Living with Hyperhidrosis: Sarah’s Story

Not long ago, you could always find Sarah in long-sleeved shirts, even in the middle of the summer.

Sarah tends to get cold easily, but she had another reason for the long sleeves: she needed something to continually wipe the excess sweat from her hands.

“My sweat was probably two to three times the average person when they’re nervous,” Sarah says.

Sarah struggled doing normal activities. “It became really hard to manage when I got to middle school. I had to do more writing and I had more interaction with other kids.” Her school papers would get wet, and later when she was learning how to drive, the steering wheel would get wet from her hands.

sarah-hyperhidrosis-success
Children and teens with hyperhidrosis have excessive sweating regardless of the environmental temperature and emotional factors. a surgical treatment called endoscopic thoracic sympathectomy, or ETS surgery can help.

Sarah’s mom, Christine, remembers the problem when Sarah was just six years old when the family lived in Japan. “We were in downtown Tokyo and it was really crowded with people, and I went to hold her hand so I could keep track of her,” Christine says. “Sarah said to me, ‘It’s okay, you don’t have to hold my hand.’ She didn’t want me to hold her hand because of the sweat.”

It wasn’t until Sarah was 14, after visiting doctors across three different continents where the family lived, that they relocated to Orange County and finally received a diagnosis: hyperhidrosis. Children and teens with hyperhidrosis have excessive sweating regardless of the environmental temperature and emotional factors. They may have sweating in the hands (called palmar hyperhidrosis) as well as the feet, under the arms and the small of the back.

“If you can imagine your hands always being wet like you just stepped out of the shower, where you hold your hand up and the sweat drips off, that gives you an indication of how significant palmar hyperhidrosis can be,” according to Dr. Troy Reyna, CHOC Children’s pediatric general and thoracic surgeon.

Sarah was referred to a pediatric dermatologist and tried prescription medication, topical ointments and electrolysis (iontopherisis). After these treatments failed to help, the family came to Dr. Reyna, who specializes in a surgical treatment called endoscopic thoracic sympathectomy, or ETS surgery.

sarah-hyperhidrosis-excessive-sweating-ETS-surgery
For children and teens who suffer from hyperhidrosis, also known as excessive sweating, a surgical treatment called endoscopic thoracic sympathectomy, or ETS surgery can help.

“Dr. Reyna was very informative and understanding,” says Sarah’s dad, Rob. “We had an open consultation discussing options and alternatives and we were not asked to make a decision at that point. In fact, Dr. Reyna encouraged Sarah to do her own research and come to her own decision. We left it to Sarah, and after a couple weeks, she came to us and told us she wanted to have the surgery.”

ETS surgery involves making two small incisions on either side of the chest and cutting the specific nerve pathways that lead to the sweat glands in the hands. This minimally invasive procedure is often done on an outpatient basis.

“When I got home from surgery, I noticed that my hands had stopped sweating completely, and I was so excited,” Sarah says.

Sarah still has excess sweating in other areas like her feet and lower back. The condition does interfere with some aspects of her life, but it is more manageable now that her hands are dry.

“If someone else with this condition is thinking about the surgery, I would definitely tell them to look into it,” Sarah says. “You’re not able to do things a regular person can do, and that’s not really fair.”

This summer, Sarah is looking forward to traveling to Germany to visit her grandparents, attending her friend’s sweet 16 birthday party in New York City—and enjoying the warm weather in a short-sleeved T-shirt.

Learn more about palmar hyperhidrosis and ETS surgery

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The Importance of a Pediatric Surgeon

Children are not just “little adults” and when possible, should be treated by a physician who is specially trained in pediatrics. Their physiology is different, and since they’re still developing, their organs are not always in exactly the same location. In this episode of CHOC Radio, Dr. David Gibbs, a pediatric surgeon and the director of trauma services at CHOC, discusses:

Hear more from Dr. Gibbs in this podcast:

CHOC Radio theme music by Pat Jacobs.

Related posts:

  • Living with Hyperhidrosis: Sarah’s Story
    Children and teens with hyperhidrosis have excessive sweating regardless of the environmental temperature and emotional factors. A surgical treatment called endoscopic thoracic sympathectomy, or ETS surgery can help.
  • Preparing Your Child for Surgery
    Surgery is scary for kids and parents, alike, but not talking about an upcoming surgical procedure can create more fear and anxiety in children. In episode number 29, Child Life ...
  • Will Your Newborn Need Surgery? Plan Now
    The news comes as a shock, usually during the first prenatal ultrasound between the 16th and 20th week of pregnancy. Treatment planning, however, cannot begin too soon when a developing ...

 

Preparing Your Child for Surgery

Surgery is scary for kids and parents, alike, but not talking about an upcoming surgical procedure can create more fear and anxiety in children. In episode number 29, Child Life Specialist Brianne Ortiz offers tips for preparing children, from toddlers to teens, for surgery.

The amount of information, in addition to how and when it’s presented, depends on the emotional and cognitive age of the child. Brianne recommends parents speak to children, ages 3 to 5, approximately three to five days before the scheduled surgery. These younger-aged children often think they’ve done something wrong, so it’s important to reassure them that’s not the case and to present information in concrete terms they understand. She reminds parents that toddlers don’t have a concept of time. Instead of saying a procedure will last an hour, for example, explain that it will be over in about the same time as their favorite TV show.

Adolescents most often worry about waking up during surgery and about pain. Brianne educates teens on the role of the anesthesiologist and the hospital’s pain scale. She encourages teens to engage with their care team and not be afraid to speak up.

Listen to the episode for more helpful tips, including resources offered by CHOC.

CHOC Radio theme music by Pat Jacobs.

Related posts:

  • Living with Hyperhidrosis: Sarah’s Story
    Children and teens with hyperhidrosis have excessive sweating regardless of the environmental temperature and emotional factors. A surgical treatment called endoscopic thoracic sympathectomy, or ETS surgery can help.
  • The Importance of a Pediatric Surgeon
    Children are not just “little adults” and when possible, should be treated by a physician who is specially trained in pediatrics. Their physiology is different, and since they’re still developing, ...
  • Will Your Newborn Need Surgery? Plan Now
    The news comes as a shock, usually during the first prenatal ultrasound between the 16th and 20th week of pregnancy. Treatment planning, however, cannot begin too soon when a developing ...

Will Your Newborn Need Surgery? Plan Now

The news comes as a shock, usually during the first prenatal ultrasound between the 16th and 20th week of pregnancy. Treatment planning, however, cannot begin too soon when a developing baby is diagnosed with a complex birth defect.

 

Some babies are born with complex conditions requiring surgery during the first few hours following birth. From the moment prenatal testing reveals an abnormality, CHOC Children’s is ready to help with the prenatal care and birth planning necessary to ensure the best-possible outcome.

CHOC has a trained and experienced team that includes perinatologists, neonatologists, pediatric surgeons and NICU nurses to guide families through the months before delivery. And families are essential to the planning process.

“The well-being of the child is surprisingly dependent on the well-being of the family, both psychologically and emotionally,” said Dr. David Gibbs, division chief, pediatric surgery, CHOC Children’s Specialists. “Preparation helps the family cope better, and the family that is coping better is able to provide better care for their child.”

According to Dr. Gibbs, recent advances in the care and outlook for babies born with abnormalities have come from closer prenatal coordination with perinatologists and families, combined with highly specialized neonatal intensive care. The CHOC NICU is rated by the American Academy of Pediatrics as a Level 4 NICU, the highest designation available and given only to facilities that also provide onsite surgical repair of serious congenital or acquired malformations.

That immediate access to the full NICU medical team, resources and support is critical for babies born with gastroschisis, a condition that requires surgery within the first hour following birth, and omphalocele, which must be corrected within the first few days. For the smallest and sickest, CHOC’s Small Baby Unit offers additional support to help babies grow and recover more quickly with fewer infections and setbacks.

For babies born with congenital diaphragmatic hernia, the CHOC Surgical NICU provides the optimal environment in which to stabilize and gain strength before surgery. One special room inside the CHOC NICU converts into a state-of-the-art operating room, allowing pediatric surgeons to perform delicate procedures within the unit.

And babies born with congenital cystic adenomatoid malformation (CCAM) may actually get to go home for continued evaluation months before surgery.

Deciding Where You’ll Deliver

Dr. Gibbs added that an important element of prenatal planning is deciding in advance where your baby will be born. Moms who know their baby will need surgery may choose to deliver at a hospital that is near a pediatric facility like CHOC. When the baby is born, the CHOC Transport Team is ready 24 hours a day to transport the baby to CHOC from hospitals throughout the region. Specially trained and equipped, this team uses ground and air transportation to travel to and from hospitals throughout Orange, Los Angeles, Riverside, San Bernardino and San Diego counties — and even beyond.

“We expect most children will do well and have normal lives,” Dr. Gibbs said. “But the first step is meeting with the perinatologist, pediatric surgeon and NICU team. Starting that relationship as soon as possible will make the process of coping with what may seem to be an overwhelming process a lot easier.”

CHOC’s surgeons provide cardiothoracic surgery, gastrointestinal (GI) surgery, general surgery, neurosurgery, urological surgery, otolaryngological (ENT) surgery, plastic surgery, ophthalmologic surgery and orthopaedic surgery.

Learn more about surgical services at CHOC.

More articles about surgery:

  • Living with Hyperhidrosis: Sarah’s Story
    Children and teens with hyperhidrosis have excessive sweating regardless of the environmental temperature and emotional factors. A surgical treatment called endoscopic thoracic sympathectomy, or ETS surgery can help.
  • The Importance of a Pediatric Surgeon
    Children are not just “little adults” and when possible, should be treated by a physician who is specially trained in pediatrics. Their physiology is different, and since they’re still developing, ...
  • Preparing Your Child for Surgery
    Surgery is scary for kids and parents, alike, but not talking about an upcoming surgical procedure can create more fear and anxiety in children. In episode number 29, Child Life ...

Matthew’s Story: Healing in the Surgical NICU

babies surgeryGrace Wu beams as she watches her son Matthew smiling and happy after enjoying his bottle.

“It’s good to see him so happy and active,” she says. “That he could do that makes me very, very happy.”

It’s a marked change from the days following Matthew’s birth almost four months ago.

As a newborn, he was diagnosed with volvulus, a condition wherein the intestine is twisted and can ultimately cut off blood circulation. Symptoms of volvulus include a distended stomach and intolerance to feeding, which Matthew exhibited.

The baby was quickly transferred to CHOC Children’s for emergency surgery at just three days old. CHOC surgeon Dr. Saeed-Ur-Rehman Awan repaired the malformation by performing an ileostomy, wherein the intestine is brought outside the body.

Next, Matthew needed time to heal his organs. He spent the next three months recovering in CHOC’s Surgical Neonatal Intensive Care Unit, a special part of the hospital’s main NICU dedicated to the care of babies who need surgery.

There, Matthew was under the care of a multidisciplinary team that included Dr. Irfan Ahmad, a CHOC neonatologist and co-director of the surgical NICU, and many other clinicians.

In the unit, the team cares for patients jointly, discussing the cases of children like Matthew as a group and forming a treatment plan that often calls for the expertise of other specialties at CHOC.

Another key component of the surgical NICU care team is parents and families. In Matthew’s case, his parents and grandfather, Jerry, partnered with clinicians on every stage of the baby’s care.

“Jerry was there every single day holding Matthew – even when he was crying,” Dr. Ahmad says. “He was a great member of the team, and he provided a lot of support.”

As Matthew began eating orally in small volumes as well as through intravenous methods, he geared up for a second surgery that would reattach his intestines. That procedure was performed just three months after the first.

After several more weeks of recovery, Matthew was able to eat fully from a bottle and was on his way home, much to the relief of his family.

“I was very worried because for the first time, I thought I might lose him,” Grace says. “I am very thankful for the care he’s received.”

More articles about CHOC’s Surgical NICU: