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How Do You Know if Your Excessive Sweating Can Be Treated? And How it is Treated
Hyperhidrosis is a medical condition involving excessive and inappropriate sweating. Dr. Charles Klodell explains the condition and its treatment.
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Learn more about Charles Klodell, MD
Charles Klodell, MD
Dr. Charles T. Klodell is a cardiothoracic surgeon that specializes in heart and lung surgical procedures including minimally invasive aortic and mitral valve repair or replacement, aortic aneurysm repair, transcatheter aortic valve replacement (TAVR) and open heart surgery. He has a special interest in minimally invasive procedures, valve repair, and innovative uses of technology and pharmacology to alleviate patient discomfort.Learn more about Charles Klodell, MD
Transcription:
Adam Ragusea (Host): I got to say, I’m sweating this interview. I’m about to talk with Dr. Charles Klodell. He’s a cardiothoracic surgeon at Florida Heart and Lung Institute. He’s a real accomplished guy. My forehead is dripping. My palms are wet. I don’t want to mess this up. Is this excessive sweating a normal response to stress or could it be hyperhidrosis? Let’s find out. It’s Helmet of Health, the podcast from North Florida Regional Medical Center. I’m Adam Ragusea. So, Dr. Klodell, everybody sweats, some of us more than others. When does it cross the line into like a diagnosable condition?
Charles Klodell, MD (Guest): People that have true hyperhidrosis, it’s not subtle. They don’t question whether or not it’s normal. They will sweat at rest. They will sweat when they are sitting in an air conditioned room by themselves just watching TV, relaxing. It’s inappropriate sweating. When you are on a treadmill at the gym, everybody sweats. Not everybody sweats in a 65 degree room and folks that truly have hyperhidrosis, will.
Host: Do we know what causes it?
Dr. Klodell: So, hyperhidrosis can be caused in theory by sweat glands that are over-receptive to the electrical impulses that are being delivered to them or it could be that there are too many electrical impulses from the brain being delivered to those sweat glands. We don’t really understand that. What we do know is we know how to treat it and treat it well.
Host: Okay, so, say that I’m somebody who just sweats, not in situations of stress, not when I’m having lots of physical activity, but when I’m just sitting on the couch, I’m sweating profusely. What can you do for me?
Dr. Klodell: Well the first thing is, we have an interview. We talk about whether it’s what we call primary hyperhidrosis which is a person who says I can remember this all the way back to my childhood days. I had trouble in school because the papers were getting smudged, things like that. Those are the patients that can be surgically treated.
Then there’s secondary hyperhidrosis. Those are patients that have developed it. They were fine and then all of the sudden at age 55, they developed it. Those patients don’t respond very well to surgery.
So, for the patients that have primary hyperhidrosis, now we talk about what body parts are impacted. Is it, what we call cephalic hyperhidrosis which is of the head or is it the more common palms and feet and some patients even have it in their arm pits. For the people that have it in their hands and their feet in particular, palmar hyperhidrosis is very, very life limiting. It’s very difficult. They have trouble shaking hands. They have trouble in social situations. And it’s easily treated.
It’s a very short outpatient procedure where we use what’s called a thoracoscope which is a very small camera. It’s smaller than the ballpoint pen refill that we would put in our ink pen. We look inside the chest, we look behind the lung, we find some nerves that deliver those electrical impulses to the sweat glands and we can use electrocautery to blunt some of the electrical impulses going to the sweat glands. That procedure takes about 45 minutes. It’s done as an outpatient and it’s over 90% successful in eliminating excessive sweating from the hands.
Host: So, what’s the recovery like? You’ve gone into my skin and you’ve cauterized some nerves. Am I going to have a lot of pain and swelling?
Dr. Klodell: No, actually really not. We usually do them on a Friday, so they then have Saturday and Sunday to get over it a little bit and by Monday, most everybody is back to normal activities. I’ve had patients that have gone and run a half marathon, 36 hours after the procedure.
Host: Oh wow. And you say the success rate is about 90%, I mean it’s got to be – for someone who has lived with a condition like that their entire life with the social anxiety of not being able to shake hands, that kind of thing; to simply turn off that symptom like a light switch, has got to be life changing.
Dr. Klodell: It really is. Over my career, I’ve done so many variable operations, everything from heart transplants to valvular heart surgery to lung cancer surgery and the number of cards and letters and positive feedback I get from the patients with hyperhidrosis after the surgery, is ten-fold all of the other things that I do. I’ve done children in their like early teenage years or even 9-10 year olds that were being home schooled because of the way they were being treated at school because of this. They were being ostracized. So, it’s just an amazing change for an otherwise somewhat disabling condition.
Host: One more question Dr. Klodell. As we said, everybody sweats, not just people who have hyperhidrosis and a lot of people are bothered by their sweating. I could imagine that there are people who would be interested in having a procedure like this done, not because it’s really a clinical problem for them, but it’s more of cosmetic problem for them. Or it’s interfering with performance. They are a rock climber and they don’t like having sweaty palms, it makes it hard to grip the rock. Is this something that people could get done on a more elective-basis?
Dr. Klodell: Yeah, that’s a great question. And thanks so much for asking that because I really do need to stress that this is for people with pathologic sweating, abnormal sweating. People that just sweat with physical activity, not a candidate. People that have generalized sweating, your body sweats for a reason. You want to offload heat through sweating. When we do it for people that have pathologic sweating, they still have plenty of mechanisms to offload heat and they don’t experience any problems related to that. For somebody that only sweats with exercise and has appropriate, situationally appropriate sweating; we would not want to do this, and they would not be a candidate for this procedure.
Host: All right Doc. Appreciate it. That’s Dr. Charles Klodell. He’s a cardiothoracic surgeon at Florida Heart and Lung Institute. Thanks for checking out this episode of Helmet of Health from North Florida Regional Medical Center. Head to our website www.nfrmc.com to get connected with one of our providers, no sweat. If you found this podcast helpful, please share it on your social channels and be sure to check back soon for the next podcast.
Adam Ragusea (Host): I got to say, I’m sweating this interview. I’m about to talk with Dr. Charles Klodell. He’s a cardiothoracic surgeon at Florida Heart and Lung Institute. He’s a real accomplished guy. My forehead is dripping. My palms are wet. I don’t want to mess this up. Is this excessive sweating a normal response to stress or could it be hyperhidrosis? Let’s find out. It’s Helmet of Health, the podcast from North Florida Regional Medical Center. I’m Adam Ragusea. So, Dr. Klodell, everybody sweats, some of us more than others. When does it cross the line into like a diagnosable condition?
Charles Klodell, MD (Guest): People that have true hyperhidrosis, it’s not subtle. They don’t question whether or not it’s normal. They will sweat at rest. They will sweat when they are sitting in an air conditioned room by themselves just watching TV, relaxing. It’s inappropriate sweating. When you are on a treadmill at the gym, everybody sweats. Not everybody sweats in a 65 degree room and folks that truly have hyperhidrosis, will.
Host: Do we know what causes it?
Dr. Klodell: So, hyperhidrosis can be caused in theory by sweat glands that are over-receptive to the electrical impulses that are being delivered to them or it could be that there are too many electrical impulses from the brain being delivered to those sweat glands. We don’t really understand that. What we do know is we know how to treat it and treat it well.
Host: Okay, so, say that I’m somebody who just sweats, not in situations of stress, not when I’m having lots of physical activity, but when I’m just sitting on the couch, I’m sweating profusely. What can you do for me?
Dr. Klodell: Well the first thing is, we have an interview. We talk about whether it’s what we call primary hyperhidrosis which is a person who says I can remember this all the way back to my childhood days. I had trouble in school because the papers were getting smudged, things like that. Those are the patients that can be surgically treated.
Then there’s secondary hyperhidrosis. Those are patients that have developed it. They were fine and then all of the sudden at age 55, they developed it. Those patients don’t respond very well to surgery.
So, for the patients that have primary hyperhidrosis, now we talk about what body parts are impacted. Is it, what we call cephalic hyperhidrosis which is of the head or is it the more common palms and feet and some patients even have it in their arm pits. For the people that have it in their hands and their feet in particular, palmar hyperhidrosis is very, very life limiting. It’s very difficult. They have trouble shaking hands. They have trouble in social situations. And it’s easily treated.
It’s a very short outpatient procedure where we use what’s called a thoracoscope which is a very small camera. It’s smaller than the ballpoint pen refill that we would put in our ink pen. We look inside the chest, we look behind the lung, we find some nerves that deliver those electrical impulses to the sweat glands and we can use electrocautery to blunt some of the electrical impulses going to the sweat glands. That procedure takes about 45 minutes. It’s done as an outpatient and it’s over 90% successful in eliminating excessive sweating from the hands.
Host: So, what’s the recovery like? You’ve gone into my skin and you’ve cauterized some nerves. Am I going to have a lot of pain and swelling?
Dr. Klodell: No, actually really not. We usually do them on a Friday, so they then have Saturday and Sunday to get over it a little bit and by Monday, most everybody is back to normal activities. I’ve had patients that have gone and run a half marathon, 36 hours after the procedure.
Host: Oh wow. And you say the success rate is about 90%, I mean it’s got to be – for someone who has lived with a condition like that their entire life with the social anxiety of not being able to shake hands, that kind of thing; to simply turn off that symptom like a light switch, has got to be life changing.
Dr. Klodell: It really is. Over my career, I’ve done so many variable operations, everything from heart transplants to valvular heart surgery to lung cancer surgery and the number of cards and letters and positive feedback I get from the patients with hyperhidrosis after the surgery, is ten-fold all of the other things that I do. I’ve done children in their like early teenage years or even 9-10 year olds that were being home schooled because of the way they were being treated at school because of this. They were being ostracized. So, it’s just an amazing change for an otherwise somewhat disabling condition.
Host: One more question Dr. Klodell. As we said, everybody sweats, not just people who have hyperhidrosis and a lot of people are bothered by their sweating. I could imagine that there are people who would be interested in having a procedure like this done, not because it’s really a clinical problem for them, but it’s more of cosmetic problem for them. Or it’s interfering with performance. They are a rock climber and they don’t like having sweaty palms, it makes it hard to grip the rock. Is this something that people could get done on a more elective-basis?
Dr. Klodell: Yeah, that’s a great question. And thanks so much for asking that because I really do need to stress that this is for people with pathologic sweating, abnormal sweating. People that just sweat with physical activity, not a candidate. People that have generalized sweating, your body sweats for a reason. You want to offload heat through sweating. When we do it for people that have pathologic sweating, they still have plenty of mechanisms to offload heat and they don’t experience any problems related to that. For somebody that only sweats with exercise and has appropriate, situationally appropriate sweating; we would not want to do this, and they would not be a candidate for this procedure.
Host: All right Doc. Appreciate it. That’s Dr. Charles Klodell. He’s a cardiothoracic surgeon at Florida Heart and Lung Institute. Thanks for checking out this episode of Helmet of Health from North Florida Regional Medical Center. Head to our website www.nfrmc.com to get connected with one of our providers, no sweat. If you found this podcast helpful, please share it on your social channels and be sure to check back soon for the next podcast.