Titubation part 3…

—————– The Science Behind It ———————-

As I mentioned earlier, for the most part I have done little scientific research on my tumor. This has been deliberate as I feel that reading on this tumor would be fruitless and only cause unnecessary angst. This is not the case with titubation. I have done several literature reviews and research of the topic, in hopes of a. understanding it better and b. perhaps alleviating it. Unfortunately, most of the data on it has to do with patients afflicted with Parkinson’s.

The National Institute of Neurological Disorders and Stroke
The National Institute of Neurological Disorders and Stroke

Tremor, as defined by the National Institute of Neurological Disorders and Stoke, “is an unintentional, rhythmic muscle movement involving to-and-fro movements (oscillations) of one or more parts of the body.”[1] Many times in the field of medicine, students and clinicians often ask ‘what is the pathophysiology?’ This is just another way of asking how something works.[2] The pathophysiology of tremor is poorly understood. One theory postulates that in many patients with tremor, the cerebellum is somehow involved, which fits my case, as my mass was very near the cerebellum, in fact pushing on it. There are various ways to treat a tremor, with the most often used modality being medication. Implantable devices have also been utilized in the past. In my case, I did not want to take any medications, and a procedure to implant a device was out of the question, thus I opted for a ‘wait and see’ approach, in hopes of it resolving itself.

——————— Now ———————–

In preparing for this post, I contemplated shooting a video of myself having one of these episodes. Then on YouTube I searched for ‘titubation,’ which returned nothing. My subsequent search for ‘head tremor’ returned a video clip of an elderly woman as shown above.[3] I must admit that watching the video brought on a flood of emotions. At first I thought, this is perfect. This is exactly what I’m going through. Then my thoughts progressed to this poor woman, the tremor almost looks painful. I wondered what it was that caused her to have this, with Parkinson’s Disease being my first thought. I wanted the tremor to stop; I wanted the clip to end. Even through a computer screen I felt uncomfortable. Then I caught myself—I was reacting as others do when they see me go through this. How could I expect anyone to react any differently if I, someone with the same affliction, react the way I do. That made me realize, that this titubation cannot be controlled; at best, now I can quell it.[4] What I can control is my own response to it. This is why when it now occurs, I try to take several deep breaths and attempt to enter an almost meditative state; I am not trying to stop the tremor, but hoping to clear my mind of any negative thoughts when it occurs.
You may wonder what, if anything I have taken away from his titubation. Well, I still struggle with it occurring, and am embarrassed by it. But at the same time, I have come to embrace it. It still happens with some frequency, not really improving but not worsening either. The most interesting part of this is the reactions that it garners. Some choose to completely ignore it, while others choose not to ignore it and ask me questions like, “Are you okay?” It is for this reason that my recollections of each episode center on the reaction to it. There is not one reaction that I prefer, although my only hope is that it does not cause the other person distress. In reality, my ultimate hope is that it goes away and never returns, but I have accepted the fact that this may be permanent. I suppose that I have not closed this chapter in my recovery but I hope as this continues I become more accepting of its occurrence. I will not lie to you and say it has no effect on me. On the contrary, I’m still embarrassed by it and I still wish it to be gone. But I now have come to accept its presence in my life, not in a defeatist way but in a patch-of-honor way. Every time it occurs it serves as a reminder of what I have been through. If my hair hides the scars, my speech returns to normal, and my gait no longer reveals my disability, will the titubation be gone as well? If all this is gone then will I be left with no reminders of this struggle?
[1] http://www.ninds.nih.gov/disorders/tremor/detail_tremor.htm
[2] For example, the simple act of breathing, is studied intensely in medical school, with countless numbers of equations and principles behind it. This, and other processes, are studied most in a course called ‘physiology’. A later course in medical school is pathology, which comes from the Greek word pathos- which means disease or suffering.
[3] I included this video in a previous post.
[4] As I mentioned earlier, it rarely occurs when I stand up, thus standing up and walking around seems to lessen the severity of the episode.

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