breath and exhale slowly.
• Relaxation and music: Combine relaxation exercises with your favorite music in the background. Select the type of music that lifts your mood or that you find soothing or calming. Some people find it easier to relax while listening to specially designed relaxation audio tapes, which provide music and relaxation instructions.
• Mental imagery relaxation: Mental imagery relaxation, or guided imagery, is a proven form of focused relaxation that helps create harmony between the mind and body. Guided imagery coaches you in creating calm, peaceful images in your mind -- a "mental escape." Practice making positive statements about yourself. One example of a positive statement would be: "I am healthy, vital, and strong."

​

WebMD Medical Reference
http://www.webmd.com/brain/essential-tremor-relaxation
SOURCES:
Johns Hopkins Medicine: "Essential Tremor."
Pal, P. Annals of Indian Academy of Neurology, July 2011.
Medscape: "Essential Tremor: A Clinical Review: Approaches to Treatment."

Reviewed by Neil Lava, MD on September 20, 2014


​

 Ten million people in the United States shake due to essential tremor. It is a syndrome with no cure yet. Medications and procedures can calm some tremors, but not all. Those of us with ET have to learn to live with it and find unique ways to deal with it.
 
My essential tremor reared its ugly head during my freshman year at college. No insecure, very shy, introverted girl wants to hear a voice behind her say, “Hey, girl, what’s wrong with you? Are you scared?” No, I wasn’t scared, just having a tremor beginning from an unknown source and terribly embarrassed.
As with most cases, my ET progressed. My head shivered back and forth as if I were constantly telling everyone, “No, no.” Nevertheless, I incorporated it into my life and prayed each day that IT wouldn’t be noticeable or IT would go away. I got married, had a daughter, taught school for twenty-seven years, and at the age of 48 retired early and enrolled in seminary. Not because I wanted to become a student again, but because God was calling me. After graduation I was ordained and pastored in six different churches in twenty-four years. Yes, I stood in front of classrooms and congregations to teach and preach. I explained ET, but didn’t dwell on it. Sixty years of tremors in my head and now it is starting in my hands. Many of you can relate to that.
 
One of my most embarrassing ET moments was at age 75 sitting next to my 104-year-old mother-in-law at her assisted living home. We were listening to an older man entertaining the small crowd with music. After a short time he told everyone to lift their hands and sway them side to side. My mother-in-law and I chose not to follow the instructions. He looked at me, saw my essential tremor head indicating no, no, and he stopped singing. He said, “No, we can’t do that! She says no.” I tried to hold my head steadier with little success. Several more times he stopped and pointed at me, so everyone turned to stare and see who was “disobeying.” Embarrassment and a little bit of anger. After the performance I did talk to him quietly. It may have embarrassed him, but I hoped he would not do that with anyone else in his audiences. Ten years ago I would have kept quiet and told myself to “suck it up, cupcake.” Not anymore.
 
Do you wonder why we don’t see many others with essential tremor in stores or on the sidewalk? Where are the other 9,999,999 of us? The best place to find others is in a support group.
 
After my second retirement, I began in earnest to write fiction books. I have two fictional series, several stand-alone books, devotionals and Bible studies, and one children’s picture book.

​ 
It took me 3 years and 7 doctors to figure out what was wrong with me.

My name is Theresa McFadden and this is my ET Story

I started with internal tremors, so I didn't know how to explain what was wrong with me (because I never heard of such a thing, no one in my family had it). I was diagnosed with anxiety (well who wouldn't have anxiety not knowing what was going on with your own body), depression (I wasn't depressed just worried) Went to see my 6th doctor who was trying really hard to find out what was wrong. My next visit I went because my voice started with a "quiver". So he was thinking MS (but that was questionable). He sent me to the RIGHT Neurologist. I lived on the couch for 3 years and thanks to my Neurologist I have some what of a life back.


Our Stories Living with ET

​“No one knows Essential Tremors better than those who are living with it.” 

​
The Truth About Essential Tremor: It’s Not Just a Case of Nerves

​The Truth About Essential Tremor: It’s Not Just a Case of NervesThis prevalent cause of shakiness is often mistaken for Parkinson's.Tremors associated with essential tremor typically occur while the person is eating, drinking, writing, typing, brushing teeth or performing another movement-oriented activity.

By Stacey ColinoNov. 11, 2015, at 9:50 a.m.+ More

If your hand routinely shakes when you hold a drink, sign your name or tap a number into your cellphone, you may fear that you're experiencing signs of Parkinson's disease. But what you're more likely to have is essential tremor, a common neurological condition that causes an involuntary, rhythmic trembling of the hands during movement but can also affect the head, voice or legs. While it's often confused with Parkinson's, essential tremor is eight times more common and affects an estimated 10 million people in the U.S., according to the International Essential Tremor Foundation.

Unlike Parkinson's, which is a degenerative disease that causes someone to lose brain cells, essential tremor is not a degenerative disorder, explains Dr. Michael Rezak, director of the Movement Disorders Center at Northwestern Medicine Central DuPage Hospital in Winfield, Illinois. "Essential tremor results from a malfunction of certain neurons, but you don't lose brain cells, and you don't lose gait or balance."

Despite its prevalence, it wasn't until 2013 that essential tremor was given its own specific diagnostic code, one that's distinct from other tremors, in the 10th edition of the World Health Organization's International Statistical Classification of Disease and Related Health Problems (ICD) code book. In medicine, the word "essential" means there's no known underlying cause for a symptom, which is the case for essential tremor. "When people hear it's essential tremor and not Parkinson's, that usually puts them at ease," Rezak says. "Essential tremor is the most common movement disorder out there, but we don't usually see people until it gets really bad. Most patients just learn to live with it."

Usually, the tremor that's characteristic of essential tremor occurs while the person is performing a movement-oriented activity – such as eating, drinking, writing, typing or brushing teeth – or when the hand is in a still but outstretched position (called a postural tremor). The severity can range from a barely noticeable trembling that's exacerbated by stress, anxiety, fatigue, excess caffeine or certain stimulant asthma medications to a severe, disabling tremor that has a significant impact on your ability to perform daily activities.
The late "actress Katharine Hepburn is an extreme example of advanced essential tremor – it affected her voice, head and arms, as well as her hands," Rezak notes. Playwright Eugene O'Neill also suffered from essential tremor. So does rocker J. Roddy Walston, of J. Roddy Walston & The Business, who became increasingly vocal about his condition in the band's 2013 LP "Essential Tremors."

The disorder affects men and women equally, and it's hereditary in more than 50 percent of people who have it. Though the average decade of onset is in the 40s, essential tremor can occur at any time, even in children. Debbie Lamb developed "the shakes" when she was in her late 20s but she didn't have a name for them until her second child was diagnosed as a baby in 2004 with "benign familial essential tremors." "It turned out that not only did I, her mother, have them, but my mother, sister, grandmother and niece all had them, too," says Lamb, now 50, a marketing executive in Vallejo, California.

There aren't blood or other medical tests that can definitively diagnose essential tremor. Instead, a neurologist makes the diagnosis on the basis of a detailed medical history and a neurological evaluation that's designed partly to rule out other possible causes of the tremor. In tough cases, a relatively new diagnostic imaging technique called DaTscan allows doctors to distinguish between patients who have a loss of dopamine, the neurotransmitter that's predominantly responsible for Parkinson's symptoms, and those who don't have a dopamine deficiency.

If your essential tremor is mild and doesn't bother you, it doesn't need to be treated. But you can take steps to mitigate the effects by avoiding caffeine and doing yoga or other relaxation techniques. Lamb relies on focused breathing exercises and meditation to reduce the severity of her tremors. A 2015 study from Australia found that doing resistance training also can reduce essential tremor and improve manual dexterity in those who have the condition.

It's often referred to as benign essential tremor because it isn't life-threatening, "but it's not that benign when it starts interfering with one's life and you can't work or eat soup," Rezak says. If it impairs your ability to function, the condition is usually treated with medications such as beta-blockers, anti-seizure drugs, anti-anxiety meds or Botox injections. There's a lot of trial and error to find a medication that works well for any given patient; sometimes drug treatment helps sufficiently, and sometimes it doesn't.
With or without medication, essential tremor is often a progressive condition. "As the tremor progresses, it can worsen or people can have breakthrough tremors on medication," explains Dr. Joseph Neimat, an associate professor of neurosurgery at Vanderbilt University Medical Center in Nashville.

Elsie Hamilton, of Englewood, Colorado, discovered this firsthand when her tremors got so bad over a 20-year period that she had to give up her career as a landscape, still life and portrait painter. Besides struggling to hold a paintbrush steady for detail work, on some days she had trouble keeping the brush between her fingers at all. In her personal life, when she was the slightest bit nervous in social situations, she would shake when moving a fork to her mouth or lifting a glass to her lips. For the last six years, Hamilton has been taking a beta-blocker for a heart condition, which helps with her essential tremor but doesn't eliminate it. "It can still be very embarrassing but I tell people up front and try to laugh it off," says Hamilton, now 54, president of the Lilly Brush Co., which manufactures and sells special brushes that remove pet hair from clothing and furniture. "My siblings, in-laws and two sons cover for me and help whenever they can."
​
For people with severe tremor that doesn't respond to drugs, surgical therapies and other treatments are gaining traction. With deep brain stimulation, a probe is implanted in the thalamus, the part of the brain that causes tremors, and a wire runs from the probe to a pacemaker-like device implanted in the chest. "We use the pacemaker to jam the tremor signal inside the brain," Neimat explains. "If the tremor gets worse, we can dial up the stimulation."

By contrast, a noninvasive procedure called Gamma Knife thalamotomy uses cobalt beams to deliver a precise dose of radiation to the thalamus to control these involuntary movements. In a recent study published in Neurology , researchers from France found that the Gamma Knife procedure improved upper limb tremor by 54 percent and the ability to perform activities of daily living by 72 percent in 50 patients with tremor.

Meanwhile, a new noninvasive MRI-guided high-intensity ultrasound technique, which uses concentrated ultrasound waves to selectively damage the part of the brain that contributes to tremors, is showing preliminary promise. "It's unique in that you don't need to cut the skin or insert something into the brain – and it's a one-time treatment," says Dr. Ali Rezai, director of the Neurological Institute at The Ohio State University Wexner Medical Center, where a clinical trial is being conducted on the technique's safety and effectiveness. "So far the results seem to be robust." The study will conclude next year, and doctors are hoping the technique gains approval by the Food and Drug Administration in short order.
​
The take-home message: While "this is a condition that can have a significant effect on a person's quality of life, it's very treatable," Neimat says. So there's no reason to suffer and shake silently or to hesitate to seek help for it.

​http://health.usnews.com/health-news/patient-advice/articles/2015/11/11/the-truth-about-essential-tremor-its-not-just-a-case-of-nerves
​

Former residents team up for book to benefit tremor disorder research

Essential tremor: Aiken resident lives with, raises awareness of disease
Stephanie Turner  Email  stephaniedturnerAS
Oct 11 2015 3:47 pm

​Getting ET
“Essential tremor (ET) is the most common movement disorder. It is a progressive, often inherited disorder that usually begins in later adulthood,” according to John Hopkins. “Essential tremor is thought to be caused by electrical fluctuations in the brain that send abnormal signals out to the muscles.”

The gene that causes ET has not been identified, and how it’s inherited, if the person does inherit it, differs among patients, according the National Library of Medicine’s Genetics Home Reference.

In some causes, “they almost know it’s coming, because generation after generation have a pretty pronounced tremor,” said Dr. Michelle Lyon, Carolina Musculoskeletal Institute’s neurologist.


 Staff Photo by Stephanie Turner Dr. Michelle Lyon is the neurologist at Carolina Musculoskeletal Institute

Since Shaddox’s father passed away before she was born and her mother died when Shaddox was a toddler, she isn’t completely sure how she got her ET, though she suspects it’s from a great aunt whose hands would shake.

“In most affected families, essential tremor appears to be inherited in an autosomal dominant pattern, which means one copy of an altered gene in each cell is sufficient to cause the disorder, although no genes that cause essential tremor have been identified,” according to the National Library. “Essential tremor may also appear in people with no history of the disorder in their family.”

There is no genetic test to detect whether or not you will get ET, Lyon said.

“Your health care provider will ask you questions about your health history and family history. He or she will also look at your trembling symptoms. Your provider will probably need to rule out other conditions that could cause the shaking or trembling,” according to John Hopkins.

ET is often confused with Parkinson’s disease, which affects less people and is more detailed in its symptoms than ET, according to Lyon.

Parkinson’s, for example, “generally involves slow movements (bradykinesia), rigidity (stiffness) and problems with walking or balance,” whereas those symptoms are abnormal in people with ET, according to the International Essential Tremor Foundation.

This weekend was packed full of drama. We, the authors/artist at the Folly Beach Wine & Sign, a fundraiser for the Diann Shaddox Foundation for Essential Tremor, knew the forecast was for rain, but being diehards we decided to give Saturday a chance. Little did we know that we would be in the Perfect Storm. 

The slow rain began and all was well… for about fifteen minutes, then the storm hit. Strong winds & heavy rain began and started lifting tents, which were strapped down pulling them loose, making them dance twirling like ballerinas. Everyone rushed outside to save the tents. We looked like a crew on a ship battening down the hatches with gust of wind and rain beating down on us. The wind did win taking a few large boards off the arbor of the SC Parks & Recreation & Locklear’s Beach City Grill, but we were able to save the tents. 

Since we had won the battle with the storm we decided to extend the Folly Beach Wine & Sign for a second day. The next day, Sunday, was a beautiful day with blue skies and temperatures in the low 70’s. The winds were still gusty but the day was a perfect day.

I had the best time and want to say thank you to the SC Parks & Recreation, Locklear’s Beach City Grill, all our authors/artists, (who had a wonderful sense of humor), and everyone that came out to support our event and help raise money for the Diann Shaddox Foundation for Essential Tremor. 

I met so many great people, Linda, Jeff, Elaine, Matthew, Peggy, Bill, Trudy, Mandy, Kirtland, Frank, Kathy, Lourie, and so many more.

We had so much fun that we have decided the next Folly Beach Wine & Sign will be held on Saturday & Sunday.

Does anyone know who this beautiful lady is? She has something in common with over 10 million Americans and million more worldwide.....Hint: She shared the same tremor disorder.










Yes, it is Katherine Hepburn

Cracking The Brain's Genetic Code

The Huffington Post  |  By Carolyn Gregoire

 

Posted: 01/23/2015 8:10 am EST Updated: 01/23/2015 9:59 am EST

An international team of over 300 scientists are taking on an ambitious project to identify eight common genetic mutations that appear to age the brain by three years on average. The team, known as Enhancing Neuro Imaging Genetics through Meta Analysis (ENIGMA) Network, hopes to pave the way for new treatments for Alzheimer's, autism and other neurological disorders.

Led by researchers at the University of Southern California, neuroscientists from more than 190 scientific institutions are bringing together a wealth of data, including brain scans and genetic data from 33 countries around the globe to identify and target genes that either enhance or deteriorate key brain regions.

"The ENIGMA Center's work uses vast datasets as engines of biomedical discovery; it shows how each individual's genetic blueprint shapes the human brain," Dr. Philip Bourne, associate director for data science at the National Institutes of Health, said in a statement.

Using MRI data from more than 30,000 people, the researchers screened millions of genome variations to determine which ones affected important brain areas implicated in common neurological disorders.

They discovered eight genes that are capable of either eroding or strengthening brain tissue, which may alter the "brain reserve" by two to three percent. In this respect, the genes seem to exert an effect on how resilient our brains are to disease.

"We have some preliminary data that shows the genes driving brain size may affect disease risk," Dr. Paul Thompson, ENIGMA's principal investigator, said in an email to the Huffington Post. "Some affect the memory systems of the brain that decline in Alzheimer's disease. Other genes affect deep brain nuclei that degenerate in Parkinson's and Huntington's disease. If you think of the brain as a mental bank account, we need to know what depletes it and tops it up."

The findings could help to devise future treatments for neurological disorders using pharmacogenomics, which uses an individual's genetic makeup to determine treatment response and created more tailored interventions.

"If an existing treatment were more effective for certain people, or only in certain people, ENIGMA would help to personalize medicine," Thompson explains. "The pain killer codeine, for example, is thought to be less effective in people with certain genetic codes. Imagine if that was true for psychiatric medications too -- it may be, and ENIGMA may offer one way to find out."

The project, which is the largest of its kind, was made possible through a $23 million grant from the National Institutes of Health as part of its Big Data Initiative to improve biomedical data.

It's a powerful testament to the kind of impact that global data collection and scientific collaboration can have.

"I love this kind of work -- it pays off financially, as people share resources and skills, and it gives us a power we never had in neuroscience," said Thompson. "It is not just data. It's also people in 33 countries working together to crack the brain's genetic code. Having 300 of the world's greatest minds attack the same problem reminds us of the allied code-breaking effort in World War II."

The findings were published in the journal Nature.

 

Cracking The Brain's Genetic Code http://www.huffingtonpost.com/2015/01/23/largest-study-of-its-kind_n_6523868.html?ir=Healthy+Living&ncid=fcbklnkushpmg00000030  

The Things of Life
Familial or Essential Tremors: You Are Not Alone
by Nancy Carol Brown Hardin
I don't dare carry a cup of coffee from the kitchen to my computer desk. It's impossible for me to take photographs with any kind of camera. Turning the pages of a book is difficult and sometimes I turn two or three. When I eat, it's almost like playing a game of "catch the fork," or the other fun game of "How much of this food can I wear?" I'm no longer able to hand write anything, and barely able to sign "Love, Mom" or "Love, Granny" to birthday and Christmas cards. I use a label program on my computer for addressing envelopes. As for other relatives or friends, they get cards from me only online. 

I'm Sure You're Wondering.... 

If you're wondering "What on earth is this woman talking about?" here's the answer. I have a condition that is known as Familial Tremors orEssential Tremors. My family knows this, but few of my online writing colleagues do, so this may be a revelation to some.

I've Lived With This For Years

That's right, it's nothing new for me. I've had this condtion for several years, but it's worsened as I've aged. Oddly enough, it seems to affect my right hand more than my left, and since I'm right handed that's not a good thing. In my young years, I was able to partially control it or mask it, but now that's no longer possible. The simple task of bringing a cup of coffee with me to my office is a cautious task at best, and a total mess at worst. Some days I can manage to actually have coffee in my cup when I get to my desk. HA!  But the solution of course, is to use acovered carafe, or a thermal cup with a no leak top. I prefer the cup, because the coffee stays hot longer.

There Are Medications For Tremor

A few years back my doctor put me on a medication originally designed to help with convulsions, but which is also used to aid the lessening of tremors. After about a year, the strength of the dosage was increased. This medication is only taken at night when I'm going to bed, because it does tend to put me to sleep. It has an accumulative effect, providing better results over a regular period of taking the drug. However, there are those who prefer not to take a medication for the problem.


Other Diseases and Conditions That Mimic
  
If I miss my meds for any reason, and I do my best not to,  my entire body shakes as though I have what the old folks in my childhood home called "St. Vitus Dance," which is actually Sydenham's Chorea, another movement disorder. As far as I know, there has never been a connection between the two. Parkinson's Disease, is another ailment that causes uncontrollable movement, caused by a degenerative disorder of the central nervous system. Again, there has never been a connection between Parkinson's and Familial or Essential Tremors.

Why Is This Called "Familial" or Essential Tremors? 

These tremors are often referred to as Familial or Essential Tremors because they usually run in families. It's thought to be a genetic mutation and is dominant, meaning if only one of the parents has it, the children are more likely to have it.  I can remember my mother as she aged, and I watched her hands shaking. I didn't realize it wasn't due to her age, but to this disorder. Now I see the signs of tremor in two of my children, a son and a daughter. They didn't show the symptoms when they were little, but developed them in their young adult years, just as I have. I'm sure as they grow older, they will have the same problems I do. There are young children who have Essential Tremor, and you can find more about it at the links I've provided below.
www.diannshaddoxfoundation.org


http://nancywriteseverything.blogspot.com/2015/01/familial-or-essential-tremors-you-are.html

The Hidden Dangers of Medical Scans Medical imaging tests
The Hidden Dangers of Medical Scans Medical imaging tests are exposing more of us to potentially cancer-causing radiation. Here's when you really need that scan and when you should just say no Over the past ten years, Jill Nelson, 52, a health coach, personal trainer and counselor in Chicago, has received at least seven computed tomography (CT) scans and close to 30 sets of X-rays for a variety of health ailments—from two separate disk fusions in her spine to a worrisome-looking spot on her lung. That’s on top of the 10 or so mammograms she has had since age 35, plus dozens of dental X-rays. “With all that radiation, I’m surprised I don’t glow,” she says. “It makes me a little uneasy—in trying to get my health problems diagnosed, did I increase my risk of cancer?”

Jill’s concern is shared by a growing number of doctors and medical organizations, who are worried about the soaring use of medical imaging tests that rely on ionizing radiation. This radiation can damage your cells’ DNA, which may, over time, lead to cancer. The more you’re exposed to, the riskier it is. And thanks to the increase in CT scans—which typically emit far higher doses of radiation than traditional X-rays or even other imaging tests like mammograms—exposure has risen dramatically. In 1980, only about 3 million CT scans were performed in the United States. By 2013, that number had skyrocketed to 76 million.

Exactly how dangerous are all those zaps? In 2009, National Cancer Institute researchers estimated that the 72 million CT scansperformed in 2007 could lead to as many as 29,000 future cases of cancer. And a couple of years ago, when the Institute of Medicine looked broadly at the environmental causes of breast cancer, it concluded that one factor that’s strongly associated with risk of developing the disease is ionizing radiation.

• HEALTH.COM: 9 Everyday Sources of Radiation
  

That sounds scary—and it is. “Limiting exposure to medical radiation should be on every woman’s cancer-prevention list,” says Rebecca Smith-Bindman, MD, professor of radiology, epidemiology, biostatistics and health policy at the University of California, San Francisco. Yet the tests are widely overused, research finds. “About a third of CT scans are clinically unnecessary or could be avoided by using conventional X-rays or an imaging test that doesn’t use radiation, like ultrasound or MRI,” says David J. Brenner, PhD, director of the Center for Radiological Research at Columbia University Medical Center.

The challenge is figuring out whether the CT your doctor wants you to have is essential or not—a judgment call that is difficult for the average person to make. CT scans can, in fact, be lifesaving. “They’ve revolutionized medicine in almost every area you can imagine, including helping prevent unnecessary exploratory surgeries and diagnosing and treating cancers, heart disease and stroke, ” Brenner says. Price and time can also be a factor since CT scans are cheaper and faster than an MRI. (For a cost comparison of common imaging tests, go to health.com/scan-costs.)

Understanding the risks of medical radiation—as well as the real benefits—will better prepare you to make the best decision no matter when you’re faced with it. Here’s what you must know to avoid unneeded radiation.

• Weighing the rewards and risks
  

When you receive a traditional X-ray, a small amount of radiation passes through your tissues in order to create a two-dimensional image of your insides in shades of gray. Air is black because it doesn’t absorb any X-rays, while bones are white because they absorb a lot, and organs are somewhere in between.

• HEALTH.COM: 15 Diseases Doctors Often Get Wrong
  

CT scanners, on the other hand, rotate around the body, sending numerous X-ray beams (and multiple times the amount of radiation) from a variety of angles. A computer processes the data to create three-dimensional pictures, providing a far more detailed view. “CTs allow us to see behind and around structures in the body in three dimensions with exquisite resolution,” Brenner says. As a result, they’re an indispensable tool in diagnosing all sorts of frightening health problems, such as finding small, early cancers (particularly in the lungs, liver and kidneys) or spotting internal injuries after a serious accident.

“They can detect differences between normal and abnormal tissue about 1,000 times better than a traditional X-ray,” says Richard Morin, PhD, professor of radiologic physics at the Mayo Clinic in Jacksonville, Fla. “Before CTs, if we suspected cancer in the abdomen or internal organs, we had to cut the patient open and do exploratory surgery, which could mean a weeks-long hospital stay. Now with a single scan we can confidently make the call in minutes, and the patient walks out the door afterward. If it’s an appropriately ordered exam, the benefit is far, far greater than any radiation risk.”

• HEALTH.COM: 6 Key Medical Scans and What They Should Cost
  

But the ease and accuracy of CTs has also fueled an alarming level of overuse. Have a headache that prompts a trip to the ER? Odds are good you’ll get a CT, even though current guidelines say that doctors shouldn’t perform imaging tests on patients with migraines or chronic headaches. Brain scans, whether a CT or an MRI, are worthwhile only if you have a headache with other worrisome symptoms, such as weakness or numbness on one side of your body, explains Brian Callaghan, MD, a neurologist at the University of Michigan. Even so, he and his colleagues recently found that about one in eight headache-related doctor visits result in a brain scan—and nearly half those patients are getting CTs, even though MRIs are more effective for peering into the brain.

“The goal isn’t to eliminate CTs but to use them more prudently,” Dr. Smith-Bindman says. “When my son did a head-dive out of a tree and was vomiting afterward, the ER doc recommended a CT scan to rule out a brain bleed, and I was happy to have the test. Five years later, when he hit his head skiing, it was pretty clear he just had a concussion, and the ER doc didn’t think a CT was necessary, so we didn’t get it. Doctors and patients need to step back a little and say, ‘Yes, this is a great test, but is it really necessary?’ If you have a CT when it’s not necessary, it won’t do any good—which means it can only do harm.”

• The radiation equation
  

X-rays and CT scans use so-called ionizing radiation, which contains enough energy to penetrate the body—and can damage DNA in your cells. Any damage that isn’t repaired can lead to DNA mutations, and those glitches in a cell’s programming center can, over many years, lead to cancer.

And we know that it does. “There’s not a single cancer-causing agent that has been studied more thoroughly than ionizing radiation,” Dr. Smith-Bindman says. Survivors of the atomic bombs in Hiroshima and Nagasaki who were exposed to even very low doses were more likely to get practically every type of cancer, from leukemia to lung cancer. Nursing mothers who were treated with radiation for breast infections—a common practice in the 1920s and ’30s—developed breast cancer at higher rates than those who weren’t. Those of us who’ve had more sunburns (caused by the sun’s ultraviolet radiation) are at higher risk of getting skin cancer. And the newest studies reveal that children who undergo CT scans of the head, abdomen or chest are more likely to develop brain cancer and leukemia over the next 10 years.

For reasons that are unclear, women seem to be slightly more sensitive to radiation than men. Children are more vulnerable than adults; not only do their growing bodies and rapidly multiplying cells put them at a higher risk, they also have far more years ahead of them during which they could develop cancer.

• HEALTH.COM: 20 Quick and Easy Ways to Get Healthier Fast
  

However, it’s important to note that our bodies are able to repair damage done to our cells by low levels of radiation. “If they weren’t, everyone who goes out in the sun would get skin cancer,” points out James Brink, MD, radiologist in chief at Massachusetts General Hospital.
The poison is in the dose, says John Boice, ScD, president of the National Council on Radiation Protection and Measurements and professor of medicine at Vanderbilt University. And the effects of exposure might be cumulative. “What may happen is that our bodies repair damage from small doses, but at higher doses our repair mechanisms are overwhelmed,” Dr. Brink explains. “And after that, subsequent exposure to radiation may propel the damaged cells farther down the path toward cancer.”

The actual danger to an individual receiving a scan (or even two or three) is relatively low. The overall risk of the average woman getting cancer at some point in her lifetime is about 38 percent; getting a single CT scan raises that risk to perhaps 38.001 percent, Boice explains. But since no one knows who is most likely to be affected, there is an element of radiation roulette at play.

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What’s more, we’re marinating in low-level radiation every day. The average person in the United States receives about 3 millisieverts (mSv) of radiation per year (more if you live at a high altitude) from the sun and naturally occurring radiation in the environment, such as radon gas. To put medical radiation in that context, a dental X-ray is equivalent to about one day of natural radiation, while a single chest X-ray is equivalent to about 10 days. A mammogram adds up to about seven weeks of natural radiation—but even that level, doctors say, poses a relatively small risk, especially when compared with the danger of missing a malignant tumor already growing in your breast. A regular-dose chest CT, on the other hand, exposes you to about twoyears’ worth of natural background radiation, or 7 mSv. Some of the Japanese survivors of atomic bombs were probably exposed to between 5 and 20 mSv on the low end. The trouble is, we don’t fully know how much our bodies can handle.

• What doctors don’t know can hurt us
  

The issue of medical radiation is now on most physicians’ and medical societies’ radars; just this fall, the American Heart Association called for doctors to learn about, and discuss with patients, the risks of radiation exposure from cardiovascular imaging tests. So it’s surprising—and concerning—how spotty regulations still are. For instance, dosages aren’t standardized across imaging centers, which means that one hospital or clinic may be delivering up to 50 times as much radiation as another facility, according to Dr. Smith-Bindman. “If machines are set too low, they provide blurry, unusable images, but the vast majority are set higher than they need to be,” she says. This is in part because it’s not a simple matter of pressing one button and lowering the dose. “There are formulas you need to use to set up a new protocol,” Dr. Smith-Bindman explains.

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And because most older machines, many of which are still in use, don’t have warning systems to alert technologists when radiation levels are set too high, mistakes can happen. The most publicized CT-related overdoses occurred between 2008 and 2010, when several hospitals in California and one in Alabama seriously over-radiated more than 400 patients. The problem was discovered after patients reported losing their hair. Since then, new technology has been created to alert technologists if the dose is too high—and new federal legislation is in the works that would require radiology centers to adopt modern imaging equipment standards by 2016.

Still, the more common problem is that too many scans are being done in the first place, particularly in the ER, where doctors sometimes order CTs before they’ve fully evaluated a patient, Dr. Smith-Bindman says. But doctors in general have come to rely heavily on these tests. One reason: Many MDs today have a lower tolerance for ambiguity than ever before and have learned to trust images to give them definitive answers, even when other methods, including a risk-free physical exam, can provide the information needed.

In addition, physicians in private practice may feel financial pressure to recoup the cost of expensive equipment. “Research has found that if a neurologist, say, owns a CT scanner, the percentage of patients getting scans is higher than what’s typically done in a radiology clinic and much higher than in similar doctors’ practices without scanners,” Morin says. Add to the mix the possibility of being sued over a misdiagnosis, and you have a recipe for overuse.

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Making scans safer
Avoiding unnecessary medical radiation starts with speaking up and being your own best advocate (see 5 Questions to Ask Before You Have That Scan, page 117). At the same time, multiple industry efforts are under way to lower exposures from CTs. One initiative, Choosing Wisely (choosingwisely.org), helps doctors and patients understand which procedures and tests—including imaging tests—are unnecessary or commonly overused. Radiologists are leading the charge to make scans safer: Image Wisely, a program created by the American College of Radiology (ACR) and the Radiological Society of North America, is focused on optimizing the amount of radiation used in imaging studies and eliminating inessential CTs and other scans. The ACR has also created the Dose Index Registry in an effort to compare dosage information across facilities. About a third of the 3,000 or so scanning facilities in the U.S. are members, which means they get updates on the dosages other centers are using for similar tests, explains Morin, who was the founding chair of the registry. (For more on finding the best place to get a scan, go tohealth.com/safe-scan.)

• HEALTH.COM: 5 Medical Tests to Think Twice About
  

Meanwhile, companies that manufacture scanners are developing new technology to lower the radiation doses. “They’ve fine-tuned the equipment so you can produce high-quality images with lower doses,” Morin says. Even so, when you need to get a CT scan, it’s always a good idea to ask if they can scan using the lowest dose possible, Dr. Smith-Bindman says. If you’re smaller or thinner, technicians can often get a clear image at a lower dose. (The bigger your body, the more radiation you require, since fat absorbs some of the beams.) Avoid unnecessary radiation from even low-level sources, like dental X-rays, which you probably don’t need every year unless you have ongoing problems with tooth decay.

The idea is not to refuse all medical radiation but to do your best to discriminate between what’s essential and what’s not. “I always tell my friends to say to their doctors who recommend CTs, ‘I’m happy to have the test, but I’d like you to help me understand why I really need it,'” Dr. Smith-Bindman says. “Medicine often doesn’t change until patients start asking questions. And when it comes to medical radiation, it’s time to start asking.”

• 5 Questions to ask before you have that scan
  

“When a doctor prescribes a medication, she always talks about the risks and benefits,” says Rebecca Smith-Bindman, MD. “Now we need to start having that same kind of discussion about medical imaging.” In addition to the obvious “Why do I need this test?” ask these key questions—especially if your doc suggests a CT scan.

1. “Will the outcome of the test change the treatment I’m likely to receive?” If the answer is no, the test may not be necessary, Dr. Smith-Bindman points out.

2. “Are there alternatives without radiation, like ultrasound or MRI?” In some cases, such as many abdominal CT scans, other scans work as well or better, Dr. Smith-Bindman says.

3. If you’ve just had a scan at another facility, ask, “Is there a reason to repeat the scan I just had?” Notes John Boice, ScD: “It doesn’t make sense to do tests twice, yet it does happen.”

4. If a CT scan is crucial, ask, “Is there a way to minimize the dose?” Doctors may be able to use a lower-dose technique, particularly if you’re petite.

5. After a CT scan, ask, “How much radiation was I exposed to?” Write it down so you have a record.

You probably don’t need a CT for… Question your doc if she recommends a CT for these health problems.

Concussion: Concussions can be diagnosed by symptoms alone. But it’s valid to do a CT if the doctor suspects a skull fracture or brain bleed, says Robert Cantu, MD, clinical professor of neurosurgery at Boston University School of Medicine.

Sinus infection: This everyday health problem can generally be diagnosed through symptoms and a physical exam, says the American Academy of Allergy, Asthma & Immunology.

• HEALTH.COM: 10 Medical Tests Women Need This Year
  

Headache: If you do need a scan, MRI is the test of choice, unless a doctor suspects a stroke or brain hemorrhage, according to the American Headache Society.

Appendicitis in children: It’s best to use ultrasound first, then follow up with a CT if the ultrasound is inconclusive, according to the American College of Radiology.

Back pain: Most cases improve on their own within a month, so it doesn’t make sense to expose yourself to unnecessary radiation. If the pain continues, ask your doctor about an MRI.

How much radiation you get from…
Airport backscatter scan: .0001 mSv
Bone-density scan: 0.001 mSv
Dental posterior bite-wing X-ray series (two to four images): 0.005 to 0.055 mSv*
Two days in Denver: 0.006 mSv
Panoramic dental X-rays (standard single image): 0.009 to 0.024 mSv*
Cross-country flight: 0.04 mSv
Single chest X-ray: 0.1 mSv
Digital mammogram: 0.4 mSv
Average yearly dose from the sun and other environmental sources:3 mSv
Chest CT: 7 mSv
Virtual (CT) colonoscopy: 10 mSv

PET/CT (often used to diagnose cancer): 25 mSv

Smoking a pack a day for a year: 53 mSv

*Dose can vary based on the type of machine used.

• Your anti-radiation diet
  

Antioxidants from food can sop up the free radicals that cause DNA damage. And some research has hinted that what you eat may shield your body from radiation’s harmful effects. A 2009 study of airline pilots, who tend to be exposed to elevated levels of ionizing radiation, found that those with diets highest in vitamins C and E, beta-carotene, beta-cryptoxanthin (found in pumpkin, papaya and red peppers) and lutein-zeaxanthin (in leafy greens, egg yolks and squash) had fewer biomarkers of cumulative DNA damage.

Researchers in Toronto have recently shown that taking antioxidants before a scan can reduce the number of DNA breaks caused by the radiation. Published results are expected within the next six months. Says researcher Kieran Murphy, MD, professor of radiology at the University Health Network Toronto: “In light of what we’ve found, making sure you have a diet rich in antioxidant-packed fruits and vegetables could be beneficial.”


http://www.health.com/health/article/0,,20871394,00.html

Exercise can benefit Essential Tremor, Dystonia & Parkinson's.
Every Victory Counts: Exercise and Parkinson's (Part 2 of 12)  

Davis Phinney Foundation

Uploaded on Mar 23, 2011

What are the benefits of exercise for people with Parkinson's disease?

What Causes Essential Tremor?

The true cause of essential tremor is still not understood, but it is thought that the abnormal electrical brain activity that causes tremor is processed through the thalamus. The thalamus is a structure deep in the brain that coordinates and controls muscle activity.

Genetics is responsible for causing ET in half of all people with the condition. A child born to a parent with ET will have up to a 50% chance of inheriting the responsible gene, but may never actually experience symptoms. Although ET is more common in the elderly -- and symptoms become more pronounced with age -- it is not a part of the natural aging process.

Essential tremor is known to be familial condition, meaning that it runs in families. At least 5-7 out of 10 people with essential tremor have other members of the family with the same condition. Genes are passed on to a child from each parent and determine what we look like, how our body functions and even what diseases we get. Particular genes have been shown to have certain changes present in families with essential tremor. 

It is not clearly understood how this genetic change leads to essential tremor. However, it is likely that it somehow affects some parts of the brain that are responsible for controlling movement.

How common is essential tremor?
Essential tremor is a common disorder, affecting up to 10 million people in the United States. Estimates of its prevalence vary widely because several other disorders, as well as other factors such as certain medications, can result in similar tremors. In addition, mild cases are often not brought to medical attention, or may not be detected in clinical exams that do not include the particular circumstances in which an individual's tremor occurs. Severe cases are often misdiagnosed as Parkinson disease.

What genes are related to essential tremor?The causes of essential tremor are unknown. Researchers are studying several areas (loci) on particular chromosomes that may be linked to essential tremor, but no specific genetic associations have been confirmed. Several genes as well as environmental factors likely help determine an individual's risk of developing this complex condition. The specific changes in the nervous system that account for the signs and symptoms of essential tremor are unknown.

What Are the Biggest Misconceptions People Have About Alternative Medicine? 
There are a lot of misconceptions out there about alternative medicine, whose advocates—and skeptics—seem to be perpetually armed with new studies and trials to support their differing perspectives.

With this in mind, we posed the following question to The Experts: What is the biggest misconception people have about alternative medicine?