Procedure dramatically alters physical and emotional obstacles of palm and axillary hyperhidrosis

 "I wouldn't have been comfortable meeting people, shaking hands, carrying drinks. It's amazing how many people want to shake your hand."

--Jessica

Nine years ago, Jessica began experiencing symptoms of hyperhidrosis, a condition in which the body produces excess perspiration. Affecting about one percent of the world's population, the condition commonly shows up in the hands and underarms, often leading to social embarrassment and emotional distress.

"I was nervous to meet people," said Jessica, an office manager who constantly wiped sweat from her hands before meeting someone.

Although she had worked with a dermatologist and taken several oral medications and topical treatments to treat the symptoms, nothing seemed to work. Jessica began to believe it was something she would just have to live with until she stumbled across a television news report one night that dealt with thoracoscopic sympathectomy, a surgical procedure that can be performed to reduce excess sweating in the extremities when other treatment options fail.

Intrigued by the procedure, Jessica investigated it further and decided to see the thoracic surgery nurse care coordinators at University of Iowa Hospitals and Clinics: Amy Nibaur, R.N., B.S.N., and Joan Ricks-McGillin, R.N., B.S.N. As specially trained nurses, the care coordinators guide and support patients throughout their treatment for a variety of thoracic illnesses. With several specialties coming together for the treatment of hyperhidrosis, the care coordinators also work as intermediaries between the patient and the medical team.

After learning of Jessica's symptoms and failed attempts with medications, the team set up a consultation with thoracic surgeon Kemp Kernstine, M.D., Ph.D., who had surgically helped several other patients overcome palm hyperhidrosis. The surgical procedure permanently relieves the symptoms of hyperhidrosis by severing the nerves to the palmar sweat glands. Surgery is indicated only if less invasive measures, such medical therapy or local injections with Botox, fail.

The surgical procedure uses a minimally invasive endoscopic technique, usually requiring two to three small puncture wounds into the chest at the underarm hair line. Since the procedure involves so little trauma, most patients are discharged from the hospital the same day and many go back to their normal activities within a few days.

Knowing that medications and treatments had only given her temporary relief, Jessica opted for the more permanent solution. Following the Friday procedure, Jessica returned to work on Monday with immediate results. "My hands have not been sweaty once," she said.

The procedure has helped boost Jessica's self-confidence. No longer fearing meeting people, she recently started cocktail waitressing on the weekends, something she would not have considered before the surgery.

Jessica is not alone with her results. "It's really gratifying to see patients who have suffered from this for 20 to 30 years have immediate results after the surgery," Kernstine said. "The results are just amazing. All our patients have resolved their sweaty palms and underarms using this procedure, which is safe and effective."

For more information, patients and families should call UI Health Access and ask for the thoracic surgery nurse care coordinators. Physicians seeking consultation or referral should call UI Consult.

Coming together

In order for patients to receive the best possible treatment options, physicians from several specialties collaborate for the treatment of patients with hyperhidrosis:

• Natisha Busick, M.D., a surgeon, has been researching the outcomes on the treatment options for hyperhidrosis.
• Javier Campos, M.D., director of cardiothoracic anesthesia, provides the anesthetic care for patients during the surgery.
• Praful Kelkar, M.D., a neurologist, helps evaluate patient outcomes.
• Kemp Kernstine, M.D., Ph.D., a cardiothoracic surgeon, performs minimally invasive sympathectomies on chronic medicine-resistant patients.
• Marta Van Beek, M.D., a dermatologist, treats patients through non-surgical interventions.