Essential Tremors and a visit to to the Dentist

 First, let me say this was not your normal dentist visit.  It was not ‘a clean and polish’ visit.  It was major oral surgery: two implants and a gum graft.  More than 5 hours in the chair! Oh, he kept me well numbed so not much pain involved but there was a fair amount of stress in the procedure.

I had promised Jill I would keep her informed about progress.  When I had a chance, I reached for my mobile: MIA!   We were waiting for the aesthetic to kick in so I asked for a couple of minutes and grabbed my laptop.  I could not type a short email.  My tremors were so bad I had to one finger, “hunt and peck” to get her a message. Even then it was garbled.

From a previous visit, I knew that the local anesthetic contained Epinephrine.  A little pain getting the injection + a little stress + Epinephrine == really bad tremors for me.  You can request a local anesthetic without Epinephrine.  I was informed that it takes longer to become effective and it doesn’t last as long. IIRC with the old teeth anesthetic you had to wait for 15 minutes or more before the dentist could start working and it took what seemed to be forever to lose its effectiveness. Something like a  half a day with a numbed mouth.

Opinion: The addition of Epinephrine to the local dental anesthetic is a money/time saving strategy without tangible benefits to the patient. I could be wrong. Perhaps I am.

Using a TENS on my Essential Tremors

 Jill is selling her condo and on Tuesday the purchaser did an inspection of the property.  There were a  couple of minor “gotchas” that needed to be addressed so a visit to Home Depot was called for. Because it can sometimes be a nightmare trying to locate a specialist item, I came prepared with the item pulled up on my laptop.  I asked the checkout clerk on the “Pro” desk where it was and received directions to the correct aisle.

The same young lady was there on the way out but the item wouldn’t scan.  I said they needed better scanners and mentioned at one time I wrote software for Point of Sale.  She mentioned she was studying computing a Predue and was hoping to work in BioMedical.

That prompted me to describe my latest computing project. Using an Arduino microcontroller, a couple of solid state switches, a miniature accelerometer and a COTS TENS unit.

There are several scientific papers describing the stimulation of peripheral nerves with an electric current that can be beneficial to a proportion of the Essential Tremor population.  cite cite cite As with almost all treatments of Essential Tremors, it only works for some of us but it works well enough to interest me in a test drive.  Unfortunately the cost of an FDA approved nerve stimulation unit is well outside my budget even if I excluded the ongoing monthly charges.

Our Essential Tremors working group had a lively discussion over the possibility of using cheap, Commercial Off The Shelf (COTS) hardware for the benefit of Essential Tremors.  The idea of a peripheral nerve stimulation unit evolved from these discussions.  A TENS unit looked to be a good  source for the electrical current. Relatively inexpensive, with controls for frequency, duration, and strength and even better, portable battery powered units are available.

At first I thought I would need to build some special hardware to switch the output of the TENS unit between the Median and Radial nerves.  Mechanical relays would be too slow as we needed to switch the output between the nerves at or near the frequency of a person's tremors; about 5-12 hz. I sourced a pair of solid state switches for the Arduino microcontroller from Hong Kong.  They will arrive someday. ;-)  There is an overwhelming selection of inexpensive accelerometers available.  I may need to try a couple before  we settle on one suitable for measuring hand tremor frequency.  The cost of materials so far will be about $50 USD + the TENS unit and my time to write some control software and integrate the whole.

Stay tuned for future developments.

The dual solid state switches arrived yesterday and here is a photograph of my working prototype.  Next up is the accelerometer to measure my tremor frequency.

(Please note: This information should not be used as a substitute for medical treatment and advice. Always consult a medical professional about any health-related questions or concerns.)