Karen watched her father take the new cereal box from the cupboard.  He brought it over to the kitchen table and tried to open it, but his hands shook so badly he couldn't get his fingers under the cardboard flap.  "I guess I'd better take my vitamins," he said.  He took one-third of a Vitamin B-50 (B-Complex) tablet and waited.  About fifteen minutes later, with hands steady as a rock, he opened the cereal box, poured some into the bowl, added milk and spooned it smoothly into his mouth.

Varying degrees of hand tremors run in Karen's family, passed from father to daughters to her son, Paul, now seven, whose hands began trembling noticeably at age three.  The doctors call them "action" tremors because the hands only shake when acting on something, not when at rest. 

The family pediatrician, reluctant to prescribe high dosage B-complex vitamins to a three-year-old because of possible negative side effects, referred the family to a pediatric neurologist for a consultation.  The neurologist explained that Paul had inherited a familial tremor, bothersome but benign.  He did not recommend using any medication unless the tremor interfered significantly with school performance or social acceptance.  The neurologist also referred them to an occupational therapist who prescribed weighted wrist cuffs and strengthening exercises.  The cuffs helped until Paul became self-conscious around other children and refused to wear them.

Learning to write was the biggest hurdle.  Paul's printing was practically illegible, so he avoided writing whenever he could.  Lack of practice slowed the development of other writing skills, too, such as the organization of ideas and application of basic grammar rules. Concerned teachers recommended comprehensive testing to determine whether Paul might have a learning disability.  Karen agreed to the testing, although she still suspected that the tremor was at the root of the problem.

One night Paul was trying to hook up some wires from a Fun with Electronics kit.  His frustration mounted because the more he tried to steady his hands to connect the wires, the more they shook.  He finally gave up in disgust.  Karen called the pediatrician the next day to talk with him about Paul's frustration and to tell him what she had witnessed happen to her father at the breakfast table.  She had always known that her father took vitamins to counteract the tremor, but until that day she had never seen how quickly and effectively they worked.  The doctor decided she could try giving Paul one-fourth of a B-50 tablet every other day.

Paul noticed a difference within a half hour of taking the vitamins.  He was able to work on the electronics kit the entire evening with steady hands.  Karen and her husband were overjoyed.  They asked Paul not to say anything about it at school because they wanted to find out what the teacher or therapist would notice without knowing about the vitamins.

At the meeting to review evaluation results, the teacher unwittingly sounded like a "before and after" commercial.  She showed a sample of Paul's shaky printing from the previous month beside a neatly printed page from that morning.  The contrast was startling.  The occupational therapist, who had also seen the changes, was both pleased and mystified. 

When Karen told them about the vitamins, they all began to talk excitedly about people in their families who had tremors.  Maybe Vitamin B-complex supplements could help them!  But certainly no one should take them, Karen cautioned, without first consulting their doctor.  

Karen, eager to tell Paul's story, hopes someone might benefit from reading about the process she went through to solve an elusive problem. Sometimes unexpected answers are right in front of us.

The other night Karen noticed Paul's previously dreaded journal on the floor beside his bed.  She picked it up and leafed through the belabored early pages.  At the end, under his neatly printed name and date, were four full pages, all written that night before he dropped off to sleep.