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Dr Jorge, ker Thank you for your reply. In fact the propranolol does seem to help my husband a bit but he has very low blood pressure so he can't take too much. We shall check out the medication with our GP. I understand from another message I have picked up on PARKINSN that pramipexole, which I believe is "Mirapex"(?), is better than levadopa since it does not accelerate the demise of dopamine producing cells, as does levadopa. However, we obviously have to find a movement disorder specialist and make sure first of the diagnosis, and this I shall now do. I have the feeling that services are better in the States, but I suppose this is logical given the greater numbers. Many thanks for your help dhiso Julie message from [log in to unmask] ----- Original Message ----- From: "Jorge Romero MD" <[log in to unmask]> To: <[log in to unmask]> Sent: Friday, April 05, 2002 1:08 PM Subject: Re: Tremor and PD > Julie: > > If the tremor is a resting tremor, and the diagnosis is PD, treatment with > propranolol is unlikely to help. Since the tremor is a problem, it would > seem that a trial of one of the anti-PD meds (levodopa, pramipexole, > ropinirole, or pergolide) would be rational. > > Given the situation you describe, a visit to a neurologist, movement > disorder specialist, or PD specialist would be advisable. > > Jorge A Romero, MD > 3600 Gaston Ave > Wadley Tower Suite 455 > Dallas, Texas 75246 > > > ----- Original Message ----- > From: "winddam" <[log in to unmask]> > To: <[log in to unmask]> > Sent: Thursday, April 04, 2002 6:07 AM > Subject: Re: Tremor and PD > > > > Dear Dr Jorge > > > > My husband has been struggling for the past 3 years to maintain a valid > and > > credible professional life whilst plagued by tremor, which to most > observers > > suggests senility and incompetence. He is a professional Chartered > Engineer, > > engaged in research and development, so you can appreciate the impression > > created by the tremor is career damaging. We live in Devon, UK. > > Medical advice we have received, whilst caring and sympathetic, offers no > > medication, apart from propanolol, and no alternatives, in fact nothing > but > > cope as best you can for the time being, then retire, and line up a good > > carer! > > This passivity is alien to us and I have just begun to research the > subject > > with the view to finding other attitudes, other alternatives, hence my > > subscription to PARKSN > > The information in your message would have been welcome to us before, and > it > > also seems from what you say that propanolol, which is the only medication > > that has been offered, is not appropriate for resting tremor. My husband > > has a pronounced resting tremor but no action tremor at all - he can still > > do very intricate manual work with no loss of dexterity. He has no > rigidity, > > slowness, nor gait problems, indeed no problem at the moment except the > > tremor, but this is now spreading and becoming worse. > > The diagnosis of Parkinson's disease was made by our local GP, and > confirmed > > by a General Consultant Physician. He has never been referred to a > > neurologist and this is the first question I need to answer. It seems to > me > > that three years is enough time to "wait and see". Is it possible you > would > > be able to indicate for me what would be considered best practice in > > diagnosis? Should there be a referral to a neurologist? Also would you > > have any comment to offer on medication? > > > > Sincerely > > > > Julie Trevithick > > > > ---------------------------------------------------------------------- > To sign-off Parkinsn send a message to: mailto:[log in to unmask] > In the body of the message put: signoff parkinsn > ---------------------------------------------------------------------- To sign-off Parkinsn send a message to: mailto:[log in to unmask] In the body of the message put: signoff parkinsn