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From: "David S. Devor" <[log in to unmask]> Subject: Inner Tremor Thanks to Alan Bonander for the internal tremor item. Internal tremor has been a major feature of Aviva's PD for the last 10 years or so. For at least 8 of those years, Aviva was able to conceal her illness from family and friends since most of it manifested as internal tremor. From the beginning, she lost the refined coordination which was always her trademark and was robbed of the pleasure of the various crafts at which she excelled. But this also was easy to conceal. The usual medications (she's been getting Jumex [deprenyl] from Hungary from the beginning) have beautifully masked the stiffness that would otherwise occur and the mild involuntary movements including circular thumb movement. Luckily she has not suffered from nausea. These last few months, there has been more deterioration in Aviva's condition than in the last 9 years cumulatively and she now walks with a cane and that with difficulty. She accepted the need for a cane only after breaking a few bones in falls since she is quite courageous by nature. At 53, Aviva hopes that pallidotomy will provide some quality of life while waiting for the expected results from genetic engineering. It is interesting that none of Aviva's doctors ever mentioned the pallidotomy option although they readily concurred when we suggested it. It is thanks to this list, Don Berns, Alan Bonander and others that we learned about it at all. There's nothing like communication. Thanks for sharing with us. We will keep you posted. David S. Devor Jerusalem