HYPERHIDROSIS

What doctor would not recommend immediate treatment for a patient with a highly visible physical and emotional disorder? What if the patient experienced lifelong side affects so disabling he or she often feared human contact and intimacy? What if the physical symptoms were severe enough to limit the patient's career choice, personal dreams and professional goals? Don't look now, but over 2-1/2 million people suffer from this disorder and you could be one of them. Its clinical name is Hyperhidrosis, but you might know it as excessive sweating of the armpits, head, feet and/or hands.

Perspiration is the body's natural cooling mechanism, but when that mechanism malfunctions, the Sympathetic Nervous System, which mans the mechanism's controls, can cause extreme sweating known as Hyperhidrosis. There is no physical pain, disfigurement or threat of early demise associated with Hyperhidrosis, and to my knowledge it hasn't inspired trendy celebrity fundraisers; however, its emotional scars run deep. Instead of threatening one's lifespan, it threatens to curtail the quality of one's life.

Most people who suffer from Hyperhidrosis are excellent candidates for a surgical procedure that delivers an extremely high and permanent cure rate, the exceptions being those who have complicating factors such as severe lung or heart illness, pleural disease, untreated thyroid diseases or have had prior chest surgery. The procedure, known as Endoscopic Thoracic Sympathectomy, requires only a few tiny incisions under the armpits and takes just an hour or two to perform. Before long, patients are back to their normal daily activities, minus the excessive sweat. Dryness, something most of us take for granted, is anything but normal for the sufferers of Hyperhidrosis. Another plus is that, since it is considered to be a medically necessary surgery, most insurance companies cover the procedure.

So, what's the problem then? Since there is a cure available with minimally invasive surgery and short recovery time with few after-effects, why aren't doctors informing their patients? In truth, some think the clammy hands and excessive sweat are a result of the patient's nerves upon having to make an office visit. The problem is, they don't question their patients to discover the extent of the condition. If patients were experiencing high blood pressure in the doctor's office, they would question that symptom, wouldn't they? If patients were suffering dizziness or hives, they would question those symptoms, too. Couldn't those conditions also be temporary as a result of a patient's nervousness while visiting the doctor's office? So, why are patients who suffer Hyperhidrosis not questioned? Perhaps it's because the doctor is unfamiliar with the disease, its available treatment or maybe the doctor simply makes the judgment that it's not worth looking into.

Like many clinicians, you may be saying, "Come on! All this to-do over a little bit of sweat?" People who suffer this disorder certainly don't consider it to be no big interruption in their lives. So much so, that they refused to be put off by suggested surgery. Of course, the surgery actually has quite minimal side effects and a 95 percent or better chance for a permanent cure. Okay, so what's the big deal? Why don't they just go have the surgery and be done with it? Here's the rub: most patients are too ill-informed or downright embarrassed to mention their concerns to their family doctor, so the ailment persists throughout their entire lives. Let us share with you some of the comments from those who suffered from Hyperhidrosis before they elected to undergo surgery. These are the stories of two people whose lives were changed forever after seeking treatment with Dr. Curtis A. Dickman, Neurological Surgeon at Barrow Neurosurgical Institute in Phoenix, Arizona.

The first was a young woman whose true personality was so suppressed as a child that few but her family and closest circle of friends knew her zeal for life and desire for the company of others. It's difficult to believe that the exceptionally beautiful woman who shared her story with us was the lonely, isolated, introverted child revealed to you in the following story. Today her easy grin and snapping eyes are quick to capture your attention. However, after hearing her story, I'd dare say this wasn't always the case.

Unbeknownst to Kara, she suffered from Hyperhidrosis. Although Kara could not put a name to her condition, she had always felt different from the other kids. As early as primary school, she remembers the wrinkled faces of disgust and whispered jeers as her little friends would shake off the drops of perspiration after coming into contact with her. Kara's mother can recall that schoolwork was almost as difficult as school play. In an attempt to make Kara's condition a little less troublesome, her mother would try to find lined paper that wouldn't run when Kara slid her little hands across its surface as she practiced her letters. However, both soon discovered that the only solution was for Kara to keep a cloth or folded paper towel under her hand while writing her school papers.

That "one-step-out" feeling plagued Kara throughout her adolescence; it wasn't until she met a few trusted friends at church that she allowed herself to confide her fears and feelings of low self-esteem. As the daughter of a minister, Kara remembers the thoughtfulness of the friends in whom she finally confided. From that day forward, they shielded her from as much embarrassment and hurt as possible. One small thing they did that stands out in Kara's mind is when they made sure to stand one on each side of her during church services, just in case she would be required to join hands with her neighbors in prayer. That way, she wouldn't have to explain about her clammy, sweaty hands to strangers. Should her friends be absent from the services, Kara would make a quick exit to the bathroom or seek safety in the back of the church during the times other members would be reaching out to one another in fellowship.

Understanding her unhappiness, Kara's parents sought the advice of several doctors. Without fail, they either minimized the problem or commented that Kara was just a nervous child and she'd soon outgrow her condition. Unfortunately, that was not to be. As she matured, she rarely dated because of the embarrassment and dreaded explanations for her cold, clammy hands. Most schoolmates and teachers thought Kara was shy, with only her closest friends privy to her secret.

About the only time Kara didn't have to hide her condition was when participating in her favorite sport: swimming. After all, everybody's hands were wet on the swim team. Driving to swim meets, or anywhere else for that matter, was also a challenge. Kara had trouble holding on to the steering wheel without constant slips from the persistent moisture created by her hands. Some days Kara's life was much like that of any other teenager's: singing to the radio and talking on the phone. The difference was, she was never very far from a hand towel or washcloth.

Even though Kara and her family had sought answers from the medical community to no avail, they never lost hope or stopped praying that someone would discover the cause of this pooling sweat that dripped from her fingertips, armpits and toes. That someone they prayed for came in the form of a Neurosurgeon at Barrow Neurological Institute in Phoenix, Arizona. A co-worker had read an article written about Hyperhydrosis, and she immediately thought of Kara. The author's name was Dr. Curtis Dickman, and in addition his work in spinal injury and trauma he is also the director of the Southwest Centre for Hyperhidrosis at St. Joseph's Hospital and Medical Center.

Finally, someone offered relief to Kara, and she jumped at the opportunity. At 27 years old, it no longer mattered that she had forgone her lifelong dream of becoming a physical therapist because she feared others' reactions to her touch. It didn't even matter that she hadn't been able to do some of the routine things other teenage girls her age took for granted like experimenting with makeup and the latest hair fashions. You see; Kara's face and scalp never escaped the ministrations of her soggy hands. No, all those things didn't matter any more. What mattered was that Kara was to have a fairly routine operation with only two or three small incisions, stay overnight in the hospital and come home with dry hands.

"What a miracle!" Kara thought to herself. She laughed as she pictured all the little things she would be able to do without a second thought. She would be able to read a paperback novel without setting it on a table and propping the pages open with weighted objects. She would be able to sleep without gloves and socks on to keep the bed from getting wet. She would be able to hold her husband's hand at the movies without leaving a wet spot where her fingers had rested on the leg of his slacks. She would be able to proudly shake hands with people and confidently hold the baby she and her husband planned to have in just a few months.

Kara was willing to do whatever it took, and prepared herself for the worst, but Dr. Dickman surprised her with the details of surgery and recovery. The procedure was called thoracoscopic (through an endoscope placed within the chest) sympathectomy (removal of part of the sympathetic nerve chain). Kara would be under general anesthesia while Dr. Dickman made two or three small incisions just below the underarm, between the ribs. In one incision he would insert the endoscope to enable him to view inside her chest, and through the other he would place the instruments used to perform the operation. Although one lung at a time would need to be temporarily collapsed in order to reveal the sympathetic nerve bundle that stimulated the excessive sweating, the lungs would be reinflated and, after a night in the hospital, Kara would return home with dry hands for the first time in her life. In just over a week after surgery, she would be ready to resume her normal activities. Only this time those activities would include lots of hugs without the worry of leaving wet handprints on the backs of others.

Kara had the surgery, and with the exception of some minor discomfort, a little bit of burning in her lungs that subsided in short order, the operation was a great success. When asked if she had any regrets about her decision, Kara commented, "I do, actually. I regret that previous doctors never took the time to understand and help me with my condition. I regret that I didn't have the surgery years ago, and that my parents had to share in the heartache and frustration I went through as a young adult." In the next breath, Kara looked up with her big, beautiful brown eyes and wide smile and there was no doubt that the mild discomfort of the operation and the short recovery period were well worth the positive results.

We have heard these same words repeated with other Hyperhidrosis sufferers. The second story is of a man whose life as a successful litigation attorney eventually earned him a seat on the bench as a superior court judge. But, life hadn't always been so good. As early as third grade, the judge remembered his tendency to avoid contact with other kids and adults. As he shared his story, he said, "I rarely touched others. If my touch was not pleasant for the other person, it couldn't be pleasant for me. I was constantly aware of my inescapable perspiration."

Thinking he was overly nervous and that was what created the sweaty hands, the judge finally decided to seek professional help. For 18 months, he underwent psychological therapy where he was instructed to record his feelings of anxiety whenever he would break out in a sweat, but there was not enough time or paper for the constant journaling. He just couldn't understand; he didn't feel exceptionally nervous or think he lacked self-confidence, so why all the sweat? Even though his success as a litigation attorney spoke for itself, he was well aware of the looks of concern on the faces of some of his clients and the looks of triumph on the faces of opposing counsel who were often mistaken as to the cause of all the sweating.

The judge laughed as he reminisced about the time they tried to collect his fingerprints, something he had to do for government clearance. His hands had perspired for so long and created so much acid buildup that it had nearly eaten through his fingertips, making it next to impossible for them to obtain viable prints. And, what prints weren't destroyed by the acid was smeared by the moist blend of ink and perspiration. Like Kara, the judge had tried common remedies like heavy antiperspirants applied almost every hour on his underarms and hands. He tried electric therapy that was supposed to shock the nerves in the hands and decrease the sweaty excretions, but that lasted only about as long as it took to put the machine away.

For a litigation attorney, it was a physical condition that actually had the power to reduce his earnings and hurt his career. After all, what client searched for a litigating attorney who could sweat obsessively at the drop of a hat? Not many! To avoid giving away his secret, he would refuse any contact with most of his clients, preferring instead for them to think him distant and bulldoggish.

One evening, browsing the web, the judge decided to type in "sweaty palms" and see what appeared on the screen. To his surprise, there was a clinical explanation for the condition. Further examination led the judge to Dr. Dickman's website and hope for a possible cure. He paused, letting his hope die down, fearing that the risk would be too high and the recovery too unpredictable; however, the temptation to find a cure was more than he could resist. In his insistence, the judge obtained a referral from his family practitioner to Dr. Dickman at the Southwest Centre for Hyperhidrosis within the world-renowned Barrow Neurological Institute. There he found answers to most of his questions about his disorder.

The judge sat still as Dr. Dickman revealed the possible surgical risks and rewards. "Well, there are some 30 to 70 percent of patients who experience a compensatory Hyperhidrosis that involves increased sweating of the chest, abdomen, legs and/ or back, even though the hands remain dry after surgery. Not to worry, though; the symptoms are usually mild to moderate and tend to improve or resolve themselves totally within six to nine months. There is a slight chance that you could experience Horner's Syndrome (a slight drooping of the eyelid) after surgery, but so far that has occurred in less than one percent of my operations."

It was obvious how desperate the judge was to find relief, when even the mention of Horner's Syndrome caused not the slightest hesitation to opt for Dr. Dickman's suggested surgical procedure. It was a complete success, and today the judge can confidently pound away at his bench with no fear of flying perspiration or an airborne gavel.

What about you? If you're reading this story and it's striking a chord of recognition with you or someone you know, then we've accomplished our goal. Two in every 100 people who read this story are currently experiencing the misery of Hyperhidrosis. My guess is that you know who you are and so does most everybody with whom you come into contact. Like Kara and the judge, you've lived with embarrassment, low self-esteem and loneliness. Perhaps you've limited yourself when it came to your chosen profession, income potential, hobbies and social gatherings.

If so, it is no coincidence Kara and the judge elected to finally share their stories with you. It is no coincidence you chose this particular website and read this particular story. There is a power stronger than any of us, a plan for our lives that includes happiness, fulfillment and purpose, and in some small way Kara, the judge and Dr. Dickman have found their way into your life's plan. They have shared their stories, insights and knowledge with you so that your life may take on a renewed purpose and so that you may discover the inner courage to become the YOU that you were meant to be. This story is not just for sufferers of Hyperhidrosis. It's for family and friends looking to help their loved ones. It's for doctors who need to inform their patients. It's for co-workers who could share this information and lessen the burden of another.

It is time we all realized that we're connected, you and I. If one of us is made to suffer, we all suffer. The limitation one places on him or herself reduces the successes of many. One ripple in the pond spreads to the water's edge and carries with it every circling wave that ruffles its smooth surface until it finally finds peace upon the still banks and comfort on its grassy slopes. Instead of throwing rocks or pebbles into the water, why not bend your face to the water's edge and get a glimpse of who's reflected within its depths. The ripple soon fades and all that's left is the image of you.

Dr. Curtis Dickman is Director of Spinal Research and Associate Chief, Spine Section, Division of Neurological Surgery at The Southwest Centre for Hyperhidrosis, located on the campus of St. Joseph's Hospital and Medical Center and housed within The Barrow Neurological Institute in Phoenix, Arizona.