Will cannabis oil stop me spilling my mug of tea?
QFOR the past 18 years, I’ve suffered with essential tremor, which has got worse and severely affects my ability to do many things.
On several occasions, I’ve had to call my wife for help to remove a mug of coffee or tea, as I’m unable to control the shaking.
I tried the beta-blocker propranolol (120mg) daily, but it wasn’t effective and caused side-effects such as breathlessness. My GP tried me on an epilepsy tablet, which also proved unsuccessful.
Is it possible cannabis oil would help?
AP. Ryan, Newport, Gwent. EssEntial tremor is the most common of all movement disorders and can be so severe that it causes significant problems, as you have described.
While it’s not known what triggers the condition, it is typically treated with betablockers, which are thought to work by blocking certain nerve impulses.
Beta-blockers are usually effective — but it does not surprise me that propranolol hasn’t worked for you, because you say in your longer letter that you are already taking a beta-blocker, atenolol, for a heart condition, and, if that wasn’t already working for the tremor, then propranolol wouldn’t, either.
anticonvulsants, such as the one you tried, can be effective: primidone is typically prescribed and, in some, can reduce the tremor magnitude by about 50 per cent. Other anticonvulsants that reduce tremor include gabapentin and topiramate.
alcohol also reduces essential tremor. You may already be aware of this, but, although a small amount — such as a small glass of wine before each meal — may help initially, a growing tolerance means that, over time, greater quantities are required, with inevitable side-effects and the potential risk to health.
addressing your question as to whether cannabis oil might help, the answer is no. the commercially available cannabis oil is known as cBD oil (it contains only the tiniest amount of the substance, thc, that causes a ‘high’).
although there is increasing interest in the potential therapeutic benefits of this and other cannabis- derived compounds, there is no evidence yet published in respect of movement disorders — so far, the research into this has been carried out only on animals.
it is a different story with neurological conditions known to affect the brain and regulation of movement, such as epilepsy, which do seem to respond to the cannabis treatments.
there are other options. a different anticonvulsant might have better effect.
surgery to destroy a small section in the part of the brain involved in the contraction of muscles may be suggested in the most severe cases.
i recommend returning to your GP to discuss these and sincerely hope you find some relief from these troubling symptoms.
QSINCE a bout of flu, I’ve had a blocked ear, which makes me feel socially detached. My doctor has diagnosed eustachian tube dysfunction and says that I must be patient — but I’m worried it might become permanent.
So far, I’ve been prescribed an ear spray, two lots of antibiotics and a nasal spray. I’m also doing steam inhalations three times a day, using a heat pad and massaging around the area.
No one has seen inside my ear, so it has just been educated guesswork so far. Should I see a specialist?
Liz Withey, Walsall, West Mids.
AEUSTACHIAN tube dysfunction is where the tube that connects the middle ear to the back of the nose becomes plugged up by persisting, gluelike mucus, as often occurs after a cold or flu.
the role of the eustachian tube is to ensure the air in the middle ear (which sits behind the eardrum) is the same pressure as that around you.
it has a small valve at one end that opens and closes to adjust that pressure — if you swallow once, you will hear the click as the valve opens and closes.
if you have a respiratory infection, mucus can be driven up the tube from the nose, or it may form in the tube itself — and that mucus may persist. this is known as glue ear.
sometimes, the valve action does not work as normal after an infection.
in your longer letter, you say you regularly try the toynbee and Valsalva manoeuvres — this is essentially when you pinch the nose and swallow or blow.
i fear this is unlikely to help an enduring problem — and the same could be said for the massage and heat pads, beyond providing a source of comfort.
if it is glue ear, another option is autoinflation. this involves using a special balloon several times a day, which you blow up in the nose to try to dislodge mucus. this is painless, but it takes time.
Grommets — tiny tubes that are inserted surgically to help drain any build-up of fluid — may be suggested.
What surprises me is that, as you say, the diagnosis has, so far, been reached by educated guesswork, because your ear has not been examined.
More than once, i’ve suspected eustachian tube dysfunction, but then found, when examining the patient’s ear, that the ear canal was, in fact, packed with wax.
i suggest your ear is examined. if there is no wax, then a test called an impedance audiogram — where a device that pushes a puff of air onto the eardrum is used to measure the resistance as the pressure rises — will confirm whether it really is eustachian tube dysfunction.
at this stage, after months of symptoms, i agree that the opinion of an ear, nose and throat consultant will be of value — so do speak to your GP.