Living with excessive sweating, or hyperhidrosis, can be incredibly hard. Hyperhidrosis is a medical condition that occurs due to overactive sweat glands, causing sweating beyond what's needed for the body to cool down. It commonly leads to discomfort, embarrassment, and social challenges.
My name is Randy Choi, and these challenges led Billy Thompson and I to create the Thompson Tee to help others deal with this problem.
If you have hyperhidrosis like we do, you’ve probably tried different ways of dealing with it. One option is endoscopic thoracic sympathectomy (ETS) surgery. ETS surgery involves opening your chest cavity and slicing the nerves that control your sweating response.
Today, I’ll share my experience with ETS surgery, some effective alternatives and what I wish I’d known before making the worst decision of my life.
Jump straight to:
- My Story of Living With Hyperhidrosis
- My Journey to ETS Surgery
- What Happens During ETS Surgery?
- Post-ETS Surgery
- ETS Surgery Side Effects
- Other Complications
- How To Decide if ETS Surgery Is Right For You
- Alternatives to ETS Surgery
- Resources for Additional Support
My Story of Living With Hyperhidrosis
I experienced my first sweat event as an early teen when a couple of cute girls sat beside me on the school bus.
A band of sweat formed around my head that dripped down to my shirt. I looked as if I’d just run a marathon and had never felt more embarrassed in my life. I didn’t know it at the time, but I had cranial hyperhidrosis — the medical term for chronic head sweat.
I became extremely self-conscious about my excessive sweating, which worsened into high school and college. In college, the campus physician diagnosed me with an anxiety disorder, attributing my sweat events to panic attacks. But how could I have 5-10 panic attacks a day?
The doctor prescribed various anti-anxiety medications and antidepressants, including Xanax, Prozac and Ativan, but none worked. Ultimately, I didn’t have an anxiety disorder. The anxiety was just a reaction to dealing with cranial hyperhidrosis.
And I wasn’t alone in my confusion. 60% of people with hyperhidrosis don’t know it’s a medical condition, and 47% don’t believe a treatment could help.
My Journey to ETS Surgery
In 2000, a billboard advertising hyperhidrosis surgery caught my attention. Concealing crazy amounts of sweat was exhausting, and I finally found a solution — or so I thought.
During the first consultation, the doctor immediately diagnosed me with hyperhidrosis. I felt like I won the lottery; I had never heard that word before. For ten years, doctors prescribed me countless anxiety medications that only left me dizzy and disoriented.
The doctor told me that people with hyperhidrosis have overactive nerves that trigger unnecessary sweating and that ETS surgery was an option.
He convinced me that cutting these nerves would end my exaggerated sweat response to stressful situations. ETS surgery was supposed to be a permanent solution, so I decided to do it — a decision I regret to this day.
What Happens During ETS Surgery?
ETS surgery takes approximately 40 minutes. Here’s how the procedure works:
- The procedure requires general anesthesia. The surgical team inserts a tube into your trachea to help you breathe during the operation.
- Two small incisions are made below one of your underarms.
- One of your lungs is then deflated to give the surgeon access to your sympathetic nerve chain.
- A small camera is inserted into your chest through one of the two incisions under your armpit. Tiny surgical instruments are inserted through the other incision.
- The surgeon uses the camera to locate the sympathetic nerve chain responsible for sweating and guides the surgical instruments to it.
- The surgeon removes the three portions of your sympathetic nerve chain that trigger sweat production.
- The tools and camera are removed, and your lung is then re-inflated.
Once the surgery is complete on one side, these same steps are repeated on the other side of your body. Your incisions are then covered with small bandages, and the breathing tube is removed from your trachea.
The Recovery Process
ETS is an outpatient surgical procedure, so you can expect to return home the same day. If you have trouble waking up from anesthesia, you may need to stay in the hospital overnight.
It’s normal to have some pain around the incision sites. Your doctor will give you oral pain medication like acetaminophen to take for 7-10 days after the surgery. You should be able to return to work within one week.
After one week, you’ll return for a follow-up visit. The doctor will remove any remaining sutures during this appointment and inquire about side effects.
Looking for more organic approaches? Read 13 Natural Ways to Stop Sweating
Just 30 minutes after surgery, the doctor sent me home with painkillers and instructed me to relax. I felt groggy, but more surprising was the phantom sweating — or the feeling of sweating profusely. I would wipe my face repeatedly, but it was bone dry.
Success, right? I was stoked for about a week.
Eight days after surgery, I began noticing sweat on my chest. So I called the doctor for a follow-up consultation. It was summer, so the doctor reassured me the heat was to blame. I took his word and went home.
A few months later, my sweating had worsened, resulting in noticeable sweat patches across my chest and torso. By the end of the summer, I went back to the surgeon. That was the first time he mentioned compensatory sweating as a side effect of hyperhidrosis surgery.
He told me that sweating after surgery was rare. After researching compensatory sweating, I discovered that just wasn’t true.
My sweat continued to worsen. Soon, I had to wear two to three undershirts daily to contain my chest and back sweat, then suddenly began sweating on my left shoulder blade. My doctor blamed my excess sweating on the heat. But I knew it was more than that.
The next time I returned, I was sweating through five shirts daily.
ETS Surgery Side Effects
In addition to compensatory sweating, I also experienced the following ETS surgery side effects:
The operation also made my face alter between dry and oily. As a result, I got acne for the first time. Eventually, the effects spread to my hands and scalp, which also dried up badly.
The side effects of ETS surgery didn’t stop at compensatory sweating. I experienced a noticeable lack of energy and had difficulty making simple decisions like choosing a brand of shampoo.
My natural feelings of assertiveness also diminished. ETS surgery affected my autonomic nervous system, which impaired my fight-or-flight response and made me feel dull and lifeless.
I felt like my metabolism slowed dramatically after surgery. I wasn’t digesting food as quickly as before and gained weight.
In dealing with these side effects, I realized that my doctor hadn’t been transparent with me, so I reached out to other ETS patients to find solace. I found that all of them were also furious with their doctors and the procedure’s results.
In addition to the above, you may experience the following common side effects after ETS surgery:
- Horner’s syndrome: Droopy eyelids, decreased pupil size, elevation of the lower eyelid or overall sunken appearance of the eyes
- Gustatory sweating (Frey’s syndrome): Sweating on the forehead, scalp, neck, and upper lip triggered by eating, speaking, or even thinking about food
- Neuritis and neuralgia: Numbness, tingling, weakness or paralysis caused by nerve pain and inflammation
- Brachial plexus injury: Weakness, loss of feeling or loss of movement caused by nerve damage
- Decreased heart rate: Slowed heart rate due to the severed connection of upper thoracic ganglions from the heart
After returning to the surgeon a third time, he prescribed me Ditropan XL — a medication for overactive bladder. Ditropan XL dries up the entire body, preventing excess sweat.
I couldn’t stand the side effects of the medication – I felt tired and disoriented all day. After two or three months of adjusting the dosage, I gave up.
On my next visit to the surgeon, he prescribed the topical antiperspirant Drysol, a heavy dose of aluminum chloride. He instructed me to apply the Drysol to my affected areas before bed and then wrap my torso in Saran Wrap. It sounded insane, but then again, I was desperate.
Imagine going through this nightly routine: You shower, apply a solution that smells like metal, wrap yourself up like a human sausage and try to sleep for 6-8 hours while the solution takes effect.
In the morning, you neutralize the solution by powdering your body with baking soda – that’s how harmful this solution is. Then you have to wash it off and repeat it every night. By the third night, I was breaking out in rashes and had to stop.
How To Decide if Hyperhidrosis Surgery Is Right for You
If I had known I’d be dealing with a more annoying sweat issue after surgery and be back on prescription medications, I would not have gone through with the surgery.
While the procedure has likely advanced, hyperhidrosis surgery is still serious and life-altering. I strongly advise that you do the following before considering it.
Meet With a Dermatologist
Dermatologists specialize in diagnosing hyperhidrosis, so they know it’s not a psychological condition. Start your search here rather than with a general practitioner.
Do Your Research and Consider Alternatives
Knowledge is power. When you’re uneducated about a problem, it’s easy to make rash decisions. Research hyperhidrosis alternatives before resorting to an invasive, irreversible procedure like ETS surgery.
Ask Questions and Get Multiple Referrals
Just because a doctor can perform ETS surgery doesn’t mean they’re an expert on hyperhidrosis or know how to treat it effectively. Visit several doctors and compare their recommendations.
Some complications from this procedure are not apparent until five to 10 years after surgery. Ask to speak to their patients, particularly those who had the surgery at least two years prior.
Know What Outcomes To Expect
The National Center for Biotechnology Information (NCBI) and the Journal of Thoracic and Cardiovascular Surgery (JTCS) report similar success rates for axillary ETS surgery; 88% and 83%, respectively.
Both studies define “success” as immediate dryness post-operation, not sustained dryness. Rates of compensatory sweating post-operation were high in both studies. In NCBI’s survey of 73 patients, 68% experienced increased sweating in new places on their body post-op. Of the 15 patients tested in the JTCS study, 60% experienced compensatory sweating.
Ask How Much ETS Surgery Will Cost
ETS surgery costs vary widely. It’s impossible to state the exact cost of hyperhidrosis surgery, but in the U.S., it’s reported to be $10,000 - $20,000. Talk to your doctor or insurance company to get a more exact estimate.
Find Out if Your Insurance Will Cover ETS Surgery
ETS surgery is usually covered by health insurance. Because the condition affects a person’s quality of life, it’s considered a necessity rather than an elective or cosmetic procedure. Check with your insurance provider to see if ETS surgery or alternative treatments are included in your coverage.
Alternatives to ETS Surgery
If you decide not to go through with hyperhidrosis surgery, there are other ways to cope. Here are some tactics I use that help keep my sweating dormant:
- Wear a sweat proof undershirt daily
- Use prescription-strength antiperspirant
- Keep fans on at home and work to keep air circulating
- Drink plenty of water
- Limit your stimulant intake (sugar, caffeine, etc.)
- Practice deep breathing and mindfulness when you feel anxiety coming on
Thompson Tee: A Safe and Affordable Solution for Hyperhidrosis
I know all too well that dealing with hyperhidrosis is a lifelong struggle. When my friend Billy came to me with the idea for a sweat proof undershirt, I was all in. He knew I had experience in the apparel business but wasn’t aware of my battle with hyperhidrosis.
Although we didn’t design the product for my specific problem, I knew it would help many people avoid ETS surgery's frustrating side effects. Thompson Tee was my chance to help others avoid what I consider the biggest mistake of my life.
Today, we regularly get testimonials from customers who say they were one step away from hyperhidrosis surgery but decided against it thanks to the Thompson Tee. Seeing the Thompson Tee transform lives around the world has been beyond fulfilling. It’s what pushes us to keep going every day.
If you struggle with axillary hyperhidrosis, we encourage you to try a Thompson Tee risk-free before opting for expensive and invasive solutions like ETS surgery.
Resources for Additional Support
I haven’t told many people about my cranial hyperhidrosis because I know they couldn’t begin to understand it. Having a group of people who get what you’re going through and can offer support and advice is very therapeutic.