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I have had tremors that my doctor calls 'non-essential

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I have had tremors...

I have had tremors that my doctor calls 'non-essential tremors' since I returned from Viet Nam in 1968. They have gotten worse over the years and, for example, when eating, I have to use a spoon becaus things fall off my fork. I target shoot on a regular basis and have difficulty holding my pistol steady. I shake constantly and am taking

Doctor's Assistant: What are all the symptoms you're experiencing (e.g. loss of appetite, fever, rash)?

Sorry, I hit the wrong key ... I have been taking Ropinirole, 2mg, for a few years to control it and have seen no results. My unit in Viet Nam was consistantly exposed to this chemical ... on an almost weekly basis. I need to know if Agent Orange is a contributor to this.

Doctor's Assistant: Anything else in your medical history you think the doctor should know?

Please ... there are FEW of us who have things like this entered in our Med Recs. The best I can do is provide a statement from a friend who sprayed this stuff and acknowledges that they dropped it over my unit.

Submitted: 9 months ago.Category: Medical
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Answered in 2 hours by:
9/25/2017
Doctor: Dr Subbanna MD, Neurologist (MD) replied 9 months ago
Dr Subbanna MD
Dr Subbanna MD, Neurologist (MD)
Category: Medical
Satisfied Customers: 6,263
Experience: American Board Certified Neurologist, Internal Medicine
Verified

Hi, I am an American Board Certified Neurologist with vast experience in diagnosing & treating all neurological as well as all other health/medical conditions, and I am very glad to help you with your health concerns.

I am sorry to hear about your health situation and the history of exposure to the poison agent orange. As a neurologist I frequently diagnose & treat this type of health situation and I can certainly help you in this regard.

I am currently preparing & typing my answer and I will post my answer here as soon as it is ready.

Best Regards!

Dr Subbanna MD

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Doctor: Dr Subbanna MD, Neurologist (MD) replied 9 months ago

Once again I am very sorry to hear about your health situation and the severe and worsening tremors you are having

I see you have had exposure to poison agent orange during the Vietnam war

Please see there is evidence to show poison agent orange can cause various types of neurological damage including severe tremors too

So it is certainly possible your tremors are secondary to exposure to this poison

I see you have been taking ropinirole 2 mg but no help so far

I will now discuss with you about the management of this type of tremors;

First of all the ropinirole dose can be optimized further. The dose you are currently on is just the beginning dose and you can increase the dose further. The highest dose of ropinirole one can try is about 24 mg per day. It comes as an immediate release and a long acting preparation, if you are taking the immediate release then it is taken about 3 times per day, if the long acting type if taken then it can be taken just once per day. One or otherway the dose can be slowly increased as tolerated and as needed and the maximum one can try is about 24 mg per day.

If ropinirole does not help, or for some reason you are not happy with ropinirole (side effects etc) and if you are looking for alternative treatment options then you may try one or more of the following treatments to control these tremors;

Trihexiphenidyl

Amantadine

Pramipexole

Levodopa/Carbidopa

Stalevo

Selegeline

Rasagiline

Rotigotine skin patches

B blockers

Primidone

Topiramate

Remeron

Clozapine etc

I am not telling all these above mentioned treatments are required in your case; I am trying to provide a list of the various treatment options like this so that you are familiar with various treatment options that are available for your condition and you may try to use them as necessary. If you see any of the above treatments you have already tried please disregard them and you may explore the treatment options which you may have not yet tried. If none of the above treatment options sufficiently help then there are surgical treatment options too that are available such as DBS (Deep brain stimulation) etc to control these types of severe tremors, although most of the patients respond to one of the medications mentioned in the above list so surgery is most often not necessary.

Once again to your main question, yes, poison agent orange is certainly known to cause myriad health complications including various kinds of brain injuries and severe tremors etc and since you have had severe exposure to this poison so there is high possibility your tremors are indeed secondary to the exposure of this poison, and the treatments for these tremors include the medications mentioned above, and if necessary there are surgical treatment options available too, as mentioned earlier above.

Wishing you the best health!

All the very best!

Please let me know if you have any additional questions or if you want to discuss this further. And please take a moment and kindly click a positive rating (preferably 5 Star/Excellent) to credit for the time & effort put by me in answering your health question, and this is the only way I will be credited for my service to you. If you have follow-up or additional questions you can ask them after the rating too!

Assuring you the best services!

Best Regards!

Dr Subbanna MD

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Doctor: Dr Subbanna MD, Neurologist (MD) replied 9 months ago

Hi, Do you have any additional health questions? Do you want to discuss this health situation further? Please let me know and I am available here.

Assuring you the best services!

Thanks & Best Regards!

Dr Subbanna MD

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