コメント広場利用の注意

コメント広場利用の際には アンケート の記載を必須にします。その後そのハンドル名を利用してください。
まるとんのブログ2、解剖ブログ、経穴ブログ、東洋医学まとめブログ、生理学と病理学ブログは姉妹ブログです。

2020年5月12日火曜日

How much can I recover having taken ETS reversal surgery?

This article is a translation of an article written in 2012, so it may be a little old...

So far, I have written on the bulletin board about the feeling I have received after ets reversal surgery. Through them, I'll write down my thought that my sympathetic nerve would be like this now, why compensatory sweating is occurring, and how much can I recover after ets reversal surgery.

【Attention】
The contents here are based on "the feeling I have received since I took reversal surgery", "a little what I have investigated", and "some of my assumption". Therefore, it is not known whether everything is correct or not, and there may be points that lack consideration. What you need to know in advance is that I am not a doctor but a patient, and that this is not a medical explanation.
So I hope you read this for the question and hope how much I will  recover by taking ets reversal surgery.
And my thoughts may be changed in the future depending on facts and conditions that I do not know. This is my idea at the moment.


About the structure of the sympathetic nerve

Here is a diagram of the sympathetic and parasympathetic nerves on the Wikipedia page (Autonomic nervous system).



It is easy to understand that the vertical line at the left side is the spine, but the others are hard to understand. so let me give you a little supplement.


  • The red line drawn in the original diagram is the sympathetic nerve. (The blue line is the parasympathetic nerve)
  • The sympathetic nerve begins in each spine (thoracic and lumbar) and goes through the lateral line to the sympathetic trunk. The sympathetic trunk is vertically connected, and each intersection is called a ganglion. The ganglion that match T1 of the thoracic spine are T1 ganglion, and in the downward direction, T2 ganglion, T3 ganglion, ….
And I will also add the following.
  • The sympathetic nerve runs with the artery, and works when it dissipates energy.
  • Sympathetic neurotransmitters are different before and after the sympathetic ganglion (The nerve before the sympathetic ganglion is acetylcholine, while the nerve after the sympathetic ganglion is catecholamine.). But the transmitters that control the sweat glands is the only exception, and acetylcholine acts before and after the sympathetic ganglion.

About my resection area and reversal area

I didn't know the area that was resected when I took ETS surgery, but I heard from the doctor who performed ETS reversal that the area is T3 and T4 on the right side, and T2 and T3 on the left.

I'll show it using the diagram above.


I think that the problem here is that the sympathetic trunk is divided up and down, and there are fewer nerves going up.


Therefore, because the parts cut by ETS surgery block the up and down flow, the substances that transmit through nerve (maybe it's acetylcholine?) have almost stopped flowing upwards. As a result, they accumulate in the abdomen, back, thighs, etc, so the more substances that promote sweating, the more these substances move toward the lower body and sweat as compensatory sweating...
Considering that large amount of compensatory sweating, not only the amount of neuromessenger that acts directly on the sweat glands in the upper body, but also the neurotransmitter on the pathway for propagation originally to every corner of the upper body, I think that they all reach the sweat glands in the lower half of the body and act directly to produce compensatory sweating.
The reason why I could say that it was caused by the stagnation of the flow to the upper part of the sympathetic trunk was because my doctor Timo Telaranta said to me about the surgical procedure that "I connected T2 and T5 to bypass on the right, and T1 and T4 to bypass on the left".

I think it's probably like this.

And even if the chest nerves was reconnected by this reversal surgery, as the sympathetic nerves on the upper side of the chest once became like a thin stream, so I think that there are many parts that have withered at the branches. Therefore, I feel that it takes time to restore the original flow even if the resected parts are reconnected.

I feel that the left side is already completely reconnected. I think that because there was only T1 nerve flowing up on left side, the force pushing upward might have flowed so strongly after reversal surgery. I think that's why I was connected first. (It took about a year and a half for my left nerve to be reconnected.)

I think that the reason why the right side is still moving more slowly not being connected even after 10 years is because the pushing force is weakened because the left side has finished moving and it is in an equilibrium state. But I still feel the moving flow of the sympathetic nerve, which runs with the arteries, so I believe it will recover more.


How much can I recover?

Even if all the movements are over, I still think that a little compensatory sweat will remain.
The first is whether the bypass which made at the reversal has enough thickness to restore the original flow, and the second is that the nerve from the resected sympathetic ganglion to the whole body may not be reconnected by reversal surgery so may be lost.
However, I think that the nerves in these unconnected parts are much less than the nerves above the chest.

My Finnish doctor said, "When we do reversal surgery, we acturally look at the nerves after ETS in the chest and do the best we can on a case-by-case basis." So I believe that this bypass, which connects T2 and T5, was the most recoverable technique in my situation.
And I'm already satisfied with taking reversal surgery because I feel the recovery of considerable decrease of compensatory sweating.

Though I don't know how long it will take to connect the rest of the nerves that are still recovering, if the nerves are completely connected, I think that sweat that comes out when moving, numbness in the hands, headaches, and dizziness, etc.. will be alleviated or desappeared.

So, this time I wrote about what I think.


Back to English articles

2020年5月8日金曜日

Relation between Drowsiness, Melatonin and ETS reversal surgery

I wrote recently about intense drowsiness after ets reversal surgery.
Today, I write down about what I have researched about it.

The hormone that induces drowsiness is melatonin.
  • Melatonin is a hormone that makes the parasympathetic nerve active, and it is secreted mainly between the evening and dawn. It is produced by a tissue called the pineal gland in the brain and is carried by the bloodstream into the body.
  • Release of noradrenaline from the sympathetic nerve endings into the pineal gland causes melatonin synthesis.
  • The body recognizes its readiness for sleep as melatonin lowers pulse, body temperature, and blood pressure, so melatonin has the effect of promoting sleep.
It makes sense to think that my intense drowsiness is caused by hypersecretion of melatonin.
It is written in the second part of the above bullet point that the increase of melatonin synthesis is started under the influence of the sympathetic nerve. Though I think that all of the various symptoms that occured me after ets reversal surgery, for example, sudden tears, panics, tooth nerve pain, white vision, dizziness, and so on, are caused by sympathetic disorder, it seems no contradiction to think this strong drowsiness as the same. and I know that this disturbing drowsiness would be temporary as these symptoms have all gone now.

In addition, I have never heard of these symptoms from other people who took this ets reversal surgery. Some people have the feeling that nerve flows or ripples, but as far as I know, I am the only one who has had these transient disorder.
I don't think this as a big issue because I think it's a process of recovery after the reversal surgery. However, there are many other people besides me who got the merits of this surgery. In this point, I don't know why...

I feel a little more refresh in my head recently, and that my mental condition has also improved slightly.


Back to English articles

眠気とメラトニンとリバーサル手術

先日リバーサル手術を受けた後、強烈な眠気に襲われることがあるってことを書きました。
それについて少し調べたことをまとめます。

眠気を誘発するホルモンはメラトニン
  • メラトニンは副交感神経を優位にさせるホルモンで、主に夕方~明け方にかけて多く分泌される。脳にある松果体という組織で生成され、血流に乗り体中に運ばれる。
  • メラトニン合成の上昇は、松果体に入力する交感神経終末からのノルアドレナリンの放出が引き金となり開始する。
  • メラトニンが脈拍・体温・血圧などを低下させることで睡眠の準備が出来たと体が認識し、睡眠に向かわせる作用がある。

私の眠気はこのメラトニンの過剰分泌が起きて発生していると考えるとつじつまが合います。
というのも、上の箇条書きの2個目の所に交感神経の影響を受けてメラトニン合成の上昇が開始されると書かれています。私がリバーサル手術を受けてから起きたいろんな症状(例えば、涙が急にぼろぼろ出たり、パニックが起きたり、一過性の歯の神経の痛みがあったり、視界が真っ白になったり、めまいがおきたり、・・・といったこと)も全て交感神経の乱れから起きていると考えているのですが、この眠気もそれと同種のものということと考えても、だいたい合点が行くからです。それら症状は今はもう全て治まっているので、この強烈な眠気も一過性だろうということは分かっています。

気になることは、こういった症状について、リバーサル手術を受けた他の人達から聞いたことが全く無いことです。神経が流れる感触だったりざわつく感触だったりといった神経の違和感までは私と同種の感触だったり私とはまた別の感触を持ってる人は何人もいるのですが、神経系の異常ともとれるこれらの症状は、知り得る限り私しかいないです。。
私はリバーサル手術後の回復の一過程と考えているから大きな問題とは考えていないのですが、じゃあ私以外は回復を感じてないのかというとそうでもないようですし、正しい所は分かんないです。

最近頭のスッキリした感触があって、メンタル的な調子もまた少し良くなった気がします。


参考URL:
メラトニン - 脳科学辞典
メラトニン - Wikipedia
松果体 - Wikipedia

2020年5月3日日曜日

Why did I get extreme sleepy after ETS reversal surgery?

The temperature in Japan suddenly rose from yesterday, and I had a strong drowsiness during the daytime today as well as yesterday.
It is so strong that it would interfere with my daily life.

What evokes this awful drowsiness? . .

Generally speaking, sleepiness occurs when the parasympathetic nerve is dominant, which anyway doesn't seem to apply to my situation.

After ETS surgery, I could not sleep well and became early awake at dawn during the summer. I think that I had become wide-awake during the day because I felt dizzy from my hotter head because of no sweat. It's almost 20 years ago, so it's difficult to evaluate correctly. .

After ETS reversal surgery, I began to feel a strong sense of nerve flowing, and I began to feel intense drowsiness during the day in summer. I was in that situation for several years, but I don't clearly remember when to when. And that hasn't happened in the last few years, but it has recurred since last year.

I have reconnected both right and left sympathetic nerves by ETS reversal surgery, but I feel that my recovery process between the left and the right are very different. The process on the left side is already over, and the right is in process, so current situation(of course, the sense of nerve flowing and extreme drowsiness) occurs to me.

It means that the feeling of nerves flowing through reconnecting the sympathetic chain causes a strong drowsiness. so I think that parasympathetic dominance is irrelevant in this point.

Anyone have an idea about this?


May. 8. 2020 Update
I did some research on drowsiness, so I wrote this.
→ Relation between Drowsiness, Melatonin and ETS reversal surgery


Back to English articles

どうしてリバーサル手術を受けた後で眠気に襲われるようになったのか?

昨日からいきなり気温が上がり、今日も昨日に引き続き昼間ずっと強烈な眠気に襲われてました。
生活に支障があるレベルの睡魔です。

どうして眠気が出るんでしょう。。。

一般に眠気が起きるのは副交感神経が優位になっている時って言いますが、それだけだとどう考えても私の状況に当てはまらないのです。

ETS手術を受けた後、夏の間は熟睡できず明け方にはもう目が覚めてしまうようになりました。昼間は頭がほてるようになってしまったこともあってか、昼間眠くはならなかった気がします。もう20年近く前になってしまうので、正しく評価するのが難しいですが。。

リバーサル手術を受けた後、神経の流れる感触を強く感じるようになって、暑い季節に昼間強烈な眠気に襲われるようになりました。数年の間はそういう状態だった気がするけどいつ頃からいつ頃までだったかとかははっきり覚えてないです。ここ数年はそういうことは無かったのですが、去年から再発しました。

私はリバーサル手術で左右両方をそれぞれ神経移植でつないでいるのですが、左側の回復のプロセスと右側の回復のプロセスが大きく異なっています。既に左側のプロセスは終わっていて、今右側のプロセスの最中のために今の事象(神経の流れる感触および睡魔)が起きていると感じています。

交感神経をつなぎ直していて、その箇所を通じた神経の流れる感触で強い眠気が出るということなのです。ここでは副交感神経の優位性は無関係だと思うのです。

このことについて何か分かる方いらっしゃったら教えていただけたらうれしいです。

2020.5.8 追記:
眠気のことについて少し調べたのでまとめました。
→ 眠気とメラトニンとリバーサル手術

2020年5月1日金曜日

代償性発汗が心配になる季節になりました

とうとうGWに突入しました。
私がはじめて代償性発汗を感じたのはETS手術を受けた翌GWの最中のことで、GW明けの通勤電車から一気に深刻になりました。それ以降も、(ひと夏でリバーサル手術を受けたけれども)毎年GWを境に代償性発汗が出ていたので、今でもGWになると「あぁ、代償性発汗の季節がやってきたな」って実感します。

今日は快晴で、近所の公園まで母を車椅子で押しながら散歩してきたのですが、日に当たっていた時、(汗が出るまではいかなかったものの)脇から汗が出そうなすぐ手前までなってました。車椅子を押しながら出歩くのは軽いとはいえ身体を動かしますから、今年はもうそろそろ汗が出るようになるかもしれないです。(去年はお花見しか車椅子での散歩はしなかったので。。)

1時間ほど陽にあたり、散歩から帰ってきてからなのですが、脇を通じた神経の流れる強い感触と共にものすごい眠気に襲われました。強烈な眠気は昼間だけじゃなく晩ご飯を食べた後の夜も続いていて、座ってパソコンしてたらいつのまにか意識が飛び飛びになってました。
過去にもこの「強烈な眠気」に襲われ続けたことはあって、これはリバーサル手術後の回復の過程と考えています。今は右側の神経がつながりつつある過程にいて、昼間陽にあたったことがトリガーとなって右脇を通じた交換神経が活発になって頭に流れ、それで起きているんじゃないかということです。そして過去の経験からすれば、また当分の間は悩まされそうな気がしています。。。

でも今私は親の介護を中心とした生活をしているので眠気に襲われても大丈夫です。この生活をしているうちに、この期間を乗り越えられればいいかなといった程度に考えています。

2020年4月19日日曜日

にんにくが交感神経を活発にして血圧を下げるという話

最近たくさんにんにく料理を食べてます。

事の発端はにんにく酒を作ろうと思って20玉ぐらい入ってるお徳用にんにくを買ってきたことなのですが、にんにく酒に使ってもなお大量のにんにくが余ってしまい、それでいろんな料理に入れて今消費しています。カレーに入れたり、マーボー豆腐に入れたり、にんにく餃子を作ったり、アヒージョを作ったり・・・

あまりにたくさんにんにくを食べ過ぎてしまってお腹を下した日があったりもしたのですが、それは置いといたとしても、にんにくを食べた翌日とかには交感神経が活発になるのを感じています。また、私よりも食べる量ははるかに少ないし血圧の薬も飲んでいるし気候の影響とかもあるので断定することはできないのですが、母も血圧が下がっていて、おそらくにんにくの影響もあるんじゃないかと考えています。

あと5玉とちょっと残ってます。
まだもうしばらくにんにく料理を食べることになるので、何か変化を感じたらレポートしようと思います。

では。
まるとん