He Avoided Soup for 10 Years:
For ten years, Juan avoided ordering soup in restaurants. He assumed worsening tremors were simply something he had to live with until a conversation with a neurosurgeon showed him another option.
His story, and the experiences of the estimated seven million Americans living with essential tremor, highlights a critical gap in public understanding: that for many, there are effective treatment options available long after medication stops working.
Specialists at Neurosurgeons of New Jersey say many people are unaware that movement disorders can often be treated surgically when medication is no longer providing meaningful relief.
“People learn to live with tremors and assume that deteriorating quality of life is something they will need to work around,” said Dr. Paul R. Gigante, FAANS, board-certified neurosurgeon at Neurosurgeons of New Jersey. “Medication is often very effective, particularly early on. But when symptoms become more difficult to control, it doesn’t necessarily mean there are no more options for the patient.”
Essential tremor is one of the most common movement disorders, affecting an estimated seven million Americans. The condition causes involuntary rhythmic shaking, most commonly involving the hands, although it can also affect the head, voice and other parts of the body. Typically it is treated with medications such as propranolol and primidone, however, not everyone achieves adequate long-term symptom control.
For carefully selected patients whose tremors continue to interfere with daily life despite medication, Deep Brain Stimulation (DBS) may offer another option.
DBS involves implanting thin electrodes into carefully targeted areas of the brain. Those electrodes connect to a small neurostimulator placed beneath the skin of the chest, where it delivers controlled electrical stimulation that helps stabilize the abnormal brain signals responsible for tremor.
“The beauty of DBS is that it doesn’t just decrease the tremors,” Dr. Gigante said. “It’s to help patients regain their independence and return to the activities that matter most to them.”
That was Juan’s experience.
He first noticed his hands shaking while bussing tables as a teenager. At first, he didn’t think much of it. A few members of his family had tremors, so he didn’t seem like something that needed attention.
Over the years, however, the shaking worsened.
His coworkers nicknamed him “Shaky Mo.” Carrying empty glasses down the restaurant floor became embarrassing because customers could hear them clattering together before they even saw Juan.
Eventually the tremor spread beyond his hands. His head began shaking. His legs became affected. He started losing his balance and began wondering how much independence the disease might eventually take away.
Like many patients with essential tremor, Juan tried medication first. Initially it helped, but over time the medications became less effective and the side effects increasingly difficult to tolerate.
“It got to the point where it didn’t work. Turned me into a zombie,” Juan said. “I was just up for anything at this point ’cause I was going nowhere.”
After learning about Deep Brain Stimulation, Juan met Dr. Gigante.
“Dr. Gigante, I mean, he made me feel like I was sitting in my living room and he’s talking to me like a friend,” Juan said. “It was probably the only surgery I wasn’t anxious prior to. That’s how comfortable he made me feel.”
One of the most tangible moments would come during his follow-up programming appointment.
During a follow-up programming appointment, clinicians temporarily switched off his implanted DBS device using a handheld programmer.
Within seconds, the tremor returned.
“I’m not doing this on purpose,” Juan said. “It’s the disease.”
Moments later, the stimulation was restored and the shaking settled again, offering an obvious demonstration of how the technology works.
“We don’t jump straight to surgery for all patients with essential tremors,” Dr. Gigante said. “But when medication is no longer providing a meaningful benefit, that’s the time to re-evaluate. A comprehensive evaluation can help determine whether another treatment approach may improve quality of life.”
“Our goal isn’t simply to reduce tremors,” Dr. Gigante said. “It’s to help people return to the everyday moments they’ve slowly stopped doing because of their symptoms.”
Success wasn’t measured by a scan or a test result for Juan.
It was measured by something much simpler.
“The day we left their office that I was programmed per se, we went right to my friend’s restaurant and I had a bowl of soup and even a glass of wine,” Juan said. “I picked up a glass of wine without spilling it or without holding it with two hands.”
Neurosurgeons of New Jersey hopes to broaden the public’s understanding of what neurosurgeons do. While brain tumors and emergency trauma often receive the most attention, modern neurosurgery also helps people regain independence from chronic neurological conditions that quietly affect everyday life. Juan’s story reminds patients that when medication is no longer enough, asking about additional treatment options may be the first step toward getting their lives back.
See more of Juan’s story here:
About Neurosurgeons of New Jersey
Neurosurgeons of New Jersey provides comprehensive adult and pediatric neurosurgical care for disorders of the brain, spine and nervous system. Its board-certified neurosurgeons offer advanced treatments for conditions including brain tumors, spinal disorders, movement disorders and traumatic neurological injuries. Through evidence-based, patient-centered care, the practice helps patients across New Jersey restore function, improve quality of life and return to the activities that matter most.
As August is Neurosurgery Awareness Month, specialists at Neurosurgeons of New Jersey are sharing stories like Juan’s to raise awareness that modern neurosurgery is not just about emergency trauma, but about restoring quality of life for chronic conditions.