This blog is a summary of the situation since I took ETS reversal surgery in Finland.
Almost written in Japanese but several articles written in English.
you can read from English articles tab.
I usually work in the office, but today I went out during work. I took the subway and walked outside. Because I wore thick clothes, the sweat stain was hidden, but my upper body was wet with sweat.
The title of this post is "#3", which is a continuation of "#01" and "#02" written in June 2012.
【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.
The "feeling of nerve flow" used in the title is just an explanation of my feeling as a result of taking ets reversal surgery by Dr. Timo Telaranta in Finland.
However, it doesn't mean that if you take reversal surgery, you will recover with such feeling. I know a number of people who have had the same reversal surgery in Finland, but no one has the same feeling of mine.
I'm the only one who used sural nerve for donner site (the others used intercostal nerve), so I'm not sure if it's due to the difference in technique or just due to individual differences...
About the structure of nerves in the arm
The nerve page of Wikipedia has a diagram of the nerves in the arm.
The red part is the artery and the yellow part is the nerve.
By the way, the same figure is also used on the ulnar nerve page, the median nerve page, the medial pectoral nerve page, and the lateral pectoral nerve page on Wikipedia. The radial nerve page uses a little different figure, but the nerves of the arm are explained in the same way.
The reason why I dared to give the difficult nerve name is that these pages say that these nerves are derived from the brachial plexus. The brachial plexus page says, "formed by the anterior rami of the lower four cervical nerves and first thoracic nerve (C5, C6, C7, C8, and T1)." As mentioned on "How much can I recover having taken ETS reversal surgery?" page before, there is a sympathetic trunk in the chest, and it seems that T1 and T2, T2 and T3 ... and all sympathetic nerves are originally vertically connected by a nerve called a communication branch.
That is to say, even if I do not understand each of the yellow nerves in the upper figure, I think that they are the parts over the nerves reconnected by reversal surgery. In other words, I think that the extension parts of the nerve blocked by ETS surgery affects not only the palm but all the arms. And the nerves of the brachial plexus are connected not only to the arms but also to the face and head, but I will write about the feeling of the nerves flowing to the face and head at another time.
The figure below shows, though my imagination, how ETS surgery may remove the nerve. And I think that partial block means cutting off a part of the four points in the figure, rather than cutting all of them. ("4 points" is because this image figure happens to be that way. Actually, I think that doctors cut what they find during surgery. As I don't know exactly, welcome your advice.)
This diagram is from the sympathetic trunk of Wikipedia, and I wrote on the premise of the enlarged view of the red circle in the figure above.
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About the place where I feel the flow of nerves
As I mentioned in the diary the other day (※refer to here and also here, but I'm sorry these article are in Japanese), the green part in the figure is the most strong part that is feeling of flowing nerve right now.
This green part is below the clavicle and seems to come out from the rib gap. Positionally, it is the tip of the "balloon" on the left side of the three "balloons" below.
It's a place that feels terribly violent, so I thought it was clearly shown, but it didn't look in this figure.
And I think that the nerve passing near the yellow circle toward the right shoulder is linked to the nerves bunched around indicated by the balloon on the upper right in the area.
This time, I applied my feeling of nerve flow to the nerve diagram and compared them.
When I was working this afternoon, sweat was exuded from my back for a moment.
It wasn't hot nor I was exercising, but I suddenly felt feverish only around torso and sweated, while sitting at my desk. This sudden sweat I had today wasn't enough to drop down, and stopped after only my back got a little wet. As I wrote in the previous article (About the "feeling of nerve flow" that I feel after ETS reversal surgery #01), sweat sometimes can be pouring out like a fall.
I am feeling the flow of nerves in my upper body all the time while I was awake, and I now still feel it flowing into my palm through my right shoulder. Though it's not numb, both hands have a tingling dull feeling. My right hand is shivering for few years all the time when I've been awake and unconscious (meaning I'm not aware of my hands).
※The figure is on the abdominal side,
but I feel the back side.
※Japanese annotation written above
means "The location varies from day
to day".
Conversely, regarding the nerves below the chest, there is also a feeling that the nerves also move as well.
What is different from the upper half of the body is that there is a flowing feeling like a landslide from some part of the abdomen / back toward the inside of spine. This happened just before. I think it may be linked to sweating during the daytime.
When I have the feeling like a landslide, sometimes I have another flowing feeling going up along the spine, or sometimes other flowing feeling going down from the thigh to the bottom. Once I feel it, the flowing will be intense for the next few days, and in particular I will feel a strong flow in my shoulders. In this way,
I feel that the nerves reduction in the lower part does not provide overall smoothly like unplugging a bath or deflating a balloon, but somewhere in my nerves collapses all at once, as if a dam broke, and then flows over my chest over the next few days. When the nerve movement settles down, I feel it at another place in the same way, and it is repeated again and again.
Though I have wrote at "Kingyo-Ita" of Japanese bulletin board system in the past that "the nerves under the chest have become like a pressurized hose, and it flows through the parts that are connected by reversal surgery while cutting off at some parts", it comes from this feeling. (※Refer to this, but I'm sorry, it is written in Japanese)
This kind of thing happened not once or twice but tens of times, and happened over and over again, and at last, little by little, so very little, the abdomen / back sweat decreased.
This feeling is just a "my personal feeling", and it is not a summary of how to recover after a reversal surgery nor an explanation of how to recover. Please understand there.
By the way, I can commute to work on the train with my shirt and back dry without any compensatory sweating in spite of at the end of June. It's not summer yet, so it's early to put together this year's situation, but I feel that the recovery is more advanced than last year.
I was at home today during the day, but the room temperature was over 29 degrees Celsius and I sweated from my back like a waterfall.
After I sweated like today, it will be continue for next few days that I feel nerve flowing intensely. It's been repeated for many years.
So I think that sweating like this is close to the sign that the nerve flow becomes stronger.
Since I made a blog, I'd write a little about the "feeling of nerve flow" that I feel.
The black horizontal line that extends from the throat to the left and right in the left figure is the clavicle and there are some ribs just below it. When I press the gap between its top rib and second rib (red point) with my finger, I can feel the nerve flow.
I've written on the bulletin board several times in the past that I often feel cracking inside my shoulder, and that place is the green and yellow area of the figure.
Especially about the green area, when I feel pain, it can be easier by pushing there with my left index finger as much as possible.
The part that I feel strongly that the nerve repeatedly connects and disconnects for the past 3-4 years is the blue part around my armpit. I think that there is a part that interrupts the flow because the nerve tube is bent after it has withered once. If pressing from underarm-side outside of the blue area toward inside of the body using my left index and middle fingers, I can feel the nerve flowing from red to green to blue. (Maybe red → yellow → green. I can't say "the feeling" clearly because there are various parts that I feel strongly and other parts that I don't feel at all...)
So there is a feeling that it flows from the red area to the yellow area. When I feel the flow in this yellow area intensely, I sometimes feel the flow to my right palm, around behind my neck, and to my left arm through behind neck, and in addition, (although both left and right) I may feel the flow to my temples through neck.
And I feel the flow of nerves from various places that I can not understand well, such as going from the green area to the back, or from the blue area toward the left shoulder through the back, etc... A lot of things happend, such as when I felt the flow of the green area strongly, the area around my right thumb and forefinger was numb, and when the blue area, the area around from my right middle finger to little finger was numb. There were so many different feelings that I can't clearly explain what kind of structure and flow it really is.
However, I think that the part to have reconnected my nerves, when I took ets reversal surgery 10 and a half years ago, was around the red area. And I think that the nerve blocked is one of the root important nerves, among spreading all over the body.
That is, even if the transplanted area is already connected, the nerve flow to each node of the body has not yet been regained, because I feel like this.
This article is a translation of an article written in May 2018.
Thanks to this event of "full bloom", I'm feeling further changes. I think the current symptom of intense sleepiness is one of them.
I already wrote today's diary about two hours ago, but this is an additional diary.
I felt sick, so I had a dinner easily, and I lay down again, then I felt that the nerves on the abdomen flowed and moved to both arms at a frightening speed.
It was completely different from the feeling until now, and was a tsunami-like flow.
It may be a symptom close to panic.
I received the following advice from my doctor who had reversal surgery in Finland. Compensatory sweating does not decrease at the same time as the nerves move, but sweating decreases at last when the nerves move to the fingertips and heads and connect to all. (※See here, but I'm sorry, it is written in Japanese)
This time, I think that the nerve through the cracked point in the right shoulder was connected to the fingertips, and became a "full bloom".
However, it isn't completely connected yet.
I still have the feeling cracked in my shoulder, and still feel the nerve flowing.
I don't know if it will continue to flow and be fully connected, or if it will gradually connect while repeating these things in a cycle of several months.
I felt like it was connected in one place in February of last year, but I know now that there was one more left. I don't know if there is another nerve to connect.
However, based on my experience until now, I think this should improve compensatory sweating and body temperature.
I heard from the person who had ETS surgery that he consulted my blog prior to the surgery.
I think that the mind and method about ETS surgery has changed from the time I received it to the present.
So I'm not sure if everything is true, but I think I will write a message to anyone who would like to take ETS surgery.
I am negative about ETS surgery.
It is not reasonable at all for a person who has had reversal surgery to recommend ETS surgery. Therefore, I always say strongly that you shouldn't do it.
Still, there are people who want to undergo it.
This is the minimum advice to those people.
What you should try before taking ETS surgery
Aluminum chloride and Iontophoresis should definitely be tried before ETS surgery. If this works, you don't have to take the surgery.
You can also use Pro-Banthine (Generic: Prospas). Many people use it for compensatory sweating, so it should work on hand and foot sweats. If you want to stop your sweat only when important, I think that you might use such a drug. Some people say that just holding it as an amulet is effective.
Nerve burned out by ETS surgery
The nerves are burn out like this. (This is an overseas video excising T2 / T3 / T4)
Burnt nerves can no longer be undone.
Some people said "I didn't know it was like this. If I saw this in advance, I didn't undergo the surgery."
Excision position of ETS surgery
The resection place where all doctors have a consensus does not seem to be established, but commonly, that for hand sweat is referred to as T2 and T3. Though T4 becomes a candidate for underarm sweat, I heard from Dr. Shiotani that T4 alone won't stop hand sweat. Since T2 has strong compensatory sweating, I think that excising T3 may be the optimal solution.
However, there seems to be no method to confirm the excision site by X-ray or the like.
Compensatory sweating
Compensatory sweating occurs 100% when taking ETS surgery.
Satisfaction is a criterion for accepting compensatory sweating while hand sweat is gone, and is a personal judgment. Since the satisfaction rate published by hospital incorporates the hospital's intention, I'm not sure whether the overall patient satisfaction is reflected correctly.
Also, compensatory sweating may worsen over the years.
Are you satisfied with the one-sided cutoff?
This is a big problem.
I think that the dominant hand is selected first in the case one-sided cutoff, but then the extent of compensatory sweating is low so likely to be satisfaction. (Of course, some people were disappointed with even only one-sided, some of whom took reversal surgery.)
If you cut off on one side, you may have another problem such as left / right difference in sweat on your face. You may want to stop sweat with both hands.
However, I think it will happen if you cut off on both sides.
I think this is why even if compensatory sweating is not too much of a concern on one-side, it can be fatal on both sides.
What is the deadly aftereffects of ETS surgery?
Intense compensatory sweating limits your summer outings.
Clothes can only be selected depending on how sweat is inconspicuous, and you are desperate for odor control.
You cannot eat spicy food in public because of gustatory sweating.
Your head is hot in summer, your hands is cold in winter.
You lose your energy, lower motivation, and change your emotions.
Is it true that it will not look like it used to be?
There used to be a time when cutting all of T2 / T3 / T4. By comparison, it may be true that it is not what it used to be. However, unbearable amounts of compensatory sweating have also occurred in people who have taken ETS surgery in recent years. Some people with bilateral T3 resection go to Finland for reversal surgery .
If disappointed at ETS surgery, then can I say that I have reversal surgery?
No, I can affirm.
If you took it in Finland, it will cost over 1.5 million yen. There is a risk that it will not work and recovery will take time. Even now, 15 years later, I'm still recovering.
ETS surgeon I recommend (in Japan)
So, though I strongly insisted that you should not took ets surgery, if you still want to take it, I recommend the "Japanese Society of Thoracoscopic Sympathetic Surgery", which studies ETS surgery seriously.
There is also a link to this group in my link collection (in the right column), and their hospitals from north Hokkaido to south Kyusyu were introduced on the site.
This week was a week when many companies take summer vacation.
Since I was able to sit down on the train and the cooling effect was strong because of few people, I commuted to work more comfortably than usual.
As for this week's situation, I had the overflowing sweat on Friday which recently occurs frequently.
The air conditioning wasn't good during the day, and the room was at 29 degrees for a while, so I felt hot from the daytime, but at that time I didn't sweat. But at night, I heavily sweated instantaneously.
When I felt its indication, my concentration is suddenly lost, and vague anxiety begin. And though I sweat only about 5 to 10 minutes, I feel it a very long time.
I haven't had such a bad thing recently, but sometimes I feel choked and get stuck. And after a while, these symptoms will calm down. Other people might think it's a panic condition, and I also think it might be the same principle as panic. But as I have not been diagnosed, I do not know the details...
What I feel is that my nerves are moving. Such indication occurs when it is ready to flow from my abdomen / back to my chest (It often happens after spending in the heat area, exercising, etc.), I feel a lot of nerve movements when resting due to pain, and It will calm down after a while.
But what I think is fundamentally different from panic syndrome is that I have never felt the fear or anxiety that I might die and I have the hope that "this helps my recovery" even in the middle of the symptoms. I thought so even when I felt suffocating, sicky, and grueling. Until now, there have been many times when I have had a terrible fear that makes me want to escape from the place where there are people, and an anxiety that I cannot express in words that stop my thoughts... is this panic at all?
Though it's not as bad as it used to be recently, I have been told from many people by now "have you been getting medicine?", "What if you see a doctor?", and so on. I escaped from people at the indication stage most of the time, but there were many times I couldn't do so, and I have been called an ambulance once in the past.
However, I always answered that there was no problem because the cause was known. It is because that I don't like doctors, that I think it's impossible that some medicine can cure me because the cause is the moving and flowing of my nerve, and that I think this symptom will disappear if the recovery after reversal surgery proceeds more and the feeling of the movements and flow of my nerve ends.
I went to the pool today.
It's great to spend hot daytime without worrying about the heat, to rehabilitate after reversal surgery by exercising, and to feel the flow of the nerve movement more intensely when you feel water pressure in the pool, so I go to the pool every week during summer.
Though sometimes the nerves that flow through my right shoulder make cracking sound inside, I feel the nerves flowing into my palms when flowing smoothly.
