palmer hyperhidrosis

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halogen

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I am a ms2 considering general surgery.....but I have severe palmer hyperhidrosis (sweaty palms) that persists throughout the day. No I am not a nervous wreck; I am actually a pretty calm person but its a condition that exists in 1% of the population.

Does anyone know of any surgery residents or practicing surgeons that have sweaty palms? If so, what do they do to control it?

Thanks
 
There's a great new procedure, usually done by neurosurgeons I believe, that cuts a sympathetic chain nerve to decrease hyperhydrosis, although the procedure is usually done for people who have this all over their body. Supposedly it's a wonderful thing.

Oh yeah, and it can be done laproscopically, with 2 or 3 ports, and takes very little time to do, and to recover.
 
Don't know any surgeons with it, but have known others that have been cured by sympathectomy...oh and by the way, it's 'palmar' hyperhidrosis (or hyperhydrosis...I've seen it both ways).

link
 
Botox is the new thing for this & prob the least morbid although you have to repeat it 1-2x a year. Might be covered by insurance though
 
To avoid the knife, consider cutting out the caffeine (if its staple for you as it is for many of us) and consider topical anticholinergic agents or even systemic agents. Of course, with systemic agents, you are also subject to symptoms like xerostomia, midriasis, sedation, etc.
 
I don't know any surgeons with the problem, but I do knnow a few who operate on it. Usually done by thoracic surgeons or general surgeons, the procedure is a thoracoscopic sympathectomy. It's generally done as an outpatient (i.e. you go home the same day). If you look on any old internet search engine by cross referencing "hyperhidrosis" and the city of your choice, you will probably find people advertising the procedure if you are in a city of any moderate to large size. I've done about 10 of them as a resident, with patients reporting excellent results.
Generally not covered by most insurance carriers, but if you can make it out that the problem is interfering with your ability to do your job, most will end up paying.

good luck, and don't let the sweaty palms deter you from the career of your choice...

pete
 
I have tried a beta blocker (low dose- 20 mg) and Drysol (topical antiperspirant) to no avail. I guess the next step is to look into the thoracoscopic sympathectomy.

PJR: Have your patients experienced any post surgical complications or side effects such as droopy eyelids, or lack of facial sweating (similiar to Horners syndrome)?

Thanks for your poignant posts folks.
 
nope, no horner's. however, i haven't seen any of them far enough out to find out if they had a recrudescene of their symptoms, but the attending that i did the cases with (just saw him today) said that none of his patients have had recurrent problems over the last five years.

pete
 
Halogen,

I would look into the BOTOX thing if it were me before letting somebody put me under one-lung general anesthesia & started gigging about with an electrocautery in my chest
 
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