UCLA Surgeon Embarrassed at Conference Confrontation

Caught Red Handed!
An Investigation Into the Methods and Tactics of Samuel S. Ahn, M.D.
By Alex Baker (songboy1234)
March 1, 2006
Draft ver.1.3

Abstract

ETS Surgeon Samuel S. Ahn, M.D.  has been caught on video telling lies about ETS side-effects, denying participation in a WebMD article and a EurekAlert! press release, admitting human vivisection and other disturbing aspects of ETS. He is evidently using a UCLA scientific study to recruit surgery patients. Ahn maintains his status as a prolific practitioner and ardent advocate of ETS, while a member of his research staff has published claims that Dr. Ahn does not even recommend the surgery at all. Download video clips here, and IHHS conference transcript here.

Table of Contents

Background

Samuel S. Ahn, M.D., is a vascular surgeon, a professor at UCLA, a pioneer of ETS surgery, and a founding member of the International Hyperhidrosis Society (IHHS). On July 30, 2005, in Huntington Beach, California, the IHHS sponsored a Continuing Medical Education (CME) conference entitled “Hyperhidrosis - Emerging Concepts & Treatments”. Dr. Ahn gave a presentation on his ETS, and afterwards fielded questions.

Dr. Ahn is also leading a clinical study into the genetic basis for “hyperhidrosis”. The study has already established that “sweaty palms” is hereditary and they are trying to isolate the “hyperhidrosis gene".  He and his staff are actively seeking volunteers and their relatives who believe they sweat excessively. The study is funded by the California Vascular Research Foundation, and conducted by UCLA Division of Vascular Surgery, and the UCLA Department of Human Genetics.

WebMD Article

My interest in Dr. Ahn was first piqued when I read a WebMD article about his genetic study.  The 2002 article, written by Liza Jane Maltin and reviewed by Gary Vogin, M.D., advises patients suffering with "hyperhidrosis" (excessive sweating) that there is “help available” in the form of ETS, “a minimally invasive surgery to snip the sympathetic nerve connection to the hand.” The article then quotes Dr. Ahn:

This, of course, is rubbish. ETS surgery has a great long list of proven side effects, and it is deceptive in the extreme to characterize ETS as merely snipping the “nerve connection to the hand”. In fact, this statement is false in two respects: 

• ETS surgery will interrupt the sweat-signals to a vastly larger body area than just the hands, usually encompassing the entire upper body above the nipple-line.
• The same nerves which lead to the sweat glands are all bundled together with nerves leading to the heart, the lungs, blood vessels, the thyroid, fat tissue, bone, bone marrow, and lots of other good stuff.

Evidently, Ahn has also issued a press release promoting his genetic study and ETS surgery. The press release warns readers that "hyperhidrosis" is "underreported" and up to "5% of the population" may be "at risk". Similar to the WebMD article, the press release says Ahn will "snip the sympathetic nerve connected to the hands", then states:

Since “hyperhidrosis” means excessive sweating, the statement clearly implies that ETS only stops the excessive sweating, when in fact it paralyzes all sweating in the denerved area, an area much larger than just "the hands".

So, I decided to pay Dr. Ahn a visit at the Huntington Beach conference to see if he could clarify any of this.

I attended with my friend "Immunorat", who is a microbiologist and frequent contributor to the ETS & Reversals forum. The audience was comprised of about 30 people, mostly medical professionals, and included Robert Szarnicki M.D., an ETS surgeon from San Francisco.

The main points of Dr. Ahn’s presentation were:

• ETS stops sweating to the hands
• Ahn is a pioneer of ETS, having started doing it back in the early 90’s
• He uses the "ganglia resection" method (cutting out entire ganglia), as opposed to the severing, burning, or clamping methods employed by other surgerons
• He only had one patient who ever regretted ETS
• He has achieved better results in the last few years, now that he consistently removes the T2 and T3 ganglia, as opposed to his previous strategy of “experimenting around”
• The only negative aspects of ETS he studies are “Compensatory Truncal Hyperhidrosis”, “Horner’s Syndrome” and “Hospital Stays”.
• Large numbers of horrible, disabling ETS results and disciplinary actions from Taiwan, Sweden, Finland and elsewhere are due to differing surgical techniques, and do not apply to him

Throughout his main presentation, Dr. Ahn repeatedly made reference to ETS surgery stopping sweating to the hands. With my own anhidrosis burning and clawing at my whole upper body relentlessly, I spoke up near the beginning of the Q&A session:

A blatant lie. He looked away toward another questioner, but I pressed on:

Even when pressed, he sticks to the lie, . . for a moment. Then,  perhaps sensing I might be exposing him, Dr. Ahn starts changing his story trying to cover his tracks:

Lies, lies, lies. He changed his story three times, and still never got close to the truth. Clearly I am dragging Dr. Ahn into admitting facial anhidrosis after he thought the question was over, and he is still hedging. He’s still not talking about the head, or the arms, or the neck, or the shoulders. No hard numbers? Truth is, Ahn’s ETS will produce permanent anhidrosis on the top 1/3 of the body in about 99.9% of cases, not 10% , not 25%. Anhidrosis on the top of the body is the expected result. And of course ETS affects thermoregulation.

Even Reisfeld admits ETS will typically limit a person to a 138 bpm maximum heart rate, whereas 160-180 bpm would be considered normal.

Of course, I couldn’t wait to ask about the WebMD article.

So . . . Ahn is saying that Liza Jane Maltin and/or Gary Vogin M.D.  fabricated a desperate and malicious lie, then falsely attributed it to him. Why would they do that? I don’t believe WebMD would do such a thing. Considering Ahn is the one who stands to gain from increased sales of ETS surgery, the most likely conclusion is that Samuel S. Ahn M.D. did indeed say that ETS has no side effects, just as the authors say he did.

Thusfar, no one from WebMD has returned my phone calls or emails.

For the record, ETS has a long list of side effects.

IHHS Conference - Vivisection

I wonder . . . Did Dr. Ahn inform his ETS patients they were being experimented upon, back in the days when he now says he was “experimenting around”?

IHHS Conference - Bone Metabolism

During his main presentation, Dr. Ahn never said anything about ETS affecting bones (or much else besides sweating). But after the Q & A started to heat up, our resident biologist Immunorat posed a technical question to Dr. Ahn about trying to quantify the effects of the nerve damage using Scatchard Plots. Ahn had nothing to say on that subject, yet apparently feeling the need to match intellects with Immunorat, gave us a glimpse into what may be the most closely guarded ETS secret of them all:     

Ahn is bending over backwards to make sure we understand this bone business is “pure theory” and not proven.  But actually, it’s a lot more proven than he lets on. Sympathectomy is known to affect bone metabolism, specifically it will increase the rate at which calcium is lost and re-abosrbed into the body (resorption). 

Ahn’s theorizing is sound, the most sense he made the entire afternoon. He shows an ability to make a theoretical prediction about ETS based on the known function of sympathetic nerves – sympathetic nerves regulate bone, therefore cutting those nerves might screw up whatever was being regulated. Pretty straightforward reasoning.

So why isn’t he doing bone scans on his patients to test out his theory? Could it be that he just doesn’t want to know? And again, I wonder if Ahn shares this “theory” with his potential customers. At least he doesn't operate on children, right? Well, not so fast.

This part of the Q&A got so interesting it merits its own seperate article. Dr. Szarnicki brought up the prospect of ETS surgeons going to jail, and Dr. Glaser had to step up and end the conversation, practically forcing Dr. Ahn away from the podium. Before that happened, I had asked Dr. Ahn about the psychiatric effects of the surgery, and instead he started talking about the pre-existing psychiatric issues of some of his patients, so I interrupted him:

On January 10, 2006,  a new member with screen name “UCLAMed” posted a thread on the ETS & Reversals discussion board with the headline

UCLAMed was seeking volunteers for the study, gave contact information and said that Dr. Ahn had a clinic available to help hyperhidrosis patients “any way possible” and to “feel free to make an appointment”. 

One line stuck out and caught the attention of the forum moderator:

What? What is going on here? Dr. Ahn is one of the world’s leading advocates of ETS!

Let’s see if I have this right. In July I attend I conference where Dr. Ahn touts ETS surgery as a wonderful, safe treatment for excessive sweating that he has been doing for 15 years, and how his results are so much better than the disasters reported elsewhere, and about how he was a pioneer of ETS and had done more of them than almost anyone else. Then in January someone from UCLA is recruiting hyperhidrosis study volunteers and saying Dr. Ahn does not recommend surgery? Huh?!?

I took the bait and sent a mail to UCLAMed, saying I was interested in the study.  I was answered by Kathleen Lin, who sent me a promotional flyer. We exchanged a series of emails about the procedure of the study, and I asked her why it was that Dr. Ahn would not recommend ETS. The only response I got was -

“I am not too positive why [Dr. Ahn] doesn't recommend surgery, but I recall him using that as the primary source in our meeting.”

Hmmmmm.  At this point I begin to suspect Kathleen Lin may have said Ahn doesn’t do ETS because she was observant enough to notice that the membership of the ETS & Reversals forum are overwhelmingly anti-ETS. That way, perhaps she could interact with new surgery prospects and their families, without triggering criticism on the discussion board. Apparently she figured we didn’t know who Dr. Ahn is or what he does.

She would be wrong about that. We were already well aware of the out-of-court settlement between Ahn and one of his patients. The patient had accused Ahn of forging a consent form, and handwriting experts were brought in.

I supplied requested information about my blood relatives who have hyperhidrosis. Ms. Lin explained that they needed to take saliva samples and would send out test kits that we would spit into. She was quite methodical, making sure I had given her the names of everyone in my whole family tree, and noting which ones had hyperhidrosis. She asked permission to contact all my sweaty family members directly. I declined and had her send all the test kits to me.

Several times Ms. Lin encouraged me to go to one of  Dr. Ahn’s “clinics”,  which take place on Tuesdays and Thursdays. Then, after she didn’t hear back from me for a few weeks, she sent me another email reminding me about the clinic.

Now, Ahn had “announced” back in  the 2002 WebMD article that his study had indeed found “sweaty palms” to be “hereditary”. I think we already knew that, because excessive sweating “runs in familes”, but in any case, Ahn has evidently confirmed it. What remains unclear are why the California Vascular Research Foundation continues to fund the study, what Dr. Ahn is actually trying to learn, and what sort treatment could possibly arise from it.

Based on my experience, it seems to me the fine work of Kathleen Lin has as much to do with expanding and working Dr. Ahn’s database of prospective ETS customers, as it does with studying genetics.

At the IHHS conference, after I has confronted him with the WebMD article and the EurekAlert! press release, Ahn offered the following disclaimer:

This strains credulity. Dr. Ahn would have us believe that someone else fabricated a press release touting Ahn’s study, warning people that "hyperhidrosis" is "underreported" and making deceptive claims about ETS, then hired EurekAlert! to put it out. Who would do such a thing? It would seem that Dr. Ahn himself would benefit from an increase in the reporting of hyperhidrosis, as this could increase the number of ETS surgeries performed. EurekAlert! has thus far declined to comment.

Most of Ahn’s competitors use advertising websites to generate business. Evidently Ahn is able to avoid these more obvious forms of advertising, because his genetic study provides him and his recruiters access to a steady stream of potential surgery customers.

What do you call the International Hyperhidrosis Society, if not a website devoted to advertising Botox® and ETS surgery? Who is responsible for its content if not its founders?