Essential Tremor (ET) affects everyone differently. But for nearly everyone with ET, common everyday tasks can be challenging. Writing, eating, drinking and dressing are functions most people take for granted. And when these activities are difficult, it can set the tone for frustration or worse, lead to a life devoid of much social or public interaction.
Fortunately, there are techniques as well as tools that can take those tasks from daunting to manageable. Occupational therapist Julia Wood, who specializes in movement disorders of all types, combines practical mental and physical approaches every day with her patients at Pennsylvania Hospital’s Penn Therapy & Fitness.
First and foremost, a full and satisfying life with ET is about adaptation. Charles Darwin may have said it best. ‘It is not the strongest of the species that survives, nor the one that is the most intelligent. It is the one that is most adaptable to change.’ For some, adapting comes more naturally. Others struggle and experience frustration. “Everybody comes to it in their own way,” says Julia. “It’s important to respect what matters to an individual. What is a patient willing to try and adapt? My job is to present ideas and alternatives and recognize what’s most appealing and most effective.”
TIP: Conserve Your Energy
Using and conserving energy wisely is an important tactic. Tackle difficult or strenuous tasks when tremor is controlled, medications are working, or before you tire. Research supports what many patients know instinctively, tremors worsen when the body is fatigued. It’s human nature that when you feel good, you charge ahead and take on tasks with full force and energy, only to crash later. Julia explains, “The tortoise wins the race, not the hare. Pace and plan. As a society, we push for productivity. But we’re not getting as much done as when we pace.”
Tip: Minimum 7 Hours of Sleep
It is important to set a bedtime that is early enough for you to get at least 7 hours of sleep. Make sure your bedroom is quiet, dark, relaxing, and at a comfortable temperature. It is especially important to remove electronic devices such as TVs, computers, and smart phones, from the bedroom. They should be turned off at least 30 mins before bedtime. Avoid large meals, caffeine, and alcohol before bedtime. As your stomach works hard to digest, it can easily disturb a good night sleep.
Additionally, exercise helps to promote good sleep hygiene. Exercise alleviates stress which has been known to diminish tremor. Resistance training is a recommended form of exercise.
Tip: Be Mindful of Body Positioning
Additionally, there are physical approaches that can help tremendously, including body mechanics and positioning. A proper sitting position, with knees and hips in line and both feet on the floor, as well as core stability for hand and arm control can be extremely helpful. Placing your elbows against your body or a surface can also give stability when using your hands for a variety of tasks.
Gadget: Eating Utensils
Being mindful of body positioning when eating is important. Bendable and large-grip utensils, deep-bowl spoons, plate guards, and non-slip eating surfaces can all make meals easier and less stressful. Liftware is a well-known resource. The company’s selection of stabilizing and leveling handles and attachments are designed to help people with hand tremor or limited hand and arm mobility. Bendable utensils worked wonders for a recent patient who came to Julia asking for assistance with specific activities.
Applying Makeup Tricks
While one of her patients was having some success adapting on her own, she wanted tips for specific daily tasks like applying makeup. Julia gave her pointers on how to better support her hand, and recommended she use a cream liner with a brush, which is far more forgiving than the liquid liner she had been using.
One patient was an avid letter-writer, with a young pen pal in Cambodia. In addition to suggesting an ergonomic pen, Julia recommended that she get a stamp made for her signature and return address information. Julia also advised on her posture and anchoring her elbows. Not only was writing easier with posture changes, her patient was also able to play the piano again, a hobby she had given up as her tremors progressed. All were minor adaptations that collectively made a huge difference in the patient’s quality of life.
Whatever techniques work for specific symptoms and individuals, it’s important to remember that the process for managing ET symptoms is highly individual. No two treatment paths will be identical. But techniques, tools and professionals like Julia can help and are available to all.
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