Published on Aug. 17, 2026
Robert Melino sat down at a restaurant with his family and looked at the menu. For most people, ordering lunch would have been ordinary. For Robert, it felt like a test.
In retirement, Robert was still used to a full calendar. He served on the board of the Italian Heritage Club, played cards with friends and continued running the tax business he founded more than 54 years ago. Staying active and connected was part of who he was.
But for years, essential tremor had made ordinary moments feel uncertain. A cup of coffee, a bowl of soup, a signature on a document — each one required focus, patience and, sometimes, quiet frustration. He had learned how to adapt, but he had also learned how much energy it took to move through the day with hands he could not always control.
That afternoon, as he waited for his meal, Robert was not thinking about a medical milestone. He was thinking about something much smaller and more personal: whether he could eat without spilling, without bracing himself, without worrying who might notice.
Living With Essential Tremor
Robert was diagnosed with essential tremor years ago by a neurologist in Palm Springs. Like many patients, he first tried medication in hopes of reducing his symptoms. Instead, the medication left him feeling “loopy,” and he quickly stopped taking it.
Over time, he learned to adapt.
“Life is the good, the bad and the ugly, and you just keep pushing through,” Robert said.
But the tremors became a constant part of daily life.
His daughter, an occupational therapist, often helped him find ways to manage his symptoms. He relied on weighted utensils when eating and learned to steady his hands whenever possible. Drinking coffee, eating soup and signing important documents all required extra concentration.
“I just accepted it and did what I had to do,” Robert said.
Although essential tremor is one of the most common movement disorders, many people don’t realize there are treatment options available when medication no longer provides relief.
Looking for Another Option
For years, Robert believed managing his tremor was his only option. Then, during a holiday gathering, he met someone whose experience changed his perspective: another person with essential tremor who had undergone a procedure that dramatically improved his symptoms. Curious, Robert asked his neurologist about the treatment. While he was initially advised that it might not be the best option because of his age, he was not ready to stop exploring possibilities.
That search eventually led him to Devin Binder, M.D., medical director of the Movement Disorders Program, MemorialCare Neuroscience Institute at Orange Coast Medical Center.
When Robert met Dr. Binder, he learned that treatment could be more personalized than he realized, with options designed for patients whose symptoms are no longer controlled with medication.
“When I met Dr. Binder, he explained everything,” Robert said. “After that appointment, I went home and told my children I was going to do it.”
Robert appreciated the time Dr. Binder took to answer his questions and explain what treatment could look like.
"He made me feel comfortable," Robert said. "I knew I was in the right place."
Together, they discussed whether MR-guided focused ultrasound (MRgFUS) could be an appropriate next step based on Robert’s symptoms, overall health and goals. After weighing the information with Dr. Binder and his family, Robert decided to move forward with MR-guided focused ultrasound.
His son traveled from Connecticut to accompany him for the procedure.
A Noninvasive Treatment With Life-Changing Potential
MR-guided focused ultrasound is a noninvasive treatment that uses highly focused ultrasound waves to target the specific area of the brain responsible for tremors.
Guided by real-time MRI imaging, physicians can precisely treat that area without making an incision or implanting a device. Many patients experience noticeable improvement immediately following treatment.
"Essential tremor can significantly impact a person's independence and quality of life," said Dr. Binder. "For carefully selected patients, MR-guided focused ultrasound can provide meaningful tremor relief and help them return to activities they may have struggled with for years."
For patients like Robert, access to this level of expertise close to home can make advanced treatment feel more approachable. Orange Coast Medical Center is home to one of the most experienced MR-guided focused ultrasound programs on the West Coast, in large part due to Dr. Binder’s extensive experience in MRgFUS.
The Moment Everything Changed
In April 2026, Robert underwent the MR-guided focused ultrasound procedure. His son remained by his side throughout the experience. Following the procedure, Robert stayed at Orange Coast Medical Center and underwent follow-up imaging, which showed the treatment area looked as expected. Then came the moment that made the change real. The next day, Robert and his family went out to eat.
For years, ordering soup in a restaurant required caution. He worried about spilling it on himself or drawing attention to his tremor. This time was different. "I ordered soup and didn't spill any on myself," Robert said. "My family and I were ecstatic." For the first time in years, the tremor in his right hand was gone.
"It was so easy," Robert said. "Dr. Binder is an angel. He's very kind and has amazing bedside manner. He was excited about the success, too."
What once felt impossible suddenly felt simple.
Returning to the Activities He Loves
Since undergoing treatment, Robert has been able to enjoy many of the everyday activities that had become frustrating because of his tremor. He no longer relies on weighted forks and knives. He can comfortably drink coffee and eat meals without worrying about spills. He enjoys playing cards and participating in community activities. One of the most meaningful improvements has been regaining the ability to write.
For someone who has spent more than five decades operating a tax business, signing documents is a routine part of life. Before treatment, that simple act had become increasingly difficult. Today, Robert can once again write his name with confidence.
The change has not gone unnoticed. Clients and colleagues have commented that his hand no longer shakes.
"They noticed right away," Robert said.
For Robert, the procedure did more than improve his symptoms. It gave him back everyday moments he once had to approach with caution.
Encouraging Others to Seek Help
Robert frequently shares his experience with others living with essential tremor.
He understands the hesitation many people feel when considering treatment, especially after living with symptoms for years.
But he also knows what is possible.
"They'd be silly not to do it," Robert said. "They'd be doing themselves an injustice not to at least learn about it."
He often encourages people to attend educational webinars and listen to the experiences of other patients who have undergone treatment. Hearing those stories helped him make his own decision. Now, he is proud to share his.
As he approaches his 89th birthday, Robert continues staying active, connected and engaged with family and friends. Most importantly, he no longer measures his day by the limitations of essential tremor.
For Robert, treatment was not simply about reducing shaking. It was about getting back to the small, meaningful parts of life that tremor had made harder. And it all started with a simple meal that no longer felt impossible.
To learn more about movement disorders and treatment options, register for the From Symptoms to Solutions Webinar: Understanding Movement Disorders Treatment Options.