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Because topical medications and injections rarely work on hyperhidrosis, Dr. Keller treats the condition by severing a small nerve in the chest, a procedure called a sympathectomy, which eliminates sweaty palms almost immediately. He has performed the operation over 230 times, and among his happy patients are a police officer who could not handcuff suspected criminals, a woman who was unable to grab subway handrails and dozens of patients who avoided shaking hands at parties.
"Before surgery, patients said that if they used a computer, pools of sweat would form on the keyboards. The paper they used for handwritten notes would become soaked. Bags of groceries would slip out of their hands. At parties, they held ice-cold drinks so they could shake hands and their condition would not be noticed," said Dr. Keller.
The survey measured the pre- and post-operative stress levels for 15 common activities such as shaking hands, driving a car or eating with a fork, and the researchers developed a mean score for all 78 patients. On a scale of 1 to 10, with 10 indicating the highest stress level, the mean score for these activities before surgery was 7.3, but after surgery dropped tremendously to 1.3. "These are very convincing results," said Dr. Keller.
To make sure that the operation is successful, Dr. Keller measures the temperature of his patients' hands in the surgical suite. The mean pre-op temperature for the right hand of patients in the survey was 31.1° C, which immediately jumped to 33.7° C post-op. "This temperature rise is exactly what we want to see if we cut the nerve in the correct location. Pre-op hands are cool and sweaty, post-op hands should be warm and dry," explains Dr. Keller.
A major drawback to surgery is that a small number of patients acquire severe compensatory sweating on the back or other part of the anatomy.
Most patients also experience hyperhidrosis on their feet and a limited number under their arms. Sympathectomy is effective for reducing the underarm condition, but not for the foot condition, said Dr. Keller.
For more information, please visit the Surgery Center of Excellence.Montefiore Medical Center, The University Hospital and Academic Medical Center for the Albert Einstein College of Medicine, ranks among the top one percent of all US hospitals based on its investments in medical innovation and cutting-edge technology.
Montefiore invests more in order to enable compassionate, personalized care and the most positive outcomes for patients and their families in New York, the tri-state area and beyond.
Montefiore’s unique combination of ‘state-of-the-art’ technology with ‘state-of-the-heart’ medical and nursing care in a teaching and research environment provides patients with access to world-class medical experts, the newest and most innovative treatments and the best medical center experience anywhere.
This 1,062 bed medical center includes the Henry and Lucy Moses Division, the Jack D. Weiler Hospital and The Children’s Hospital at Montefiore, a large home healthcare agency and a 21-site medical group practice located throughout the Bronx and nearby Westchester.
Montefiore treats all major illnesses and has distinguished centers of excellence in cardiology and cardiac surgery, cancer care, tissue and organ transplantation, children's health, women's health, surgery and the surgical subspecialties. Montefiore Medical Center focuses on providing family-centered healthcare in a nurturing environment that extends well beyond hospital and clinic walls.
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