 http://www.privatix.fi/index.shtml?&a=0&s=navig_03&l=en&d=03_faq

FAQ (Frequently Asked Questions)

Are there any side effects in ESB surgery?
In every surgery there is a risk of some side effects. Due to the constant development of the method, the main side effect, Compensatory Sweating, or more correctly Reflex Sweating, has been minimized, and exists in less than 10 per cent of the patients. 
Are there any risks in the ESB surgeries?
Every operation and anesthesia carries some risk. The rate of operative occurrences in our operations has been very low. In our material of more than 1.000 patients there has not been a single bleeding. However, sometimes a minor leak in the pleural cavity may require a small suction tube being left overnight on the chest wall.
Sometimes a Horners sign may develop for a short period of time. It is a slightly drooping eyelid, which does not impair vision. It is no real risk with the ESB, the clamping method, because the condition readily can be corrected by reposition of the clamp. 

What is the success rate of the Privatix method?
If success is measured by abolishment of the major symptoms like palmar sweating, sweating of the face, blushing, as well as a level of anxiety, then nine patients out of ten have had their main symptoms eliminated. 

What are the effects of the ESB surgery to the heart?
The operation stabilizes the function of the cardiac nerves. This usually somewhat lowers the blood pressure and pulse rate. Also the tendency of ectopic beats diminishes as well as the occurrence of heart arrhythmias. Overall, the effect of this operation seems to be quite beneficial to the cardiac function.
Because of this stabilizing effect on the cardiac nerves, the heart racing will usually be cured. 

When can one get back to work?
The patients coming from elsewhere usually stay overnight in the hospital. Some minor back burning may occur during the first couple of days. Easy work can be started the day after the operation, and heavy duty work can be resumed after two weeks as well as calisthenics, body building or other sport training. 

What about insurance?
Many insurance companies cover the procedure if it is considered to be a medical necessity. However, the Finnish social security does not yet cover it. 

What is ESB, and how is it performed?
ESB, endoscopic sympathetic block, is similar than ETS with clamping technically. This means, that the sympathetic nerves are compressed with clamping to block their function. Still, the nerves remain viable and ready to function, if the clamps are taken away. This means that this surgery is reversible.
ESB means also, that the nerves compressed are selected individually according to the Lin-Telaranta classification of symptoms. Thus:


In HH, or hand sweating, only the T4 level is treated 
In FS, or facial sweating, as in CH or craniofacial hyperhidrosis, only the T3 level needs to be treated 
In FB, or facial blushing, T2 level needs to be treated 
In SP, or social phobia, depending on the more specific examination, left sided T2 to T4 treatment may be sufficient, in some cases the surgery has to be bilateral. 
What kind of Anesthesia is used?
General anesthesia is normally used. The intubation tube is not necessary, however, a laryngeal mask is more gentle to the patients throat. 

Do the symptoms (blushing, sweating) ever come back after ESB?
Sweating femains permanently cured, however, with the newer method the hands or face are not bone-dry but some very little skin moisture remains. Bone dry hands or face often result from the more conventional ETS methods and are very often bothersome. Skin needs just a little moisture to keep young and functioning. A too dry hand or face often becomes irritatingly scaly or itchy.
The blushing never goes away 100 % but only about 80 %. This also is healthy, since only the deceased are completely pale. The diminished blushing may during time somewhat return, though not usually disturbingly.
The biggest benefit is the stopping of the vicious cycle, which the blushing has brought about. After the surgery, it often is helpful to begin to learn new ways of living. To learn to cope with the formerly difficult, embarrassing situations should be the major personal effort, where also therapeutic help may be required. 

Can ESB cure sweating of the armpits?
The new technique of T4 clamping is also useful in armpit seating, and this without significant compensatory, or better, reflex sweating, as has been the case with earlier methods. 

Will ESB cure my psychological symptoms (social phobia)?
ESB has proved to be a very useful treatment for social phobia, the best that there is. While the medication (pharmacotherapy) and psychotherapy give relief in 50 to 70 % of the cases, ESB helps in 85 % of the cases, and at much better level of life quality. This has been proved to be so statistically higly significantly in a University based study of more than 200 patients. 

Does ESB reduce the ambient redness in the face?
ESB often reduces the ambient redness in the face, even if it is performed at levels T3 or T4 for sweating symptoms. This is why we normally propose T3 treatment also for those FB patients, who also have facial sweating as a part of the problem. Usually the blushing is also taken away for the most part. However, after drinking alcohol and exercise the diminishment of blushing may be less marked. This is not necessarily a drawback, in our opinion. 

Why do my hands become warmer after ETS?
The warming effect of the sympathetic block is a reflex phenomenon, which may subside with time in 1 to 2 years. However, in ESB the hands never get colder than they originally were, whereas in conventional ETS this is a risk, when there has been Raynauds syndrome, or otherwise cold fingers before the surgery. 

Will ESB have an effect on the way I exercise? 
It may seem right after the surgery, that the endurance or maximal capacity to sport has been lowered. This usually gets normalized within 2 to 4 months, and in the investigations, the oxygen uptake capacity has remained intact. 

What is the usual age of onset of facial blushing and hyperhidrosis? 
Facial blushing is often present already in the preschool age and prepuberty. The worst blushing, however, nearly always begins with puberty, that is in teens. Then it usually diminishes with age, but when not relieved at the age of 20, it usually is long lasting, and may need ESB, if very disturbing.
Sweating may begin already at an early age, and is not so dependent adolescent development. Many times, however, it gets worse in the teens. 

Where is Privatix Method available?
ESB is performed according to the Privatix Method in Finland in Helsinki, Tampere, and Oulu, and in Italy in Meran. 

How much does ESB cost?
The price for the bilateral ESB (for sweating and blushing) is 6 500  in Helsinki. In Italy the price is 3 900 . The prices include all hospital costs. 

How many ETS reversal surgeries have you performed?
Dr. Telaranta has performed mor than 100 sympathetic nerve reconstructions. His experience on nerve reconstruction surgery is based on 3000 nerve reconstruction surgeries performed for traumatic nerve injuries. 

What is the success rate of ETS reversal surgeries?
81 % of these patients have had clear benefit from the surgery. 

What is the main benefit of the ETS reversal surgery?
Compensatory sweating may immediately be greatly reduced, and further reduction may happen from 6 months up to 3 years after the surgery. 

Do FB and HH, or FS come back after ETS reversal?
You need not be afraid of that, because the nerves do not recover that well. You only can get back some moisture in the hands and the face, which is only good for grasping and for skin nourishment. The blushing does not recur markedly. 

How many reversals have been a complete success?
The reconstruction of any nervous system never can restitute the original situation completely. A handful of patients have had a most remarkable result with practically no CS and nearly normal sweating of the hands and face, with a simultaneous benefit of permanent having got rid of HH and FB, though! Thats a success, I would say, though not to the original situation of still blushing and sweating unbearbly! 
