12 Years

2 days ago, it was exactly 12 years since my ETS procedure. As of today, after 12 years of having the ETS procedure done, I think I am so far so good! And never regretted a bit since the day I woke up from my anaesthesia in the operating room. 

To recap, in the first 5 years my palms were definitely totally dry and warm, then slowly they became more "natural'' as in they would start sweating a little according to the usual physiological processes (eg. during fright and flight response, the palms would be moist, but one wipe would clear the sweat off immediately). In the last 2-3 years, my palms would tend to respond even more "naturally" to my daily activities, with moist in the palm more frequently than before. However having said that, it does not mean my palms are sweaty, it's just not as dry as they used to be in the first 5 years. Nevertheless, doing daily activities, like playing the piano, guitar etc are all not affected. 

If there is a scale of sweatiness, with 0 being no sweat, and 10 profusely sweating. Then, I would rate it as such: before ETS (10/10), first 5 years of ETS (0/10), next 5 years of ETS (1/10), and recently 2/10. So all in all, it is still very tolerable.

The dissociation of sweatiness between my head and neck vs the torso areas is definitely more and more distinctive. When I exercise, my torso area (nipple downwards) will be profusely sweating, but upper head and neck almost dry. When I eat spicy food (even a tinge of spice or pepper), my forehead will start sweating but my torso will be entirely dry. So long as I avoid spicy food, I am perfectly ok. Drinking coffee (especially 2 cups or more) might get me headache and faster heart beat, and a little more moist in my palms. One cup of latte per day is perfectly fine. Alcohol has no effect.

I haven't been following up with the latest technology of ETS procedure, but I would presume that 12 years today, the procedure must have been even more advance and refined with even lesser side effects post-op. Perhaps for those who are still contemplating of doing this surgery, I would highly recommend you to go find out more and it would probably be the best decision you make in your life (and career).

5 Years Post ETS

I have not been updating my blog for the last 2 years, as nothing much as happened. Enjoying every moment of the dry and warm hands - and so much (so much!!) things that I could do, which I could not possibly dream of doing all these years before the ETS. Playing the piano, weight lifting at the gym, bowling, and the most dreadful task for sweaty palm sufferers - hand shaking with strangers.

However for the last 1-2 months, I started noticing my palms especially the right side started to sweat more than usual. Not that much of sweat, but under bright light I could see the "reflection" and sweat between the palm creases! Oh no... I hope the nerves at the sympathetic chains have not regrown or re-routed. 6 titanium clips on each side were implanted. The doctor told me the chance of any regrow of the nerves was absolutely minimal. But now I am starting to see some changes...

Chillies or any spicy food have been a no-no especially for the past 2 years. In the recent months, even a tiny bit of spice or pepper will cause PROFUSE sweating on my forehead. So much sweat that even a medium size towel will be soaked, after a spicy meal. But for me that is tolerable, as it is a great trade off for my dry palms. I just opt for zero spicy food most of the time.

Soles have been sweaty too, but I am not quite bothered by them. Most of the time I put on socks while at work, and even at home, sweaty soles aren't that bothersome.

However, now that the palms are more sweaty than usual really makes me "nervous" and "in fear" that the old time nightmare will strike back.

Hopefully I won't turn into that ol' "sweatyman" again...

Before and After

A picture is worth a thousand words. See for yourself the "before" and "after" effect of ETS.

Well, I dunno if other methods work as good as ETS, but I have no regret getting the op done. Just compare the pictures below, and you understand how I felt before this!

Before ETS. Really cannot imagine going back to those awful days!

...and after ETS, immediately!

2Y4M Post ETS

Time flies. It's been 2 years and 4 months ever since I had my ETS done. Till today I still hold on to the same thought as before - no regret - undergoing the ETS.

However, the side effects which are slowly surfacing now in me, to some people, may be disturbing and irritating, or merely unacceptable. But for me, I'm still grateful that my palms are still dry and warm!

My armpits are both starting to sweat more nowadays. For whatever reason. I have to carefully select my clothing, as I cannot wear dark coloured cotton shirts, as the armpit sweat marks will be extremely obvious and unsightly. The armpits used to be so dry after the ETS operation, and I thought it was so cool that I didn't need to put on any anti-perspirant or deodarant on them anymore. But now, even with anti-perspirant, they still sweat a lot, especially in hot and humid environments.

I also realise that I can't take any more spicy food. Not even a little spicy. A simple chilli sauce on my nuggets will cause my forehead to sweat profusely. But if I avoid spicy food at all cost, I am just as ordinary as I am. Luckily I don't enjoy spicy food all this while, and hence this does not bother me a lot. Only occasionally when colleagues and friends invite me to Thai food or Indian cuisine, then I will bring along a small towel to wipe my forehead sweat! :D

My palms are dry and warm, but nowadays I notice at times, the palms will be moist a little, especially after heavy exercise or anxious moments. Never like before when they were dry and needed moisturiser. Nowadays I don't apply anymore moisturiser because my palms, in fact, feel more "natural" than those days immediately post-ETS. They "sweat" a little at appropriate time. And that's what I want!

These are just the very few side effects I am "suffering" now, but if you ask me, my answer remains the same - no regret undergoing the ETS.

Sweaty palms are just a 1000x more of a nuisance than not having spicy food, or sweat in my armpit.

Almost 2 Years Post ETS

Time flies. It's been almost 2 years since I had my ETS done. I have benefited so much ever since I had the surgery performed on myself. It was an operation I should have done long ago! No regret, definitely.

However if you ask me today, what sort of side effects or complications I am experiencing.. Well, I can tell you for sure that there are not many major one, except probably I can no longer take any spicy food anymore. Even with just a little pepper or chilly in the food, my forehead will sweat so badly that it just won't stop. I literally need to use a towel to continuously wipe off the sweat while eating the spicy food. That's how bad it is today.

And in the recent few months, I suspect my sympathetic nerves are "regrowing". I at times start to get a little more moist palms, especially during anxious moments. They were completely "stone dry" for the first 6-12 months post ETS, but now, my palms appear to be more "natural" - ie. they sweat at "appropriate" times!

My soles and armpits are starting to sweat more than the first year post-op. But well, that was not my main reason I went for the surgery anyway... so it's ok! :)

But if you ask me, whether I regret having that operation...The answer is NO. I definitely enjoy the days with my dry palms. I have been able to do so many things I have longed to do; and now in bank or immigration office, I am able to have my "correct" thumbprint all the time, and the officers no longer need to complain of my "blurred" thumbprints!

Side effects of ETS

It has been many many months since I last did my ETS, and at times I already have forgotten that I was a palmar hyperhidrosis sufferer for the last 30 years or so. The surgery was very successful that I am now a total new person, with dry hands!

Many people on the internet claimed that their palms became stone dry, and I must admit that this should be my case too. My palms are 99% of the time "paper dry", I call it, and another 1% occasional moist when I feel anxious. But the odd thing is that when I feel my palms are moist, actually its just a sensation more than reality. There is actually no sweat on my palms! Weird!

Over these many months post-ETS, I must say that there are 2 major problems I encounter as the side effects of that surgery.

No more spicy food for me. Yes! For the recent months, it has been very obvious that I can't tolerate spicy food like before. Everytime I take those spicy food, my forehead will sweat so badly, that it starts to drip and drench my whole face. I at most have 5 minutes, the moment I start eating the spicy food, before the sweat kicks in! And once it kicks in, I have to vigorously wipe off the forehead sweat, otherwise it will drip on my food! But one thing funny I notice is that, not all type of spicy food make my forehead sweat. Only food with pepper and curry powder in it will create this hassle. Others like chilly sauce, strong peppermint sweets, or ginger will not have this effect. I am still researching on this till today.

The other problem I am experiencing is the loose grip I am having now, after the palms sweat no more. At times, my palms are so dry that anything I hold in hand will slip off if I am not careful. One of the worst nuisances is when I am driving through the checkout points at the apartment or shopping mall, the parking ticket or pass occasionally slip off my hands; and I have to open my car door to go pick that card or ticket up! But most of the time, I must say I will consciously remind myself to hold on things tightly, so as not to lose the grip.

Well, although the two mentioned above are considered some of the problems post-ETS, the benefits of having my dry palms back, are far greater than the little nuisance of life I have now. I would rather choose not to have spicy food, but I want a pair of dry hands to continue with my daily life!

Almost 1 year post ETS

It's been almost a year since I had my ETS surgery done. To look back at the whole 11 odd months, I feel that I have been a "new" person and that I have done many more things that I could not believe to have done in the past.

However many people asked me about the compensatory sweating problem. Well, it indeed started happening about few months ago, but not to the extent or severity of those people who wrote in various blogs in the internet. It will only happen to me when the surrounding temperature changes (eg. sudden movement from a cooler place to an outdoor environment), taking hot and spicy food (eg. curry and Thai food), anxiety state (eg. playing PS3 video games) and when I fall sick (eg. URTI or fever). Other than that, the compensatory sweat does not seem to come at all.

The sole sweating is the one I do not consider as compensatory sweat, as it happens all these years even before the ETS surgery. In fact, I must say that the sole sweating is much less, as what the surgeon told me pre-op. He told me that the sole sweating would decrease by around 20-30%, with the thoracic ETS; unless of course I went for the lumbar ETS for a total cure of the sole sweating problem, but there is a high risk of getting erectile dysfunction! ;)

The lower back compensatory sweating is sometimes quite a nuisance, but if I were to compare it with palm sweating, I would choose the former! Trust me! With lower back sweating, it at times can get quite a lot, and drench my shirt; but because of the constant absorption of sweat by the shirts I am wearing, there is at least a few hours before I need to change - or in fact most of the time, it dries up by itself! For palm sweating, you can't be on cotton glove all time to help you absorb the sweat! And that's the major difference!

Falling sick time, I would definitely sweat more at the lower back (since the palms won't sweat anymore). But in the past, my palms would sweat horrendously whenever I fell ill. So at least this time around, somewhere else which is not so prominent, is taking over the sweating process. Cool! ;)

1 year is almost up, and my response to people who are still asking whether they should go for the ETS. I would say "YES". However, it has to be a severe form of palmar hyperhidrosis we are talking here, and definitely worth every penny spent and every minute on that operating table!!

Hand holding

Ever since my palms are dry, I am able to do weight lifting in the gym, and also carrying my kids while going out shopping. All these were never possible during my sweaty palm days.

The slippery effect was in fact dangerous for anyone doing weight lifting, if you know what I mean! Imagine the weights slipping off your grips, and falling directly onto your chest wall or neck.

I was also never able to carry my kids during outings. The sweat would come on, if I exert or constantly holding on to something. Even after a shopping spree, and my hands carrying many bags of stuff, the palms and fingers would sweat non stop, making the grip very lose and difficult to hold on to anything. Really a nuisance.

But today, I am really happy that I am able to constantly holding on to any object in hand, for a long time.

Oh yes, the best is to be able to constantly holding on to my wife's hand, and not fearing my palms would sweat again.

Sand Art

I was trying out the Sand Art painting few days ago, together with my kids, at a shopping mall. It involved scooping up sand and smearing it on the designated areas on the cardboard with a nice picture. The aim was to colorize the picture with colorful sand.

I could remember how tedious it was back in those days with sweaty palms. Those school days, when I was playing with sand or beads, my palms and fingers would sweat non stop. All the sand and beads got wet and stuck all over my palms. Nuisance!

But today, I could play with the sand again. And obviously not a single sand particle got stuck to my palms. I just slightly swing my wrists each time, and all the sand would fall off. Clean!

5 months post-ETS

5 months since my ETS surgery, let's share what I am feeling right now. The answer is "NO REGRET!"

Dry Hands
My hands are dry, and I could do so much more things than ever before. No ordinary person can comprehend how messy and nuisance it is to have sweaty palms. Shaking hands with other people was a nightmare for me, but now, I have always been the "initiator" for hand shaking! Confidence level and total image boost are both important for people working in the service lines. Only swimming instructors don't need ETS surgery! ;)

Soles and Armpits
Even though the ETS that I underwent did not promise me anything for my sweaty/smelly arm pits and sweaty soles, I was (perhaps) the lucky one which the ETS corrected both my problems. Now I have no more sweaty arm pits and no more smelly "fox smells" (in chinese). Armpit deodorant is now history for me. Soles are probably not 100% dry, still remain a little moist. But then putting on slippers and walking in the shopping malls nowadays, won't make me trip over because of the slippery feet!

Sweaty Forehead
I read many of post ETS patients writing on the internet, that they became "bone dry" nipple upwards. But probably I was the lucky one (or perhaps Dr Khoo did a great job by clipping precisely on the right places) I still sweat over my forehead and arms and armpits and chest! But the sweating comes only when I exercise or eating chilly hot food! This is of course normal for any ordinary people. But for a post-ETS patient like myself, of course preserving this sweating above the nipple line is indeed an important phenomenon.

Blood Pressure
My blood pressure post ETS was reduced by a little. Before that, it was always in the pre-hypertension range of 130/80. Post ETS, my BP became 125/75, which is indeed a good "long term treatment" without medication side effect! ;) I am trying to exercise regularly now, to further reduce my BP to a healthy level of systolic 120mmHg.

In summary, I am just happy with the result (so far). I will continue to monitor myself over the months and years to come. Hopefully no new problem arises. But even though it's been just 5 months since the ETS, I feel like it's been a long time, because I have managed to do so many things which I can't before this!

If any of you are still contemplating a cure for your sweaty palms, I would recommend you to go for the ETS. But make sure you survey (the doctor, the procedure, the possible side effects etc.) properly first, as this is a decision solely by you yourself. After a successful operation, you will be totally transformed into another person, trust me!

Compensatory Sweating

I noticed recently that my compensatory sweating, especially at the lower back and thigh areas, will only come if there is an extreme change of surrounding temperature.

Recently, I just came back from Australia, and because it was winter there (temperature around 8C-18C), the sudden change in temperature back to 36C over here, had caused my compensatory sweat to come. I believe the humidity also played an important part in causing the sweat.

However, after 2-3 days, when I have adapted back to local weather, my compensatory sweat disappears too.

I am going to try again, when I visit Korea later this year (also winter), and I will be able to confirm this phenomenon, and therefore able to understand better the compensatory sweating mechanism in me.

Filling up forms

I used to dislike filling up forms in the banks or govt offices. The main reason was my sweaty palms and fingers would be aggravated and it was distressing when filling up those forms. I chose internet transaction whenever I could, to avoid such embarrassing moments.

Sometimes even traveling overseas, I needed to fill up disembarkation form. And I usually remembered to do that right in the flight, rather than at the immigration counters. In the latter, my hands would sweat like mad, and I could not even hold the pen properly. The whole form might be drenched and looked horrible when the officer took it back from me.

But today, I am not facing this problem anymore. Just yesterday, I went to the bank to fill up the transaction forms. And it was first time in my life, when I could actually take my own sweet time filling up those forms without having a single drop of sweat from my fingers or palm. The forms remained dry and neat. The pen grip was good. And best of all, I was not even anxious with the huge crowd around me.

At the gadget outlet

Whenever I wanted to test out electronic gadgets (like laptop, PDAs, smartphones or cameras) at the outlets, it was really a tough time for me. The sweaty palms and fingers would almost always drench the devices instantaneously, the minute I held on to them.

Despite the demo units had been touched by hundreds if not thousand times, they usually were still brand new looking. Therefore, even the sales personnel would be extra careful in handling them. With wet hands, the devices would be wet, and upon returning to the sales personnel, they would usually give me that look "Eeeew!"

Today, I have no problem in handling and touching any devices, and testing them out thoroughly before buying. Thank God, my hands are dry now!

Playstation and XBox

Those days, I could never play the video games, because by 5 minutes into the games, the consoles (or the controller devices) would be so drenched that I was worried the sweat might damage the devices!

And the worst of all, would be your friends were waiting next in line to take over your console to play the game. They would be like "EEEeeeeewwww!!!! Gross!!" And that's the "compliment" they would yell on my face.

Therefore, to avoid all these embarrassment, the best thing was NOT to join in the game at all. And that constituted "anti-social" behaviour! ;)

Today, I could play with the video game consoles, just like any ordinary guys next door. I could play the games with my kiddos, and they really enjoy the sessions with me. What a wonderful time I have with my kids.

And thanks to the dry palms now.

Forehead sweating

I had been told prior to the ETS that I probably would not sweat anymore on my forehead. In fact  I read on the internet, many patients who underwent the ETS described their "bone dry" skin above the nipple line.

Today I wanted to try if this is all true, post ETS. And I ordered a bowl of spicy curry noodle for lunch. Before the surgery, I had always sweated very badly on my forehead, scalp and around the lips whenever I took something spicy. I also wanted to test out if the "gustatory sweating" is happening to me or not.

Halfway through the spicy meal, I was rather elated that my forehead and scalp and neck started sweating just like before! However my arms, forearms, armpits and both palms were dry and warm! That's exactly what I have wanted. This is what I call the "normal" response.

And my lower back and buttock area did not sweat. Soles were a little sweaty but that was normal for me. There was no "gustatory sweating".

All I can conclude after today's spicy meal is that I am happy that I am being normal again, thanks to the ETS.

Coffee

Coffee has always been my favourite. But back in those sweaty palm days, drinking coffee was a nightmare for me. I used to call it "enjoy now, suffer later".

Everytime after drinking a cup of coffee, my palms were sweaty and my heart beat very fast. My head would pound and become heavy, and both my arm pits and soles would be drenched. Thanks to the caffeine effect. That's why I could only always drink at Starbucks, not because I particularly like the coffee, but because they are the one who provide de-caffeinated coffee in all of their choices.

Today, I am different. I can drink whatever types of coffee at any bistro or cafeteria, without any problem even after 2 cups of Espresso! My heart beat does not increase, my palms stay dry, my head does not hurt, and my armpits and soles are just slightly moist.

I do not need to specially order for de-caffeinated drinks anymore. I can choose whatever I like, anywhere, anytime.

Now, that's what I call "suffer first (ETS surgery), enjoy there after"! ;)

Ophthalmoscope

I was never able to use the ophthalmoscope properly during those wet hand days. It's all because of the dials both in front and side of the scope. With wet fingers, the grip was never there, and adjusting the dial up and down to get the best vision while busy looking into patient's eye, was actually more of a nightmare than a enjoyable moment.

I really wish there was a digital ophthalmoscope around, but so far I have not seen one.

The otoscope, on the other hand, has got no dial. And therefore I had no problem using it even though the hands and fingers were wet.

But today, using the scope is a breeze. Good grip, index finger turning the dial whenever I want, and even my the other hand touching the patients' foreheads does not return that weird look from them anymore.

Menthol sweets

In those days, I could not enjoy any mint-containing sweets, like Menthos, Fisherman Friends or Hacks. The mint/menthol content would accentuate my sweaty palms by many folds. Whenever I took any of those sweets, my palms would go into a "berserk" mode. The sweat would come on non-stop. And it took a long while for the sweat to go off, even after stopped taking the sweets.

Today, my palms no longer sweat. I can take any spicy food, menthol/mint containing sweets or even strong Espresso. That's what I call "enjoying life".

Power steering

Other than not able to use the camera with dials or slide down cover, I was also unable to drive cars which do not come with power steering. But luckily most cars nowadays come equipped with power steering feature.

I still recall how embarrased it was years ago, when my friend asked me to help her reverse park into a narrow parking lot. She was driving one of the smallest national cars - Kancil. But for your information, the Kancil did not come with power steering function. So although the car is light and tiny, i had a tough time manouvering the steering wheel. All because of my sweaty palms. There was no proper grip at all. And you could already predict the outcome - neither I could reverse park that car.

I have always installed the steering wheel grip in all the cars I drive. Even though they do come with power steering function, I just want to make sure that I always have proper grip to the wheel to prevent any untoward event.

Today, I do not need worry on that anymore. I have recently tried driving a Kancil without the power steering function. And you would also probably have guessed the outcome - I am now able to reverse park because my palms are dry and the grips are perfect.

Camera

During those sweaty palm days, I never was able to use a digital SLR camera. The heavy camera with its fully functioning dials and knobs and whats not, were really not easy in my hands. Loose grip, and the camera would fall to the ground. And with all those dials, my fingers were always wet, and it was really very difficult to turn it properly. All because there was inadequate grip between the fingers.

I had always opted for small point and shoot cameras, without dials, and only contained digital buttons. I could only press the buttons, but definitely not turning those dials. Even the Sony Cybershot series which come with the slide down front cover, I was not able to use properly. I was not able to pull down the slide cover each time, because my fingers were wet. All I could use were those like Canon iXus series, and not all of the models, but selected ones like the iXus 850, because all were only press-on buttons, and no dials.

Therefore my choices of cameras were always limited.

But now, I can use any camera I like. And I am planning to get a Digital SLR, and join my friends for outdoor shooting some days!