Tracy squinted, momentarily blinded by the harsh brightness of her surroundings. The clouds which had been blocking the sun until then had drifted away, and the late-afternoon sun reflecting on the white roof of the office building forced her to pause for a moment while her eyes adjusted. The contrast between the dimly lit stairwell behind her and the expanse of the practically glowing roof surface was unsettling.
Her current course of action could jeopardize her reputation, relationships, career and possibly get her arrested, but strictly speaking, her behavior wasn't life-threatening. Even so, when she briefly shut her eyes against the glare a few recent memorable events from her life flashed through her mind, making her wonder, "This is so not me, how did I get to where this is even possible?"
Tracy had enjoyed a good but unexceptional life until a couple of years earlier. Her Mom and Dad gave her a stable, loving household to grow up in. There were the usual conflicts between her teenage self and her parents, who were way stricter than those of her friends about how she could dress, when she could begin dating, how late she could stay out, but she never rebelled or defied their rules.
As she looked back on it, she wondered if wanting to get away from her strict upbringing might have been why she married her first serious boyfriend. Kyle wasn't anyone's idea of a wild guy, but he wasn't as strait-laced as her folks, and she had never regretted getting married barely out of her teens. She was amazed at the stories her friends who had gone away to college told her about their casual hookups and spring break shenanigans, but couldn't imagine behaving that way herself.
Tracy's life began to change in her mid-twenties, so subtly at first that she convinced herself that the earliest symptoms of the neurological illness she would eventually be diagnosed with were caused by the stress of having to take care of a newborn daughter, Emily, as well as her first child, a lively two-year-old boy named Kevin.
Tracy loved both children and Kyle helped with them as much as he could, but since he worked long hours she was on her own much of the time. Getting too little sleep and eating poorly, she began to notice a tremor in her right hand. The tremor was intermittent and not severe, so she shrugged it off as simply a sign she needed more rest and soldiered on.
When Emily began to give up nursing in favor of eating solid food at nine months old, Tracy was thankful to be able to sleep for longer stretches, and also that Kyle could take over some of the feeding duty. She also felt a bit guilty, even though she knew she had no reason to. At Emily's one-year-old checkup, her pediatrician was perceptive enough to see Tracy was still struggling a bit, and noticed her tremor, which hadn't become any more intense but had begun affecting both hands. "I know Emily is my patient, not you, but I think you should get checked out to see what's causing the tremor you're experiencing," the Doctor recommended.
"This," Tracy asked, holding up her hands, "I had something like this for a little while after Kevin was born. It went away after his first birthday."
"It may be nothing, but you should see your doctor to be sure," the pediatrician told Tracy before saying goodbye.
When Emily was almost two years old, Tracy was ready to place her in a daycare center and Kevin into the preschool program at the school where he'd be starting Kindergarten in a few months. She was looking forward to being able to go back to work. There was a problem -- her tremors had become both more frequent and more noticeable.
She could no longer convince herself that nothing was wrong, and was worried that she wouldn't be very effective at the clerical and secretarial work she had done before Kevin was born. The way her hands often shook, she couldn't imagine even getting past a first interview. She had her general practitioner refer her to a neurologist to get to the bottom of what was causing her tremors, and hopefully find a solution.
Her first-ever appointment with a neurologist was both unsettling and reassuring for Tracy. She was stunned to hear that she did indeed have a disorder causing her tremors, one which couldn't actually be cured, but was encouraged to hear that any progression would likely be very slow, and was usually treatable with a prescription. "This isn't something which can kill you, but it will always be with you at some level. "You'll need to come in every six months to verify the medicine is doing what it should, and not doing anything it shouldn't. If it isn't working, or is causing troublesome side effects, we'll adjust your dosage as needed," he assured her.
"How much is this going to shorten my life?" Tracy asked; she was beginning to tear up, thinking of her children.
"It really isn't the kind of disease which kills people directly," the doctor said, "but if not treated, the worsening tremors can definitely affect your quality of life, and could make it more likely for you to die some other way, such as a car accident, a severe fall, or choking on food. The good news is that for most people, getting on the correct course of medicine will entirely prevent that sort of outcome."
Tracy didn't like the idea of being dependent on a forever prescription, but agreed to give the drug the doctor wanted her to try a chance. Kyle picked up her first supply of pills the next day on his way home from work. As soon as he handed her the bag she opened it and had a look at the long, long list of possible interactions with other medicines, not a big concern because she wasn't taking anything else except an occasional acetaminophen.
She studied the list of common side effects more carefully, some of which seemed as bad as the illness she already had! The list of rarely occurring side effects was even longer, but the first half dozen or so seemed less troubling than the more common ones, so she put away the tiny slip of paper, saving it to be reviewed some other time.
As Tracy was nearing the end of the 90-day supply of her prescription, she had mixed feelings. Her tremors had almost entirely disappeared most of the time, but did sometimes flare up if she was tired or stressed out. The good news was that she seemed to be tolerating the drug well, with no sign of side effects. She called her neurologist, who suggested that since she wasn't having any noticeable side effects, increasing the dosage of her anti-tremor medicine slightly might be worth a try. She agreed, and began taking the new dosage. After a few weeks at the higher dosage, her tremors were eliminated.
Soon after getting her tremors under control, she found a job as an administrative assistant at a non-profit agency in the center of her city helping homeless people find housing, her hands now steady enough to type as quickly and accurately as she ever had.
