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  ou arrive at your date's place early. You want everything to be perfect. The flowers are yellow roses, meant to signify more than friendship but not quite love. You stand in front of the door and gather yourself. After a deep breath, you press in the doorbell. The door swings open and your date is in front of you, smiling. You are thanked for the flowers that you brought, a gesture you are assured  

was wholly unnecessary, but thoughtful nonetheless. You step inside your date's home, confident that you've made the best first impression that you could. You wander into the living room, while your date goes to the kitchen to find a vase. As you sit down on the couch, from the kitchen come the words that you'd been dreading.

"Can I take your jacket?"

Your jacket: your last line of defense in an effort to disguise the growing dampness on the armpits of your shirt. You've got the sweats again. At first, it's just a little moisture under your arm. Then, a drop of perspiration breaks free and trickles down from the armpit, along the side of your body before being soaked up somewhere around your waistline. Or maybe you just imagined it. But before you know it, your shirt is soaked from bicep to shoulder blade and you need another shirt. The sweat is everywhere. Your hands are clammy and your feet feel like you're standing on a deep forest bed of moss or some kind of lichen-bearing rock. You look as though you've just run a marathon or played a few games of one-on-one hoops when all you've really done is walked a couple of steps from your car to the front door.

Are you just nervous? Or is this is medical condition?

Could be. Your case of the sweats may be a sign of a medical condition called hyperhidrosis. Hyperhidrosis occurs in people who have very active internal thermostats in their body. In essence, they


are machines that are extremely efficient at jettisoning heat from their body. The effect of this heat loss ranges from excessive sweating in the hands (palmar hyperhidrosis) and feet (pedal hyperhidrosis) all the way to general abnormal heat loss in varying parts of the body (primary hyperhidrosis). Primary hyperhidrosis is a genetic syndrome, while most of the other forms of the condition are the result of glandular hyperactivity.

It seems easy to laugh this off, like many acquaintances of hyperhidrosis suffers do, like many doctors do. It seems like nothing more than a hypochondriacal disorder or the ramblings of an overanxious person. In fact, reading this may cause you to think twice. Are your hands abnormally sweaty or did the condensation on that can of soda linger on your hands just long enough to make you question yourself? Are your feet clammy or is the room just a little too warm? Maybe these people are just nuts; sweating is an irritating but normal part of life, like shaving or Ricki Lake.

"A lot of people are blown off by their doctors and told to get over it," says Dr. Garza, who runs the Hyperhidrosis Center in Houston, TX, "that it is only sweat, that they are just nervous. These comments can be both embarrassing and insensitive to people who deal with the condition day after day. It affects every part of their life."

And Dr. Garza would know. He's practiced the treatment of hyperhidrosis for nearly 20 years. He abandoned thoracic medicine about eight years ago to focus solely on hyperhidrosis. He's also a sufferer, having dealt with a mild case since his teenage years. About five years ago while he was at home for Christmas, he noticed that his mother had her face wrapped in a towel. It occurred to him that for as long as he could remember, she'd always done this. "It hit me. My mother, who was 79 at the time, has suffered from this all her life. I looked at her feet. She was wearing sandals and her feet were dripping with sweat. I turned to my brother and he was sweating excessively also. This was Christmas time, the middle of winter. Something was wrong."

Wrong, indeed. The horrors of a sweaty existence number many. From losing your grip on the phone while trying to order a pizza to driving away members of the opposite sex with hands that feel like sea eels, a sweaty body is an inconvenient body. Your dry cleaning bill alone makes such an existence nearly prohibitive. As the sweat stained shirts and pants that are beyond cleaning or repair pile up, you're almost embarrassed to leave the house to shop for more clothing in the fear that your sweaty hands will slip down the railing of the stairwell in your building causing you to take a nasty spill. Perhaps even break your sweaty hip. And we haven't even talked about the implications of foot odor. Powders and sprays only mask the smell.

Though the causes and body parts affected may be different, the condition is by no means confined to a small portion of the population. It is estimated that nearly 12 million Americans suffer from clammy hands, damp feet and armpit stains. It appears anyone can have hyperhidrosis, but certain groups are more prone to it than others. According to Dr. Garza's website, about 1 in every 25 Caucasians could be classified as having hyperhidrosis. On the contrary, nearly 1 in every 5 Asians are sufferers. "That means that in the Houston area alone, nearly 120,000 people have some form of this and they don't even know it." Dr. Garza estimates that he sees between 600-700 patients a year. Many of them come from areas along the coast and big cities, where humidity and moist air reign. But he also gets patients from areas like Denver, Aspen and Anchorage, where despite the dry cool air, people not only sweat but "they're cold too."

Depending on the severity, there are many treatment options for hyperhidrosis. (See sidebar.) A mild case can usually be treated with over-the-counter deodorants, such as Maxim Deodorant and Certain-Dri, or with prescription deodorants like Dry-Sol that use active ingredients like aluminum-based compounds that clog sweat glands and stem sweating. More extreme cases call for iontophoresis (an electroshock treatment that is not a cure, merely a band-aid) or anti-depressants to control anxiety-related hyperhidrosis. Even botox has been suggested as a mitigatory measure, so we can all rest safely knowing that Susan Lucci, Connie Chung, Marv Albert and a host of other TV broadcasting personalities and Hollywood celebrities are safe from the clutches of hyperhidrosis. Angie, a sufferer who went the non-surgery route said it's worked like a charm. "I've been going into the bathrooms between my classes to see how unsweaty my armpits are. This is such a breakthrough for me," she said in a testimonial at the website

For extreme cases, Dr. Garza recommends Endoscopic Transthoracic Sympathectomy (ETS). ETS is "a ten minute procedure that stems the heat loss by clamping the nerve that stimulates sweating." There are side affects, including dry skin and compensatory sweating. Dr. Garza specializes in an ETS method that seeks to curtail compensatory sweating by clamping only those nerves that affect sweating in the "front' chest, shoulder, underarms and back. Clamping the nerves



If You Want To Destroy Your Sweating...

...try some of these solutions, which range from the standard, local drugstore, over-the-counter variety to the doctor approved, heavy-duty prescription types.

Available at local drugstores, Certain-Dri costs $6 a bottle and uses aluminum chloride to clog pores to prevent sweating. No prescription needed.

Maxim Deodorant
As with Certain-Dri, Maxim uses aluminum chloride as its active ingredient. Slightly more difficult to find in stores and slightly more expensive at $14 a bottle.

This antiperspirant must be prescribed by a doctor and uses a 20% aluminum chloride solution. Prices vary, but ranges from $12 to $16 a bottle.

In addition to curing wrinkles, Botox may also be used to help cure hyperhidrosis, but according to its Website, doesn't appear to have been officially approved as a treatment option.

Under this process, an electric current is used to deliver a medical solution into the skin that stops sweating. While an effective treatment for extreme cases, the treatment is short lived.

With ETS, or endoscopic transthoracic sympa-thectomy, a doctor makes an incision through the armpit, then clamps the nerve that controls sweating.



that allow facial sweat can be dangerous to the internal chemistry of the body. Forty-four percent of all heat that escapes the body escapes through the head. Stopping the body's heat loss mechanism in such a critical area can be harmful."

All in all though, Dr. Garza finds that the effects of hyperhidrosis are generally more emotional than physical. "I treated one patient who had a body temperature of 94.5. I could feel the heat coming off of him as I stood next to him. Understand that this will not make them sick. People can just towel off their hands. I've found instead that most people spend their lives hiding from this. They are unable to sustain a relationship of any kind. They become hermits. The first thing that I ask my patients is how this affects their personal life. Work, relationships, how are they affected."

This kind of nervousness can be crippling in all facets of life. Anxiety only initiates more sweating. On a job interview, it's nearly impossible to focus on swaying the job interviewer when all you can think about is how he's going to react to your freakish sopping wet handshake. When out on a date or in a bar and talking to a member of the opposite sex, how can one focus on trying to get that person back to their place when in the back of their mind they are terrified that the person is going to laugh not at the size or shape of their genitalia but at the waterfall of sweat seeping down their back? These are some of the thoughts that someone with hyperhidrosis must face every day. One patient in particular stood out to Dr. Garza.

"About six or seven years ago, a man came into my office looking for help. He was 36 years old. Rich, high-society Bostonite. I asked him about his life and he told me he was supposed to get married last month. I asked him what happened. He said he'd called off the wedding. The idea of walking down the aisle with sweat dripping down his forehead didn't bother him as much as knowing that he'd have to stand in a receiving line at that society wedding and shake hands with everyone. He was terrified. So he called off the wedding without giving his fiancée a reason. Of course, he had the surgery and everything came out fine. But his ex-fiancée wouldn't even see him. That's the kind of effect this has on people's lives."


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