Strength gone again

Just now I am back to around 5 push ups.

I am curious if anyone else with PTS by whatever name you know it- has this sort of fluctuation in strength. My doctors will not discuss it, which is just as well since they do not understand anything about it.

Timolol and strength update

Well, it has been a bit more than a week since I have stopped the beta blocker eye drops, aka Timolol. The theory is that they may have either caused or exacerbated my tremor and muscle weakness. The timing suggests at least a probable cause enough to be suspicious.

Initially, I felt that my fine motor control was much improved, and the few twitches I have had ongoing appeared to have stopped.

But then I had to go and spoil it all by attempting to do a bit of yard work today.

Trying to lift things is still a problem. But, overall my lower back and upper legs felt much stronger than they have in previous similar outside work. My hands, particularly on the left, still tremor after any exertion. At one point I had my left hand resting on a board trying to hold it steady, and it was shaking quite a lot. I just tried to work through it.

During the work period, I had a few instances of just not knowing how to proceed. I am not good at building things anyway, but this was a fairly simple thing to attempt. I am not sure why things like this seem to happen. I guess there was a symptom for confusion listed in the Timolol. And I also know that can happen for magnesium deficiency. It has got to be the Timolol unless there is still something else at work here other than NA and its associated weirdness.

I got to a point, I just had to quit though. It was not quite done, but I was at a point that going on would have been prone to my making mistakes, and some of those could be dangerous when weakness takes over while using power tools. My shoulders were done. I could feel my scapulas trying to hold my shoulders stable- and it hurt a bit. Now I have trouble reaching my arms out away from my body. I may have over done things.

But I also just did 30 push-ups with only minor shaking towards the end.

Another blunder- What What else is new? Tremor and many other symptoms may be side effect of eye medication

Some of you may remember from earlier posts that my latest official bout of NA hit in the end of 2006. By the early part of 2007, I was having the start of eye pressure increases. After a few tests, I was given a prescription for Timolol. In the period after this, I noticed that I had tremor and fatigue that seemed to go beyond anything seen discussed for people who are recovereing from an attack of NA.

When I went to a Neurologist to see what the tremor was caused by, I told him that I was taking Timolol to control the high eye pressure. He prescribed Propranolol for the tremor. I asked him if it was a problem if I was already taking Timolol, since I knew they were both beta blockers. I knew to ask- He told me there was no problem.

Info on Timolol interactions from http://www.medicinenet.com/timolol_ophthalmic_solution/article.htm

“DRUG INTERACTIONS: Combined use of oral beta- adrenergic blocking agents, for example, propranolol (Inderal), atenolol (Tenormin), metoprolol (Lopressor) or carvedilol(Coreg) with ophthalmic timolol can result in additive effects. Thus, patients may experience excessively low blood pressure or reductions in heart rate.”

Note, it says “can result in additive effects” if Timolol is used with Propranolol. Who knew? Further down it talks about side effects of Timolol.

“SIDE EFFECTS: Ophthalmic timolol can cause irritation to the eye which may manifest as pain or dryness in some people. Rarely, timolol eye drops can result in side effects that are seen with other oral beta adrenergic blockers. For example, persons can experience fatigue, insomnia, nausea, slow heart rate, low blood pressure, cold extremities, and shortness of breath or wheezing.”

From another site http://www.drugs.com/sfx/timolol-side-effects.html

“All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome when using Timolol Gel Eye Drops:

Blurred vision; dizziness; dry eyes; feeling that something is in your eye; headache; increased tear production; minor burning, itching, or stinging of the eye; nausea.

Seek medical attention right away if any of these SEVERE side effects occur when using Timolol Gel Eye Drops:

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); chest pain or discomfort; confusion; eye irritation, swelling, pain, or discharge; eyelid pain, redness, scaling, drooping, or swelling; fainting; pain, numbness, weakness, or tingling of an arm or leg; severe or persistent headache or dizziness; shortness of breath; slow or irregular heartbeat; swelling of the hands, ankles, or feet; vision changes.”

It goes on to add among others, vertigo and tinnitus, both of which I have had since this all started. I have also had quite a few of the others at various times, always blaming NA for the ones not directly related to eyes. My new Eye Doctor asked me if I had any tremor, and when I said yes, he asked about exercise intolerance and depression. Here I thought all of my troubles were either from NA or that maybe other doctors had missed something obvious, and a lot of this could be due to my eye medication. It is no doubt a good thing that I stopped the Propranolol on my own. It may be my tremor was caused by its cousin Timolol.

Needless to say, he took me off of Timolol. If I truly need eye medication in the future, there are others without the mess of side effects.

Another cycle of improving strength?

Well, maybe I am about to start a new phase of improving strength again. I am not even going to hope it will last. More than likely it will not. The last few times I tried to do any push ups I was only able to do 3-4. Just now I was able to do 12 before having to drop to my knees. And now the next day, I have done 15. We shall see. I do not want to push myself to fast.

Over all the weakness is still worse now than it was a few years ago. I have sagging skin around my right bicep at the elbow joint. It does not look like how I remember my arm. I doubt I will be able to strengthen it enough to fill it out again. When I look at my right arm in a mirror, I can fully see the tremor of the muscles even without applying any tension.

Weakness, and tremor, and shaking. . .

From what I can see out on-line, and what I see in reports for my blog site, shaking and tremor of various kinds does happen with those of us attempting physical exercise while recovering from PTS or NA attacks. This generally is not covered specifically in sites I have seen, but there are enough general searches by my blog readers to suggest it is somewhat of a concern, and I have decided that it makes sense it would be a problem.

With PTS, you have something attacking the major nerve plexus sites in the body. If it is a big enough attack, you get the most severe symptoms everyone knows about. But, PTS/NA is not specific in the nerves it impacts. How would it determine only to attack the nerves that would lead to a winging scapula? The other nerves of the plexus sites must also be impacted, but maybe just not at the same level. It stands to reason, in my thinking anyway, that there can be ongoing weakness of the areas impacted, just as there is to the most obvious impacted areas. This weakness is caused by damage to nerves that serve other muscles through the body. If the nerves can’t fire effectively as they normally would, you have incomplete contraction of the muscle and this causes fatiguing of that muscle, leading to shaking of the larger muscles and tremor of the more fine controlling muscles of the hands and fingers.

For me, I have a recurring pattern of weakness followed by improving strength for short periods. But, the regained strength does not last. That may be normal also, depending on the way PTS is triggered for the individual. During the strong periods, I have normal strength and no tremor or shaking. As the strength wanes, the tremor and shaking returns and increases again. During this time, effective exercise is severely limited. It is hard to exercise when the muscles stop working. I may have said parts of this before, but you have to attempt to exercise once in a while to keep up on the cycles. During a strong period, exercise works and I think it is good to do it then to try to regain all you can in what may be a very short burst of normal or at least close to normal strength.

A better way for Scapular Pushups

My Physical Therapist originally showed me how to do scapular pushups to help strengthen and stabilize my shoulders. I never felt that it did much the way I was shown. Here is a bit more advanced way to try if you want.

http://www.youtube.com/watch?v=ALzFr2GT-Is

Updated Magnesium withdrawal update

First, I had noticed a bit of tension in my arms and shoulders, which seemed to add to my jittery nature a bit. Then I realized my temper had shorthand down a bit. I should warn those around me prior to experimentation with changing magnesium dosage or stopping it completely. Then it was shortness of breath.

Breathing is important after all, and if you already suffer from NA, you are sensitive (or I am anyway) to any breathing changes. Why? If you do not already know, NA can impact the cervical plexus in some instances. The cervical plexus is the place where the phrenic nerves originate and then travel down to the diaphragm. If your phrenic nerves are involved in a NA attack, you can have loss of some diaphragm function. Now, it could be that I already have some losses, and taking the magnesium away just made my function worse than normal. Or it could be a coincidence that for the few days I was off magnesium, I had shortness of breath to the point it disrupted my sleep. The more this goes on, the less I believe in coincidences.

So, I started the magnesium again, and my breathing was back to normal. Well, I still had to take a pronounced deep breath once in a while, but with the magnesium, I could do this. Without it, I was gasping at times.