Intention Tremor

We learn new things every day. People around us tell a story we didn’t know, or we might read something, giving us a greater understanding on a topic. A longtime buddy of mine sent me a podcast a few months ago. It was an hour of information on cerebral palsy. A couple guys had done research on the disability. They took their findings and had a discussion about cerebral palsy in an effort to better educate their listeners. I have always found an in-depth discussion surrounding CP to be uncomfortable. It embarrasses me to admit I lack a clear understanding of cerebral palsy. It’s a disability that effects people in many different ways and I’ve gotten caught up in blindly battling my own challenges. It never crossed my mind to better understand the medical side of those physical tests. The podcast brought the medical reasons of those difficulties to life. The most interesting challenge I learned about was the intention tremor.  An intention tremor is defined as a slow tremor of the extremities that increases on attempted voluntary movement. I had never heard the term until listening to this cerebral palsy podcast.

The intention tremor hits home during the holidays. There are more family dinners and nights spent out with friends. Throughout the years I’ve been fortunate to sit around many tables with people who are close. However, I’ve always found the dinners to be challenging. Many times, I find myself seated at a table without much room to maneuver. In these confined spaces, it’s difficult to steady my hands in an attempt to do anything. I’m fortunate to have people who are willing to help in those situations. They dish food onto my plate and skip me when passing the food around the table. It takes away much of the anxiety associated with family meals. There is still curiosity inside about why I struggle with the physical participation around the family dinner tables. Not only do I struggle passing plates of food, but also reaching for my drinking glass. During the course of dinner, I’ll reach for my glass only to experience a shaky hand making the attempt. The more I focus on steadying my hand to balance a glass the shakier my hand becomes. I’ve never understood the reason.

To be honest, I haven’t done a lot of my own research on the subject of my challenges. Listening to the podcast opened my eyes to understanding more about the disability. Ataxic is the type of cerebral palsy that seems to most closely describe the challenges I face. Ataxic CP affects the smallest percentage of cases, about 5-10%. It’s characterized as having trouble with fine motor skills. An example is possibly not being able to write well. Another challenge could be having trouble walking due to difficulty with balance, which are both difficulties I battle. The final piece of the ataxic puzzle is the intention tremor, which was most surprising. It has caused a lot of thought surrounding the challenges I face daily and could be an important window into my frustrations around a dinner table.

The interesting part of the intention tremor is my perception of the inconsistencies within the tremor. There are many times during a dinner with friends or immediate family when I can manage dishing up food and lifting my drink. When I can participate in the dishing of food and reaching to drink from my glass freely, it feels liberating, like an unexpected break from CP. I find the liberating feeling to be consistent in situations where the tremor is less intrusive. These experiences seem to happen when I have more room around me to function. It seems the more confined I feel around a table, the more active the tremor. The podcast has provided comfort in helping me understand the challenges. I never realized the distinct possibility of a tremor in my wrist and hand effecting my physical functionality. With the knowledge, other thoughts come to mind, like strength to improve the tremor and psychological trust in the functionality of my hands.

After doing some research with a buddy, we found an interesting tidbit about a tremor. He has some knowledge of basic medicine and his knowledge made for an interesting conversation around the intention tremor. Neither of us are medical experts. We found a study dealing with the effect strength training may have on tremors. The study dealt with a tremor in the study participants index finger. They found the group of students who performed strength-training experienced an improvement in the steadiness of their index finger. Showing that performing heavy weight training may improve the effects of a tremor. The conclusion of the study translates to my challenge with the intention tremor. Strength training has always been beneficial in reducing the symptoms I face with CP. The training seems to have caused improved steadiness in my hands. It has also improved my gait along with overall movements throughout my body. There still seems to be a psychological factor when it comes to lifting and balancing things with my wrists.

As a child, I would spill things on a relatively consistent basis. Every time there was a spill it forced someone to clean up. When I was young it never was for me to clean and as I became old enough to help clean my own spill, it felt people would rush to take care of a mess. It felt I wasn’t capable of cleaning something I spilled. After dropping something or tipping over liquid, the anxiety hit me as someone would hurry to clean. It almost caused a feeling of making up for the incident, maybe an attempt to wash away the experience. I can understand someone wanting to take away any sense of guilt over something I couldn’t control. Still, each time I couldn’t balance a plate or glass and subsequently dropped it, I felt quilt. The embarrassment attached to causing a perceived fuss made me focus more on my movement around dinner tables. It frustrated me further when giving more focus to steadying my hand only made things worse. The intention tremor sheds light on the reasoning behind the frustration.

Those early years lacking balance seems to play a large role today. The load baring exercise I work on with the trainer helps with most everything around cerebral palsy. My writing slowly improves along with balance and the tremor in my hands. However, the years of spilling almost everything in my hands has a psychological impact. It leads to questioning how much the tremor is improving. When I reach to pass a tray of food, dish something onto my plate, or attempt to handle my drink, I question my ability. The old feeling of guilt and anxiety can wash over me, because I fear the repercussions of spilling. I never want to cause a scene of chaos, as people would take time away from dinner to help clean a mess. The feeling around a meal can be overwhelming, but understanding part of the cause may help undue some of the psychological impact. When I sit around a table today I will have a better understanding of the trembling in my hands. Maybe with that understanding, I can gain more confidence in the improvements I’m making, and find the relaxation to perform more of the physical tasks.

There are many things to be thankful for this time of year. Today is Christmas Eve and I look forward to sitting around one of the tables I’ve discussed. Even with the anxiety of cerebral palsy, I feel blessed to be a part of dinner tonight. The people I love most will help me however they can, as we celebrate family and the birth of Jesus. Beyond my family I’m thankful for longtime buddies who take the time to send me information on cerebral palsy. I admit it’s a podcast I was apprehensive about hearing and it took time to build the courage to listen. But, I’m glad I finally sat down and took the time to listen. I learned many things about cerebral palsy I didn’t know. My buddy didn’t hesitate to send it, because the content might hurt my feelings. I’m thankful to him for that, and tonight when I sit around the family dinner table, I’ll better understand the trembling in my hands. Merry Christmas!





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