Unilateral ETS and/or T4 Sympathectomy- Reduced Compensatory Sweating?

      • Guest
        Atul on #18081

        Hi there, this is directed to those who underwent Unilateral endoscopic thoracic sympathectomy (ETS) surgery (for one side/palm) instead of bilateral (both sides/both palms) and/or those who did a T4 Sympathectomy (ETS surgery at T4). Just some context- normally the surgery is done at T2, T3, or T4 or a varying combination of those depending on the area/s a patient experiences excessive sweating in. T2 is usually for facial sweating/blushing, T3 for sweaty palms/hands, and T4 for axillary/underarm sweating (if i'm not mistaken).

        Please note that the following is simply my readings/takeaways and hence the findings/legitimacy of the findings may be questionable/not accurate (hence please do your own extensive research and speak to others who have undergone the exact same procedure should you be interested in getting the procedure done (as it is permenant/irreversible in most cases): I have gone through quite a few research papers/publishings recently and read that both unilateral ETS and/or T4 sympathectomy significantly reduce the incidence and/or severity of compensatory sweating and any known/associated ETS side effects. The reason for reduced severity/incidence of compensatory sweating in unilateral ETS is supposedly because only one side/palm is operated upon/for and hence the opposite palm still continues to sweat excessively and hence heat can still disipate to a decent/satisfactory level. Furthermore, T4 sympathectomy supposedly results in a lower incidence of compensatory sweating as it is situated lower down the sympathetic chain aswell as doesn't make your palms completely dry (in many cases leaving them slightly moist/moist) hence once again allowing for a decent/satisfactory level of heat dissipation.

        Hence I wanted to reach out on this forum to determine if your experiences match those of the research papers/findings. Hence:

        For those who underwent Unilateral ETS (for just one side/palm):

        1. Do you have compensatory sweating (please answer with a yes or no) and if so do you have mild, moderate, or severe compensatory sweating?

        2. Have you experienced any listed ETS side effects such as lowered heart rate (bradychardia), low levels of motivation/unclear thinking/difficulty focusing/low levels of energy, compensatory sweating, gustatory sweating, difficulty with thermoregulating (feeling hot all the time), complete dryness of everything above the nipple/chest line (anhidrosis)?

        3. If you could please share your overall experience:

        – Indicating at which level you got operated (T2, T3, T4 or a combination of those)
        – How long its been since you got operated, the reason for getting operated (specifying the areas you sweated before getting operated)
        – Any noticeable changes/improvement experienced in your levels of palmar/axillary sweating (if so by what %)
        – Whether your compensatory sweating has reduced over time (that is if you have compensatory sweating)
        – Whether you would recommend getting operated unilaterally.

        For those who underwent a T4 sympathectomy (unilateral or bilateral):

        1. Please specify if you were operated unilaterally or bilaterally.

        2. Have you experienced any form of compensatory sweating (please answer with a yes or no) and if so do you have mild, moderate, or severe compensatory sweating?

        3. Do you feel that your compensatory sweating would have been worse if you got operated at T2 or T3 (or both) rather than at T4 (or T3 & T4 if you were operated on both).

        4. Do you still experience some amount of moisture in your palms (primarily) and/or underarms or is one or both of them completely dry?

        5. If you could please share your overall experience:

        – Indicating how long its been since you got operated
        – The reason for getting operated (please specify the areas you used to sweat from before getting operated)
        – Any noticeable changes/improvement experienced in your levels of palmar/axillary sweating (if so by what %)
        – Whether your compensatory sweating has reduced over time (that is if you have compensatory sweating)
        – Whether you would recommend getting operated at T4.

        Thank you for your responses. I appreciate it! 🙂

        Reply
      • Guest
        Sandy on #18629

        There are known risks associated with ETS, but perhaps the most important for the patient to
        understand the risk is compensatory sweating. Compensatory sweating occurs when treatment for hyperhidrosis decreases or eliminates sweating in the original problem area, but the body then compensates by increasing sweat production in another area of the body. Compensatory sweating is the most common side effect of ETS, and it develops in between 3% and 98% of patients. This wide range may be accounted for by varying definitions of compensatory sweating and variations in the surgical approach for treatment of hyperhidrosis. The most common sites for compensatory sweating occurrence are abdomen, back, legs, and gluteal area. Adult patients and those who have a preexisting tendency to sweat in the inguinal folds, buttocks, back, and upper thighs are at greater risk for compensatory sweating.

        Reply
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