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#1 2009-09-26 04:39:12

Takei
Member
From: Southern Highlands, NSW, Aust
Registered: 2008-06-28
Posts: 12

Essential Tremor !!

This may sound a bit whacky. 

I suffer from an ailment called Benign Essential Tremor, whereby my right hand has a slight shakiness (nothing at all to do with Parkinsonís disease).  Itís quite a common condition found in all races and affect both men and women.  It is usually inherited.  There is no cure at present.  Some drugs can help but there are usually side affects, so Iím steering clear of those.  Funnily enough alcohol can alleviate the problem to some degree!

Itís by no means fatal; just a nuisance.  Needless to say it is an impediment when it comes to playing the shakuhachi (great for vibrato!)

I started having shakuhachi lessons about twelves months ago and am progressing slowly, which is fine, I have all the time in the world.  The shakuhachi brings me a great deal of pleasure, even at this early stage.  Iím just coming to grips with the kan register and beginning to learn all about meri notation.

My teacher is sympathetic and patient and possibly feels that if I relax more it may help.

My question, is there anyone reading this forum who similarly suffers and have they found a solution that somehow helps with their playing?

Thanks................./Patrick


........ Music expresses that which cannot be said and on which it is impossible to be silent - Victor Hugo

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#2 2009-09-26 08:32:39

nyokai
shihan
From: Portland, ME
Registered: 2005-10-09
Posts: 613
Website

Re: Essential Tremor !!

None of this is based on any actual experience with BET, but:

If alcohol helps, my guess is that beta blockers would work, with fewer side effects. I had a short spell of stage fright about five years ago and used beta blockers for a couple of gigs -- no side effects at all for me.

Or if you're interested in meditative "mind over meat" approaches, I've been really impressed with yoga nidra, a very deep form of body-scan meditation that has worked for me in alleviating all kinds of symptoms, though this limited practical use is somewhat of a western bastardization of an ancient Indian tradition. A compact "efficient" modern form of yoga nidra is available in the iRest CDs of Richard Miller (google iRest) -- pretty amazing stuff, I think.

If general relaxation is indeed a factor, any form of meditation -- for instance vipassana -- couldn't hurt.

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#3 2009-09-26 16:41:43

LowBlow
Member
From: Germany
Registered: 2009-08-23
Posts: 15
Website

Re: Essential Tremor !!

Maybe this is helpful: Try vipassana as taught by S.N.Goenka. He teaches vipassana with emphasis on mindfulness to your body. It is called body sweeping. You will find him on the net.

Harald

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#4 2009-09-27 14:10:11

Priapus Le Zen M☮nk
Historical Zen Mod
From: St-Jerome, Quebec, Canada
Registered: 2006-04-25
Posts: 612
Website

Re: Essential Tremor !!

If this medication is available in your country I would strongly recommend Sativex. It helps a great deal in many of my M.S symptoms including some spasm and random glitch my body does.

This thing is all natural and isolated parts of THC and so far I only got the benefits without getting any of the tripping of marijuana or any other toxic side effects to liver that come with other conventional medications.

You can read more about Sativex here http://en.wikipedia.org/wiki/Sativex


Sebastien 義真 Cyr
春風館道場 Shunpukan Dojo
St-Jerome, Quebec, Canada
http://www.myspace.com/shunpukandojo

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#5 2009-09-29 12:02:19

lowonthetotem
Member
From: Cape Coral, FL
Registered: 2008-04-05
Posts: 529
Website

Re: Essential Tremor !!

I am not sure that Beta Blockers would be appropriate for this application.  They are adrenal receptor antagonists, meaning they block the reception of adrenaline.  That is why they are effeective with stage fright, because your fight or flight response kicks in under stress, the effect of a large secretion of adrenaline.  Unless the tremors are a result of stress or occur in stressful situations only, I don't think a Beta Blocker will help, and they have some pretty profound side effects.

I don't have this, but from what I understand it is a nuerological disorder.  Alcohol has a depressive effect on the nervous system.  THC acts on the nervous system, but it can act as a stimulant for some and a depressant for others, according to conventional wisdom.  Of course, my intense desire to take a nap after smoking a splif tends to convince me that it is depressive.  That is something you would have to experiment with, if you are willing.

Some other things that you may try are other depressants like sleeping pills (maybe just half of one to depress your nervous system but not sleep).  You could also try other nueral compounds that have a depressive effect.  You can get melatonin at most health food stores.

As far as meditation goes, I would not do anything that is very prescriptive, meaning something where there is a right and wrong way to meditate.  This may lead to more stress which would excite the nervous system more.  I would not suggest any meditation that requires you to assume a posture that you aren't used to.  Try laying on your back with a pillow under your knees and one under your head.  Just relax a while and let your breathing regulate.  Don't TRY to breath a certian way or anything, just breath comfortably.  When this is done, try saying to yourself, "As I breath in, I notice the top of my head.  As I breath, I relax the top of my head."  You can travel down your body this paying attention to each little part.  Some places to isolate are the eyes, nose, ears, neck, shoulders, chest, right and left arms, hands and fingers, lungs, heart, stomach, liver, guts, legs, feet, and toes.  It may seem strange, but the more detailed you are at first, they better the results.  In time you can move to a more total scan of the body, recognizing stress or tension with the in breath and releasing it with the out breath.

Deep relaxation meditation can help your nervous system produce more of those relaxing/depressive nueral compunds like seratonin, melatonin, and others.  Oddly enough, cardiovascular exercise for twenty minutes or more can also help with the production of these compounds in the body.

Just as an FYI, I am not a doctor, nurse, or meditation instructor.  I have worked with folks that have tremors, but they had Parkinsons.  We treated it with exercise to some extent.  However, I believe essential tremors occur most often during concerted effort to coordinate movement, such as producing the correct fingering on a flute.  This factor may be difficult to overcome.  My guess would be that relaxation while you play would help.  That is, not getting too stressed about playing correctly.

Just some thoughts.  As with all internet advice, take it with a grain of salt and a heaping helping of skepticism.  Still, nothing ventured, nothing gained.


"Turn like a wheel inside a wheel."

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#6 2009-09-29 13:26:47

nyokai
shihan
From: Portland, ME
Registered: 2005-10-09
Posts: 613
Website

Re: Essential Tremor !!

http://www.essentialtremorinfo.com/betablockers.htm (like Lowonthetotem, I am certainly no kind of medical practitioner, but personally experienced no side effects from beta blockers).

These days I tend to think that laughter is the best medicine, meditation second, and marihuana and its derivatives pretty excellent in some cases (such as pain).

Last edited by nyokai (2009-09-29 14:32:15)

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#7 2009-09-29 15:23:40

Ambi
Member
From: Leeds UK
Registered: 2006-06-22
Posts: 108

Re: Essential Tremor !!

Hi Takei, my question would be "why are you playing?"
If you have a (sympathetic) teacher you're doing really well! Just keep doing what you are doing, don't try and fight yourself - If you are really good at vibrato then enjoy the vibrato.
Relaxation of the hand tremor will come - probably when you start struggling with embouchure or something.

if it was easy we wouldn't be doing it.

Slanche Va


"The trouble with having an open mind, of course, is that people will insist on coming along and trying to put things in it."

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#8 2009-09-30 01:12:53

Lodro
Member
From: Australia
Registered: 2009-04-02
Posts: 105

Re: Essential Tremor !!

Acupuncture/Acupressure has had good results for Benign Essential Tremor. Possibly working on the Stomach meridian at the foot (see acupuncture charts). You could try seeing an acupuncturist as an option.


Each part of the body should be connected to every other part.

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#9 2009-09-30 10:17:06

lowonthetotem
Member
From: Cape Coral, FL
Registered: 2008-04-05
Posts: 529
Website

Re: Essential Tremor !!

like Lowonthetotem, I am certainly no kind of medical practitioner, but personally experienced no side effects from beta blockers

The side effects of Beta Blockers are not always evident to the casual observer or even the patient.  The most fundemental side effect that I am familiar with is that they suppress the exercise response of the heart, meaning when you run or something similar, your heart rate will not increase as normal.  Adrenaline is responsible for the exercise response.  If the heart does not pump faster with increased activity, the body may not get the oxygen it needs, including the heart itself, to function properly.  Ironically, the exerciser often says to himself, "Hey, I am working hard and I am hardly even winded, maybe I can go harder."  That is why it is important to take them under very close supervision.  They are usually relegated to patients with recent cardiac events (bad events that is) who cannot afford to have their heart rate increase at all.  During a recovery program prescribed by a physician, they exercise at relatively low levels of exertion under the supervision of a trained exercise professional (yes not all of them are she-she personal trainers in biking shorts and tight-ass underarmour shirts) who monitors both their heart rate constantly as well as the oxygen saturation level of their blood.  These seem like pretty drastic side effects to me, considering they affects the heart and circulation of oxygen.  I am surprised a doctor would prescribe them for anxiety, but if you came through it well then kudos.  I am sure they were not prescribed at the same dosage.  This is not the only side effect, as adrenaline affects other hormone levels, like testosterone, so if you can get away with something less "invasive" I would investigate those first.

However, if the essential tremor is not caused by a secretion of adrenaline, the beta blockers will have no effect on the issue whatsoever.  From what I understand about this disorder, it is caused, supposedly, by a non-fatal degeneration of certain types of nerve cells within the brain, not an abundance of adrenaline.  I am not trying to argue with you Phil or belittle your advice.  I just don't think that this condition warrants or would benefit from beta blockers, which have a very specific application.  Stage fright, however, is likely the direct result of an inordinate amount of adrenaline being released into the blood stream, and that is why it worked so well for you.

Interestingly, it seems to me that since these tremors arise from effort to coordinate movement, playing the shakuhachi would be a good therapy for the condition.  Maybe, over time the shakuhachi may help to improve your condition, or at least mitigate it and slow its progress.  It may prove to be a kind of occupational therapy for you.

Last edited by lowonthetotem (2009-09-30 10:22:30)


"Turn like a wheel inside a wheel."

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#10 2009-09-30 10:54:57

nyokai
shihan
From: Portland, ME
Registered: 2005-10-09
Posts: 613
Website

Re: Essential Tremor !!

It is pretty common for classical musicians to get beta blockers prescribed. They are prescribed so freely, in fact, that I did not know they are as harmful as you point out. I would never want to recommend anything that could be harmful, so my apologies if my personal experience was uninformed. I only took exactly two low dose Inderal pills in my whole life, one before one gig and one before another. I have never had stage fright before or since then.

As for use of beta blockers for BET, here's what the Harvard Medical School Family Health Guide says:

"Beta blockers ó especially a long-acting version of propranolol (Inderal) ó are one of two main medications used to treat essential tremor... Studies show that beta blockers help 45%-75% of patients." (http://www.health.harvard.edu/fhg/updat … 204c.shtml)

But if you can make it work, there is no doubt that meditation beats medication!

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#11 2009-09-30 11:25:02

lowonthetotem
Member
From: Cape Coral, FL
Registered: 2008-04-05
Posts: 529
Website

Re: Essential Tremor !!

Seems like you have researched it some, Phil, and I wouldn't say that Beta Blocker are dangerous, they just need to be taken with alot of respect, if that makes sense.  They scare the doo-doo out of me, because I used to help patients who were taking them and could croak if I pushed them too hard.  So, I probably have a gut reaction to them that may be different than other folks.  Again, it is likely an issue of dosage, since they don't stop production but interfere with reception of adrenaline.  Also, the term "help" is less than clinical, if you ask me.  You have to weigh the benefits with the side effects, exactly how much does it help and exactly how will you pay for that help in terms of side effects.  Ultimately, a doctor has to make the decision, luckily.

I do remember one old dude who loved taking them.  He said it was a good excuse to make his wife get on top and do all the work.  He told her, "It's either that, or you have to let my trainer come in and observe."


"Turn like a wheel inside a wheel."

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#12 2009-10-19 11:36:22

lowonthetotem
Member
From: Cape Coral, FL
Registered: 2008-04-05
Posts: 529
Website

Re: Essential Tremor !!

If this medication is available in your country I would strongly recommend Sativex. It helps a great deal in many of my M.S symptoms including some spasm and random glitch my body does.

This thing is all natural and isolated parts of THC and so far I only got the benefits without getting any of the tripping of marijuana or any other toxic side effects to liver that come with other conventional medications.

If this is not available in your country, you may want to try Relora.  It is a blend of extracts from Magnolia bark and Rhodadendrum that seems to be very similar to Valium.  It moderates stress hormones, so it may be worth looking into, and it is relatively inexpensive, non-toxic, and also all natural.


"Turn like a wheel inside a wheel."

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#13 2009-10-20 01:35:17

Takei
Member
From: Southern Highlands, NSW, Aust
Registered: 2008-06-28
Posts: 12

Re: Essential Tremor !!

Many thanks for all the advice and for the concern shown. 

I shall discuss the situation further with the doc and find out asmile if any of the stated remedies are available in Australia and bsmile whether they might be suitable and not conflict with medication I'm prescribed for other health issues.

But whatever....., this problem will not deter me from playing the shakuhachi to my best ability.

Cheers............./Patrick


........ Music expresses that which cannot be said and on which it is impossible to be silent - Victor Hugo

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#14 2009-10-20 21:16:25

Jeff Cairns
teacher, performer,promoter of shakuhachi
From: Kumamoto, Japan
Registered: 2005-10-10
Posts: 517
Website

Re: Essential Tremor !!

Hi Patrick,
I had a similar sounding problem with shaking to the right hand (in fact, arm) that I attributed to nervousness on stage.  Personal discovery found that it was due to poor posture whereby my right shoulder hung somewhat forward, likely to accommodate the reach of my right hand to the lower part of the shakuhachi. This caused the nerve to become pinched at the wrist which was accompanied by slight shaking.  I found that by bringing my shoulder back and square, I was able to stop the shaking.  As a secondary note, the thought that the shaking was a result of nervousness (stage-fright) caused me to feel more anxious and nervous which in term compounded the shaking.  This type of mindfulness took care of the shaking and I found since then that nervousness was not an issue at all.  I might add  that in the case of stage-fright, knowing you are on top of your music and that the audience is largely there to appreciate it and not to be necessarily critical helps.  Again, a certain type of mindfulness.


shakuhachi flute
I step out into the wind
with holes in my bones

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