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Friday, September 16, 2011

PART III: TREATMENT

-Quick Hyperhidrosis Overview-

Hyperhidrosis is a debilitating condition that affects nearly 1% of the earths population. 
It is characterized by:
excessive sweating that can be socially embarrassing, career restricting, & in some cases, very disabling. Patients with hyperhidrosis suffer from excessive sweating that commonly involves one or several parts of the body, including the hands, feet, axillae (underarms), or, less often, the face. It can be triggered by exercise, stress, and/or embarrassment, but most commonly it is completely without any triggers; it just happens. 
Hyperhidrosis most commonly presents itself as extreme — even dripping— wetness of the hands, rendering the patient too uncomfortable to shake hands, making paperwork and writing difficult, and often leading to uncomfortable skin conditions.

How does sweating work?

The sympathetic nervous system, which is a part of the vegetative nervous system, pushes electrical signals to the sweat glands on the surface of the body when the body thinks that it needs to be cooled down. The peripheral nerve fibers begin with small nodes of ganglia located sequentially in a chain passing along the side of the spine.


This makes up the sympathetic trunk.
With excessive sweating these signals are being sent when they are not needed. It is unknown as of yet exactly why this is occurring.

TREATMENT OPTIONS

Anti perspirants

 Deodorant... we all wear it (well... most of us).  The main component in Deodorant that keeps that sweat from coming out so much, is aluminum chloride. The higher the %, the better it works. Unless you have a condition that eats aluminum chloride for breakfast ...Hyperhidrosis.  

 

My experience:

Drysol did nothing to lessen my sweating and the only thing it did was irritate my skin.  My sweat glads were not phased.. deodorants only purpose for me was to de-odorize my pits.

 

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I o n t o p h o r e s i s

The hands or feet are placed into water (the deeper part of the trays are filled with water) ...and then a "gentle" current of electricity (15-18A via a D/C generator) is passed through it. The electricity is gradually increased until the patient feels a light tingling sensation. The therapy lasts about 10-20 minutes. It requires constant reapplication thereafter otherwise sweating will reoccur. Many who suffer from light to moderate hyperhidrosis are content with this method, however the treatment is time consuming and can cause discomfort. It is very difficult to apply to the armpit region and impossible in other areas.
My experience:
Painful. Feels like your nails are being pulled off, tedious... and did not suppress my sweating to a degree worth continuing treatment.

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B o t o x

Another popular hyperhidrosis treatment is.... botox! [Botulinum toxin type A] -It was approved by the FDA in 2004 for the treatment of severe underarm sweating [primary axillary hyperhidrosis]. Botox is one of the most lethal poisons known, as it interferes with the effect of the transmitter acetylcholine... (In the peripheral nervous system acetylcholine plays a role in skeletal muscle movement, as well as in the regulation of smooth muscle and cardiac muscle. In the central nervous system acetylcholine is believed to be involved in learning, memory, and mood) ...at the synapses; In low doses however, it can reduce the transition of impulses and thus sweating activity. The procedure is as follows: iodine/dye is rubbed on the armpit to locate sweat glands.  Then a grid is dotted out on your armpit to mark injection locations. Then, small doses of botox are injected into each of these spots. It isn't your usual shot & rather discomforting. I had 25 dots in each pit. This temporarily blocks the nerves that stimulate sweating. The effect usually lasts between 2 and 6 months (mine only last 2...). The treatment must then be repeated to continue suppression of the sweating.

 

Mr. Sweat G. Lands newest hobby after botoxin'

 

Some side effects of this method could include:

injection-site pain and flu-like symptoms, mild but temporary weakness and intense pain. Also it is a costly treatment, especially given that it must be redone continuously. Botox is most commonly used for underarm sweating, and it is not suitable for large areas ...*insert OW here* Botox is not used in the palms and feet because it can cause temporary weakness of the hand & foot muscle.

 

 

My Experience:

I received botox by my medical provider (insurance covered it thank the Lord!) ..twice.  The first time was painful but worth it, my armpits ceased sweating for almost two months, and it was really exciting as a 16 year old to be able to wear prettier shirts! BUT.... the pit water returned & my 2nd treatment proved unsuccessful. I also still suffered from severe sweating everywhere-else

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Endoscopic Thoracic Sympathectomy (ETS)

involves...
interrupting a specific portion of the main sympathetic nerve, which is a part of the autonomic nervous system. The sympathetic nerve "chain" is made up of a network of nerves that branch off from the spine and form next to the ribs in the chest.
Each sympathetic nerve branch originates from a bundle of cells called a "ganglion." 

Through two small incisions under the armpit (approximately half an inch) a specific ganglion that causes sweating is located and removed. Then the signal which tells the body to sweat in a specific region is "turned off", reducing localized hyperhidrosis. The exact ganglion that is removed depends on the area of excessive sweating that is being treated.

A general anesthetic is administered for the operation. 

When the patient is asleep...

 (looks comfortable enough.....)

....a small opening is created in the upper chest through the ribs. The lung on the side being operated upon is collapsed to give more  r o o m  to work. 

 

Then a camera on the end of a telescope is inserted through the ribs to track and find the nerves which are to be cut & once it has been found, two other holes are made so that the cutting tools can be inserted. 

Once the nerve has been cut and titanium clips are clamped on the severed ends, the tools are removed and the lung is expanded. To ensure that all the air has been removed from the chest cavity, a plastic tube may be left in so that any air trapped in the chest cavity can escape

The operation is then repeated for the nerves on the other side. The surgery amazingly only usually takes about 2 hours! The operation is mostly an overnight operation, and a stay of a few days afterwards is usually ordered.


SIDE EFFECTS

  • The operation can lead to excessive dryness of hands, such that moisturizing cream must be applied to avoid the skin cracking.
  • Compensatory sweating often occurs on other places. This sweating generally occurs on the back, and also can be on the feet and legs. Also there may be sweating on the side of the face when eating. Compensatory sweating tends to occur more frequently with and operation to fix axillary hyperhidrosis.
  • Gustatory sweating may occur, this is the increase of sweating when smelling specific foods which are strong, spice or sour.
  • Neuralgic pain.
  • Drooping of the eyelid due to nerve damage, this usually is temporary. If this occurs then a plastic surgery procedure called a blepharoplasty is required.
  • Ribs may be sore and painful during breath while coughing, this is normally temporary.
  • Artery damage
  • Nerve damage
  • Inability to control body temperature
  • Inability to raise the heart rate and thus work out physically

 

 

MY EXPERIENCE

On July 21st 2006, at 17 years old... I had ETS done.  I stayed in the hospital 3 days. I immediately woke up with soft warm dry hands.....! Recovery was painful as the tissue between my ribs was cut, and I had a lot of burning nerve pain.   

To sum it all up in a few sentences... This procedure CHANGED my life... for the better. Yes.... I have side effects. My left hand sweats more than my right, my right hand gets really dry.  I have burning nerve pain in my back a lot.  I have pretty severe night sweats frequently... 

 yeah... thats my shirt. sometimes I change my shirt 3-4 times a night.



My body temperature can suddenly fluctuate dramatically from cold to hot or hot to cold resulting in suddenly feeling like I'm burning up and thus profusely sweating on my back/stomach/face.  Cardio is hard for me because my heart is working extra hard when pushing myself to such exertions.

BUT...

I wouldn't take the surgery back for a second.  It is a case of.. 45 steps back... 1,000,000 steps forward. Being able to wear normal clothes, feel like a girl... write on a piece of paper without ruining it, shaking a hand... holding a hand, give a hug... open a door, drive a car, wear flip flops-  things you just don't think about and take for granted in a normal life.  I thank God everyday for blessing me with such a successful surgery as I know there are a lot of people that have experienced life changing problems.. for the worse.

 

 

An Unexpected Visitor...

Ironically, after the surgery I hit what I'd say was the darkest part of my life. I was now a senior in High School. I could wear normal clothes! NaMe BrAnDs... I wanted to be PoPuLaR in high school -something I never had experienced. I lost touch with true friends and most importantly.. my true self. I hid my farm-girl video-game playing self. I wanted to be cool and go to parties. I drank. I showed more skin. I pretended to be someone I wasn't. 

 

All of the things I'd consider my "lowest points" were this year period after my surgery.  Luckily that phase didn't last long after graduation and my journey to serve the Lord has recovered and flourished.


 

 

***Disclaimer***

I am not a licensed professional or doctor of any sort and before you proceed with any of these methods of treatment.. do your research and talk to your doctor.  

If you have anymore questions about my surgery, current life, or anything else; feel free to comment or email me!

Cowgirl12685@hotmail.com 

 

 


3 comments:

  1. Had no idea that you had to go through so many painful things. That would have been really scary =[ very powerful. I whine to this day about how unpleasant my first lumbar puncture was...I think you topped me. Competing for most rare diseases and disorders that require painful poking and snipping at the nervous system is what friends do right ;]!

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  2. Thank you for being so open and honest. I never heard or knew anything about that condition before, and its really good to understand it a bit now. I cant even imagine having it... You're so much stronger than I would be!

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  3. Thank you girls! It feels very good to get this all out. One of my "dark" secrets that has crippled me a lot, both before and after surgery; but logically do we have time with every person we encounter in our daily lives to explain all that? ..no :-( lol. Thus.... we must mask it to our best abilities (MS Jess...) and try to be normal! But what is normal? we all have our struggles, physically, mentally, emotionally. We are all living stories. We must strive to be the best version of ourselves for the Lord!

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