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Here are my suggestions:

1. Consult at least two other physicians that are familiar with the procedure but do not preform the procedure or have any financial interest in your decision. Try seeing one dermatologist and one neurologist.

2. Bring a family member or close friend to the consultation. Having an objective third party present will prevent you from making an emotional decision regarding the surgery.

3. Do not make your decision based solely on information gathered from surgeons websites, brochures and phone calls to the surgeons office.

4. Do not schedule a consolation that can be followed by a surgery the same day. Go to a consultation and then spend at least a few weeks considering the risks.

5. If you go alone to the consultation, bring a tape recorder to record the conversation. Tell the doctor you want to record the conversation. If he objects, then you have learned something about him.

6. Realize that testimonials from happy post-op patients are anecdotal and do not reveal anything regarding the possibility that you will regret the surgery.

7. Even though a minority of patients regret the surgery, regret is not at all rare. A five percent regret rate is 1 in 20 patients. A minority for sure, but hardly a rare occurrence. Many studies demonstrate regret rates much higher over the long term.

Hi whatdoido18,

If you elect to have the surgery, which I sincerely hope you don't, I wish you the best. Should you choose go through with it, do so with the knowledge that regardless of the location of the surgery (T2, T3, etc.) or the experience level of the surgeon, you are risking a lifetime of suffering from conditions far worse than that which you seek to cure.

Here what you should know going in:

1) There is not a single shred of objective, scientific evidence that T3 ETS leads to fewer and/or less severe side effects relative to T2 surgery. None. Zero. Zip. I'm not kidding. You can do your own research if you'd like, but I can assure you none exists. Dr. Garza's claims about T3 surgery are scientifically baseless.

2) Sympathectomy at T3 does involve partial sympathetic denervation of heart and the vascular smooth muscle of the upper torso. This fact can be verified in one of hundreds of neuroantomy or neurophysiology text books. Again, Dr. Garza's claims are baseless and false.

3) The effect of sympathectomy on excessive sweating is displacement, not cure. "CS" is a euphemism used to disguise the fact the surgery causes hyperhidrosis of trunk and lower limbs that is as bad or worse than the original condition.

4) ETS will "cure" you palmer hyperhidrosis by completely eliminating your ability to perspire over a large region of your body. This is a pathological condition called regional anhidrosis. It's unhealthy and detrimental.

5) You cannot avoid any of the above adverse effects by choosing the "right" surgeon or having the surgery done at the "right" location. What you got from Garza (and what you will get from any ETS surgeon you talk to) was a sales job. The marketing of this surgery is rife with omissions, misleading information and outright deceit. Be wary of any claims made.

Finally, I would encourage you to discuss your plans for surgery with several other doctors who have no financial interest in your decision. Go to your general practitioner, maybe a dermatologist and go see a neurologist.

One physician I spoke with after my surgery put it this way: "When you are seeking treatment for a condition, never contact a physician who has a procedure to sell. Visit a physician who has no financial interest in your treatment decision, i.e. one who will consider your condition objectively and put your health first."

In other words, don't assume that because some guy has a medical degree and a license to wield a scalpel that he's honest and ethical.

Good luck.

whatdoido,

Here's my take on your questions/concerns.

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Garza did mention that T3 cutting is only at the shoulder, arms level. Therefore, I would still be able to sweat from my head, which I want.

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That is a mostly true, but misleading statement. The honest truth is that you will likely still be able to sweat some from you head, but it's not guaranteed. There is variation in how each individual is wired and there is some risk of loss of head sweating. I've talked to T3 patients with facial/cranial anhidrosis. It's rare, but still a possibility.

However, you might get compensatory hyperhidrosis on your head. CH occurs in areas not denerved by the surgery. I've spoken with T3 patients who developed quite severe facial/cranial hyperhydrosis from T3 surgery.

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He also mentioned that my hands would still have normal sweat during exercise, which I also want.

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Now that is utter BS. I can't believe some surgeons make the claim that the surgery only affects nervous sweating but not thermoregulatory sweating. Don't believe it. It's nonsense. The signals that travel to your sweat glands follow the same pathways, down the exact same neurons whether the sweating stimulus is anxiety, heat or exercise.

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Also, b/c I don't always excessively sweat in my hands, feet and armpits--I can go a week sometimes without sweating, controlled mentally--I think the CS might not affect me as much.

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The problem with predicting that the grass will be greener on the other side is that you have no way knowing if that is true. Ask anyone here and they'll tell you that they convinced themselves prior to surgery nothing could possibly be as bad as what they were already dealing with. That's what surgeons count on to sell the procedure.

The truth is that you have know idea what CS is like until you experience it first hand. There is no way for you to predict in advance whether you'll find that trunkal and lower-limb hyperhidrosis preferable to palmer and axillary hyperhidrosis. But, once you have the surgery, you'll have to live with the displaced hyperhydrosis for life whether you like it or not.

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I'm seriously contemplating not doing the surgery anymore, but I don't know how I can have a professional life w/o it.

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Well, speaking as someone whose professional life was ruined (causing me to change careers in midlife) by the effects of this surgery, I can say that by getting the surgery you may limit your career options as well. I've known a number of people who had to change careers to cope with the effects of the surgery.

I'll shut up after I offer this last bit of advice. One thing you said demonstrated you have already found the secret to the real cure. You see, this ham-fisted surgery treats the physical symptoms of your anxiety by destroying the pathways between your brain and numerous organs including the sweat glands. It's destructive and does not address the root cause. You will sweat excessively the trunk during periods of anxiety rather than your palms and armpits.

So, I urge you to treat the problem at the source: the anxiety. You said, "I can go a week sometimes without sweating, controlled mentally", so you know it is possible. I'm not saying that that is an easy task. It's a very difficult one that you will likely have to work on throughout your life. But, it is, by far, the best approach.

Good luck.

P.S. Garza recommends cutting over clamping because cutting is easier for him to perform. He get paid the same regardless and the clamps are a pain in the ass to put in. Cutting is way easier. The effects are the same.