There is a "sea" in the palm: the road to rebirth of a girl with hyperhidrosis of hands

1 Youth trapped in sweat

On the summer solstice of 2024, in the Department of Thoracic Surgery at Peking Union Medical College Hospital, 26-year-old Xiao Xia trembled as she handed the medical record to Director Li. On the unfolded tissue, two dark palm prints were spreading at a speed visible to the naked eye, and the water stains on the edges were expanding outward like a tide.

"These years, I even have to wipe my palms with my sleeves before I dare to shake hands."

Before he finished speaking, a drop of sweat fell "plop" on the floor of the clinic, causing a clear echo in the silent space.

This girl from the water town in the south of the Yangtze River has been living in the "rainy season" in her palms since she can remember.

When I was in elementary school, my homework books were always soaked and became translucent, and I had to use a towel to pad the answer sheet during exams. During college interviews, my resume blurred in my hands like an abstract ink painting. When I met my boyfriend's parents at the beginning of last month, the tea cup slipped from my palm and broke into pieces.

These memories grew wildly in her heart like damp moss.

What suffocated her the most was attending her best friend’s wedding last year. When the bride’s bouquet was handed to her, she could only shake her head in panic - those delicate petals withered in her hands at a speed visible to the naked eye.

2 Decoding the Secrets of the Sailor

Primary Palmar Hyperhidrosis , the silent "invisible tyrant", is affecting about 4.5 million people in China. Its essence is the abnormal excitement of the thoracic sympathetic nerve chain. The "survival defense mechanism" that should be activated under stress has become a gate that never closes in these patients. The latest "Chinese Thoracic Sympathetic Nerve Surgery Expert Consensus" revealed that about 65% of patients have a family history of genetics, and the peak incidence is concentrated between 15 and 25 years old - the most brilliant years of life.

While ordinary people are browsing their phones comfortably in an air-conditioned room, people with hyperhidrosis of hands may be experiencing the following embarrassing moments: the touch screen malfunctioning due to sweat, documents becoming smudged into ink when signing, and the other person subconsciously wiping their hands on their trouser legs when shaking hands .

The 2022 "White Paper on the Quality of Life of Patients with Hyperhidrosis of the Hands" published by Shanghai Ruijin Hospital shows that more than 40% of severe patients have anxiety and depression tendencies, and 23% of respondents have given up their ideal career choices due to sweaty hands. This hidden disease is quietly eroding the possibility of life at a sweating rate of 60 to 80 drops per minute.

3 Precision revolution on the tip of the scalpel

"You are suitable for ETS surgery."

Director Li drew two red lines on the CT image, as if drawing a map to a new life. Video-assisted thoracoscopic sympathectomy (ETS), a technology that has changed the fate of countless patients, is creating a silent revolution in the field of thoracic surgery.

In the operating room, a sophisticated "neural symphony" is being performed. The anesthesiologist precisely controls the double-lumen endotracheal tube to allow the patient to ventilate with one lung; the surgeon cuts two 0.5 cm "keyholes" in the axillary folds. As the 4K ultra-clear thoracoscope is inserted, a fantastic microcosm emerges on the display screen - the pale pink lung lobes gently rise and fall like clouds, and the silvery-white sympathetic nerve chain looms between the mediastinum. When the special electrocoagulation hook accurately cuts off the T3-T4 ganglia, the palm skin temperature curve on the monitor suddenly jumps, climbing 2.8℃ in 20 minutes, witnessing the magic of "transforming the desert into an oasis."

Data shows that the surgery has an immediate efficacy of up to 98%, but what is less known is that behind this "keyhole" is a century of medical evolution:

ETS:

From the first open-chest sympathectomy in 1920, to the introduction of thoracoscopic technology by Brazilian doctors in 1992, to the application of artificial intelligence-assisted positioning systems today, ETS surgery now achieves "millimeter-level" precision strikes, with intraoperative blood loss of less than 5 mL, equivalent to the weight of half a coin.

4. Rational choice to clear the fog

The sunlight in the clinic shone obliquely on the consultation model, and Director Li used Xiao Xia's CT images to construct a 3D neural map.

“Will cutting the nerve affect arm strength? ” This is the most common misconception among patients.

In fact, the nerves that control limb movement and the sympathetic nerves belong to different "highways ", and will not interfere with motor function under standard operation. As for compensatory sweating, big data gives a rational answer: among the 15% incidence rate, only 3% requires medical intervention, and most of them are concentrated in the hot summer.

Even more exciting is that a 10-year follow-up study of the Department of Thoracic Surgery at West China Hospital revealed that the comprehensive quality of life score of patients after surgery increased by 72% , with key indicators such as social confidence, career development opportunities, and marriage success rate showing exponential growth. The girl who refused to participate in a piano competition due to sweaty hands stepped onto the stage of the Vienna Golden Hall in the second year after surgery; the boy who gave up his dream of becoming a surgeon due to sweaty hands is now a rising star in neurosurgery.

On the scale of medical ethics, doctors innovatively introduced the " sweat weighing method " decision-making system: using a special absorbent membrane to collect the patient's hand sweat before surgery. When the amount of sweat in 24 hours exceeds 50mL (about half a cup of water), surgery becomes the recommended option.

This evaluation method, which quantifies subjective feelings into objective data, has helped countless hesitant patients find a fulcrum for decision-making.

5 Another Possibility of Life

On the morning of the third day after the operation, Xiao Xia stood in front of the floor window of the hospital. The morning light penetrated her outstretched palms, casting a clear projection of palm prints on the wall.

There were exclamations coming from the nursing station one after another - a young programmer held his girlfriend's hand for the first time; an art student was leaving dry brush strokes on his sketchbook; a medical student who was about to graduate repeatedly stroked his dry stethoscope.

Behind these new scenarios is the continuous technological advancement of thoracic surgeons: they have developed micro-thoracoscopes for pediatric patients, extending the lower age limit for surgery to 12 years old; designed intraoperative nerve monitoring and early warning systems for patients with special physical conditions; and even explored reversible nerve clipping, leaving more possibilities for the future.

In Xiao Xia's discharge diary, there is such a record:

This rebirth of touch is the most precious gift that modern thoracic surgery gives to patients with hyperhidrosis of the hands - it not only cures the body's rainy season, but also allows the life scripts blurred by sweat to be rewritten.

At the intersection of medicine and humanities, ETS surgery is not only a technological breakthrough, but also a golden key to unlock the wheel of destiny. Those souls that once huddled in the damp will eventually touch the myriad possibilities of life in the dry and warm palms. As Director Li often said during his ward rounds: " We cut off the out-of-control nerve chain, and connect the spring of life. "

Editor: Liu Yang and Zhao Na

Proofread by Li Na and Li Yule

Producer: Peng Bin

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