ETS surgery why can't they get it right?

[surfsider]

So probably all of you are aware of ETS and it's use for supposedly curing hyperhidrosis and facial blushing. From all of my research it seems that ETS should ONLY be performed on people with palmar hyperhidrosis or palmar and another form and not really for facial blushing.

I'm also wondering why soooo many different surgeon's have different techniques, some only cut or clamp the T2 for palmar some T3 alone some says T4 alone and some do a inbetween the ganglia T3-T4 or T2-T3. I think that to say that a specific T nerve controls a specific area of sweating like the palms or the head or the armpits is inaccurate. I believe that the truth is , that no matter what T level you cut or clamp you're going to be dry from the hands and from the nipple line up for the most part. Do you all agree. I think that these surgeons are just trying to say they've figured out a way to lessen compensatory sweating or other side effects by advertising a certain method. For example, I thought T3 is the safest method for curing hand sweating without too much compensatory sweating, but I've talked to someone who had T3 cut for palmar hyperhidrosis and he's experiencing grave side effects. I think the truth is these surgeon's are still experimenting trying to see what effect will take place when they intervene or clamp or cut a certain T nerve.

And also to say that the clamping method is reversible is a load of crap in my opinion, yes there is a chance your nerve can regenerate somewhat if you get it out in time but hellooo in order for the operation to be successful you have to destroy the nerve or the pathway from the brain to the nerve to the sweat glands. Right? They need to get this figured out, I'm tired of thinking of ETS as a solution and hearing how for one person it can change their life and another person ruin it. It doesn't make sense.

 

[iDShaDoW]

Well, it's pretty understandable that they're doing this and learning as they go along. Think about public awareness of what hyperhidrosis is. Most people think you're just gross or nervous and sweating up a storm.

I doubt anyone here on the forum is a neurosurgeon so no one's really qualified to say which T nerve affects what in the human body.

I'm sure plenty of the doctors claim they have a technique that the other doctors don't. It gives them more credibility, they can claim credit for pioneering a new method. There are plenty of doctors out there trying to make as much money as they can, and there are just as many that really want to do good in this world and help others out.

All you can do is deal with it as best you can til there is some sort of truly effective method discovered. Many people here have stated time and again that you should only consider ETS after you've exhausted all other courses of action. And even then some people would rather just realize there's not much they can do and not even think about ETS for a minute.

 

[surfsider]

Yea, i don't even think they should be doing this surgery when it seems that it's ruining more people's lives than it's helping. It was banned in Sweden where it originated which should tell us something. But it does seem to help people out with severe enough symptoms who can deal with the side effects. I'm not so much scared of the physical side effects like the CS but it's the mental side effects which scare me most. I've heard some people say they don't feel strong emotion after ETS anymore and don't appreciate things like music the same and feel like walking zombies. So it appears that ETS is a psycho surgery that eliminates sweating from the nipple line up in most cases. It just frustrates me that it's so heavily advertised as a cure for hyperhidrosis when it really isn't, it's more of just a trade-off. I think in the future theyll have improved methods for controlling HH that don't have anything to do with destroying part of your nervous system. Ive heard of Botox solutions put into iontophoresis units for example which is probably really effective. It's also hard to say if one requires surgery when HH is very subjective, for one person they might not even notice or care about a lil excessive sweating and for another it can mentally take a toll on them. I think the best thing to do is stay positive and try other solutions as a means of controlling it until they find something better with more of a 100% satisfaction rate rather than a 50% or less satisfaction rate with ETS

 

[klamm76]

Becuse they dont have a clue about the nervous system.!

They just are surgeons whit scalpels,the even call it the sweating nerve....Cutting T1,T2,T3,T4 etc its not just the sweating nerve.It has a huge impact in other functions in your body too.Another thing,we HAVE to sweat!!!!!!!!!!!!!!!

 

[surfsider]

Yes I agree, so why don't they Ban this surgery in the U.S. like it was banned in Sweden and other places?? Some are even trying to change the wording of ETS by calling it a Sympathotomy instead of a sympathectomy which they say is the removal of the sypathetic chain. I think it's ridiculous that they advertise this surgery so much. And I don't understand how thy can get all these positive testimonials from patients on their websites when it doesn't seem to be helping that many people.

 

[iDShaDoW]

Unfortunately things have to be learned somehow and I don't think they could do these kinds of things on other animals and see how it effects them.

How do you think they figure out what prescription meds do? They experiment on people and see how it effects them.

Maybe someday the US will stop being stupid and allow more research to be done on stem cells that might allow one to regrow the nerves that were clipped.

This in turn will allow different things to be tried on Hyperhidrosis sufferers without the permanent negative sides effects that may occur.

 

[klamm76]

Another thing is that someone will take their own life if they don`t get rid of hand,feet,face etc sweating.

So as a LAAAAAAAAAAAAAAAAAAAAAST solution maybe some people have got a better life after this ETS shit....But there is hard evidence that a lot of people get it much worse....So who is strongest in their mind...people even take suicide because they loose their girlfriend,even if they have a perfeckt body/system

Conclution....I dont actually know,,,some get it better whit this trade of (move one problem to another place on the body).In the same time its like Pinker says: if people continue to take ETS operation they wont stop doing it.
So if everybody say fuck of to the ETS surgeons ,they have to find another solution to figth Hyperhidrosis...But I say one thing,that wont be the surgeons,because like I said before THEY DONT HAVE A CLUE ABOUT THE NERVOUS SYSTEM.

So then maybe biologist,meds,nervrolog or some of those people have to try something that works to cure HH,because we will still suffer and complain about this....They cant just ignore us!!

TNX

 

[klamm76]

YE its just like that.

But if you want to discuss ETS go to
http://etsandreversals.yuku.com/

But ill think Ill remember seeing your name in there already,,,soo?

Its like no good answer to anything,I whish it was for all of us,but there isnt.

Point is; ETS is a gamble,,are you ready to gamble whit your life or/and future.?

When it comes to Hyperhidrosis you hope and hope for something god to hear,,but it feels like everything that is being said isnt what you like to hear,,,but still this is the hard fact about HH.

Sad but true!!

Only the future thats count,no one can predict that.So as still we not are dead ,there is hope in the future.

In the mean time we have to cope whit this shit,and do the best,be as positive as we can.

TNX

 

[surfsider]

Yea from a common sense perspective, it doesn't make much sense to cut or destroy part of your nervous system to solve a problem. I mean what one person considers severe hyperhidrosis another might consider near normal or only mild it all depends on the person and how they feel it affects them. I mean HH had to be around back in the 1800's and before that time and what did people do about it then. ....NOTHING. they probably just accepted it and had no idea that they had this disorder if we can call it a disorder, personally i just think it's hereditary and some people sweat more than others in different places. These doctors try to make it seem like its a disease that can only be cured through ETS surgery. I can understand the distress it causes but I mean unless your hands literally drip with sweat throughout the day then I wouldn't say this is severe. When I went to a doctor who performs ETS he told me that I had a 6 or 7 on a 1-10 scale of sweating. He made me hold my hands together for 15 minutes and then added lotion to them to provoke more sweating, he then took a picture to show the insurance companies in case they asked. He told me that I would get compensatory sweating and that you'd have to risk having a dripping sweaty back or other areas for dry hands etc. This surgery is just re-routing the sweating, we as humans are suppose to sweat so it isn't natural to stop sweating completely in multiple areas because we're suppose to sweat to a certain extent to get rid of heat. That's why I think everyone should spend time trying to control their HH through iontophoresis or antipersperants because ETS is essentially permanent. These surgeon's should make sure their patients no about allll the alternative treatments. They shouldn't be experimenting on patients to see what results are produced. It isn't right.

 

[klamm76]

He yea what is right or not I dont know.I DONT think all these ETS surgeons are evil,but they make big money on it.And they can not repair things if its going wrong for the patient.As in many other operations.

But those surgeons who hide the side-effects an lie about the % on how many get cs etc,and someone just suffer from eks, mild armpitsweating or mild blushing.Cut their nervous system and take NO responsebilety after...Those people Ill consider as greedy and evil motherfxxxxxasfgasgas.

But when ETS started in sweden it was just a "axident/conviniense (sorry my english. Because this operation was for heart patients and some of those heartpatients had a blushing or sweating problem,and that was gone as a positive side-effect back then.15-20 years ago.Then it was halleluja we have foud a cure for this problem to.But after a while there was comming more and more horror stories about the terribale side-effects as the years went by.Now it is forbidden to do ETS in Sweden.


Same whit iontoforese,that device was originale made for the purpose to get some kind of drugs into the bodysystem in the hands (dont remember for what).But same story here some of this people to got rid of hand sweating or got rid of 80%90%.So then its was used against HH.

But at least ionto havent made some serius side-effects that we know of til now.(some get red skin,cuts etc) ,but you can stop the treatment when you want to,there is a way back,if you know what I mean.This design was also used for about 15-20 years ago.

Since then they havent come up whit something else in this 15-20 years..Why??

Because they think ETS is the solution/cure...NO,and ionto is to time consuming and it does not work as a 100% cure for this.

They just dont know what to do,because they have this different options and dont do any special sience to cure HH because of this.Offcourse you have meds and many different antiperspirants,botox,but they doesnt work properly either.

I think HH IS a disease,because we dont sweat normal.But i think its a biologic problem,and underlying cause to this.

All we have today,meds,antiperspirants,ionto,botox etc it just cover sweating in different ways and strengt from human to human.There is NO permanent cure for this that I have come over. Accept ETS then,,,hehhe.But REALLY man ETS is not the answer to this (hh/blushing) problem.There are tooooo many stories out there that ETS has destroyed their life.Goes from bad to worse.

So for me 15-20 years there have not been any progress for us HH sufferes,why.They dont take it serius,no real sience.Just look at it like a cosmetic problem or something like that,I dont know?

Tired of saying this same words,but that is how it is for me anyway.

TNX

 

[Alvinsduckie]

one neurologists opinion...(reprinted with permission)


http://www.rsdrx.com/sympathectomy_failure.htm

1. Sympathectomy is analogous to the act of killing the messenger. The sympathetic nervous system has the critical job of properly controlling and preserving the circulation in different parts of the body, especially in the extremities. By paralyzing the system, the extremity will be more apt to have disturbance of circulation and is left unprotected from fluctuation in circulation.

Sympathectomy is similar to permanently removing the central heat and air-conditioning system and never replacing it because of malfunction.

Sympathectomy permanently damages the temperature regulatory system. The reason sympathectomy does not cause side effects other than ineffective control of pain as well as impotence and orthostatic hypotension is because it is invariably partial and incomplete.
2. Even after "complete" removal of the sympathetic plexus for the upper or lower extremities, the sympathetic nerves in the wall of the blood vessels are left intact.
3. As shown in Table 6, the most common form (over 80%) of RSD is disuse RSD. In this situation, the sympathetic system is temporarily hyperactive. Proper conservative treatment would prevent any unnecessary invasive surgery (such as sympathectomy) in such patients.
4. Usually the patients that end up needing sympathectomy are the ones who suffer from ephaptic dystrophy. Sympathectomy in such cases cause a classic Cannon phenomenon. This physiological phenomenon refers to the fact that the end organ that is controlled by sympathetic nerve fibers will become uninhibited in its chemical dysfunction. As a result, even though the sympathetic fibers are not contributing to acetylcholine or become uninhibited with resultant increase of pain input.

In diabetic neuropathy RSD, sympathectomy dramatically relieves the pain for the first 1 to 3 years. Then deafferentation can Cannon phenomenon set in. As a result, invariably by the second to fifth year the patient ends up with a lot more pain. Sympathetic blocks repeated every 6 to 12 months yield similar results.

In patients who have had sympathectomy, thermography shows an increase of temperature in the focus of ephaptic nerve damage (Cannon phenomenon) with secondary increase of pain and discomfort.
5. There is a significant overlap in the border areas of sympathetic nerve dermatomes. As a result, the adjacent intact sympathetic nerves try to overcome the lack of sympathetic input. This contributes to the failure of long-term effects of sympathectomy.
6. Whereas the neiospinothalamic tract is quite consistent in its anatomical pattern, the sympathetic nerves and plexi are phylogenetically old, and show a marked individual variability in humans. This causes a problem at the time of surgery and results in the gray rami branching off and entering in a few adjacent areas of the sympathetic paravertebral chain. As a result, the removal of part of this chain does not guarantee a "complete" sympathectomy.
7. The sympathetic nervous system functions symmetrically and bilaterally. So the removal of a portion of this system on one side does not achieve a "total sympathectomy.
8. At times when patients undergo lumbar sympathectomy, we have noted that they may develop Horner's syndrome on the same side or marked vasoconstriction of the hand on the same side, reflecting the complex and primitive connections of the sympathetic nervous system. Cooper has shown vasoconstriction in the hand during electrical stimulation of the lumbar sympathetic chain. We have noted development of de novo RSD in the ipsilateral hand in two patients after lumbar sympathetic block.
9. Repeated sympathectomies are no guarantee of success.
10. Another side effect of sympathectomy is that the patient loses motivation for physiotherapy and exercise. Because sympathectomy results in immediate relief in the first few months, the patient has less inclination or motivation to exercise and help improve the circulation of the extremity.
11. Even in the cases of rare and severe major causalgias, it makes more sense to resort to a morphine pump than to sympathectomy.

The application of sympathectomy in management of RSD should be strongly discouraged.

If the patient suffering from RSD has a short life expectancy (less than 5 years), then sympathectomy makes sense and should be done.


Sympathetic nervous system is bilaterally and symmetrically innervated. Unilateral sympathectomy cannot be complete.
Bilateral sympathectomy has too many side effects (e.g., hypotension, impotence).
SNS is anatomically primitive and structurally inconsistent. Amoebic-type connections of the ganglia makes "total sympathectomy" impossible.
Overlapping SNS thermatomal innervation results in postsympathectomy regeneration.
Cannon's phenomenon (topical noradrenergic autonomy) at the area of ephapse perpetuates the postsympathectomy pain.
Spread of RSD to adjacent structures results in new manifestations of RSD in remote areas, e.g., Horner's syndrome or de novo RSD of hand after lumbar sympathectomy.
The permanent destruction of thermoregulatory function of SNS causes latent complications, e.g., RSD in contralateral extremity.
War and peace RSD and war and peace medical(e.g., dibenzyline treatment results in Lebanese war) and surgical results are not identical and comparable.
The war casualties are more likely to be stress-induced analgesia (SIA) than peacetime trauma (e.g., a work injury is more likely to be stress-induced pain- SIP - because of legal complications). SIA pain responds better to treatment.
Repeated sympathectomies are invariably doomed to fail.