I'm on vacation while I wait for the FHT to sort out the red tape in me joining the practice. This is giving me time to sort through questions that have come up during residency.
One was after a disagreement I had with a doc about what a pill rolling tremor is. The doc I was working with insisted it was a fine movement of the wrist. I was really sure it was a fine movement between the thumb and index finger.
I love being right.
You see pill rolling in some folks with Parkinson's disease. It's often a tip off for me that I need to look for other symptoms to determine if I should be worried or if its just a nervous tic. Because its a resting tremor it's one that is often difficult for the patient to hide and will present itself during the Q&A portion of our visit.
Have a look at this article on how pills used to be made to get an idea of where the name came from. My favourite quote is:
Pharmacists could coat pills to disguise the flavour of the medicine, making them easier to swallow. Depending on how much the client was willing or able to pay, thin gold or silver leaf, calcium carbonate (to achieve a pearl finish), sugar, or gelatin could be used. Many of these coatings made the pills indigestible. As a result, they would pass through the digestive system whole, without delivering medication.
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