Imagine praying that you wouldn’t blush or overly perspire numerous times every day. Some people spend much of their waking hours hoping to avoid the embarrassment of these uncontrollable body responses. They feel trapped and limited during basic daily activities such as grocery shopping or in their ability to progress in their career.
There are various medications and cognitive therapies to treat excess blushing. Additionally, laser treatments or botox can treat excess sweating--which also is known by its official medical name of hyperhydrosis--but if these therapies don’t work or have unacceptable side effects, then there is a surgery that might help. It too has it own risks and success rates but it can be an option to consider for those who are desperate for a solution.
Endoscopic thoracic sympathectomy (ETS) is a surgery that destroys the nerves that stimulate blushing or sweating in the hand, face and underarm areas. These nerves are part of the sympathetic nervous system, which is responsible for the “flight” or “fight” response in our bodies. The nerves that control these actions run along each side of the spine in a long chain.
There are nerve bundles in the chains called ganglion, which are cut in very specific spots depending on which sympathetic response is being changed. The ganglion involved for blushing and hyperhydrosis are in the upper part of the thoracic spine above the shoulder blades and requires the skills of an experienced surgeon at performing ETS.
ETS is performed under general anesthesia as a laparoscopic surgery. The surgeon cuts a small incision on the side of the chest wall under the armpit. Instruments and tools to visually locate and cut or clamp the nerve ganglion are passed through the incision. To move the lung out of the way, carbon dioxide is passed through a tube into the chest space. The same procedure is repeated on both sides of the spine.
All surgeries carry risk of infection, bleeding, damage to other structures and death. ETS additionally can cause other side effects such as: Horner syndrome (permanent eye droop and pupil dilation), increased sweating in other areas below the neck as a compensatory response, nerve damage to the scapulae requiring physical therapy, as well as other side effects.
Success rates and satisfaction statistics are variable depending on whether the person was treated for hyperhydrosis or blushing and whether they feel their quality of life was improved overall. Excessive sweating of the hand has the highest reported success rate, above 95 percent, with facial blushing in the 85 percent to 95 percent success rate range and underarm sweating at 60 percent, depending on what source is reviewed. According to Wikipedia between 2 percent to19 percent regret having the surgery and up to 50 percent feel their quality of life has diminished.
However, for those people who feel they are at the end of their rope and who have not had adequate success with medications or other treatments, ETS can be a blessing. It is a risky surgery and should not be performed before exhausting all other methods. Consult with more than one doctor if you are contemplating having ETS. Bring someone trustworthy with you to hear all the risk and benefits to help you make your decision.
sources:
http://en.wikipedia.org/wiki/Endoscopic_thoracic_sympathectomy
http://www.facialblush.com/ETS%20risks.html
http://www.hyperhidrosis.com/faq.htm
Michele is an R.N. freelance writer with a special interest in woman’s healthcare and quality of care issues. Other articles by Michele are at www.helium.com/users/487540/show_articles