Sometime in late 1997, I started using the Internet regularly, and one of the first things I did a lot of research on was hyperhidrosis (more specifically, excessive hand sweating). I was quite amazed to learn that there was a simple surgical solution to my problem of excessively sweaty hands in the form of endoscopic thoracic sympathectomy (ETS). I also felt better knowing that my problem was due to a sympathetic nervous system disorder, rather than due to any medical condition or some kind of nervousness or heat sensitivity disorder. At the time, not too may surgeons were offering ETS surgery. Nevertheless, the top few search results for "hyperhidrosis" on altavista in 1998 were all related to ETS surgery, and were dominated by a website/group called surgicalteam.com.
Unlike today, there were no well known anti-ETS websites on the internet at that time, since ETS had only become a popular option to cure hyperhidrosis recently. There were as yet not a significant number of people who had adverse side effects from ETS and who also had an organized internet presence. The most popular hyperhidrosis related website in 1998 was USA-based surgicalteam.com, which promoted ETS surgery trips to Sweden with the renowned and pioneering team of Dr. Goran Claes and Dr. Christopher Drott, which invented the endoscopic approach to sympathectomy. Surgicalteam has since expanded significantly and now offers ETS with surgeons around the world. The company also started offering weight reduction surgeries in the early years of the new century, and seems to have purchased the hyperhidrosis.com domain name. Hundreds of surgeons around the world now offer ETS surgery, and click here to see ETS surgeon rankings.
Prior to 1998, I had only tried a cream and a lotion to treat my severely sweaty palms when in my mid-teens, to no avail. I wanted to get rid of this problem in so that I could shake hands and write without smudging everything. So, in the spring of 1998, when I was 19 years old, I booked my ETS surgery via surgicalteam.com after calling several of their happy ex-clients listed in a brochure they sent me. These clients all seemed happy with their results. The cost of the surgery was $6,000, and I paid out of pocket since my college health insurance refused to reimburse me and I didn't know that you could appeal that decision at the time. Today, most insurance companies will pay for virtually all hyperhidrosis treatments, including ETS surgery and iontophoresis. Ruth Matti was the main contact person at surgicalteam at the time, and neither she nor my soon to be surgeon Dr. Claes discussed iontophoresis or other alternate treatments with me. In fact, I never talked to Dr. Claes till reaching Sweden for the surgery! At the age of 19, I was, not surprisingly, a bit rash in my decision making. Even today, most surgeons will not tell you or force you to try iontophoresis before contemplating surgery.
So in July 1998, I flew to Gothenburg, Sweden for my ETS surgery with Dr. Goran Claes. Upon arriving in Gothenburg, I got picked up and dropped off to a hotel. In the evening, I had to find my way to the Carlanderska hospital in order to meet Dr. Claes. Carlanderska is quite a secluded hospital, and it took me some time to find the correct entrance with an intercom, via which I had to convince some Swedish person why I should be let in! Not a great start.
At the hospital, I was examined by several serious nurses and also got to meet a number of patients. At least half the patients were from Scandinavian countries and were there to get rid of facial blushing. Several were there for a re-operation, since their first ETS did not remove their blushing permanently. Only one other patient named Joel was from the US, and he came with his mother. I was glad to meet someone else who could speak English well. Joel and his mother bought me dinner and while eating with them, I learned that Joel played some kind of instrument, but this task was made quite difficult by him having dripping hands half the time.
At night, Dr. Claes came by and met each patient individually. He was a very genial man and put me at ease despite his English not being great. He asked me a few questions about what sweating I wanted to get rid off (I responded that I wanted to get rid of my hand sweating, while facial sweating did not bother me too much). He said that with the surgery, both hand and face sweating would definitely stop, and feet sweating might stop too, but no guarantees. Later I learned that he cauterized my second (T-2) thoracic ganglion. Dr. Claes discussed the main side effect of compensatory sweating with me, and also mentioned the very small chance of other problems such as Horner's Syndrome and possible complications during surgery.
The next day, I had my ETS surgery, probably some time in the morning. I was put under general anaesthesia, so I do not remember the exact timing of the event. It was the first time I was ever "knocked out" in my life. After waking up, I do remember a very significant pain under my chest area, along with dry hands! I was ecstatic to finally have dry hands. Later the same day, we were allowed to go to a sauna in the hospital and I went with Joel, who also seemed to have had a successful surgery. I do not think we even stayed in the hospital that night, but maybe I am wrong. I think I stayed at my hotel that night, and left Sweden the next day. Dr. Claes did meet me once more after the surgery, and several years later, sent me surgery documents I requested. All in all, the surgery was relatively easy compared to what I had been expecting. The pain in the chest area must been tolerable the next day in order for me to fly out of Sweden.
In the days and months after surgery, my hands remained completely dry and I was very pleased with the surgery results. As an added benefit, my facial sweating also disappeared and my resting heart rate supposedly decreased slightly according to the surgery records. Several days after the surgery, I noticed that my feet sweating had returned. Months later, I was sure that the feet sweating had actually worsened. It seems like instead of getting compensatory sweating in my trunk or other body areas, my feet sweating worsened. This was the worst side effect I got from surgery. In the short term, I would say that my satisfaction rate from the surgery was an 8 on a 1 to 10 scale (with 10 being the highest).
About two years post surgery, I started getting some sweat return to my right hand. This was nowhere near as significant or frequent as prior to surgery. To this day, while my left hand is dryer than a normal hand and sometimes even has white areas on it due to excessive dryness, the right hand never gets this whiteness. Sweating on the right hand can be significant if I exert myself excessively, or sometimes when I am drinking coffee/caffeine and in stress. Most of the time, the right hand is completely dry. Interestingly enough, Joel also had his right hand sweat again, and he went back to Sweden for a re-operation. I kept in touch with Joel for a few years, but have since lost contact.
Another side effect I got that seemed to worsen several years post ETS was gustatory sweating. This is sweating when eating spicy foods, and on rare occasions, even when smelling spicy foods. It is strange that by having my T-2 ganglion cauterized, I can no longer sweat from the face or forehead or scalp. However, eating spicy foods (which I prefer) does cause my forehead to sweat, and this is a documented potential side effect of ETS surgery.
The last side effect that I noticed several years after ETS surgery was Raynaud's syndrome, or excessively cold hands. Some people see cold hands become warmer after ETS surgery, but I got the opposite reaction. However, this problem seems to have subsided considerably in recent years, and I think I get cold hands only when stressed, and particularly when stressed while the weather is cold outside. According to an e-mail to me from Dr. Goran Claes, this severely cold hands side effect happened in two percent of their patients due to "increased sensitivity to surrounding catecholamines".
In the long-term, I would say that my satisfaction with ETS surgery is a 7 on a 1 to 10 scale (with 10 being the highest).