Glycopyrrolate cream - is it worth asking for?

[dezza]

A few months ago, I had iontophoresis with glyco solution treatment for my hand and feet hyperhidrosis, which almost made me completely sweat free.

Since the treatment was discontinued (the hospital were only able to offer it for two months), I have been using my own iontophoresis machine with tap water, and, with regards to the sweating, I'm back at square one. The sweating is as bad as it used to be before having the glyco treatment.

I've come across a couple of forums (including this one), that glycopyrrolate cream is available, and that some people have found this to work well.

I have a follow up appointment at the hospital next week, and would possibly like to suggest trying this, although I understand it can be difficult to have this prescribed.

If possible, I would like to take some details on the cream to my appointment, to help me suggest this treatment.

If anyone may have any details about the cream, and how to get it, it would be much appreciated if it could be posted on here, so that I can print off this thread and take it along.

I've pretty much exhausted all other treatments (apart from ETS, which I wouldn't really like to do), and as the glyco worked well in the iontophoresis, it seems like a good idea to try the cream.

Thanks in advance

 

[dezza]

Thanks for that Pinker.

Please let me know how the GP appointment goes.

 

[Jezza]

That cream sounds more promising than a lot of other things I've read about.

I sincerely hope your GP will be cooperative.

I'm ready to try some medications as well, since my quest to finally get the palmoplantar botox injections that my insurance effectively covers (when performed in hospital, not private clinic) keeps on getting crushed by the evil powers at hospitals that just refuse to do the treatment because they feel they lack the experience (in reality, it's just inconvenient to give this treatment for them)

In fact I had a good conversation a couple of weeks ago with yet another dermatologist at yet another hospital;

D: Yeah, so you tried all the first line treatments, oh you already tried ionto and botox injection work for your hands, and now your looking for a hospital who can give you the treatment for hands and feet. Yeah, I used to work in a smaller hospital and on occassion we did the treatment there, but I don't think we do it here, but I can check and call you back in several weeks. I don't know if the other hospital does it anymore either so...You see, I don't know if our dermatology department can get the operating room for this (nerve-block)...

I: Ok, so alternatively, could you tell me which other hospital could do this treatment (they don't mind --> welfare state --> public care --> private not so much) in case it couldn't be done here.

D: Well, no...but you know what else you could do against the HH, we usually do this in our hospital...

I: Euhm...take medications?

D: No, no, that has way too much side-effects, no we use a procedure called ETS...( 8O -Sound of jaw crashing through vinyl floor-)

I: Well I heard about that, but I've read it has a lot of negative effects as well, and in fact it is banned as a procedure in the country it originated in.

D: Oh really? Well, I think we had pretty good experiences with it, maybe you should make an appointment with one of our surgeons...

I: I was there the previous time I was here at the hospital, since they made the appointment there, and I told them it wasn't an option for me...

*Sigh*

I'll be getting the call back Wednesday...

 

[dezza]

I was told that botox couldn't be used on the hands and feet, as it's not licensed in the UK, and that it would be too painful to use on these.

It's just a shame that there seem to be so many treatments available, but only a few that can be used - doctors will only go through the process of aluminium chloride - iontophoresis - ETS, or so I've experienced.

Good luck with the phone call Jezza, hope it's good news. IT would be good to hear of anything new on here.
Is your GP actually aware of this cream, Pinker? I thought most weren't trained in this type of thing, and most I know won't even consider the possibility of prescribing something like that?

 

[Jezza]

I was told that botox couldn't be used on the hands and feet, as it's not licensed in the UK, and that it would be too painful to use on these.

Well, initially this was the case, but now, most hospitals/ medical professionals either use that reasoning as an excuse not to have to do it or simply don't know that this isn't true anymore. I've had the following experience:

Btw, I'm Dutch, so I guess I encounter more or less the same problems as you do with public care. First the government let's us pay tons of money for whatever they want so we have health care for all, than you need the care but you don't get it and you have no money left to pay for it privately yourself.

Damn I hate communism...Anyway...

I have had injections to my palms two times now. First time was in a hospital, they didn't do the procedure for palms normally (only very occasionally), but I came there from the start saying I had already tried all the first line treatments (strong anti-perspirants etc), that that didn't work and that I wanted to try botox injections (my GP had apparently been reading up on HH after I had been there years before when he said there was no real treatment, and sent me to the hospital with an indication for botox injections, really surprisingly and refreshingly cooperative...)

After I had been in the hospital several times and over several months followed their protocol, once again with antiperspirants, ionto etc...it was clear for them as well that didn't work and they couldn't not give me the injections.

However, they used EMLA cream as an anaesthetic, and they might as well hadn't used it, since this doesn't work at the level they do the injections. It was mad pain, really more than anything I could imagine, but I figured hell, it is supposed to be like this and after this I have dry hands for several months, so I stuck through it for 10 injections right and 9 left. Unfortunately, the fingers would be even more painful, and they refused to treat them. To be honest I don't think I could have handled that anyway.

But now the good part...

Although that treatment was very painful, the pain was gone quite fast, and the places they treated remained absolutely dry. This encouraged me to look further into it, and I learned that with a proper anaesthetic and when fingers were treated as well it might be a good treatment without side effetcs. So I tried to find a hospital who did this...so far without succes though, I found one hospital who did the treatment, but they wouldn't take anymore patients, since mostly insurance doesn't cover it and the hospital pays for it with their own funds. Ironically my insurance would cover it but bureaucracy rules supreme in The Netherlands. The neurologist who treated the patients however (and a specialist in the field of HH) did treat more patients in his private clinic and I decided, although I didn't like to pay E900 for something I think I should get from our "welfare state" to have my hands treated there.

I got a letter saying there would be anaesthetic injected in my wrist, but when I got there, the guy said he would use icecubes. With the previous treatment in mind initially I thought WHAT!?! but then I thought ah well let's try it, and

IT WAS NEARLY PAINLESS...only the injections in the fingertips were a little bit uncomfortable, but nothing near the unbearable experience with the EMLA. The result is good as well, the sides of my fingers still sweat a little (it could be better with two injections next to each other in the fingers), but at least I can give people hands now without too much discomfort and in not too stressful situations hold up my hands to receive something without people getting scared. And another benefit is that you bleed less because the cold makes sure there is less blood in the hands.

I couldn't believe it...just icecubes and botox...The hospitals have water, botox and freezers...they could help easily...shame that they just refuse to.

For some more info on this method you can see some videos on the International Hyperhidrosis Society (www.sweathelp.org) the link to the videos is http://www.sweathelp.org/English/Physician.asp (just click on the one you want to see --> hands or feet)

Alternatively they can also use a nerve block, this shuts out the pain alltogether but it is a (minor) operation and therefore somewhat risky and IMHO unnecessary, but I think hospitals rather do the nerve block than the icecubes...

I'll start a small topic about the icecubes...

 

[dezza]

Unfortunately in the UK, hospitals are reluctant to try anything new, or anything that they 'don't usually do'. They just use the same procedures, which sometimes have poor results.
It's a shame that Drs don't understand the condition - but I guess as they don't feel what we feel, it might be difficult for them to really understand how annoying the condition is!
I do find it amazing that botox is possible in a private hospital, but yet many NHS hospitals say that it is impossible to do... Guess it's just standard procedure.
Pinker, regarding your suggestion about taking the phone number along, that's exactly what I'm going to do. I've printed off your thread, and will take it with me to my derm. appointment next week. Hopefully they'll be willing to help out.

 

[dezza]

I had my hospital appointment and as they had never heard of it, they were unwilling to prescribe the cream, or even look it up

I have an appointment next week with one of my regular GPs, who know that I've been seeking treatments for years, so hopefully she'll be willing to consider helping me out with this.