Surgical Treatment For Sweaty Palms

We’ve all done it. Just ahead of meeting someone important, we have discreetly 
given our palms a quick “wipe down” on our clothes so that when we present our hand for a handshake, it is not a sweaty testament to our nervousness. 
In that situation, this annoying increase in perspiration is simply our body’s response to stress or excitement. There are a number of people, though, for whom sweaty palms is a constant problem and one that literally stops them from functioning normally. 
Known as palmar hyperhydrosis, this is a condition that is not common, but not rare either, says Dr. Julius Toth, head of thoracic surgery at Southlake Regional Health Centre. 
What few people know is that for those who suffer from it, there is a surgical alternative and costs are covered by OHIP.
For people with palmar hyperhydrosis, the palms of their hands sweat so much they are unable to handle paper, hold a pen or shake hands. While most have difficulty using a computer keyboard, in some extreme cases that function is impossible because the amount of moisture is so great, it shorts out the keyboard.
“Along with the obvious physical difficulties, is an even greater concern for the anxiety and self-esteem issues this condition creates,” says Dr. Toth.
To alleviate the problem, Dr. Toth performs a surgical procedure, known as a sympathectomy. Unless you are part of the medical community, you might question why a thoracic surgeon, a doctor who performs operations on the organs in the chest, performs a procedure to eliminate excessive palm sweating. The answer is that this particular surgery involves portions of the sympathetic nerve chain, located beneath the ribs in the chest.  
The sympathetic nervous system produces signals for the production and expulsion of sweat on the surface of the body. Groups of nerves become active when someone is frightened or stressed. Among the obvious physical reactions are dilated pupils, blood flow restrictions and, of course, sweaty palms. In cases of palmar hyperhydrosis, this system is overactive, even uncontrolled. 
Dr. Toth performs this minimally invasive surgery microtelescopically by making two, and sometimes three incisions, each about the diameter of a chopstick, between ribs on the side of the chest to allow for an imaging device and surgical instruments to be inserted. During the surgery, nerve bundles are divided and those sending signals to produce sweat in the palms are removed. 
There are only a handful of surgeons in Ontario performing this surgery and due to its intricate nature, Dr. Toth believes it should only be performed by a surgeon with a thoracic subspecialty and only on patients at least 17 years of age. 
“Most of the 25 or so patients I perform this surgery on each year are between the ages of 17 and 40,” says Dr. Toth. “These are people who have a significant impact on their social interaction patterns as a result of their hyperhydrosis.” 
As with any major surgery, there are risks. One side effect to this surgery is 60 to 70 per cent of patients will have increased perspiration somewhere else on their body, says 
Dr. Toth. Referred to as compensatory sweating, areas of the body commonly affected include the trunk and groin area. 
“Having this surgery is not something individuals should enter into lightly. They should take the time to research the potential for side effects and have a thorough discussion with their surgeon before making a final decision,” he says. 
One of his patients, who would rather not be named, underwent the surgery last 
summer. She began to see changes in the amount her hands perspired during her teens and by the year before her surgery, she was finding it affected her ability to work or attend 
university. 
“Just about any function I had to do with my hands was severely impacted,” she says. At first she thought this was a side effect of stress and tried to control it but soon realized it was very much out of her control. 
“I realized that when I was totally relaxed, I still had the same problems,” she says. Her family doctor prescribed a special cream, which was ineffective, and ultimately referred her to Dr. Toth. 
A year after the procedure, she remains positive about the treatment. Although she has experienced some additional perspiration, she feels she can deal with that privately, something she could not do with palmar 
hyperhydrosis. 
“My life changed the very next day after surgery,” she says. “It was absolutely worth it.”


source:- yorkregion