Hyperhidrosis, ETS and Reconstruction Journal

Life Before ETS and Before Medication
Life Before ETS but After Medication
ETS With Dr. Nielson (August 2000)
Life after ETS without Medication
Life after ETS with Medication
ICNG Reconstruction with Dr. Lin (August 2003)
Life after ICNG
Documents & Data

I put this page together so I could record my life and thoughts with hyperhidrosis, blushing, medication, ETS and ICNG. I am a 28 year old white male living in Milwaukee, Wisconsin. Hopefully people who are considering ETS and other alternatives will find this page helpful. You can find other really good pages with information regarding hyperhidrosis and I won't try to duplicate them; so I'll just record information related to my experiences -- not what I heard from other people. In all honesty, I didn't start keeping records of these things until I had ETS. I didn't create this page until I had the ICNG. If you have any questions, feel free to contact me at:

I'm sorry about any advertisements that may appear on this page; I'm a very private person and chose to put this info only on a freebie anonymous web server that is paid for by advertisements.

I came up with a "Quality of Life Index Number" to judge my relative happiness in life related to my condition. This number is somewhere between 0 (suicidal) to 10 (just finished smoking my crack pipe - just kidding). I'll use this number to compare my attitude differences throughout this page. You'll see.

Also, I've been known to lurk at the following HH/FB forums:

Life Before ETS and Before Medication
I was always a shy kid growing up. But, I didn't notice facial sweating & blushing until high school. Looking back, the way I dealt with it was by withdrawing from social situations. As a result, I had few friends in high-school. I intentionally did things to avoid attention in high school (and later college). I almost NEVER raised my hand in class or contributed. This is not to say I was a bad student. In fact, I got straight A's all throughout high school.

It wasn't a complete loss, though. I spent most of my time productively reading, learning and becoming very good at my job and my hobbies. I was able to land and maintain a very good paying job (after the Army) that allowed me to be one of the guys that sat quietly in the corner doing things that nobody else could figure out. I was very careful not to draw too much attention because that would make my FS/FB worse. It was a vicious cycle that limited what I was willing to do.

Somehow I got the guts to join the Army directly out of high-school. Actually this wasn't too bad because if you kept your mouth shut, you could avoid attention and that was good for FB. The FS was still an issue and I was still sweating all the time. I completed my four years in the Army and somehow started a very low-profile college life in 1997 at the age of 22. Everything was going as expected until one day about 2 years later (1999) I was surfing the internet and typed in "excess sweating" in a popular search engine. My life changed after that.

I still remember my excitement when I learned that other people suffered from the same things and that facial sweating and facial blushing are indeed related. I always thought I was just a sensitive, nervous person and that was all.

Looking back on it, I also would have considered myself having a classic case of social phobia along with lots of anxiety. I don't know if FS/FB or the social phobia/anxiety came first, but it is definitely a viscious cycle. I was petrified to talk to people. This is why I put off treating my problems. Dating was even out of the question.

That's right. At this point, I'm 24 and never had a girl-friend or even a date. Go ahead and laugh if you want, because none of you know who I am. If I do say so myself, I'm pretty good looking and at this point people must be thinking I'm gay (not that there's anything wrong with that), but I'm not. I was always amazed when I'd read posts from people and guys would say that they don't know how to explain HH to their girlfriend. In my mind, I'm thinking, wow, how do you manage to even get a girlfriend with FB/FS and high anxiety? I'm 24 and haven't ever had a date.

A few things that I remember especially bothering me:
  • After taking a warm (not even hot) shower or bath, my entire body (especially my face) would sweat for a good 15 minutes after the shower/bath. This pretty much defeated the purpose of taking a bath/shower.
  • After doing any intense physical activity (running, bike riding, moving stuff around, etc), my entire body (especially my face) would sweat for quite a while. A shower wouldn't help. It was almost like my body never got the news that it's not hot anymore.
  • Folding warm laundry would trigger heavy sweating. Maybe if I had a girlfriend back then, I could have pushed this off to her. ;-0
  • Climbing into a hot car. Ugh!
  • I was always nervous. Don't ask me how I ever completed public speaking class in high school and later college.
  • Having to introduce myself somewhere. Especially if I went to a meeting/conference where the first thing you do is go around and tell everyone about yourself. I'd be bright red and shaking even before they got to me. Man, did I hate that.

  • I finally decided to take action after a complete melt-down in the barber's chair. Those of you with facial sweating problems know exactly what I'm talking about. It's just not cool to leave the barber's office with a half-cut head of hair.
    "Quality of Life Index Number" = 2

    Life Before ETS but After Medication
    The hardest thing I've probably ever had to do was call the doctor's office and ask to make an appointment for these issues. But, I did and eventually got prescriptions for Drysol and Robinul. This definitely helped with the sweating. The Robinul helped break the sweating --> anxiety --> blushing cycle that seemed to be destroying me. I'd have to take double doses of Robinul before visiting the barber or going on a date. I still didn't feel like I was functioning as a "normal" person, but the viscous cycle was somewhat broken.

    At this point, I was flying high, though. Watch out ladies, there's a player in town. Finally I have the guts to start socializing and before you know it, I'm dating a couple of extremely cute girls. He he he!

    Honestly, if I could redo everything again, I probably would have stopped right here and added Xanax and life would be perfect.
    "Quality of Life Index Number" = 8

    ETS With Dr. Nielson (August 2000)
    I did a lot of research on ETS. This was back in 1999 and 2000 so I think there is definitely more information available now than there was then. But at the time, there was still the cutting vs. clamping debate and that was about it. The biggest thing was finding an experienced surgeon who could cut or clamp at the desired level. Back then, most people agreed that the "right" level was the T2 for FS/FB.

    The reasons I wanted ETS were 40% facial sweating, 40% facial blushing, 15% armpit sweating (much more than normal, but FS/FB was still the biggest issues for me) and maybe 5% for hand sweating (more than normal too, but never dripping hands like I've read about).

    So, in August 2000, I had my T2 "Microcut" by Dr. Nielson in San Antonio, TX. I did this as a stealth-solo mission. None of my friends or family knew about it. In fact, none of them know anything about this other than I used to sweat a lot and they probably used to think I was gay because of how little I used to socialize. The ETS stopped all facial sweating and most instances of facial blushing.

    I didn't get Horner's or any pesky GS from ETS. In fact, I never got other weird side-effects that some people report like flakey skin, hair falling out or cold body parts. Sure, my hands were extremely dry and I had to put lots of hand lotion on to help with daily things like reading books and newspapers or counting money. Some people reported problems with their complexion, but I think ETS actually helped my complexion. I never had a complexion problem, but ETS seemed to tighten my pores on my face and just gave an overall better complexion. I don't feel too manly noticing and talking about things like my complexion, but I just wanted to disclose everything I can to let others know. I did notice a tiny bit of gustatory sweating when eating things like german potato salad or sometimes ketchup. On a scale of 0(none) to 10(horrible), the GS would be a 1. I only mention the GS because that's the only time I would ever feel any dampness on my face ever during the next 3 years. The 2 scars disappeared 99%.

    I will save a lot of typing and just say that the entire trip and procedure was very easy, comfortable and 99% pain-free.

    The things I liked about Dr. Nielson and his staff:
  • A lot of information, pictures and testimonials are available at his website .
  • He seems careful to be as unintrusive as possible (like cutting T2 isn't intrusive). But, what I'm talking about is he doesn't remove any ganglia; he cuts the nerve trunk and does a low cautery on the ends. In reading the operative report, he seems to emphasize a low setting on the cautery tool and I *hope* that the T2 ganglia wasn't cooked and this may help later ICNG reconstruction. (more below)
  • His procedure really is almost pain-free. I left the hospital a few hours after the procedure.
  • His staff did a great job with the insurance paperwork and made things very simple on me. My insurance company paid for almost everything except the flight and hotel of course.
  • He seemed really concerned about follow-up. He provided a 1-day, 1-week, 1-month, 3-month, 6-month and 12-month follow-up sheet that I should fill-out and fax to him to see how I'm doing.
  • He and his staff were receptive to my compensatory sweating concerns for a year after the surgery. I'd call them and say the CS is getting worse and they'd phone in prescriptions to my pharmacy. This was very nice since we're about 1300 miles away from each other. This allowed me to try different medications to help with the CS and not have to make appointments with my regular doctor. After 12 months though, they said I should really start visiting my regular doctor which is fair.
  • He and his staff are very professional and I still haven't heard any bad things about him.
  • He provided a detailed Operative Report and photos of the procedure for me to keep. So, in theory, I know exactly what was cut and where.

    My ETS-Operative Report (PDF Format) (DOC Format)
    My Intra-Operative ETS Photos (PDF Format) (DOC Format)

    The things I didn't like about Dr. Nielson and his staff:
  • I never got to correspond directly with him. (more below)
  • I think he still cuts T2 and sometimes T3, also. This seems a bit outdated.
  • He seems to be the only one convinced of the kuntz nerve theory.

  • Note, to this day, I have nothing but high respect for Dr. Nielson and his staff. Even though I later developed heavy CS, he and his staff are excellent and very willing to help.
    "Quality of Life Index Number" = 5.5

    Life After ETS Without Medication
    During my research for ETS, I concluded that I should wait at least a year or two before deciding whether the surgery was a success or not.

    Immediately after ETS, I felt really relaxed for the first time in my life. My heart rate was really low. Dr. Nielson's staff said I should take my pulse and BP occasionally during the next few weeks at one of those things in the supermarket and email the results to them. I remember that my heart rate was usually in the 40-50 beats per minute range. Three years later (just before the ICNG), my resting heart rate was back up to 60 bpm. Like others have mentioned, when getting a physical, the nurse or doctor would comment that my pulse is nice and low (thinking that I must be an excellent athlete). I try to get a physical once a year and some of the nurses comment that most people get nervous going to doctors, so many times, people have a higher than normal pulse in the doctor's office. Not mine.

    The CS was interesting. The day after the surgery, while I was still in San Antonio, I definitely noticed heavy CS but in all fairness, it is *extremely* hot in San Antonio during August. When I returned home to Wisconsin, the CS wasn't too bad for the remainder of the Wisconsin summer. So far, so good I thought. But gradually over the next few months (even during the winter), I'd start getting episodes of heavy CS. Unfortunately, it never got better.
    "Quality of Life Index Number" = 4.5

    Life After ETS With Medication
    Several months after ETS, I started experiencing episodes of pretty bad CS. For example, I'd be having lunch with a friend, and while eating, I'd start feeling sweat running down my stomach and back. Note, I'm just sitting down eating, not running on a treadmill, and sweat is rolling down my stomach/back. Or, I'd be talking to my boss and the same thing would happen. Ugh!!

    Summers (and sunshine in general) were awful. After a few minutes in warm weather, sweat was rolling down my stomach and back. This is a very uncomfortable feeling and is almost impossible to fully explain the feeling to future ETS patients. I'd have to be very careful about what kind of chairs I'd sit down on because I'd leave sweat marks on the chairs. As many others have done, I'd be very careful about the types of clothes I wore so people couldn't see the CS. Exercising became very difficult because my energy level kept getting lower. I used to be a guy who could regularly run 5-6 miles (I grew to like running while I was in the Army), but now the best I can do is maybe 1-2. When running, my heart rate would stay pretty low and it was almost pointless. Needless to say, not a day went by when I didn't think about what a mess I was in.

    But, Dr. Nielson and his staff, as well as my regular doctor were pretty good about having me try different medications. I tried:
  • Levsinex
  • Hytrin
  • Robinul
  • Clonidine
  • Xanax (*)

  • I still think that Robinul put the biggest dent in CS. The initial calmness I felt after the ETS only lasted about a month and then the anxiety slowly came back as the CS/RS got worse. Xanax really helped if I had to give a presentation for work. It kills 90% of anxiety, which really cuts down on anxiety-related CS.

    I ended up getting Xanax while going to my doctor's office one day. I mentioned that I happened to be taking a couple of classes that require presentations and I could *really* use something to take the edge off. He didn't have a problem giving me a prescription, but insisted that I go see a psychiatrist to discuss any anxiety issues. This was fair and I must admit my doctor is pretty cool. He's the one that first prescribed me Robinul on my request (I had my internet print-outs). So when I went to this psychiatrist guy (he's pretty cool too), he mentioned that at one of the shrink conferences he went to where there were several presentations, more than 50% of the shrinks admitted to using some type of medication to relax them while giving their presentation. Wow!

    I was hoping like hell that the nerves would somehow regenerate. Like many others have commented, I noticed after a year or two that the sweating line moved up an inch or two above the nipple line. Unfortunately, this had no effect on the CS/RS. Like somebody said on one of the boards the other day -- "great, now instead of being drenched from the nipple line down, I'm drenched from the shoulders down!" Also, I regained a slight amount of moisture to my hands. For example, if I was in a meeting at work, the tables have a flat black surface and I'd notice if I had my hands flat on it and moved them away, I'd see a sweat outline on the table. I noticed that this seemed to be normal (I noticed it from other people too). The outline quicky evaporated. Unfortunately, this didn't diminish the CS/RS either. The realization that both the sweat line moving up and moisture returning to my hands didn't seem to have any effect on my RS/CS pushed me toward reconstruction.

    When it is 95 degrees outside and you're the only one whose head is bone-dry, yet your body is soaked, how do you explain that to people? When it's 75 degrees in the office and you have sweat marks showing on your stomach and back through your shirt, how do you explain that?

    I seriously started researching some type "reversal" to this mess. But I must say I was still much better off than my old high school days. I was still occasionally dating women. I had much better social skills and was more confident. As a result, I finished college and landed a much better job in every possible way. I don't think that would have been possible if I hadn't made the first step of contacting doctors. That's why I'm not bitter about any of this. I truly feel for the people who say their lives have been destroyed by ETS because I certainly understand how that is possible.
    "Quality of Life Index Number" = 4

    Reconstruction ICNG with Dr. Lin (August 2003)
    After 3 years of suffering from bad CS and little energy from ETS, I started looking into a "reversal". I use quotes because I know that nothing can 100% undo cutting the sympathetic nerve as it crosses the 2nd and 3rd ribs, but something must be possible.

    My research led to 3 possibilities:
  • Dr. Telaranta's sural or intercostal nerve graft in Meran, Italy
  • Dr. Reisfeld's sural nerve graft in Los Angeles, California
  • Dr. Lin's intercostal nervous graft (ICNG) in Taiwan

  • Based on my research I think all 3 doctors are excellent. I exchanged emails directly with Dr. Lin and Dr. Telaranta. Dr. Reisfeld even called me after my first email to his office. That was very nice. I thought this was quite different from my experience with Dr. Nielson. I never once directly corresponded with Dr. Nielson except for a 1-minute meeting right before the surgery and a 5-minute meeting the day after the surgery.

    Another thing that gave me hope was one email that I got from Dr. Telaranta while asking questions about reversals. He said that one thing he can tell me for sure is that since I had Dr. Nielson's "T2 Micro-Cut", that I have a really good chance for a successful reversal. I'm not sure if it's because of how unintrusive Dr. Nielson's procedure is (not removing any ganglia and using pretty low settings on cautery tool). I get the impression that Dr. Telaranta is a pretty honest guy; so I don't think he was saying this just to grease the rails for me to get his reversal procedure.

    But, my research led me away from the sural nerve graft in favor of Dr. Lin's ICNG. I think Dr. Lin is a pioneer in his field for many reasons:
  • The Lin-Telaranta classification (even though that came well after my ETS)
  • He was the first surgeon to start using clamps (ESB)
  • I very much believe his distinction between compensatory sweating vs. reflex sweating.
  • His ICNG seems to be very innovative, and I *hope* that time will prove it effective.

  • I must admit, I was a little hesitant about going all the way from the US to Taiwan for surgery. And I almost decided on Dr. Reisfeld's reversal because he is here in the US and it would be *much* easier for me to fly to LA and have his outpatient procedure. But, I felt Dr. Lin's ICNG was my best hope for improvement even though his procedure is a 4-day/3-night one.

    Dr. Lin charges US $10,000 for his ICNG. I felt like I was in a movie when I "wired" US $10,000 to this "offshore account". I highly doubt that my insurance would have covered this and I have an HMO now anyways. So my regular doctor (who probably would have been against the ICNG) would have to refer me to a specialist (who probably would have been against the ICNG too). Then the specialist would have had to give the big OK for my insurance company to pay a small portion of it. Not to mention the surgery would be thousands of miles away in a foreign country. There is no way in hell *my* insurance company would cover any decent chunk of the ICNG cost. Other insurance companies and plans may differ. As a result, I paid for the ICNG entirely out of my own pocket. Interestingly my non-HMO company a few years ago had no problem approving my ETS without any visit to a doctor beforehand.

    I'll try to break down the cost of the entire trip, but keep in mind you pay Dr. Lin the US $10,000 and make all the other arrangements yourself, although he did assist in making the hotel reservations (you still pay, though):
  • US $10,000 for the ICNG itself (including hospital, surgical and anethesia fees)
  • US $1,364 for airfare (Chicago to CKS Airport in Taiwan -- I wish I could have found cheaper)
  • US $208 for 3 night hotel stay (You could get by with 1 night, but I wanted 2 full days for sightseeing
  • US $30 total for food (they're pretty reasonable)
  • US $20 total for all bus and taxi fares (they're pretty reasonable, too)

  • Dr. Lin responded to all questions quickly and politely. I've heard people comment about his limited English. While English clearly isn't his first language, I had no problem understanding any of his emails or any conversations I had with him while in Taiwan. As I write this (about 6 days after the ICNG) I am very grateful to Dr. Lin for giving me hope.

    After several months of thinking things over, reading every entry in every internet forum I could find, reading every google hit I could find, I decided I was going to have the ICNG. I notified Dr. Lin and began making the arrangements. He said that I can have the ICNG either in Taipei (in Northern Taiwan - very close to the big international airport) on a Saturday of my choosing or Kaohsiung (in Southern Taiwan). I think Dr. Lin lives and works mostly in Tainan which is pretty close to Kaohsiung, but even though there is an "international" airport in Kaohsiung, I couldn't find any flights to it. So I decided to have the surgery in Taipei. I suspect that the reason Dr. Lin does the Taipei ICNG's on Saturday is because he has to come all the way from the other side of the island. I kinda felt bad about that, but I scheduled the ICNG for Saturday August 23, 2003. I thought it'd be nice to spend about 2 days before the ICNG sight-seeing. Note to self, Taiwan is extremely hot and humid in August -- not exactly a tourist paradise for CS/RS suffering people like myself. Dr. Lin offered to help me make hotel reservations for the 2 days I'd be sight-seeing in Taiwan. Soon Dr. Lin's secretary Miss Vita Liu emailed me with the hotel information and told me which shuttle bus to catch from the airport to the hotel.

    At this point, the only thing I didn't know was exactly where I needed to be in Taipei the day of the surgery. Dr. Lin gives me Miss Vita Liu's phone number and has me call her the day I arrive in Taipei. Dr. Lin also gives me 2 phone numbers for him in case I can't contact Miss Vita Liu. One was his phone number during the day and the other was his phone number at night (after 10:30 pm). Wow! That's pretty cool.

    I think he understood that I was kinda nervous about being in a foreign country getting surgery. But it was very nice that I had all of this information, including what I think is his office and cellular/home phone numbers. Again, compare this to me never having direct correspondence with Dr. Nielson.

    Again, I conducted this as a solo-stealth mission (no friends or family knew). So, after a 4-hour flight from Chicago to San Francisco and another 12-hour flight to CKS International Airport, I found myself in Taiwan around 11pm. The CKS airport is beautiful and very modern. I couldn't help but notice that it was much nicer and cleaner than Chicago's O'hare, San Francisco's Airport and LAX. In fact, I think it's the nicest airport I've been to since I was at the Denver Airport a few years ago when it was brand new. I exchanged some US Dollars for some New Taiwan Dollars at the currency exchange. As of that time, I could get about 33 NT$ for each US$. Like all airports, there were signs all over the place. Fortunately, most of them were in both Chinese and English. So, I had no problem finding the bus-station in the airport and then buying a bus ticket (135 NT$) to Taipei. The
    buses had big signs on them saying "CKS to Taipei", so far so good. Forty minutes later, I'm in Taipei and I have a little map and I get off the bus about 2 blocks from the hotel. I check into the Leo Foo Hotel around 1am without any problems. The hotel staff speak very good English and find the reservation Miss Vita Liu made for me.

    At this point, I try to go to sleep, but with the time change, I don't get much sleep. I wake up in the morning and have a nice complimentary hotel breakfast buffet. I call Miss Vita Liu and she answers right away. She speaks perfect English and we make small talk. So it's Thursday morning and the surgery is on Saturday at 10am (I wanted 2 days for sight-seeing). Miss Vita Liu says to call her from the hotel lobby Saturday morning when I'm checking out of the hotel. Since most taxi drivers don't speak English, the hotel will write the directions to the hospital down in Chinese and give it to the taxi driver. That worked exactly as described and getting to the hospital was very easy.

    Then I go outside and man is it hot and humid. I walk around anyways for several hours and I'm soaked. I can't help but think that everyone is staring at me. But that's OK. The people in Taiwan are extremely kind and friendy. Many of the people speak English so I didn't have much problems finding my way around. I couldn't help but notice dozens of 7-Eleven convenient stores and at least 6 different McDonalds while I was walking around. I've never seen so many motor-scooters in my life. I lived in South Korea for a year and still, Taipei has it beat. I see a Starbucks and stop for an iced coffee . The rules of the road are indeed crazy. It is fun to watch. Other things I noticed were lots of buses, and many brand new looking taxis. Both of the taxis I ended up using looked brand new, had leather seats and had the AC cranked! I had a list of places I wanted to see from a little guide book, but I just ended up walking around both days. I bought a new digital camera several months ago and I took a bunch of pictures too.

    7-Eleven Store

    Some buildings have a little checkpoint outside where a guard checks everybody's forehead with what looks like some kinda gun or scanner. That's weird I thought. It turns out, at hospitals and other types of places, this little scanner is some type of thermometer or thermal imaging device that checks to see if you have a fever. It's left over from the SARS scare they had a few months back. Believe me, I checked if SARS was still an issue in Taiwan before scheduling the surgery. Every time I came back into the hospital after a walk, they'd scan me with it.

    Day 1 (Surgery Day, Saturday)

    The day of the surgery, I jumped into a taxi right outside the hotel and 10 minute later I'm at the hospital. Dr. Lin said he'd get to the hospital at 9:00am and told me I should get to the hospital between 9:00-9:30am so I could get blood-work, ECG and a chest X-ray before having the surgery around 10:00am. I'm a bit nervous so I end up getting to the hospital early around 8:30am. I walk into the lobby and go to the front desk. The nurse quickly recognized English and yanked another nurse that spoke perfect English. She brought me up to a nice waiting room on the 2nd floor of the hospital. The waiting room had a big TV and nice big comfortable chairs. She asked me to take a seat and said Dr. Lin isn't there yet. I knew this because it was 8:30am and he said he'd get there at 9:00am. So I watch TV for about 20 minutes and Dr. Lin arrives around 8:50am. I see him and he greets me right away. He is dressed in regular clothes and is towing a rolling-suitcase behind him. He sits down and starts with small-talk and then starts talking about my CS/RS and the original surgery. I think he already knew most of this stuff because I sent him my Operative Report and Intra-Operative photos from the original ETS by Dr. Nielson. He is very nice and we talk for about 15 minutes in this waiting room and then Miss Vita Liu walks in. I didn't expect to meet her here, but I guess that makes sense, because she walked me through all of the forms I had to fill-out for the blood-work, ECG and chest X-ray. All of that takes only about 30 minutes and before you know it 10:00am is rolling around.

    Dr. Lin has one more little meeting with me and goes over my X-ray, ECG and blood-work. He says everything is a go for the surgery. Before you know it, Miss Vita Liu directs me to a little changing room that has several lockers and asks me to change into this little pink gown and put my clothes into one of the lockers. While I'm changing, Dr. Lin knocks on the door and hands me little blue sandals to wear. It's kinda funny, because I have the build of an American football running-back. So, I'm slightly on the big/muscular side of normal. Seeing me walk out of that room wearing a little pink gown and little blue sandals must have been quite a sight.

    I see Dr. Lin is now in his surgery outfit and directs me to walk with him to the operating room about 15 feet away. I'm amazed at how informal this is. The anesthesiologist directs me to sit down on the operating table. This is weird. Dr. Lin and the anesthesiologist put the arm-pieces on the table and strap my arms down. While the anesthesiologist is putting an IV into my arm, I'm making small talk with Dr. Lin. He tells me the surgery normally takes 2-3 hours. I noticed a Sony TV monitor right next to Dr. Lin that surely he'll be using for this surgery. I couldn't help but remember that when I had the original ETS with Dr. Nielson, I remember that they used a Sony TV monitor too. Not that it matters, it's just something I remembered thinking at the time.

    Before I know it, the anesthesiologist asks me a few questions (like my weight and if I'm allergic to anything) and tells me he's going to give me something in my IV. A minute later he is waving a mask a few inches above my nose and mouth and tells me that this will put me to sleep. I only remember taking a few breaths and then I was out.

    The next thing I remember was waking up in some type of holding room. It wasn't the operating room and it wasn't the room that I'd spend the next several days in. As soon as I woke up, they wheeled me to a private room on the 8th floor of the hospital. Room 805 to be exact. The first thing I remembered when I woke up was I was *extremely* thirsty. I was still kinda out of it and I was asking everybody and their brother for some water. Once I made it to the room, some nurses came in with a big bottle of water and poured some into a cup and gave me a drink. Then Dr. Lin came in with 2 more bottles of water for me. Everybody was very nice. I recalled reading an earlier ICNG patient's remarks about being surprised about getting his own room in the hospital, so I wasn't too surprised that I got my own room. I mentioned that I got a new digital camera a few months earlier, so I was a bit picture happy.

    Picture 1 of Room 805
    Picture 2 of Room 805
    Bathroom in Room 805
    Picture 1 from Balcony of Room 805
    Picture 2 from Balcony of Room 805
    Picture 3 from Balcony of Room 805
    Outside Picture #1 of Hospital in Taipei
    Outside Picture #2 of Hospital in Taipei
    Outside Picture #3 of Hospital in Taipei
    Scooters Everywhere in Taipei!

    What did surprise me, however, was the pain. The pain is *very* real immediately following the surgery. I recalled reading this from other ICNG patients too. So, maybe it's not fair to say I was surprised about the pain. I'm thinking, man this hurts much worse than the original ETS surgery. Now I know why the treatment is 4 days and 3 nights. I'm going to need it.

    That got me to thinking how Dr. Reisfeld's sural nerve graft surgery can be an outpatient procedure. I'm wondering if Dr. Reisfeld injects a Ropivacaine/Depo-Medrol mix or something similar into the intercostal spaces and paravertebral regions to give a near pain-free post-op state. I know you may be impressed, but I just snagged that from my ETS Operative Report. Because I had almost no post-op pain after my ETS with Dr. Nielson and that's probably the trick he uses. I don't think Dr. Telaranta's nerve graft is an outpatient procedure either. Maybe the theme is Americans are wimps (I'm American so I can say that), so American doctors try to eliminate as much pain as possible. I'm not sure if this is because the pain management philosophy is different compared to other other countries.

    Soon I see Dr. Lin and he says the surgery went well. He asks about the pain, and I tell him. He says the nurses will soon be giving me a few shots to help with that. He also says he put some type of "chest tube" in me. Now, I've watched ER and I know what a "chest tube" is and this isn't it. There was one "chest tube" on each side of my chest. But, I guess they were tubes and they were connected to my chest. So, I'll go along with them being called "chest tubes". I remembered my original ETS surgery with Dr. Nielson that he put little catheters through my chest toward the end of the surgery to allow air to drain and my lungs to fully re-inflate. So, I think that's what these "chest tubes" were. A few minutes later the nurses came in and gave me 3 shots -- 1 in each shoulder/chest area and one into my IV. This helps a lot with the pain. Dr. Lin says he's going to stay for the night and tomorrow morning I'll get another chest X-ray and remove the "chest tubes". The nurses tell me if I need anything just pick up the phone next to the bed and dial 700. OK. No problem.

    The room is nice enough. It has a small refrigerator and a small TV on top of that. It also has its own bathroom. I think the pictures I took actually make the hospital look nicer than it is. It's kinda like your grandma's house, even though it's clean, it's kinda old and weathered. But, I wasn't there for comfort; I was there for Dr. Lin's surgical skills. I also remember the bed being a little on the small side. If I laid perfectly flat, my feet would dangle over the edge of the bed. But, I did notice that I was quite a bit larger than the average patient in that hospital.

    Thank goodness the hospital has cable and the TV has a remote, otherwise I would have gone crazy from boredom. I'm able to locate a couple of movie channels (HBO, Cinemax and some other movie channels) that show American movies (Chinese subtitles). I killed a lot of time watching TV, reading books and listening to my MP3 player. Later that night (this is still Saturday, the day of the surgery) Dr. Lin comes in again and checks in on me. I'm doing fine, the pain is less now, but my chest still hurts when I breathe deeply. He says most of that will go away tomorrow when the "chest tubes" come out. We chat a bit more and he reminds me if I need anything, that I should dial 700 and the nurses will come in. He says he'll be staying here in the hospital just a few rooms down. So, if I need anything, he'll be there too. That's pretty cool.

    By the way, my primary nurse was extremely good looking but her English was a little limited. She understood most things, but sometimes I'd speak too fast and she'd go grab another nurse (who spoke perfect english) to help out. They came in later that night and asked me if I wanted anything to eat. I wasn't too hungry but they said I really should eat something. They asked if I like McDonald's. Sure I do. Before you know it, they're back with a meal from McDonald's. I'm not sure if this is because the hospital doesn't seem to serve food, or if they thought I wouldn't like Chinese food. The nurses are all very nice.

    Day 2 (Sunday)

    I didn't sleep very well that first night. It was probably a combination of jet-lag and the pain. Anyhow, first thing Sunday morning, my nurse gives me a few pills to take and they wheel me downstairs to get a chest X-ray. They also emptied 2 big beakers of fluid under my bed. One had a few inches of somewhat clear fluid and the other had a few inches of a reddish fluid. Strange. Now before they wheeled me downstairs, they had to unhook the "chest tubes" because it turns out that they were connected to the big beakers. That kinda freaked me out. I guess the "chest tubes" weren't just draining out air. But they said everything was OK. At this point, I'm still pretty sore. I had to lean forward for them to put an X-ray board beneath my back and man did that hurt. So they wheel me back upstairs and Dr. Lin looks at the chest X-ray and says my chest looks good -- my lungs are now well inflated so he'll remove the "chest tubes".

    I remember him waiting a few minutes in my room before taking the chest tubes out. I remember that Universal Soldier was on TV (Jean-Claude Van Damme & Dolph Lundgren) at the time, and I found it funny because it looked like Dr. Lin found the movie interesting. Just something I noticed. So, I guess what was a medical student finally arrives and watches Dr. Lin take the chest tubes out. That hurts pretty bad too. I think the tubes were held in by stitches. In any event, after he took the chest tubes out, 60% of the pain went away. Finally!! He also asks if I had any RS last night, and I guess I didn't but, the hotel was pretty cool and all I did was lay down. So, I don't think that was much of a test.

    Now Dr. Lin says I can get dressed in regular clothes and highly recommends I walk around outside and get something to eat. No problem. I change out of my little pink gown that I really just used from the waist down and put on my regular clothes. I feel *much* better. Like I said, most of the pain was from those darn tubes that were connected to my chest. My chest is still sore but it's OK as long as I don't cough or sneeze. Dr. Lin says he'll be back on Tuesday afternoon around 1pm (Day 4) to check on me and then I can leave. No problem. One of my walks was actually pretty long all things considered, probably about a mile. When I got back to the hospital I didn't feel any dripping sweat on my stomach or back. Dampness was there, but nothing dripping. I think that's a very good sign so far considering it was well above 90 degrees outside, sunny and very humid. I think this is very good. I took several walks and ate another McDonald's meal that night.

    Later that night, I asked if I could take a shower. I was just going to take a shower without asking, but there were no regular towels (only paper towels) in the bathroom. I'm not sure if they did that on purpose or what. They said that I shouldn't but I could kinda give myself a sponge bath or something like that. So, I clean myself off as best I can in the bathroom. I still had what I think is Betadine (the antibiotic red/orange liquid they clean the skin with before surgery) on my chest and that is kinda hard to remove with soap, water and paper towels. But, I do my best with what I have and I feel pretty good and clean now. Something else I noticed (which I originally thought was from my lack of shower), is that my face now becomes oily which it wouldn't do before the ICNG. During my little "sponge bath", I undo the tape on the little bandages covering the entry ports from the surgery. There are 3 on each side. Two of them are very tiny and don't have stitches and I think will completely disappear. The lowest one is the one from the chest tube and has a stitch in it, but that looks like it'll disappear too. I remember Dr. Lin saying that I can take the stitches back to the US with me and I can take them out after a week. I've never taken my own stitches out, but it must not be too difficult. Also, I feel tingles often throughout my face. No sweat (yet).

    Day 3 (Monday)

    More of the same. Three times a day, my cute nurse takes my pulse, BP and temperature and also 3 times a day she gives me a little package of pills to take. I'm beginning to wonder if my nurse works 20 hours a day because she always seems to be here. I take several more walks and still dampness, but no dripping. So far so good. Again, the pain is still there, but nowhere like the first day and a half. More reading, movies and MP3 player. Miss Vita Liu comes by to check on me. I think she did this because this was the only day that I didn't see Dr. Lin (I think he was back in Tainan).

    Day 4 (Tuesday)

    More of the same. My regular nurse isn't here today. Looks like she finally got a day off. Now I have a different nurse. By now, I must have watched about 20 movies and I pretty much finished the 3 books I brought with me and listened to all songs on my MP3 player about 50 times each. I'm really getting bored and I can't wait until Dr. Lin shows up at 1pm. He was right on time and talks to me for a bit and wanted to know if I've had any RS/CS and how I feel. I tell him so far everything is OK and he says that is good and that it will take 1 week to 1 month for my sweat patterns to normalize. That sounds reasonable, and that's what I've read anyways from other ICNG patients. He asks me what time my flight is and I tell him it's at 11pm. He says I can leave the hospital anytime this afternoon and asks me if I need any pain medication. I say no because I'm really feeling much better. Most of the pain has been replaced with numbness in the chest area around the surgical entry points. This should go away in about a month. We say good bye and I leave the hospital a few minutes after he left my room. I roam around a while taking pictures before I grabbed a taxi to the bus station where I caught a bus to the airport. I was very early and I ended up waiting several hours in the airport for my flight. That's OK because I grabbed some coffee and read a few newspapers.

    Day 5 (Wednesday)

    This is the longest day of my life because of the time change. When I was wandering around the airports, I walked around a lot carrying my heavy backpack. I did feel that "dripping" sensation once but that was after a really long hike with the backpack and went away pretty quickly when I stopped. Also, I should mention that I hadn't taken any Robinul since the day before the surgery. Not bad. Finally, I get home and I'm beat. Out of habit in the summer-time, I immediately crank on the air-conditioning to HIGH. I take a quick shower and then fall asleep. I wake up several hours later and check my email. While reading my emails, I notice that I'm really cold. So I lower the AC down to LOW. The only time I've done that is to save electricity, not because I'm cold. That is another good thing. In fact, sometimes I shut the AC off all together. While catching up on my emails around 9pm, I get an email from Dr. Lin checking up on me. I give him status and he quickly sends a response thanking me for status. Still, very nice doctor.

    Day 6 (Thursday)

    I didn't sleep at all last night. I just wasn't tired, so I spent a few hours during the early morning making this page. I type pretty fast, so it didn't really take too long. The pain is slowly going down and being replaced with numbness. I go shopping and run a few errands. I still haven't done anything too strenuous. Fortunately, I took 2 weeks off from work for this, so I don't go back to work until next Tuesday (after Labor Day).

    "Quality of Life Index Number" = 7

    Life After ICNG
    One Week After ICNG (August 30, 2003)

    OK, so it's exactly 1 week post-ICNG and so far I've definitely seen an improvement. Keep in mind that I used to take 6-8 mg of Robinul a day to combat CS/RS. I haven't taken any Robinul since the day before ICNG. Some of the things I've noticed:

  • My overall sweating amount has definitely decreased massively.
  • No sweat on my face so far, but I do notice oil being produced which I never had before ICNG.
  • I have a much better sense of well-being. I can't exactly explain the feeling -- maybe there's some anesthesia still floating around in my blood.
  • I feel quite a bit cooler all the time. I'm always turning down the AC in my apartment. I never would have done that before except to save electricity ($money$).

  • By "passing" the CS/RS test, I mean just detecting a little bit of dampness on my lower body (no dripping). In fact, now the lower-body dampness actually has a cooling effect on me (what a concept). Here are some of the CS/RS tests that I've "passed" so far:

  • Driving my car after it's been sitting in the hot sun all day
  • Folding my laundry right when it comes out of the dryer
  • Having a conversation with a complete stranger while doing my laundry
  • Going for a long walk and stopping suddenly (my CS/RS used to be especially awful whenever I'd *stop* something)

  • One of my long walks was checking out all of the Harley Davidson Motorcycles in town this weekend. Milwaukee is the home of these motorcycles and this weekend is the 100th anniversary of the company. Motor scooters are to Taipei as Harleys are to Milwaukee:

    Harley Davidson Motorcycles #1
    Harley Davidson Motorcycles #2
    Harley Davidson Motorcycles #3
    Harley Davidson Motorcycles #4
    Harley Davidson Motorcycles #5

    Also, today I took my 2 stitches out myself. It was much easier than I thought. I used a cuticle cutter (like a nail clipper, but with a really sharp angled edge) and then cleaned the area with alcohol. The wound with the stitch was the one from the drainage chest tube. That's by far the ugliest of the 3 wounds on each side, but even so, it isn't so bad -- it looks like it'll pretty much fade in a few weeks or months.

    My return of energy is kinda hard to measure right now. I mentioned that I do have a much better sense of well-being, but my chest is still pretty sore and numb so there isn't much I can do except take long walks. I can't wait until I can go back to the gym and resume running. But that's definitely out of the question for at least another 2 weeks.

    I've put reminders on my calendar to update this site weekly after today. In my never ending quest for knowledge, I'm taking 4 classes at University of Wisconsin - Milwaukee this semester and that starts next week. So between school and working full time, I'll be pretty darn busy and I'll have many opportunities to test out the ICNG.

    "Quality of Life Index Number" = 7

    Two Weeks After ICNG (September 6, 2003)

    Time flies and it's already two full weeks post-ICNG and so far so good. This week I returned to work and started night school again. So, it's safe to say I've been very busy.

    I have mostly good news but I'd like to get the bad news out of the way -- the pain. I don't mean to sound like a wimp or sissy, but I have to admit, I thought the pain would have faded a bit more, but I think the pain is pretty much the same as it was last week. It fluctuates, though. Sometimes it feels like I just did 500 push-ups (not that I really could). Other times, it feels like somebody whacked me in the chest with a baseball bat. Then sometimes, it feels like a bad sunburn on my upper-arms, upper-back and chest. Sleeping is still a bit uncomfortable. Walking or using stairs causes weird chest pain. The pain is especially bad when I first wake in the morning and as I'm getting tired at night. I don't like taking aspirin or pain-killers, so I've found the best way for me to ease the pain is to take a long, hot shower.

    I have a habit of rereading all of the posts on the two or three internet forums related to ETS and I stumbled upon one guy's post who had the ICNG and he made a comment that he felt like he was walking like Al Gore (walking stiff like a robot). I definitely know what he means now, because the pain is less if you don't move your arms while walking. In fact, if I don't move at all, the pain pretty much doesn't exist.

    Oh yeah, a few other minor things. My hands do seem to be a bit drier than before the reconstruction. This isn't too troublesome for me -- lotion on my hands once or twice a day and I'm OK. Also, I seem to have an unquenchable thirst. I have no idea how this could be related to ETS or ICNG, but it's something that I just started noticing within the past week or so. It doesn't bother me, it's just kinda interesting. I'm sweating less, yet I'm thirsty all the time.

    OK, with the bad news out of the way, everything else is pretty much good news. The lack of CS/RS continues to make my confidence grow. This past Wednesday, I was about 10 minutes late to a meeting and when I walked through the door my co-workers were just approaching a topic where I knew I'd be the main contributor. All eyes were on me for a good 15 minutes while I gave my input. The meeting room was small and on the warm side. There were also two strangers (sales people) interrogating me in this meeting about what I want or need to make their product better. I had a "safe CS shirt" on and I kept waiting for that awful dripping feeling on my chest/stomach, but all I ever got was a slight dampness on my lower back.

    The very first day back to work after my "two week ICNG vacation" I was sitting at my desk and made a comment along the lines of "man, is it cold in here or what?", and the guy who sits next to me said, "I think it's hot in here". I have a mini six-inch fan on my desk for the summertime because the AC in our building isn't the best (many other people have little fans on their desk too and I'm sure that not all of them have had ETS) and I found myself turning it on and off all day (in the past, I'd just leave it on all the time).

    Speaking of returning to work, I remember being nervous about returning to work. Maybe I was nervous since this would be the first time seeing all my co-workers in 2 weeks and also since the ICNG. I was seriously considering taking some Xanax when I talked myself out of it. I try to use the Xanax only when absolutely necessary and I'm glad I didn't take any because once I walked into the office, I actually felt pretty good and relaxed.

    I'm also in a much better mood and as a result, much more social than usual. Again, I'm hoping as time goes by my confidence will continue to improve. I'm able to tolerate and sometimes enjoy the sunlight now. I'm not sure if this is because I'm in a better mood or what, but in the past, any sunlight would trigger CS/RS and I'd avoid the sunlight like a vampire. The shades in my apartment and my office were always down and I've actually found myself opening them to look outside during the day.

    I'm taking night classes Monday through Thursday nights after work. Monday was a holiday, so I had 3 night classes this week. I refuse to pay for parking, so I end up parking about 4 blocks from the University. In the past, between the time I'd arrive in the classroom and the time the class would start, my body would begin sweating (from the walk) like an overheated car stranded on the interstate. Not so this week. I'd only get a thin film on my body.

    I must admit, that my mind still seems to be expecting CS/RS all the time and sometimes I find myself lifting up my shirt when nobody's watching, only to discover a tiny bit of dampness on my trunk. This kinda makes me wonder more about the distinction between compensatory sweating (CS) and reflex sweating (RS). I know Dr. Lin makes the distinction and a post on ezboard.com got me thinking more about this.

    A gentleman on the board gave an analogy that CS would be like having a string of light bulbs connected to a battery. If you get ETS (cut the wires to some of the light bulbs), your lower body will sweat more (the other light bulbs will glow brighter because the same amount of power is being sent to fewer bulbs). I think most people consider this a good analogy of CS.

    Then there is RS. I liken this to driving a car with a couple of missing spark-plugs and a broken speedometer. When the driver needs to go somewhere (the body needs to get rid of excess heat), he keeps pressing the gas pedal too hard (the body sweats too much) because the speedometer isn't giving him an accurate reading (feedback isn't reaching the brain). This is just my theory anyways.

    I think that description of RS describes the main reason I wanted the reconstruction. In fact, I think that it describes my condition pre-ETS. I remember before ETS I just thought my brain never "got the news" that my body isn't hot anymore and would just flood my face with sweat like a giant radiator in a car. I noticed this especially *after* something (a walk, shower, bike-ride, etc). Or even worse, the sweat would start *during* social interaction. Then *after* ETS, while my trunk & lower body started to sweat in an honest effort to remove excess heat, it never "got the news" that my body isn't hot anymore so would keep pumping out the sweat on my trunk & lower body. But, I'm sure that sweating in an area restricted by clothing does make it harder for the body to remove excess heat compared to sweating in an unrestricted area like the head. But even when I'd be wearing shorts and no shirt in the summer, the sweating was awful, so not all RS/CS could be explained by clothing "getting in the way".

    OK I'm rambling now, back to my ICNG recovery. Sometimes I now detect a little moisture on my upper-lip. It's nothing I can see in a mirror, but I just feel a nice cool feeling on my upper-lip while I'm breathing. It's actually a nice feeling after 3 years of a bone-dry head.

    I still don't feel "over the hump" yet because I remember reading other people reporting a "short lived nerve graft benefits". I'm not going to fall into the same trap I did after having ETS. The trap of "oh, this is great, it's only been 2 weeks and I'm doing great!". I know that things can change quickly. It's only been two weeks so far, so I'm just keeping a positive attitude and trying to keep everyone posted on my story.

    "Quality of Life Index Number" = 7

    Three Weeks After ICNG (September 13, 2003)

    The only big change I've noticed between the last update and now is that the pain has diminished nicely. I can now sleep very comfortably (during the last week or two just rolling around in bed was kinda painful -- but not the past few days). If I had to estimate, I'd say that the pain is about 80% gone and the numbness is about 50% gone.

    As a reminder, the reason I decided to have the ICNG was 80% for RS/CS and 20% for loss of energy. Although looking back, my lack of energy may have been partially due to my unwillingness to do things that would cause horrific RS/CS.

    I still notice some minor moistness on my upperlip, but nothing visible in a mirror. I also notice "things happening" on my head -- kinda like the pins & needles feeling I had for a few weeks after the ETS a few years ago. I hope that's a sign of things to come, but it's hard to say.

    My hands are still drier that normal and I've had to buy more hand lotion. It's nothing terrible though. I remember for the first two years after ETS, my hands were bone dry and I'd go through hand lotion like there was no tomorrow. The third year after ETS, I didn't seem to need quite as much, though.

    Well, that's about it so far. So to recap my current status, since ICNG:

  • I've seen a big reduction in CS/RS
  • The pain from the surgery is 80% gone
  • The chest numbness from the surgery is 50% gone
  • My hands are drier than immediately before ICNG
  • My attitude and quality of life is definitely higher now

  • "Quality of Life Index Number" = 7

    Four Weeks After ICNG (September 20, 2003)

    OK so it's been exactly 4 weeks since ICNG and this should, in theory, be a big milestone. I remember Dr. Lin said that it "takes at least one month to see the final results of ICNG". So far, I'm doing pretty good. The CS/RS is still much better than before the ICNG. I do notice it creeping around when I'm in very high-stress situations, but it's still not nearly as bad as it used to be.

    Also, today was the first day I went to the gym. I did a light workout and I felt great afterwords. I did 30 minutes on an exercise bike and then a light workout with free-weights. I'd normally run a mile or two, but any high-impact activities like running still kinda hurt my chest a little. I definitely noticed moistness on my upperlip while exercising (I mentioned this before and wasn't too sure about it) and I must admit it felt pretty good. I noticed that my armpits sweat more during exercise than before ICNG and it seems to be pretty symmetrical. Again, no visible sweat on my face, but I notice something going on up there that's hard to explain. I have to admit that I've been feeling kinda lazy about not exercising because it's been a big part of my life since highschool and later in the Army. So this is pretty important and I'm feeling much better as a result.

    I received the operative/surgical report on the ICNG that I requested from Dr. Lin a while back. It was a bit different that I expected. It had more sketches and less writing. He requested that I not post it on the internet so I'll respect his wishes and not do that. To be honest, I don't see too much different on the operative report than what has already been posted on some internet forums. Dr. Lin did say that "there are still some very special and important tiny procedures when perform ICNG, which is difficult to describe by words". The general procedure is pretty well known.

    It seems to me that the ICNG procedure may vary depending on how the original ETS was done. I had a T2 ETS by cutting the trunk as it crossed the 2nd *and* 3rd ribs (above *and* below T2).

    Dr. Lin divided the 3rd intercostal nerve a few inches after it left the T3 ganglia (I'm guessing about the "few inches"). He then divided the main trunk at the upper border of the 2nd rib. I think this is basically "freshening up" the main trunk. He then rotated the free end of the 3rd intercostal nerve and connected it to the "freshened up" area of the trunk (just below T1 ganglia).

    I know of at least 1 person whose ETS was T2 cut above the T2 ganglia only (note; only *above* T2, *not* below). I believe if Dr. Lin thinks the T2 ganglia is OK, then he'll use a 2nd intercostal nerve and reroute it to the T1 area (there is also some question about if he used to "freshen up" the main trunk around T1 before connecting the intercostal nerve to it).

    I'd say the pain is about 90% gone and the numbness is about 75% gone. I'm feeling the pain and numbness fading away further every day. Well, I can't think of much else to say. I'm going to bump the "Quality of Life Index Number" up to 7.5 because I'm feeling pretty good about being able to resume going to the gym.

    I'm also going to start doing these updates bi-weekly instead of weekly. I think the updates will be more useful that way. Well, that should about do it for this update.

    "Quality of Life Index Number" = 7.5

    Six Weeks After ICNG (October 4, 2003)

    It's been exactly 6 weeks now and 2 weeks since my last update. Nothing much to report especially because there's been a bug going around and I caught a cold last week and it caused me to feel like crap for a good 5-6 days. I've been coughing and sneezing all week. At least I can cough and sneeze now without any pain. Let me tell you that for the first few weeks after ICNG, a cough or a sneeze would feel like somebody was stabbing me in the chest and back.

    I get the feeling that my anxiety and "awareness level" is creeping back to what it was before ETS. And I don't necessarily like that too much; all I can do is deal with it. Before ETS, I remember myself always being in "overdrive": noticing *everything* about my surroundings, nit-picking all of my own work and that of others, etc. There's been a few times where I knew I'd be in anxiety producing situations (like *big* meetings, presentations at work/school) and I took xanax and *robinul* before the event. With that combination I feel very good during the event, but I still try only to take it when I need to. I think I mentioned before that the ICNG seemed to work better on RS than on anxiety-related CS (at least for me). But overall, things are still OK. The way I look at it is before ETS, if I didn't take big doses of Robinul, I was abolutely miserable and sweaty. So, I don't worry too much about taking a little Robinul after ICNG.

    The pain is about 99% gone. I think I'm going to start running again this weekend. Don't get me wrong, I can still tell I had surgery in the chest area, but I would't classify it as pain. As far as the numbness goes, I can now feel 4 distinct "numbness bands". There are two 2 inch by 4 inch bands just below my nipples and another 2 bands at the same level on my upper back. The measurements are just rough estimates but seem about right. Again, I only notice it when I'm trying to notice it (or in the shower with the water hitting my chest). Dr. Lin used my 3rd ICN for the graft, so I'm sure a 2nd ICN graft would cause different areas of numbness. I still think the numbness is slowly going away because I remember for the first few weeks, a big chunk of my chest was kinda numb.

    One of my many bad habits is enjoying foolish events like WWE (formerly WWF) shows when they come to town. Even though I know it's fake, it's good entertainment -- it's quite a show with the music, drama, fireworks and high-flying events. Anyways, the WWE came to Milwaukee this past Tuesday and I got 2nd row seats. I took a few pictures:

    WWE Picture #1
    WWE Picture #2
    WWE Picture #3
    WWE Picture #4

    I'm going to lower the QOL Index back down to 7 because of my cold, and the need to take robinul/xanax before big events still.

    "Quality of Life Index Number" = 7.0

    Eight Weeks After ICNG (October 18, 2003)

    It's been eight weeks since ICNG and I don't have much to report, so I'll make it brief:

  • The CS/RS is better than before ICNG, but my lower-body still sweats more than before ETS.
  • The back of my head and neck occasionally feel cool (moisture?).
  • The pain is 100% gone.
  • Some numbness still exists.
  • My hands are very dry.

  • I've had a crappy last 2 weeks at work. I had to go out of town all this past week with several people from work (most of whom I don't like and annoy me constantly). The week before that I had to go out of town with different people from work who also annoy me. Then again, maybe I'm just being difficult -- no, that's not possible. ;-) Oh yeah, that means I've missed 2 weeks of night-school and this next week I'll have more exams. Oh joy!

    As far as the CS/RS goes, it seems OK and only kicks in when I'm extremely anxious about something. On a related note, I was shopping the other day and picked up some new Under Armour shirts. These shirts are terrific! I wish I would have found these earlier. Even though my CS/RS is better now, these shirts fit tightly and have a nice cooling feel to them. After ETS I bought several coolmax shirts, but they were kinda itchy after a few washes. These Under Armour shirts are super smooth and feel very cool.

    I'm going to slightly lower the QOL index from 7.0 to 6.9 just because overall, I feel a little worse right now. The travel arrangements and my work schedule the past 2 weeks didn't allow me to continue my physical rehab (getting back in shape) and I'm feeling out of shape.

    "Quality of Life Index Number" = 6.9

    Ten Weeks After ICNG (November 2, 2003)

    Today is actually 10 weeks + 1 day after ICNG and things are pretty hectic around here. I have another bad habit which I've learned to keep in check the past few years -- coffee. I've been pretty busy the past few weeks with work and sometimes find myself guzzling way too much coffee which causes some CS/RS. Nothing too bad though -- still better than before the ICNG. Another interesting thing I've noticed when I've overdosed on caffeine is that my head tingles much more than normal and my armpits sweat more than they have since ETS.

    I'll try to summarize my current status again:

  • Less CS/RS than before ICNG, but I notice a *little* more trunk sweating than immediately following ICNG, but some of this could be due to my excessive coffee intake. I've thought of switching to decaf, but that would be like drinking non-alcoholic beer. What would be the point?
  • The pain is 100% gone except that I occassionally notice a sharp pinching feeling a few inches behind the incision points. This maybe happens a few times a week on each side of my body. The weird part is that it isn't at the incision points, it's behind it. This doesn't bother me.
  • I think more of the numbness is fading away. I don't really feel distinct bands of numbness anymore, just a *slightly* less sensitivity to touch in my chest area. I couldn't care less about this little numbness.
  • I've noticed more tingling feeling on my forehead and back of my head. When exercising, I feel a *little* moisture on my upper-lip.
  • I feel much better after working out now than I did before. I'm not sure if I'd call it a "runner's high" yet, but I definitely feel like I've given 100% after a work-out.
  • My hands are still pretty dry (drier than before the ICNG), but that is easily taken care of with lotion.

  • Tomorrow morning, I'm going out of town for a few days. I checked www.weather.com for the destination and the high temperatures are 83-86 degrees F (29-30 degrees C), so I'll see how I feel in warmer weather.

    "Quality of Life Index Number" = 6.9

    Three Months After ICNG (November 23, 2003)

    I've been re-reading my journal and compared to August & September, the results of the ICNG have faded a little. Instead of a "massive reduction in sweat", I'll now have to say that the results are only "pretty good". A few other factors that make things difficult to judge:

  • I'm more nervous and anxious now than pre-ICNG.
  • The extra anxiety seems to trigger uncomfortable dampness in some situations --but rarely any dripping sweat.
  • But, the weather is cooler now.

  • As I mentioned before, I'd sometimes take Robinul to deal with the anxiety-related CS/RS. Robinul seemed to help more than any other medications I've tried. But, one medication I never tried was Ditropan (oxybutinin). I figured I'd experiment with it to see if it helps more or less than Robinul. I saw somebody post a link to order Ditropan over the Internet so I ordered myself a bottle last week. Call me naive, but I was surprised that I didn't need a prescription or anything -- you've gotta love the Internet.

    The Ditropan arrived in 2 days and so far, I'm amazed at the results. I don't remember being so completely dry -- ever. My entire body is nice and dry whenever I'm on it. Maybe my body was getting used to Robinul since I've been taking it for over 3 years. The only side-effect from the Ditropan that I've noticed is a dry mouth -- very dry. I don't mind because that means it's working. And I've always been a big water drinker. The weird thing is that Ditropan is mostly used to treat bladder-control problems. It seems that it has a side-effect of drying the body. This is good!

    Now the hard part. What should my QOL index be? On one hand, I think the ICNG results have faded some. If it weren't for the Ditropan, I'd put my QOL index down to about 6. But, the Ditropan clears up all remaining CS/RS much more so than the Robinul did. Knowing that I'll be completely dry puts me in an excellent mood all the time. All things considered, I think my QOL is back to the point pre-ETS, when I was just on Robinul.

    My next update will probably be in 3 months (6 months post-ICNG). I'll see how things are then.

    "Quality of Life Index Number" = 8

    Six Months After ICNG (February 22, 2004)

    Tomorrow will be 6 months since my ICNG with Dr. Lin in Taiwan. Not much is different now compared to my last update 3 months ago. Keep these things in mind while reading:

  • It's winter up here. And winters are pretty cold in Wisconsin.
  • I've been taking two to three 5mg tablets of Ditropan daily to eliminate any remaining CS.

  • While keeping those things in mind, I think I am seeing improvement compared to this time last year (pre-ICNG). I don't know how much of it is because of the ditropan, the ICNG or the psychological thing (knowing I had something "reversed").

    Physically, I'm feeling much better. I'm in the gym more now than ever. I started doing something new a few months ago at the end of every workout -- I run up and down 15 flights of stairs 4 times (without stopping). That really gets my heart going and even though I sometimes feel like I'm about to die afterwords, I still feel pretty good. I think this demonstrates that now I can at least get my heart rate up pretty high.

    A few other things:

  • My hands are still somewhat dry, but not as dry as immediately following ICNG.
  • No noticeable sweat/moisture from the head.
  • While working out, I notice the "pins and needles" effect on my arms and shoulders.

  • Overall, I think the ditropan + ICNG has worked pretty well for me. I don't think about CS bogging me down all the time. As an example, last month we had a "cleanup day" at work that required us cleaning up our storage area for some stuff. This involved moving lots of things around (taking them to the basement, throwing things out, etc). Normally I would have felt the sweat dripping after a few minutes of physical work. But now it would take several hours of moderate work like that for me to feel any dampness. But, I still think the true test will be this summer.

    "Quality of Life Index Number" = 8

    Nine Months After ICNG (May 23, 2004)

    Today is exactly nine months after having Dr. Lin's ICNG procedure. It's slowly beginning to warm up. A few days have been hot and humid. Things are going very well as long as I take Ditropan. I take two 5mg tables when I first wake up and two 5mg tablets around 1pm. I'm almost hesitant to stop taking it because of how comfortable I feel while using it. But, I think I'll experiment in the middle of summer and see how bad my CS is without Ditropan. I'll report back the results then.

    Overall, I feel very good. I no longer worry about sweating through clothing at work (or anywhere else for that matter). I'll even wear light colored shirts. Previously, that would have been a big no-no because it would make dripping CS very obvious.

    Just like I mentioned in my last update, while I'm doing strenuous activities like running or working out at the gym, my arms and shoulders get an itchy, pins and needles feeling. No sweat, though. But it reminds me of the mild GS feeling I used to get when eating things like German potato salad. Even though there is no sweat on my arms/shoulders, the itchy pins & needles feeling is the same.

    I'm honestly not sure how much the ICNG has helped. I know the Ditropan definitely has and anyone who emails me asking about the ICNG for CS, I urge them to try Ditropan and/or Robinul. The more people I hear of getting ICNG, the lower the success rate seems to be.

    "Quality of Life Index Number" = 8.2

    2.5 Years After ICNG (February 23, 2006)

    It's been quite a while since I've updated this site, so here goes. The more time passes, the less helpful I think the ICNG was. About a month ago, I ran out of Ditropan and went without it for about a week. I definitely noticed CS with only minor physical activity (I was still taking the occassional Robinul that I had left from a while ago). And keep in mind, it's pretty cold and dry up here right now.

    There has been absolutely no return of sweat to my face -- even during heavy exercise. But, I never really feel overheated. I've pretty much accepted that I'll have to continue taking medication if I want to avoid CS. I think the ditropan has been working as well as it always has. It's pretty much a life saver for me. Last year, when I went to my regular doctor for a physical, I told him that I was taking ditropan to combat the CS. He was happy that it was helping, but didn't really have too much to say about it. I'll probably schedule another physical soon and this time ask him about the long term side-effects.

    Am I mad at Dr. Lin? No, not really. The ICNG at least gave me hope that I needed very badly. Shortly after the surgery, I asked Dr. Lin for the operative report from the ICNG. He asked me not to post it on the internet, but I don't think I'll ever see him again, so here is a copy of the ICNG operative report.

    I'll keep my QOL index at 8.2 -- I'm learning to deal with things. No huge changes in the past year.

    "Quality of Life Index Number" = 8.2

    Documents & Data
    Outline of the Autonomic Nervous System
    ETS for Hyperhidrosis (Hayes 2003)
    In Hyperhidrosis, Looking for a Pattern (Stolman 2003)
    Medications for Hyperhidrosis Post (Anonymous 2001)
    Lin-Telaranta Classification (Lin/TT 2001?)
    ETS - Detailed Info. for Prospective Patients (Eastern Surgical 2003)
    ICNG Info. (theColumbian 2003)
    ICNG Drawing (Eyes_so_Sad 2003)
    Dr. Nielson's Charges for ETS (theColumbian 2004)
    "ETS Sucks" License Plate (theColumbian 2004)