Ends Misery of Wet Palms, Feet for Eight Year Old Girl
by Beth Reinhardt, San
Antonio Express News
Wanted to Hold Rachel's Hand
A petite 8-year-old with blond hair and big blue
eyes, Rachel Walther had hands that were constantly wet and cold.
Her hands and feet would sweat.
She wore gloves at piano lessons
to keep the keys dry. She kept a towel in her desk at school to
wipe off her papers. Her tennis racket slipped during
of her perspiration. But what made her cry was that no one wanted
to hold her hand. Rachel has hyperhidrosis, a condition that causes
Her mother, Sarah
Walther, knew something was not right. "At age2, I noticed that her socks would be soaking
wet and her hands would be sweaty," Sarah recalls. When Rachel
was 3 years old, her mother knew the sweaty hands and feet were
abnormal, but their pediatrician said she would outgrow it.
"Then I saw a '20/20' special on it and,
boy, did I bawl. I thought, 'That's my girl, that's my daughter,'"
Sarah says. At the time, she did not hear the name, hyperhidrosis,
and it was several years later before Sarah found a diagnosis for
Hyperhidrosis affects 0.6 percent to 1 percent
of the population, or about 6,000-10,000 people in San Antonio.
It is a hereditary condition caused by an overactive sympathetic
nervous system. Symptoms include extreme sweating of the hands,
underarm area, face, scalp, or feet. It is associated with Raynaud's
Syndrome (cold hands that often change colors because of hypersensitivity
to temperature change), facial blushing and Reflex Sympthetic Dystrophy,
pain of the hands and arms.
Hyperhidrosis causes more than the physical discomfort.
With time, it becomes an emotional issue. After seeing the news
special, Sarah and her husband, Larry, knew their daughter would
be in for a tough time as she got older. Despite not having a diagnosis,
they still prayed for a treatment. The first treatment, Drysol,
a topical antiperspirant used by athletes, did not work.
In the fall of 2000,
Sarah asked her prayer group for help. Amazingly enough, a member
of the group had just heard a story about hyperhidrosis. Rachel's
condition now had a name and a possible treatment. Sarah took
the 800 number and put it on her bulletin board. The day Rachel
came home from school in tears because no one wanted to hold
her hand, Sarah called. "I
had no idea the office was in San Antonio,"
Dr. David Nielson is a successful
cardio-thoracic surgeon who specializes in endoscopic lung therapy
on adults and children. But what Nielson is fast becoming known
for is his innovative treatment for patients with hyperhidrosis.
Micro-endoscopic thoracic sympathectomy, created by Nielson, is
the least invasive surgery for people suffering from hyperhidrosis.
This procedure has the quickest recovery time and has a highly
successful improvement rate for those suffering from excessive
sweating of the hands and almost equally as high a success rate
for those suffering from underarm sweating, facial blushing, Raynaud's
Syndrome and RSD.
Nielson became involved with the treatment for
hyperhidrosis in the late 1980's while at Temple University Medical
School. At that time, treatment of hyperactive sympathetic nerve
dysfunction was very invasive. It involved making a single large
incision or four 1/2-inch to 1-inch incisions in the chest, spreading
the ribs, severing the nerve and several painful days in the hospital.
As technology allowed, Nielson has continuously improved his endoscopic
techniques of his heart and lung surgeries, which he used to create
the ETS procedure, by making smaller and fewer incisions.
During the procedure, Nielson makes a single incision,
one-twelfth on an inch per side, under each arm. Nielson inserts
a 2 mm scope, camera and micro scissors into the incision. Nielson
compares the size of his instruments to angel hair pasta. Once
the sympathetic nerve is identified, he severs it, which instantly
improves the excessive sweating. The procedure takes 30 minutes.
The patient is able to leave two to four hours after the procedure.
Rachel is the youngest patient and smallest to
have the procedure done. His patients now range from 8 to 75 years
"When I met Rachel for the first
time, I noticed the profound sadness and the distress it
was for her at this young age," Nielson says. "Rachel
told me just how much it affected her by the look on her
When asked about
her sweating, Rachel would become very annoyed. "Every time I'd start to sweat, I'd get so mad.
I'd feel like screaming my head off," Rachel says.
Many people are misdiagnosed. Dermatologists recommend
Botulinum Toxin injections into the hands or Drysol as a treatment. Some
patients are told to simply deal with the problem. Patients, especially
young patients, are told it is related to puberty. Other patients
are told the sweating is a panic attack and are prescribed anti-depressants.
Patients suffering from hyperhidrosis - from teens
wanting to date but won't due to sweaty hands to adults choosing
a career - face a lifetime of emotional problems, Nielson explains.
"I can recount stories of patients who have
been excluded by classmates," Nielson says, while detailing
the emotional pain that hyperhidrosis can cause. Hyperhidrosis
affected the lives of 17-year-old Katie Stevens, a senior at MacArthur
High School, and 19-year-old Megan Kolenda, a freshman at San Antonio
"I felt separated from the others," Stevens
says. "I was really embarrassed because my hands were so sweaty
and I didn't know what was wrong with me."
Kolenda agreed with
"I felt different, and I was always shy. I worried about meeting
people or getting my paper wet in school." Although they have
never met, Kolenda and Stevens used the same techniques to cover
up their sweating. They always wore denim pants because it absorbs
the sweat. They were able to wipe their hands on their jeans. Both
carried a sweater even in the hottest months, and wore only white
or dark colors so that the sweat would not show under their arms.
"I saw the reaction on people's face when
I would shake their hands and they would have to wipe their hands
off," Stevens says. Kolenda says she used stories to cover
her sweating by saying she had "just washed her hands."
"Dr. Nielson was so nice and comforting," Stevens
says. "He shook my hand then took my hand and rubbed it. He
was not cringing or anything."
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