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Dar, In reply to your cold hands. Paul's hand, and the arm that has the tremor (right) is cold, almost always. This is with or without any medication at all. We went to a vascular surgeon to see if the condition was reflex sympathetic dystrophy. It was not. Paul also has had right shoulder surgery to relieve a rotater cuff and biceps tear and decompression of the shoulder. This relieved a lot of pain until the physical therapist had Paul go too far too fast and now the shoulder is very bad again and always the cold hand and arm.. Sorry this isn't very encouraging. Jan for Paul