Anatomy of Deception
An analysis of a sympathectomy consent form
Here we analyze excerpts from the official sympathectomy consent form used at Addenbrooke Hospital, Cambridge University. Authorship of the consent form is credited to "Department of Vascular Surgery", quotes from it are in the colored boxes, my remarks are interspersed, and the entire document can be found on the Addenbrooke site.
"Consent form" is defined as: a form that advises patients about all potential risks and benefits of any treatment they are to receive; a standard procedure in all hospitals and clinics (empahsis added). Let's see if the Addenbrooke paper qualifies.
Hyperhidrosis is the medical term for excessive sweating. The amount of sweating becomes ‘abnormal’ when it persistently exceeds the amount necessary for control of body temperature. You have been recommended to have surgery to reduce this excessive sweating.
Sounds good, right? We've got excessive sweating, and the surgery is going to reduce it. This is a blatant deception for two reasons:

First, sympathectomy can destroy all sweating in the top 1/3 of the body forever. Sweating in this area is reduced all right, reduced to zero, a very undesirable result when it comes to regulating body temperature. There is a world of difference between "reduce this excessive sweating" and "stop all sweating forever".

Second, sympathectomy has been shown to increase total body sweating more often than it decreases it. That's right. In the majority of cases, compensatory sweating on the lower body is so severe that it more than makes up for the total loss of sweating on the upper body. The use of the word "reduce" on the consent form is just wrong.
Sympathectomy: A sympathectomy operation aims to interrupt the sympathetic nerves that carry the sweating signals to the sweat glands. The nerves to the hands, armpits and face are the ones most easily treated by this technique and are all found within the chest region.
This passage deludes the reader into thinking that the doctors have isolated the "nerves that carry the sweating signals", and that sympathectomy involves only "nerves to the hands, armpits and face". Actually, the nerves that go to the sweat glands are all bundled together with nerves that go to the heart, the lungs, the blood vessels and lots of other good stuff. There is no way to un-bundle them. There is no "sweat gland nerve". It doesn't exist.
Intended benefits of the procedure • The purpose of the procedure is to reduce the amount of sweating.
In case you missed it, they repeat the big lie. Thoracic sympathectomy does not "reduce" sweating. It totally kills sweating in one area, while drastically increasing it in another.
• Medications: there are no specific medications for the symptoms of hyperhydrosis [sic]. Psychotropic and anticholinergic drugs, which have been tried, tend to have too many side effects to be acceptable to patients.
Yes, but at least you can stop taking medications. The surgery they are recommending is permanent, and it also tends to have too many side effects to be acceptable to patients, but this consent form doesn't mention that. Coincidentally, the vascular surgeons who authored this document make money from sympathectomy, but not from medications.
Serious or frequently occurring risks

• Following the operation, you might experience chest wall pain from the wounds and also from the small amount of gas which irritates the lining of the lung. Painkillers usually control this well; discomfort beyond 7 days is unusual.

• There is a rare chance (less than 1%) of pneumothorax. This is where the lung collapses from too much gas or air around the lung.

• There is a rare chance (less than 1%) of Homers[sic] syndrome. This involves damage to the sympathetic nerve to the eye – resulting in a small pupil and slight droop of the eyelid.

• Compensatory sweating: Commonly there is increased sweating in other areas of the body. This can be severe enough to become a new problem (in 5 to 10 % of cases). In most cases the increased sweating is mild and not a major problem.

• The operation may fail to control sweating in about 5% of cases.

• Wound infection is uncommon (1 to 2 % of cases).
This is the entire section on risks. The authors make no mention of heart problems, no mention of thermoregulatory problems, no mention of blood vessel paralysis, no mention of decreased lung volume, no mention of mental and emotional changes, no mention of chronic fatigue, no mention of chronic pain. Horner's syndrome also includes anhidrosis, but that is left out. Compensatory sweating is trivialized. They cite a figure of 5 to 10% with severe CS, but no definition is given. They fail to mention that a large percentage of patients are disabled by sympathectomy, and that the word "disabled" and "disabling" appear in the medical literature in reference to sympathectomy.

And, not missing any opportunity to deceive, they rephrase the big lie for the third time, stating that sympathectomy "may fail to control sweating in about 5% of cases". Clearly this implies that in 95% of cases, sweating is controlled.

Repeat after me: Sympathectomy does not "control" sweating. It kills sweating in one large area, and makes it uncontrollable in another area.

Big difference.
by songboy1234
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