Living with Liquids

Coping with Essential Tremor Articles

By Dr. Joan Harrison Dash

One of the scariest parts of having tremor is carrying liquids, especially hot ones. It’s also the most apparent, with run-away waves forming at the surface and spilling over the sides. It helps to plan ahead and understand the challenges posed by some types of containers and some kinds of social situations.

Raise your hand.
When something is top-heavy it’s inherently unstable, and anything unstable is a big problem for someone with tremor. An object is top-heavy when its center of gravity (okay, its center of mass) is too far above its base of support, causing it to wobble unsteadily.  You wouldn’t hold a tall glass of water by its base, for instance, because the weight of the water would pull the glass off-center. Most people would comfortably grab the glass of water somewhere around the middle.

People with tremor, however, have to aim higher. Your fingers should be placed at or above the surface of the water. If the glass is really full, put your hand above the glass and carry it with your fingertips placed just below the edge of the rim. The point is to make the glass ‘bottom-heavy’, with the weight of the liquid pulling down from your hands.

This brings us to wine glasses, which are inherently top-heavy. If you are surrounded by purists who feel the proper way to hold a wine glass is by the flat base, here’s some good news. Because of your tremor, you won’t need to do this anymore. Holding a wine glass by the base is absurdly difficult because the weight of the wine is so far above its support. Unfortunately, holding the glass by the stem may also be beyond your ability. With the weight of the wine still above your hand, that weight will pull the glass off-center, turning each tiny movement of your hand into a big movement of the top of the glass. This will result in expensive dry cleaning if you have a taste for reds.

The only way for you to hold a wine glass is to place your fingers near the surface of the wine. This is unfortunate because everything you touch during the evening will be transferred onto the glass either as a fingerprint or a greasy smear. But, at least you’ll know which glass is yours.

Don’t raise your hand.
Whenever you raise anything above shoulder level, a whole new set of muscles come into play and your shaking gets worse. This is often a problem at a restaurant when someone suggests a toast or simply lifts a glass and says, “Cheers.” You will come to hate this word.  It’s bad enough holding the liquid steady while you stretch your arm up and out, without other people trying to destabilize your glass by hitting it with their own. On the other hand, you don’t want to spoil a quick, pleasant moment by refusing to participate. Meet the situation half-way by moving your glass away from you, but still lower than your shoulder, and then let the others lower their glasses to reach out to you.

A collins glass is a glass tumbler which typically will contain 10 – 14 U.S. fl. oz.

Straighten it up.
Imagine carrying a liquid in a juice glass with straight sides. Now imagine carrying that same liquid in a martini glass. It’s easier to carry liquids in the straight-sided glass because the vertical sides result in a smaller surface area compared to the volume of the liquid. Avoid any container that’s wide at the top and narrow at the bottom, because the bigger the surface area, the more your tremor will be amplified. Of course, the smallest surface area compared to volume is a beer bottle but it’s not good to carry one of those around all the time.

Go out and buy yourself some new mugs, glasses and soup bowls, all with straight sides. Taller is better. Even if you have never had a Tom Collins cocktail, and have no idea what it is, type in “Tom Collins glasses” into Google and have them shipped to you because they are tall and straight.
Look for tall, straight mugs, also. If you’re going to a party where wine will be served in one of those infernal plastic cups with their sloped slides, consider bringing your own small glass with straight sides. Or fill the plastic cup half-full and go back for seconds. Put your hand over the cup when someone is threatening to top it off, because you might not be able to pick it up again for the rest of the evening.

Helping Hands.
Don’t be afraid to ask for help when it comes to carrying soup in public. There are very few situations in which a tremor should make you wave the white flag of surrender, but this is one of them. Soup bowls often have sloped sides and create huge surface areas. You will not be able to carry (often hot) liquid from the buffet to the table, so quietly ask someone, “Could you help me?” and then stick your hand out flat to show them your tremor.  Conversation will continue to flow around you and no one
will notice.

Keep your cool.
Obviously, you want to try and avoid carrying really hot liquids. Sometimes, though, someone hands you something very hot or you take something out of the oven or microwave that sloshes and penetrates your oven mitts. Because of your tremor, you will occasionally feel the pain of being scalded, which sounds worse than it is. The pain is short-lived, lasting only a minute or two, and doesn’t leave any scars. It helps, though, to know in advance how your body will react. Specifically, a lot of neurotransmitters will rush into your bloodstream once you feel the burn and, in an instant, your shaking will suddenly get much worse, leading to a cascade of greater tremor, more spillage and more pain. So immediately look for a place to set down the cup or pot. Anywhere. You’re looking for an emergency landing here. If necessary, step back and let everything fall to the floor. Then wave both hands in the air and shout an obscenity so everyone knows it wasn’t a stroke.

Foam at the mouth.
If you need caffeine, order a cappuccino. If you need alcohol, order a beer. Both of these are exceptionally easy to carry because they have foam at the surface. The foam is made up of bubbles which dampen the movement of the liquid. The bubbles create friction which absorb the energy of the oscillations, preventing the liquid from sloshing. In order for this to work the foam has to extend all the way across to the sides.

If it’s got a saucer, it’s not your cup of tea.

In the Middle Ages, a saucer was only used for serving condiments and sauces.
In the Middle Ages, a saucer was only used for serving condiments and sauces.

Unless you want to stop all conversation, never try and carry a cup by its saucer. Ask for a mug. If a cup and saucer is your only option, carry the cup and the saucer separately, with the saucer safely and soundlessly below the cup but still near enough to catch any spillage. The fancier the cup, the more narrow it will be at the bottom, so try and hold the cup as far above the surface of the liquid as possible. Lift the cup from above, with your fingers and thumb on the top rim, feeling the cup as a weight below your hand, and thinking about the steady, calm force of gravity pulling on your fingers.

At home, use a lightweight, easy-to-carry dinner plate as a wonderfully huge saucer underneath whatever you are trying to carry. Again, carry the dinner plate separately, a few inches below as a safety net. Then put the plate down and use it as a wonderfully huge coaster.

Make it a stiff one.
Avoid soft-sided cups because your tremor will compress the sides and begin a wave pattern at the surface of the liquid. The pattern is a series of concentric circles moving out to the edge and then bouncing into the center, and then out again. It’s fascinating to watch, except when you’re trying your best to prevent it.

With paper cups, like those found at a rest stop on a highway, the solution is simply to double them up (and choose a size larger than you need even though it costs more.) With one cup inserted inside the other, the cup is surprisingly stiff.

Styrofoam is not so simple because even when you use two cups, it’s still flexible. A Styrofoam cup is almost diabolical – it has a wide opening with a narrow base, it’s squeezable, and its purpose is to carry hot liquids. If Styrofoam is your only option, insert one cup inside the other, and add milk first to cool the coffee or tea as it enters the cup. Fill it barely half full. The result will not be to your taste, but what you are looking for is simply a prop in a social setting. You don’t have to actually drink it.

Plan on it.
In the end, you have to accept the laws of physics and know you will spill stuff. Plan on it. Literally, plan ahead for spills because that will help to reduce the frustration when they happen. Wear black pants in order to hide spills on your lap. Choose leather for your couch. Replace your carpets with the stain-free kind, especially on stairs. Resolve to make every surface of your home, along with every article of clothing, either easy-care or at least inexpensive.

Joan’s tremor was noticeable to her at the age of 11, but she was not formally diagnosed by a pediatric movement disorders neurologist until she was 14. Essential tremor affects her hands, arms, and legs, but it didn’t stop her from receiving her PhD in engineering from Harvard. “I wrote this article because a couple of my friends have recently started shaking,” Joan said, “and they are upset and embarrassed by it. I want to share my coping mechanisms with them and all those affected by this condition. I want to get them to lighten up a bit and see their tremor for what it is … it is not who they are.”