How Does Medicare Cover Essential Tremor?

By Danielle Kunkle Roberts,
Co-Founder of Boomer Benefits

Danielle Kunkle Roberts, Boomer BenefitsEssential Tremor (ET) is a neurological disorder that causes involuntary shaking and trembling. It affects approximately 10 million people in America, according to the International Essential Tremor Foundation, which makes ET the most common neurological disorder.

While not dangerous, the condition can make simple tasks such as tying your shoes or drinking a glass of water more difficult. ET can also get worse over time.

Because ET is more common for people in later adulthood, it’s good to know how Medicare will cover treatment of this disorder.

Medicare Part A Hospital Benefits

Original Medicare is made up of Part A hospital benefits and Part B outpatient benefits. 

Part A covers inpatient hospital stays, skilled nursing facility care, and hospice care. This is the part that would pay most of the expenses related to a hospital stay for deep brain simulation (DBS), which is a common surgery that provides relief from tremors and stiffness.

Medicare Part B Hospital Benefits

Medicare Part B covers outpatient care. This includes doctor visits, preventive care, lab-work, diagnostic testing, emergency care, outpatient surgeries, physical therapy, durable medical equipment and much more.

Part B will pay for your patient visits to your specialist, the necessary neurological exams and lab-work and any outpatient procedures used to control ET symptoms.

One outpatient procedure to treat ET is focused ultrasound treatment. This minimally invasive treatment was approved by the FDA in 2016. It is the first brain disorder treatment to be allowed reimbursement by Medicare Part B. The procedure destroys a small amount of brain tissue that contains nerve cells which are responsible for the tremors.

Earlier this summer Medicare announced benefit coverage for patients in 16 states. Additional states were added this past fall. There are numerous medical centers that now treat patients with Essential Tremor using MR-guided focused ultrasound. A Medicare physician must document why the procedure is reasonable and necessary.

Medicare Part D Drug Benefits

Outpatient medications to help treat your ET symptoms will fall under Part D. Medicare Part D is optional coverage  beneficiaries can purchase to reduce the cost of their prescriptions.

These plans are sold by private insurance companies and each plan has its own premiums, copays, coinsurance, pharmacy network, and drug formulary. Beneficiaries can use Medicare’s Plan Finder Tool to search for the right plan.

Your Medicare Cost-Sharing

As with all insurance coverage, Medicare covers a share and the member also pays a share of their coverage. This is called your cost-sharing and it usually comes in the form of deductibles, copays, and coinsurance.

Part A has a $1364 deductible in 2019, and Part B has a smaller $185 annual deductible. Medicare Part B covers 80% of your outpatient procedures. You are responsible for paying the other 20%.

Fortunately, you can supplement your coverage with either a Medicare supplement policy or a Medicare Advantage plan. Both types of coverage will help to limit your out-of-pocket expenses on the gaps in Medicare.

Beneficiaries can call 1-800-MEDICARE or consult a Medicare insurance broker for guidance in choosing a plan that fits their needs and benefits.

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Danielle K. Roberts is a Medicare insurance expert and co-founder at Boomer Benefits, a licensed agency that helps beneficiaries with their supplemental coverage options.

‘Tis the Season of Giving and Understanding the New Tax Laws

LET YOUR GIFT BE YOUR LEGACY

December is traditionally a time of giving. It’s the holiday season where gifts are exchanged and people reach out to help others, including organizations that do good in the world. Many charitable organizations receive their largest contributions in December.

While most charitable contributions are not motivated by tax write offs, this incentive has been engrained in society for the past 100 years. It was 1917 when charitable giving was approved as a tax deduction. The War Revenue Act of 1917 was adopted shortly after the US entered the war (World War I). The idea behind the act was to provide support for charities who otherwise might not survive the war.

Exactly 100 years later, in 2017, the Tax Cut Jobs Act was passed, changing the landscape for charitable giving. The new law reformed individual and corporate income tax. It increased the standard deduction and family tax credits, and eliminated personal exemptions, making it less beneficial to itemize deductions. What does all this mean if you are making charitable contributions? And how can you still give and save on your taxes?

Know the Rules
Understanding the ins and outs of the new tax laws can help you set goals. Most importantly, know what tax bracket you are in and the standard deduction amount. Here are the tax brackets for 2017 and 2018 so you can compare the changes.

Try Bunching
The new law doubled the standard tax deduction, which means fewer people will probably itemize their taxes. But, you can only make deductions if you itemize your taxes. Try to take advantage of itemizing by consolidating charitable donations. So instead of giving smaller amounts for two years in a row, give two or three year’s worth of donations in the same year so the gift is enough to deduct.

Consider a Donor-Advised Fund
A donor-advised fund is a charitable investment account established specifically to support a charitable organization you care about. It allows individuals to make a charitable contribution and receive an immediate tax deduction of up to 30%, then recommend grants from the fund over time. Direct donation of publicly traded securities is one of the most common ways to set up this type of fund.

Know the Value of Your Gifts
Most people give to a cause or charity because they believe in the purpose and the mission and want to be a part of it. Don’t lose sight of this. The gifts you give may be deductible in a given year, but their benefits can be life-changing for the cause you are supporting. Imagine knowing that because of you and your support, research was conducted that led to a cure for essential tremor. Let your gift be your legacy.

Learn More
Everyone’s personal finances are different and tax laws can be complicated. For more information check with your financial advisor or tax consultant to create a plan that works best for you. 

The Best Caregivers Practice Self-Care

“You cannot serve from an empty vessel” ~Eleanor Brownn  

Carla Cheatham PhotoBy Rev. Carla Cheatham, MA, MDiv, PhD, TR

When we care for a family member, taking time to care for ourselves can be especially hard, assuming the resources are even available to allow us to do so. We do not want them to think they are a burden. We might feel sad for what they are going through, wishing we could fix it and make it all better.

We may feel selfish about stepping away for a bit of respite because they do not get to take a break from their illness, so why should we? We often feel compelled to push ourselves harder and further than is healthy, mistakenly seeing self-care as a luxury or feeling guilty for taking time away.

Selfishness is when we take care of our own needs at another’s expense. Self-care is when we take good care of ourselves so we CAN show up well for others. Exquisite self-care is our first and greatest priority if we wish to be good caregivers.

When we do not put our own oxygen mask on first, we can help no one and are more likely to develop compassion fatigue, the emotional and physical state that occurs when the amount of care we are taking in isn’t enough to make up for the care we extend.

Setting too high of expectations for ourselves can leave us feeling something is wrong with us, but humans under stress can get impatient, short-tempered, and long for our situation to be different. That happens, but will be less likely if we take in what we need to maintain our internal resources.

National Family Caregivers Month logoWe may feel powerless to change our circumstances and get the full support we need and deserve, but we are not helpless to take action on our own behalf. Even with very little time to ourselves, we can find mini-moments throughout the day to lower our feelings of stress and increase calm in our bodies and brains.

4-square breathing—Using your heartbeat as a timer, breathe in for the count of 4, hold that breath for 4, breathe out for 4, and hold for 4. You can do 3-4 of those in about a minute a couple of times a day.

Hand washing ritual—As caregivers, we wash our hands often and experts recommend doing so for 25 seconds. Take that time to breathe, feel your feet on the floor, soften your belly and torso, and lower your shoulders away from your earlobes where they’ve crept up due to stress.

 Waterfall doorway—Pick a doorway you walk through often. Imagine a waterfall coming down through that doorway washing off the stress of the day collected to that point to keep from accumulating it all day long.

 Common cues—Pick a common object, like a penny or a certain type of bird. Each time you see one, pause for 5 seconds and check in with the committee in your head to see if negative or self-defeating messages are running through your brain. If so, change the narrative with a positive phrase, mantra, or prayer repeated over and over again for a few more seconds until you feel a positive shift.

Phone a friend—Call someone you trust to talk about anything else other than your struggles and stressors. Even 5 minutes with someone who reminds us we are part of a larger world beyond the circumstances of our current moment can help to center us.

Three Good Things—Research has shown if, within one or two hours before sleep, we write down three good things that happened during the day and what made those moments positive, we sleep better and our rates of burnout go down substantially. Do this for 14 days. It only takes a few moments and re-trains our brain to see the positive as well as the negative our brains can so easily focus upon.

ABC’s of Gratitude—When we most need to practice gratitude is often when we feel the least grateful. Name something that begins with each letter of the alphabet for which you are grateful.  Even if our list starts frustratedly with apples, bananas, cats, and dogs, by the time we get to wisdom, yogurt and zebras our perspective will have shifted and we can feel the difference inside.

Hopefully something in these words has given you a couple of tools and encouragement to help you walk this journey. You and your loved ones deserve all the support and moments of peace you can access along the way.

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Carla Cheatham is the principal and lead trainer for Carla Cheatham Consulting Group, LLC and serves as a national keynote speaker and educator teaching in the areas of clinical presence and attunement, compassion fatigue and resilience, ethical spiritual and existential care, grief support, ethical boundaries and healthy teams, and more. She publishes two blogs through CarlaCheatham.com and HospiceWhispers.com. She is the author of Hospice Whispers: Stories of Life and its companion piece, Sharing Our Stories: A Hospice Whispers Grief Support Workbook.

Being ‘Mindful’ May Help in Managing Essential Tremor

By Dr. Michael Braitsch, PT, DPT
Tribe Wellness, LLC

Photo of Michael Braitsch, Tribe WellnessIf you’re like me, you’ve heard over and over again the value of mindfulness. It’s become quite a popular buzzword in a variety of manners of marketing. As we enter the next frontier of neuroscience and brain health, it seems like you can’t go anywhere without hearing about mindfulness. But what does mindfulness really mean and how can it be useful in daily life or in managing life with a tremor?

As a physical therapist, I have seen time and again the role of increased stress ramping up the severity of a patient’s symptoms (whether it be chronic pain in someone’s lower back, the amplitude or frequency of a tremor, the incidence of freezing gait in someone with Parkinson’s disease – the  list goes on).

I’ve met many people though with an essential tremor who usually say something like, “If I really focus on it, I can kind of calm my tremor down.” This is mindfulness!

The even better news is that practicing mindfulness can have far reaching benefits to improve quality of life with or without a tremor. It makes good sense. When we are calmer, we learn better, we perform better, we are less distracted, and we can even tap into a level of subconscious skill to make life easier.

While this all sounds great, I’m also here to warn you that it takes some effort and consistency; however, we all know that most worthwhile things in life take some effort. The intention of this blog post is to clarify what mindfulness practice is and how it could be helpful.

What is Mindfulness?
Many people consider the practice of mindfulness as simply, being aware of the present moment and the task-at-hand. Merriam-Webster’s dictionary defines mindfulness as:

“1 : the quality or state of being mindful

2 : the practice of maintaining a nonjudgmental state of heightened or complete awareness of one’s thoughts, emotions, or experiences on a moment-to-moment basis “

So “mindfulness” is really a practice. It’s NOT a destination. It has a lot of similarities with meditation or directed thinking which is common in all religious beliefs, to quiet the mind you don’t have to run off to the mountains or join a monastery. Rather, mindfulness provides a method of intentionally directing one’s focus to the task-at-hand, while avoiding judgment (both good and bad).

Let’s break each of these down further.

Focus on the Present
An increased focus on the present moment is a heightened commitment to directing one’s attention to the task-at-hand. Even though the mind may wander, coming back to the present is the key for mindfulness. We are all human beings and have a natural tendency to consciously or unconsciously drift into other thoughts, but coming back to “right now” is the goal of this practice. Oddly enough, in a world where multi-tasking is everywhere, mindfulness practices teach us that we are more effective and more efficient when we slow down and focus on what we are doing.

Be Non-Judgmental
Each day we make thousands of decisions. For the sake of survival of the species, we have an evolutionary drive to constantly judge things as good or bad, helpful or harmful, useful or a waste of time. Using our “fight or flight” response has served us tremendously for thousands of years. This is often the hardest part of mindfulness. Reinforcement of use of the “fight or flight” hardwires us to rush ahead to the next moment. However, when we lose sight of the present and constantly let the mind race, neuroscience tells us that we strengthen our brains’ stress responses to everyday tasks. On an extreme level, a heightened stress-response can have far-reaching negative effects. While it’s helped humanity to survive, we’ve become hardwired to get bogged down by incessant mental chatter. Mindfulness shows us that we can remain focused on the task at hand without judgment, and on a very practical level, rewiring our brains from training a ”stress-response,” to instead, training a “relaxation response.”

As we strive to increase our focus and to quiet the mind, we can find an abundance of benefits from improved awareness. We can even gain insight into why we feel a certain way or perhaps a deeper level of relaxation. This training has a powerful effect on our autonomic nervous system. By choosing presence and mindfulness, a hyperactive brain or a hyperactive nervous system can be slowed down, leading to a wealth of benefits including improved cardiovascular health, improved cognition, and more!

But What About My Tremor?
Managing stress is great for everyone. For someone with a tremor, it can be even more helpful. Most people I’ve met who are dealing with essential tremor say something like, “my tremor gets worse when I’m stressed out.” Stress and depression can even create a negative cycle that increases the tremor currently, and because of embarrassment about worsening of the tremor, causes more stress and depression. While there have not yet been studies on practicing mindfulness as a means of managing essential tremor, there have been many anecdotal reports of it helping. It stands to reason that even if mindfulness did nothing for the tremor itself, the already established far-reaching benefits make it worth the effort until a study can show what so many people have already reported. Why not give yourself a chance to reduce stress and feel good, right?

Can I Practice Mindfulness While Exercising?
Now for my favorite topic. . .there are forms of exercise that harness and foster a mindful approach while also striving to calm the mind and strengthen the body. As a physical therapist, my life’s mission is to help people move better and feel better. The research on the role of exercise in managing stress is abundant to say the least. As a long-time martial artist, I’ve seen first-hand the changes that can occur with dedicated practice of martial arts and the increased sense of well-being that students develop. Tai Chi is easily the most common form of martial art with emphasis on mindful practice because it is low-impact, easy to modify, and because it focuses on breath with movement. Alternatively, yoga has provided an avenue for mindful training for centuries and pilates also employs a mindful approach to movement, capturing the benefits of mindfulness and exercise.

What Else Can I Look at to Learn More?
Mindfulness resources are everywhere! There is no shortage of resources when it comes to mindfulness. The best practice though, like the best exercise, is the one that you can do consistently.

Here are a few to start with:

 

Educating Family Physicians about ET and the IETF

By Patrick McCartney,
IETF Executive Director

One of the pillars of the International Essential Tremor Foundation’s mission statement is “to provide hope to the essential tremor (ET) community worldwide through awareness.”

As we all know one of the biggest challenges we face is raising awareness for ET. This is a daily task for our staff. We use a variety of channels including social media, printed materials, and talking with patients, caregivers, and family members every day on the phone who have questions about this disorder.

Another way we try to raise awareness is by attending national conferences and sharing a variety of information on ET. October 10 through 12 I attended the American Academy of Family Physicians Family Medical Experience in New Orleans, LA. There were more than 5,000 family doctors attending the event. This is the third year we have attended and it’s a great opportunity to share with family doctors the resources the IETF has available for them and their patients.

I shared our Patient Handbook, IETF brochure, ET vs. Parkinson’s fact sheet, medical alert cards, IETF pens, and Tremor Talk magazines with them. The ET vs. Parkinson’s fact sheets were so popular I ran out the second day and had to make more copies at the hotel for the last day of the show.

A couple of takeaways from this conference:

  • Every doctor I talked with had treated ET patients, but not one of them was AAFP Conference 2018aware of the IETF.
  • Several of the doctors I talked with have ET or have family members or friends who have it and were excited to see the resources we have to share.
  • Everyone I spoke with said they would share our information and/or direct their patients, friends, or family members with ET to the IETF either through our website or our toll-free phone number.

I would encourage you, as I encouraged these doctors, to be advocates for ET and the IETF in your community. There are a lot of stereotypes and stigmas associated with ET. Don’t let them prevent you from sharing your story and explaining the daily challenges you face because of ET. And let others with ET know they are not alone.  There are IETF support groups all around the country. You can find a listing of them on our website.  If there is not one in your area consider starting one or join our online support group on Facebook (Essential Tremor Awareness Group).

We appreciate your support and if you have any questions please don’t hesitate to contact the IETF at 1-888-387-3667 or info@essentialtremor.org.

Wrapping Your Mind Around Head Tremor

(This is an article from a past issue of Tremor Talk magazine. It’s just a sampling of the stories we include in each issue. Annual donors to the IETF receive Tremor Talk magazine in the mail three times per year.)

By Arif Dalvi, MD, MBA
Director of the Comprehensive Movement Disorders Program
Palm Beach Neuroscience Institute 

Dr. Arif DalviThe term tremor refers to an involuntary shaking of any part of the body. While tremor in the hands is most common, head tremor can also occur. In patients with essential tremor, head tremor can be an isolated symptom or may occur in combination with hand tremor. Essential tremor is by far the most common cause of head tremor. Another cause is cervical dystonia, also known as spasmodic torticollis. Head tremor may also occur in patients with Parkinson’s disease. Stroke, head injury, and multiple sclerosis are other causes of tremor but are less likely to cause head tremor.

Hyperexcitability and rhythmic activity in the circuits of the brain are believed to be the underlying mechanism for tremor. One such circuit includes three areas deep in the brain called the red nucleus, the inferior olivary nucleus (ION), and the dentate nucleus. This circuit is responsible for fine-tuning voluntary movements. Proper function prevents any undershoot or overshoot of movements. An abnormal response in this circuit, especially within the ION, can lead to tremor.

Approximately 95 percent of patients with essential tremor present with hand tremor. However, about 35 percent of patients have head tremor either by itself or in conjunction with hand tremor. Some patients also have voice tremor. Hand tremor occurs mostly with posture, such as when holding an object away from the body and against gravity. This contrasts with hand tremor in Parkinson’s disease that occurs when the hands are at rest. Muscle rigidity, slowness of movement, change in posture and gait also occur with Parkinson’s disease but are uncommon with essential tremor. A lip or chin tremor may also be seen in patients with Parkinson’s disease.

Cervical dystonia can be another cause of head tremor. Dystonia refers to a state of abnormal muscle tone leading to painful muscle spasms and abnormal posturing of a part of the body. When the muscle spasms and abnormal posture affect the neck it is referred to as cervical dystonia. Sustained abnormal posturing of the head is a hallmark of cervical dystonia. An enlargement of the neck muscles may be observed in cervical dystonia but is unusual in essential tremor.

Other features include an asymmetric elevation of the shoulders, excessive eye blinking or blepharospasm, and spasms of the facial muscles. Like ET, cervical dystonia can spread to one or the other arm, in long-standing cases. However, unlike essential tremor the head tremor from cervical dystonia may be associated with neck pain due to dystonic spasms.

Patients with cervical dystonia may employ sensory tricks to reduce the severity of the tremor. Touching the cheek or chin (a geste antagoniste) is a commonly employed sensory trick. Head tremor with cervical dystonia has a directional component and is usually worse when looking in one direction and reduced when looking in the opposite direction. It may be possible when examining the individual to find a head position where the tremor almost disappears. This position is referred to as a “null point”.

The diagnosis of tremor remains a clinical diagnosis. An MRI or CT scan of the brain is usually ordered to rule out structural lesions such as stroke, multiple sclerosis or a midbrain tumor. In patients where there is a question of whether the problem is essential tremor or parkinsonism, a DaTscan may be ordered. This scan is targeted towards the dopamine transporter (DaT) in the brain which is deficient in parkinsonism but normal in essential tremor. Blood tests to rule out hyperthyroidism and, in younger patients, screening tests for Wilson’s disease may also be considered.

The treatment of tremor is guided by the underlying cause. Propranolol and primidone are the mainstay of treatment for essential tremor. Other medication options that are helpful include gabapentin and topiramate. Cervical dystonia may respond to treatment with benzodiazepines. Clonazepam, which is a long-acting benzodiazepine, may be preferred in comparison to shorter acting drugs such as alprazolam or lorazepam. Baclofen can reduce dystonia by acting on GABAB receptors. Tizanidine is an alternative to baclofen. However, since tizanidine can cause liver damage (in rare cases), monitoring of liver enzymes for the first six months is recommended.

Botulinum toxins can play a role in the treatment of head tremor, particularly in dystonic head tremor. Botulinum toxins block the release of neurotransmitters. This results in decreased transmission of the signal from nerve ending to the muscle, thus reducing the tremor. Repeat injections are required every three to four months.

Deep brain stimulation (DBS) surgery was approved by the FDA in 1997 for the treatment of tremor. However, the target in the brain varies based on the condition being treated. DBS surgery carries an approximately two percent risk of bleeding in the brain, hence it is only offered to patients with advanced tremor that is disabling and not controlled by medications. Head tremor can be more difficult to control than hand tremor and may require DBS surgery to be done on both sides of the brain.

Non-pharmacological methods to reduce head tremor rarely provide sustained benefit. Physical therapy is generally not useful, however, relaxation techniques can help reduce tremor as anxiety is often an exacerbating factor. There is no specific diet that is helpful but reducing caffeine intake can help reduce tremor.

Not every person with ET will be affected by head tremor. But if you are, it is important to talk to your physician so you understand what it is and what treatment options are best for you.

 

 

 

Having a Positive Impact on Those Who Struggle with Lifelong Conditions

Each semester, the International Essential Tremor Foundation presents four scholarships to students with essential tremor. The scholarships represent hope for the future, and provide support to these students during a pivotal time in their lives. As part of the scholarship application process, each applicant is asked to write an essay that answers the question, “How has essential tremor affected my life?” The following essay is from one of our fall 2018 scholarship recipients

 

By Deirdre Maciak,
Student Salem State University
Salem, MA

Essential tremor (ET) has affected me physically and emotionally, and has also played a role in my future career plans. I began noticing ET when I was in middle school, and was officially diagnosed as a sophomore in high school.

Photo of Deirdre Maciak, 2018 scholarship recipientPhysically it has affected me when I work out at the gym, play saxophone in my various school bands, and is worse when I’m tired or stressed out. I have tried a couple of medicines so far to treat it, and am working to determine what the right level of medicine is for me for now.

Emotionally it has affected my confidence level, especially when I realized how noticeable it had become. I sometimes hold off on activities I would like to do because of the ET, but am learning to manage the condition more proactively and look forward to being able to try new treatments in the future.

ET has also impacted my career choice to a degree as well. I am looking to pursue either nursing or biology in college, partly because I want to be able to have a positive impact on others who struggle with lifelong conditions. I also want to have the opportunity to either research new drugs or related treatments that would make the lives of those who deal with these types of conditions better.

I recently learned that a family friend, who is a research scientist, is actually working on a new drug for neurological disorders, which was very exciting. This type of work is intriguing to me.

I am very excited to start my college career this fall. While I know that ET will have some impact on me, I am becoming more confident that it’s a condition that I will be able to manage during these upcoming college years. I hope to both benefit from future ET treatments and, also have the chance to work on them as part of my future career path.

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Interested in supporting students with ET during their educational journey? Make a donation to the ET scholarship fund online.

Educating Others About Invisible Disabilities, Including Essential Tremor

Each semester, the International Essential Tremor Foundation presents four scholarships to students with essential tremor. The scholarships represent hope for the future, and provide support to these students during a pivotal time in their lives. As part of the scholarship application process, each applicant is asked to write an essay that answers the question, “How has essential tremor affected my life?” The following essay is from one of our fall 2018 scholarship recipients

 

By Megan Hartley,
Student at Florida Southern College

When I was 15, I was diagnosed with essential tremor. In March 2018, my 15-year-old sister was diagnosed with essential tremor. This letter is for her.

You have heard all the negative experiences that have been a part of my diagnosis: the accusations that I stole my grandmother’s handicap because I couldn’t possibly have one of my own; being bullied because I got extra time on exams that I “didn’t need;” and not being able to walk after a long day. People will be cruel because they do not understand.

What I want you to know is that it isn’t something that has to define you or be completely negative; so many positives have come out of it for me. It has allowed me to better understand what it is truly like to have a diversity that no one understands. It has pushed me to try to educate those who do not understand invisible disabilities in a positive way.

In the spring of 2016, I was allowed the opportunity to be on the cover and to speak out about what it is like to have anxiety and essential tremor for the International Essential Tremor Foundation’s magazine, Tremor Talk.

At Florida Southern alone, in my role as a resident advisor, I have been able to design community-wide programs that encourage students to ask questions and to get knowledge about those diversities they do not understand. The series that went on to win community program of the year included invisible disabilities, culture and identity. I have had the opportunity to present at the Florida Resident Advisor Conference and took home an award for my presentation about invisible disabilities inclusion in the residence halls.

Quote about invisible disabilitiesThis semester, I am partnering with other campus organizations to promote invisible disabilities week on campus in October. I have had the opportunity to do multiple projects and papers about disabilities and their relationship to the world around us. You are able to combat the negativity by allowing it to be an education opportunity for those around you.

Overall, what I want you to understand, is that, for me, the positives outweigh the negatives. I believe that essential tremor has allowed me to be a more compassionate person. Though I cannot speak to every diversity, I feel as though I can understand what it is like to have your identity questioned simply because it is not seen from the outside.

Though some days the tremors make it difficult to stand, I will always stand up for those who need it.

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Interested in supporting students with ET during their educational journey? Make a donation to the ET scholarship fund online.