Dry Palm, Mind Calm! - Dr. Avinash Katara

Posted by : Hinduja, 11 Jun 2012 07:52 AM
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Have you ever had your palm dripping with sweat when you gave a job interview? Has your partner ever shunned you because your hands were too wet to hold? Have you been writing your exams with heaps of blotting paper? Do you hesitate to shake hands on a closing deal for the fear of watching it fall apart? If yes, stop to ponder. This is not something you have to live with. This is a common problem worldwide, and there is a solution at hand.
Sweating is an important bodily function that allows us to keep our body temperature within the normal range. We all sweat as a normal response to different forms of stress, heat and exercise. However, some people sweat excessively or disproportionately to such stimuli.
Hyperhidrosis refers to excessive sweating that is non-physiological and disproportionate to that required for regulating body heat. It can either be generalised, from all over the body, or may affect particular areas of the body like the palm of the hand, armpit, sole of the foot and face. When we sweat excessively all over the body, it is often as a result of an underlying medical illness (which can range from infections to tuberculosis, hormonal problems, drug reactions and even cancer). Hyperhidrosis can also be due to no apparent cause, and this is usually the case in patients who experience excessive sweating in select areas like the palms, soles and armpits.
Sweaty palms fall in this category—where there is no apparent cause. It affects both sexes, all races and often has a family predisposition. It affects one to two per cent of the population.
Regardless of which part is affected, excessive sweating is a nuisance to those who suffer from it. Of these, sweaty palms is the most incapacitating. It poses no serious threat to life. However, there are other emotional and physical disabilities arising from it. Patients are not only uncomfortable, but often socially and professionally embarrassed by it, for instance, while shaking hands, writing, playing musical instruments, handling paper, painting, using electronics, computers and mobile phones. The problem usually begins in childhood and gradually progresses during teenage and adulthood. When the soles of the feet sweat more than they should, it becomes very difficult to even wear open slippers and flip-flops.
Sweaty palms can be controlled to some degree with commercial antiperspirants. However, stronger treatment is often needed. Several solutions, gels, films, ointments or medications have been tried for this condition. Acupuncture, biofeedback, anti-anxiety medicines and various herbal remedies have been tried with limited or no success. Botox® injections and electric stimulation (iontophoresis) have also been tried. These 
often fail to give long-lasting relief and surgery is a useful option for these patients.
Minimal access surgery has revolutionised the treatment of sweaty palms. Endoscopic Thoracic Sympathectomy (ETS) is a minimally invasive procedure that allows access to the sympathetic chain that lies deep within the chest cavity. The sympathetic chain is selectively blocked where it sends out nerve branches to the sweat glands in the palm. Special instruments are inserted into the chest through tiny holes with negligible scarring as compared to conventional surgery that involve opening the chest. It has excellent results with more than 90 per cent success, which is usually permanent. 
All it takes is a keyhole procedure with 24 hours in the hospital. And you could say good-bye to all those moments where you wish you were in someone else's shoes... or gloves!
Dr Avinash N. Katara, 
MS, DNB, MNAMS, MRCSEd, Fellow-MIS (Singapore), is Laparoscopic, Thoracoscopic & Bariatric surgeon.

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Posted by : Hinduja, 09 Jul 2012 07:17 AM
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