HEALTH: Little-known surgery cures excessive sweating

Thursday, August 16, 2012


Brampton Guardian: HEALTH: Little-known surgery cures excessive sweating

'Remarkably simple' 20-minute procedure covered by OHIP

Leanne Dronyk tried it all.

Deodorants. Medicinal and clinical antiperspirants. Even painful, expensive Botox injections, the effects of which last only six months.

For 20 years, Dronyk has suffered from excessive sweating in her hands, armpits and feet. Called hyperhidrosis, the condition affects three per cent of the population.

“It’s embarrassing, especially in the hands,” Dronyk, 31, said this week. “If you go to shake somebody’s hands whether for an interview or somebody you’re just meeting, right away they assume you’re nervous because you’re sweating. Even in relationships, I would never hold hands because it was too embarrassing.”

Dronyk’s entire wardrobe consisted of white or black tops, an effort to conceal sweat stains. She’d wear jackets to cover her sweating, which only made it worse.

The Brampton woman found her desperately sought, long-awaited cure in September, when an Oakville doctor she’d seen for Botox injections referred her to an Etobicoke thoracic surgeon who performs a little-known 20-minute procedure known as Video Assisted Thoracoscopic (VATS) Sympathectomy.

Post-surgery, Dronyk said her sweating is “maybe five per cent” of what it had been.

“It’s a huge, huge difference... It’s definitely amazing. I’m so glad I did it... It’s like night and day.”

William Osler Health Centre thoracic surgeon Dr. Kashif Irshad is one thoracic surgeon in Toronto who performs high volumes of the leading-edge day surgery.

VATS Sympathectomy is a minimally invasive surgical technique that involves cutting or clipping a patient’s hyperactive sympathetic nerve chain, which goes to the sweat glands in the hands and the armpit.



The surgeon makes two incisions, each three millimetres-long, in the armpits and inserts plastic ports to allow manoeuvrability of the surgical cauterization tool (for cutting), as well as a miniscule video camera that enables the surgeon to operate under magnification.

Irshad learned the technique at the University of Pittsburgh, and has performed the surgery for the past three years, at a rate of three to four patients per month.

The procedure is covered by OHIP.

The alternative, Botox, cost Dronyk $350 for her last pre-surgery regimen of 20 injections in each of her armpits; the remaining 90 per cent of the cost covered by her company benefits plan.

Last April, Irshad performed VATS Sympathectomy on Tiffany Dault. Dault’s family doctor referred her after she decided Botox was not for her.

“The surgery was quick, painless, recovery within a week, fully healed and able to come back to work,” Dault, 28, said. “I’ve had no sweating problems since.”

Dault does now experience “compensatory sweating” on the top of her belly and in the middle of her back. “But I’d much prefer that over armpit and hand sweating.” Compensatory hyperhidrosis occurs in 10 to 15 per cent of patients, Irshad said.

“It has been extremely life-altering,” said Dault, who lives in Brampton. “I’m no longer embarrassed. I can shake people’s hands. I can wave hello. I can wear tight-fitted shirts, dresses when I choose to of any colour and not have to worry about embarrassment.”

Irshad wants to raise awareness of the surgical cure, unknown even to most family doctors. He has given talks to physicians, and sent out information pamphlets.

“The problem is people don’t know about it,” Irshad said of VATS Sympathectomy. “It’s unfortunate that patients aren’t aware that there is an alternative (to Botox injections) that is a permanent solution to this. That it will provide them lifelong relief and won’t be a financial burden, and will allow them to function normally socially.”

Thursday morning, Irshad performed the “remarkably simple” surgery on a young woman in operating room Surgery 1 on the main floor of Etobicoke General Hospital.

Results are dramatic. Surgery provides “instant relief” for life.

“In the waiting room, I have patients hugging me. They realize it was needless suffering.”

Another patient drove from his home in Waterloo a week after surgery to shake Irshad’s hand. “‘Thank you very much. I can shake your hand very firmly now. It has changed my life,’ he told me.”

Doctors don’t know the cause of hyperhidrosis. But VATS Sympathectomy is successful in more than 90 per cent of cases of patients with sweaty palms, reports the American Sympathectomy Institute.

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