U.S. Government Studies the Neurocardiologic Dysfunction of Sympathectomy Patients

I participated in the study in November, 2004. For five days I underwent a battery of tests, including PET scans, drug tests, sweat tests, a tilt-table test, EKG, and a lumbar puncture (spinal tap). Conclusions:

1. Partial cardiac denervation as a result of bilateral thoracic sympathectomies.

2. Complete absence of blood vessel constriction in the arms, as expected in thoracic sympathectomy.

3. Complete loss of sympathetic innervation to the thyroid.

4. Abnormal catecholamine levels in the spinal fluid.

Bear in mind that these researchers are only looking at a few of the many aspects of ETS dysfunction.

http://www.truthaboutets.com/Pages/NIH.html

NIH Book: Sympathectomy is "Neurocardiologic Disorder"

Senior Clinical Investigator David S. Goldstein, M.D. Ph.D., calls ETS "surgically induced autonomic failure". learn more

Changes in Blood Flow following Sympathectomy

PDF
EFFECT OF SYMPATHECTOMY ON BLOOD FLOW IN THE HUMAN LIMB
Stein et al. Am J Physiol.1948; 152: 499-504

Blood diverted from muscle to skin after sympathectomy

However, the clinical results of both surgical and neurolityc sympathectomy are uncertain. Indeed these procedures lead to a redistribution of the blood flow in the lower limbs from the muscle to the skin, with a concomitant fall of the regional resistance, mainly in undamaged vessels. The blood flow will be diverted into this part of the vascular tree, so that a

"stealing" of the blood flow may occur.

Vito A. Peduto, Giancarlo Boero, Antonio Marchi, Riccardo Tani

Bilateral extensive skin necrosis of the lower limbs following prolonged epidural blockade

Anaesthesia 1976; 31: 1068-75.

Medical Errors Action Group in Australia

Australia has the highest rate of medical error in the world according to the World Health Organisation's 2002 Report released late last year .

16% of our hospitalised patients will suffer a significant adverse event which is totally unrelated to their original medical condition . This translates as 1 patient in 6 , which is four times the reported occurrence of medical error incidents in the United States , and a full 6% higher than Britain's 10% error rate .

18 , 000 Australian patients die each year as a direct result of avoidable injuries and complications inflicted from withn our health system environments .

Another 50 , 000 Australian patients per year are left with permanent disabilities , and hundreds of thousands more are avoidably injured to some greater or lesser degree .

80 , 000 Australian patients per year are hospitalised due to medication errors , syphoning a massive $350m from the Federal Health Budget annually .

And these figures do not take into account the recognised errors which take place in other clinical outpatient settings such as GP surgeries , radiology suites , and other outpatient clinics where the error rate has been found to be at 23% in one Sydney study .

Dr Hashmonai

　The 6th International Symposium on Sympathetic Surgery
　　　　 May 4-6, 2005 in Vienna, Austria
　　 　　http://www.medacad.org/isss2005/isss.htm

　　 　　Welcome PDF より

　 　 　" This is a field in which the unknown is still substantial
　　 　　and the some of the known - controversial. "
　　 　　Dr. M. Hashmonai　ISSS President

Dopamine - according to Oliver Sacks

"Dopamine is responsible for the flow of consciousness, flow of emotion, the flow of the mind."

Dopamine governs drive and creativity

Many patients after ETS complain about loosing their drive, their spark and creativity. Many say that they feel that part of them has been switched off.

Dopamine and sympathectomy.

Articles

Serum Dopamine--Hydroxylase: Decrease after Chemical Sympathectomy

Science 3 September 1971:
Vol. 173. no. 4000, pp. 931 - 934
DOI: 10.1126/science.173.4000.931
Richard Weinshilboum ¹ and Julius Axelrod ²

¹ Pharmacology-Toxicology Program, National Institute of General Medical Sciences, Bethesda, Maryland 20014
² Laboratory of Clinical Science, National Institute of Mental Health, Bethesda, Maryland 20014

Dopamine-- hydroxylase is an enzyme that is localized to catecholamine-containing vesicles in sympathetic nerves and the adrenal medulla, and is also found in the serum. Treatment of rats with 6-hydroxydopamine, a drug which destroys sympathetic nerve terminals, leads to a decrease in serum dopamine--hydroxylase activity. The decrease is not due to an effect on the adrenal medulla or to an increase in circulating inhibitor or inhibitors of enzyme. These data represent evidence that at least a portion of the circulating dopamine--hydroxylase activity arises from sympathetic nerve terminals.

sympathectomy severs both vasomotor and sensory fibres

CUTANEOUS INNERVATION IN MAN BEFORE AND AFTER LUMBAR SYMPATHECTOMY: EVIDENCE FOR INTERRUPTION OF BOTH SENSORY AND VASOMOTOR NERVE FIBRES.

ORIGINAL ARTICLES

ANZ Journal of Surgery. 73(1-2):14-18, January 2003.
COVENTRY, BRENDON J. BM BS, PhD, FRACS *; WALSH, JOHN A. MD, FRACS +

Abstract:
Background: Rest pain and severe ischaemia in patients who are unable to be offered (further) surgery to revascularize the lower limb is still problematic. Lumbar sympathectomy has been used for many years but the mechanisms by which this works are not absolutely clear. Both sensory and vasomotor fibres travel in the lumbar sympathetic chain and the effects of lumbar sympathectomy on these nerve types have been investigated in the present paper.

Methods: Immunohistochemical methods were used to detect neuropeptides contained in sensory and vasomotor nerves in the lower limb skin of (i) patients having amputations for peripheral vascular disease (PVD) after previous (chemical or surgical) sympathectomy; (ii) patients having amputations for PVD without previous (chemical or surgical) sympathectomy; and in control normal skin. The three groups are compared and the results are discussed.

Results: Normal and PVD controls had intact sensory and vasomotor nerves around dermal cutaneous blood vessels, but these were completely or virtually completely lost after lumbar sympathectomy, by either chemical or surgical means.

Conclusions: Lumbar sympathectomy severs both vasomotor and sensory fibres, suggesting that relief of rest pain may be explained not only by increased cutaneous and muscle blood flow, but also by nociceptive sensory denervation.

ASERNIP-s never reviewed the ETS surgery. Why?

May 31 2003 - Madonna has written to many Institutions in Australia, including proposed reviews of ETS in Australia. Morgan and FFSO have researched continually for evidence of side-effects with ETS/ESB. Patients have shared their personal and private stories on this site and the boards. Surgeons such as Dr T and Dr Lin have admitted there are side-effects. Together we have worked as a team and finally there is promising news. I have just received a letter from the 'Australian Safety and Efficacy Register of New Interventional Procedures - Surgical' and they will "undertake a systematic review of [ETS]" and "warrant it urgent attention".

http://www.ets-sideeffects.netfirms.com/home3.4.html

ETS for blushing?!

Those with blushing problems are often desperate to find a cure for their excessive blushing. Many people are turning to a medical treatment called Endoscopic Thoracic Sympathectomy, frequently referred to simply as ETS, for help with their problem blushing. At first glance, ETS seems like a miracle treatment for problem blushers. Those who market and perform ETS tout the procedure as a an almost guaranteed cure to excessive blushing. For people who have invested time and money in numerous treatments such as hypnosis, cognitive behaviour therapy, and numerous potions and pills, the thought of being done with problem blushing once and for all is certainly an appealing one. However, upon further investigation, the risks and side effects of ETS seem quite consequential. Before anyone decides to pursue ETS as potential medical intervention for problem blushing, he or she certainly needs to thoroughly research all aspects of the procedure. Since blushing is triggered by the nervous system, ETS actually impacts the nerves. The procedure literally involves either clamping off or cutting the nerves responsible for the blushing reaction. While problem blushing is a serious problem for people who experience it, deliberately damaging nerves as part of a medical procedure to cure blushing is certainly not something to be taken lightly. Nerve damage is permanent and irreversible, so those who are considering the procedure must be sure they understand exactly what they are doing, and have a clear picture of the potential side effects and consequences. The nerves in the human body are all interconnected, so it is not possible to deliberately damage specific nerves without impacting other nerves in the body as well. Therefore, there are a number of side effects that people who undergo ETS can expect to experience. The nervous system is very complex, and ETS can trigger both hyper sensitive nerves in some parts of the body and nerves that are completely desensitized in other parts of the body. Additional side effects can include decreased lung capacity, decreased stamina, trouble with regulation of body temperature, and compensatory hyperhidrosis.
http://www.theinformationservice.com/index.php?option=com_a3000&task=showarticle&id=77413

British Association of Aesthetic Plastic Surgeons

Douglas McGeorge, president of the British Association of Aesthetic Plastic Surgeons, said clinics were "abusing" the fact the public did not take enough time to assess treatments.

http://news.bbc.co.uk/2/hi/health/7171789.stm

Putting sales before patient safety

Some cosmetic surgery clinics are using aggressive marketing and putting sales before patient safety, according to consumer group Which?.

Undercover researchers at 19 clinics found the risks of procedures were often played down during sales pitches.

Some of the clinics described invasive surgery as "scarless" or "minor procedure", said Which?, which wants tighter regulation of the industry.

http://news.bbc.co.uk/2/hi/health/7171789.stm

Further news from Australia - action group

As a new development a support and action group has been set up in Sydney, Australia, that will act as a representative of the victims of the ETS surgery in communication with the government organizations (MSAC, RACS, ASERNIP-s) and Health Minister to negotiate the situation that needs to be addressed following the recent suicide of Tim McCarthy, who was disabled and devastated by the side-effects of his ETS surgery.
It also will provide support with the communication for the patients distressed after undergoing the surgery. They will provide information and links to other groups overseas. The soon to be updated Australian website can be found here:
http://ets-sideeffects.net/index.html

The survey was conducted between November 2003 and June 2004 and funded by the nonprofit Institute on Medicine as a Profession, a think tank that promotes medical professionalism through a center at Columbia University. It uncovered notable gaps between ideals and practice in the areas of self-regulation, managing financial conflicts and conserving limited resources.

Study Finds Gaps Between Doctors' Standards and Actions

Physicians Think They Should Report Errors and Incompetence -- but Say They Often Do Not

By Christopher Lee

Washington Post Staff Writer
Tuesday, December 4, 2007; Page A08

and what does the Australasian College of Surgeons has to say?

ASERNIP-S has not conducted a review on sympathectomy. It was previously listed for MSAC to review (hence why ASERNIP-S did not review) however I believe instead it was referred to PBAC. I have no information as to what happened with this review although I recently found out that it was only looking at a pharmaceutical treatment. ASERNIP-S is only able to review the published evidence however our current funding does not cover conducting any new systematic reviews. We would be happy to do a full systematic review on this topic but this would require significant funding, in the order of $150,000. The reason for this is that we would need to examine all study types in detail, as it is clear from what you have provided there is an enormous evidence base.
All that I can suggest is for you to contact the federal government, possibly MSAC and state governments for funding to have a full review done.

In our searches we located a guideline paper on the procedure from 2007 which indicates that the procedure should only be considered in severe cases when alternative treatments have been tried and were unsuccessful.

The Australian Government relies on

The Government relies on the advice of the medical profession in relation to the clinical relevance of procedures already listed on the MBS. If the Royal Australasian College of Surgeons were to formally advise the Government that it no longer regards this procedure as being clinically relevant, the Government would take appropriate action in relation to the MBS.

Do you think you are too young to have grey hair?

You might be onto something. Here is a published article:


Arch Dermatol, Vol. 93, Issue 2, 235-236, February 1, 1966

ARTICLES

Gray hair and sympathectomy. Report of case

A. B. Lerner

You have reached the most complete version of this article accessible.

Has there ever been a controlled trial done on the effects of sympathectomy?

in Australia? Overseas?

Isn't the procedure considered experimental if such study/trial has not been done?
Are medical companies allowed to introduce new drugs without such trials/studies? What would happen to a company that would do that?
Who is responsible if such thing occurs?

The answer according to the Royal Australasian College of Surgeons is: NO!