Surgery can help stop excessive hand sweating
Published Tuesday December 1st, 2009
Procedure involves cutting a branch of the sympathetic nerve that controls sweat glands
Mandie Harris, 20, a college art student, couldn't work successfully with charcoal or watercolours because the heavy sweat off her hands smudged her art.
The same problem had made her reluctant to hold hands with her high school boyfriend.
Contractor Don Shoemaker, 35, can commiserate. He was so reluctant to greet guests with an overly sweaty handshake that he didn't want to have a wedding. Somehow he got through it.
They suffered from hyperhidrosis, which brings with it excessive sweating, usually from the palms, feet, armpits and/or the head and face.
Before having surgery to treat their conditions, both tried all sorts of palliatives and cures to no avail. They visited doctors, both family physicians and dermatologists. Each tried a product called Drysol, and Harris used special antiperspirants that made her break out in rashes. Shoemaker used skin-drying lime from concrete and he bought an electric machine that shocked the hands.
In what he considered a last-ditch attempt to dry out his palms, he tried Botox.
"That was really painful. That's all I can tell you," he said, adding that the doctor put anywhere from 25 to 35 needles in one hand. "It slowed (the sweating) down maybe by 25 per cent."
He passed on having his other hand done.
But the sweaty palm problems went away for both after they underwent a fairly simple surgery called endoscopic thoracic sympathectomy. It involves cutting a little branch of the sympathetic nerve that controls the sweat glands. Which branch is cut depends on which body part the patient wants to stay dry.
Thoracic surgeon Manisha Shende did the surgery on both Harris and Shoemaker. An assistant professor of surgery in the Heart, Lung & Esophageal Institute of the University of Pittsburgh Medical Center, Shende estimated she handles 90 per cent of such surgeries in the area.
"In the last year and a half, I've done about 70," she said. "This is without advertising. People talk."
No wonder. The surgeon said between 2-1/2 per cent and three per cent of the population has the condition.
Shende learned the procedure while training as a thoracic surgeon at the Mayo Clinic in Minnesota. She then moved for three years to New Jersey, where she began developing her reputation for the procedure.
"I love doing these," she said. "They are the most grateful patients I have. It changes their lives."
The patient is put under general anesthesia with arms outstretched to afford the surgeon access to the designated branch of the sympathetic nerve and to keep the patient still. The entire procedure takes 15 minutes, Shende said.
She makes two incisions of 3 millimetres to 5 millimetres under each arm to reach the targeted branch of the nerve.
"They're very well hidden," she added. "There are no stitches, no dressings. They go home that day. They can go back to work in a day or two; students can return to school the next day."
Shende said the biggest potential side effect is compensatory sweating (excessive sweating on the back, chest, abdomen, legs, face, buttocks or feet), usually during mild exercise. "A higher heart rate may happen (but) it is extremely mild and it goes away. Compensatory sweating also levels off."
Reached at Indiana University of Pennsylvania, Harris said she's not troubled by side effects. "The sweat has to come out somewhere. It comes out on the torso like every other person...
"I hardly think about it anymore. It's like I never had a problem with it. It's definitely helped me with my art classes as well. I can draw and not worry about my fingers smudging the work."
Shoemaker now sweats more from his back than he did before his surgery, but he considers it a small price to pay.
"I'm so happy," he said. "It could make you cry talking about it."
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