Adrenal Tyrosine Hydroxylase: Compensatory Increase in Activity after Chemical Sympathectomy

Destruction of peripheral sympathetic nerve endings with 6-hydroxydopamine causes a disappearance of cardiac tyrosine hydroxylase, accompanied by a twofold increase in adrenal tyrosine hydroxylase and a small increase in phenyl-ethanolanine-N-methyl transferase.
Robert A. Mueller ¹, Hans Thoenen ¹, and Julius Axelrod ¹
Science 31 January 1969:
Vol. 163. no. 3866, pp. 468 - 469
DOI: 10.1126/science.163.3866.468

Cardiac hypertrophy accelerated by left cervical sympathectomy

Cellular and Molecular Life Sciences (CMLS)
Volume 37, Number 7 / July, 1981

Summary Cardiac hypertrophy in spontaneously hypertensive rats was accelerated by denervation of the left cervical sympathetic ganglia. Supersensitivity due to denervation may also exist in cardiac muscles.

This work was supported by a grant of the Ministry of Education for 1980.

---

Joint inflammation is reduced by dorsal rhizotomy and not by sympathectomy or spinal cord transection

Ann Rheum Dis. 1994 May; 53(5): 309–314.

PMCID: PMC1005329

Joint inflammation is reduced by dorsal rhizotomy and not by sympathectomy or spinal cord transection.

K A Sluka, N B Lawand, and K N Westlund

Marine Biomedical Institute, University of Texas Medical Branch, Galveston 77555-0843
http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1005329

NMDA and Sympathectomy

CONCLUSIONS: NMDA receptor is related to the induction and maitenance of neuropatic pain, and sympathetic nervous system has a main role in the already induced neuropathic pain.
The Effects of NMDA Antagonists and Sympathectomy on the c-Fos mRNA Expression in the Neuropathic Rat.
http://www.koreamed.org/SearchBasic.php?DT=1&RID=47481

Role of Dopamine in behavior modulation

Role of Dopamine in behavior modulation

These findings support the idea that DA signals errors in expectancy and that DA signaling is necessary for certain behavioral responses to unexpected events.
Behavioural Brain Research
Volume 122, Issue 2, 1 October 2001, Pages 193-199
Mitchell F. Roitman^a, Gertjan van Dijk^b, Todd E. Thiele^c and Ilene L. Bernstein^{, ,}

Sympathectomy eliminates the fight-or flight response and is used as a surgical treatment of anxiety disorders and phobias

What the myriad of anxiety disorders have in common is a state of increased arousal or fear. Anxiety disorders often are conceptualized as an abnormal or exaggerated version of arousal. Much is known about arousal because of decades of study in animals and humans of the so-called fight-or-flight response, which also is referred to as the acute stress response. The acute stress response is critical to understanding the normal response to stressors and has galvanized research, but its limitations for understanding anxiety have come to the forefront in recent years.

Thoracic Sympathectomy In Social Phobia: A Pilot Study

http://www.ispub.com/ostia/index.php?xmlFilePath=journals/ijs/vol7n2/social.xml

Recurrent and enhanced vasoconstrictor function makes Sympathectomy a questionable treatment for vascualr disorders

T2 sympathectomy leads to long-lasting inhibition of palmar sweating, which does not correlate to loss of vasoconstriction. Recurrent and enhanced vasoconstrictor function 3 months following endoscopic sympathetic block has major implications for its use to treat enhanced vasoconstriction.
http://www.neurology.org/cgi/content/abstract/60/11/1770
Neurology 2003;60:1770-1776
© 2003 American Academy of Neurology

Norepinephrine activates pain pathways after nerve injury

According to MedicineNet, RSD involves "irritation and abnormal excitation of nervous tissue, leading to abnormal impulses along nerves that affect blood vessels and skin."

Animal studies indicate that norepinephrine, a catecholamine released from sympathetic nerves, acquires the capacity to activate pain pathways after tissue or nerve injury, resulting in RSD.
http://arthritis.about.com/od/rsd/a/rsd.htm

Autonomic Hyperreflexia is caused by noxious stimulation below the level of the lesion in a patient with a sympathectomy at or above T6

...The efferent sympathetic fibers recover from the initial injury but remain unaffected by central inhibitory input from the brain stem and hypothalamus.
The severity and manifestations of autonomic hyperreflexia are affected by the level of the sympathectomy. With mid-thoracic lesions below the level of cardiac accelerator fibers, hypertension is accompanied by reflex bradycardia transmitted via cardiac accelerator fibers and the vagus. In patients whose sympathectomy is above the level of the thoracic cardiac accelerator fibers, tachycardia may occur because cardiac accelerator fibers become part of the efferent sympathetic activity rather than part of the central inhibitory input from the brain stem and hypothalamus. Arrythmias and occasional heart block may accompany changes in heart rate.
Clinical manifestations of autonomic hyperreflexia include vasodilation, decresed sympathetic activity, and increased vagal activity above the level of the lesion such as nasal congestion, flushing, headache, dyspnea, nausea, and visceral muscle contraction. Vasoconstriction and increased sympathetic activity below the level of the lesion cause vasoconstrictive pallor, sweating, piloerection, and somatic muscle fasciculation. Patients also develop hypertension with headache, blurred vision, myocardial infarction, andretinal, subarachnoid and cerebral hemorrhages that may lead to syncope, convulsion and death.
Handbook of Neuroanesthesia
page 343

By Philippa Newfield, James E. Cottrell

Contributor Philippa Newfield, Stephen Onesti, James E. Cottrell

Published 2006, Lippincott Williams & Wilkins

Sympathectomy suppresses cell-mediated (T helper-1) responses

In vivo, chemical sympathectomy suppresses cell-mediated (T helper-1) responses, and may enhance antibody (T helper-2) responses. Noradrenergic innervation of spleen and lymph nodes is diminished progressively during aging, a time when cell-mediated immune function also is suppressed. In animal models of autoimmune disease, sympathetic innervation is reduced prior to onset of disease symptoms, and chemical sympathectomy can exacerbate disease severity.
Annu Rev Pharmacol Toxicol. 1995;35:417-48.

Substance P has a proinflammatory role

These studies have been carried out in a large number of patients with long-standing autoimmune diseases. It turned out that sympathetic nerve fibers are lost in chronically inflamed tissue, while substance P-positive nerve fibers sprout into the inflamed area.

Brain Behav Immun. 2007 Jul;21(5):528-34. Epub 2007 May 22. Links

http://www.ncbi.nlm.nih.gov/pubmed/17517488?ordinalpos=58&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DefaultReportPanel.Pubmed_RVDocSum

Posted by Mia

Sympathectomy alters immune responses

Our findings suggest an involvement of the CNS in sympathectomy-induced alterations of immunity.
Brain Behav Immun. 1998 Sep;12(3):230-41.
http://www.ncbi.nlm.nih.gov/pubmed/9769158

Recurrent and enhanced vasoconstrictor function makes sympathectomy a questionable treatment for vascualr disorders

T2 sympathectomy leads to long-lasting inhibition of palmar sweating, which does not correlate to loss of vasoconstriction. Recurrent and enhanced vasoconstrictor function 3 months following endoscopic sympathetic block has major implications for its use to treat enhanced vasoconstriction.
http://www.neurology.org/cgi/content/abstract/60/11/1770
Neurology 2003;60:1770-1776
© 2003 American Academy of Neurology

EFFECTS OF SYMPATHECTOMY ON catecholamine concentrations ...

EFFECTS OF SYMPATHECTOMY ON catecholamine concentrations ...

Effects of surgical sympathectomy on catecholamine concentrations ...

completely depleted from the pineal gland. These results. suggest that NE in the pineal gland ... amine declines following sympathectomy. Bjrrklund et al. 4 ...
www.springerlink.com/index/QP13674817684227.pdf - Similar pages - Note this
More results from www.springerlink.com »

CARDIOVASCULAR CHANGES POST SYMPATHECTOMY

Short- and Long-term Effects
Pulse rates taken at rest and after effort were significantly
lower than those taken after operation, and the blood pressure
response to exercise was blunted. ECG tracings showed a sig-
nificant change in the electrical frontal plane axis and shortening
of the QTc interval.



Tel-Hashomer, and Tel Aviv University Sackler Medical
School, Tel Aviv, Israel, and the National Heart,
Lung, Blood Institute, National Institutes of Health,t Bethesda, Maryland

SYMPATHECTOMY CAUSES PARTIAL AUTONOMIC FAILURE

NIH Book: Sympathectomy is "Neurocardiologic Disorder"

SURGICALLY INDUCED autonomic disfunction

HEAT STROKE AFTER SYMPATHECTOMY

As you - I mean your body - will have no control over thermoregulation, and you will not be able to cool off from your head (the top of your head gets rid of 40% of your body's heat, but it will be unable to do so. Completely!), even small exertion will cause a major drain on your system. Effectively you will be cut into two separate bodies: the top part of the body will be in constant hyperthermia - overheating your brain..., and the lower part from the shoulders down in constant hypothermia. One hot the other always cold, because of the changes in the circulation, and the thermoregualtory dysfunction. Your head will not know how hot your body is, as the signals from the body going to the brain are cut. The adipose tissue has been denervated, so it will not be able to send 'reading' the body's temperature ..or to send signals... Because your head is constantly hot, it thinks, asumes, that your body is as hot as the head (would make sense....but not any more), so it goes into overdrive to cool off where it can, to sweat where it can: from the shoulders or nipple line - again - depending on the level where the sympathetic chain was cut. On the shoulders up, neck and face you will not sweat any more, - this condition is called anhidrosis, - your skin will become dry, brittle, flaky, eliminating the skins natural cleansing process, that happens through sweating. It will also affect the circulation of the scull and the hair growth. There have been reports of the changes in hair colour, in fact becoming ..grey following sympathectomy. Hair loss has been also reported.
The surgery is also performed in cases where they have to do skin grafting, in order to reduce the immune responses of the skin, so it will not reject the new skin. It will make your skin more vulnerable and prone to infections. In general it will change your body's immune responses and make you more vulnerable to certain diseases and conditions. Arthritis is one of them.

bioinfo.pl
Ann Thorac Surg. 2007 Sep ;84 (3):1025-7 17720429
Is previous thoracic sympathectomy a risk factor for exertional heat stroke?
Alan D L Sihoe , Raymond W T Liu , Alex K L Lee , Chak-Wah Lam , Lik-Cheung Cheng
We report the case of a physically fit young man who presented with severe, life-threatening heat
stroke after running a 10 km road race. He had previously received bilateral thoracic
sympathectomy for axillary hyperhidrosis at another hospital, and was known to have upper body
and limb anhidrosis. Thoracic sympathectomy can result in reduced sweating and disturbed
peripheral vascular and heart rate responses. Patients should be warned that these mechanisms may play a role in the development of exertional heat stroke.

SYMPATHECTOMY and the drugs you should not take

VISKEN®
(pindolol)

INTERACTIONS

Potentiation of the antihypertensive effect occurs with ganglionic or peripheral adrenergic
blocking drugs and in the post-sympathectomy patient (see “PRECAUTIONS”). Calcium
antagonists and antiarrhythmics (see “WARNINGS”).

SYMPATHECTOMY causing damage

The damage to the sympathetic ganglia, be it in the form of sympathectomy, chemical sympathectomy, and radiofrequency (all of these sympathectomies are cardinal sins), or repetitive stellate ganglion blocks are damaging (causing "Virtual Sympathectomy") and can complicate the chronic CRPS pain further rather than helping the patient.

SYMPATHECTOMY IS A FAILURE

CRC Press, Boca Raton, Florida

H. Hooshmand, M.D.

CAUSE OF FAILURE AFTER SYMPATHECTOMY

1. Sympathectomy is analogous to the act of killing the messenger. The sympathetic nervous system has the critical job of properly controlling and preserving the circulation in different parts of the body, especially in the extremities. By paralyzing the system, the extremity will be more apt to have disturbance of circulation and is left unprotected from fluctuation in circulation.

Sympathectomy is similar to permanently removing the central heat and air-conditioning system and never replacing it because of malfunction.

Sympathectomy permanently damages the temperature regulatory system. The reason sympathectomy does not cause side effects other than ineffective control of pain as well as impotence and orthostatic hypotension is because it is invariably partial and incomplete.
4. Usually the patients that end up needing sympathectomy are the ones who suffer from ephaptic dystrophy. Sympathectomy in such cases cause a classic Cannon phenomenon. This physiological phenomenon refers to the fact that the end organ that is controlled by sympathetic nerve fibers will become uninhibited in its chemical dysfunction. As a result, even though the sympathetic fibers are not contributing to acetylcholine or become uninhibited with resultant increase of pain input.

In diabetic neuropathy RSD, sympathectomy dramatically relieves the pain for the first 1 to 3 years. Then deafferentation can Cannon phenomenon set in. As a result, invariably by the second to fifth year the patient ends up with a lot more pain. Sympathetic blocks repeated every 6 to 12 months yield similar results.
In patients who have had sympathectomy, thermography shows an increase of temperature in the focus of ephaptic nerve damage (Cannon phenomenon) with secondary increase of pain and discomfort.

http://www.rsdrx.com/sympathectomy_failure.htm

SYMPATHECTOMY IS AN EXPERIMENT

Article
Sympathectomy as an experiment in human physiology
J. Paterson Ross
Surgical Professorial Unit, St. Bartholomew's Hospital
A Hunterian Lecture delivered at the Royal College of Surgeons, February 3, 1933.
ABSTRACT

(P.S.: It is still an experiment! There has been no objective trial or study into the effectiveness, safety and efficiacy of the procedure. No real long-term study into the effects of the surgery. There has been one study that reported that 25% of the patients operated for palmar HH said that their original condition returned within 5 years. Remember? Nerves regenerate. The sympathetic chain does not. You might end up with the return of your original symptoms, plus the many adverse effects of the surgery (decreased heart rate, lung function, abolished homeostasis, inability to maintain the correct bloodpressure, high plasma NOREPHRINE, that has been associated with joint inflammation, arthritis, also: 95 % of the patients who underwent Sympathectomy ended up with Sclerosis within 6 years!!!, irrespective of the fact if they had diabetes or not, etc etc. )

article - cerebral damage, sympathectomy

Complications of endoscopic sympathectomy
Alan E. P. Cameron
Abstract
Four cases are presented in which complications occurred during or after thoracic endoscopic
sympathectomy (TES). In one patient inappropriate TES resulted in disabling hyperhidrosis. In one
patient laceration of the subclavian artery required major surgery. In two cases intraoperative
cerebral damage occurred. Training in TES is essential.
Copyright © 1998 Taylor and Francis

SYMPATHECTOMY FOR BLUSHING- MOST SEVERE SIDE-EFFECTS

SYMPATHECTOMY FOR BLUSHING- MOST SEVERE SIDE-EFFECTS

As a standard procedure surgeons operate the patients by cutting or clamping the sympathetic chain at T2.
In the last 10 years there are more and more articles and presentations at conferences discouraging against this operation, as it is known to cause the most severe side-effects.

DISCLAIMER

BEFORE IT GETS OUT OF HAND:
I AM NOT A MEDICAL PROFESSIONAL, IF YOU ARE WONDERING. I AM A JOURNALIST, WRITER AND RESEARCHER. THE INFORMATION CONTAINED ON THIS BLOG ARE EITHER QUOTES FROM MEDICAL JOURNALS OR MY CONCLUSIONS BASED ON THE YEAR LONG RESEARCH I HAVE DONE AND THE EXPERIENCES OF THE PEOPLE WHO HAD THE SURGERY AND LIVE WITH THE CONSEQUENCES.
I WILL TRY TO BE AS OBJECTIVE AS POSSIBLE AND QUOTE AS MUCH FROM THE MEDICAL PAPERS AS POSSIBLE - WITHOUT BREACHING COPYRIGHT LAWS.
I BELIEVE THAT IT IS FOR THE BENEFIT OFF ALL OUT THERE TO HAVE HAVE AS MUCH ACCESS TO THIS INFORMATION AS POSSIBLE, AS EXPERIENCE SHOWS THAT THE DOCTORS DO NOT INFORM THE PATIENTS ABOUT THE POTENTIAL HARM THEY ARE CAUSING THEIR OWN BODY.
ONE NEEDS TO SHED THE UTOPIC THOUGHT THAT DOCTORS ARE CHARITY WORKERS. THIS WOULD NOT BE THE FIRST CASE TO SHOW THAT THEY ALL ARE IN THE BUSINESS. AND WE KNOW WHAT BUSINESS IS ABOUT.
PS: I DONT'T KNOW IF THERE ARE IDEALS LEFT OUT THERE??? ANY??!
AGAIN: IF YOU HAVE PROBLEM WITH WHAT YOU READ HERE, DO YOUR RESEARCH, SPEND A YEAR WITH THIS STUFF AND THEN GIVE ME A CALL. WE CAN TALK. OR EMAIL.

CEREBRAL DAMAGE

DISEASES OF THE CARDIOVASCULAR SYSTEM (SURGICAL) 1

the dangers of cerebral damage which may follow the use of the carotid or ..... years after sympathectomy was 41, whereas five years after sympathectomy ... arjournals.annualreviews.org/doi/abs/10.1146/annurev.me.01.020150.000455 - Similar pages - Note this

Complications of Mediastinal Surgery

of the subclavian vein without revascularization may lead to transient upper ... The development of cerebral edema after thoracoscopic. sympathectomy is ...
doi.wiley.com/10.1002/9780470988367.ch14

CEREBRAL REVASCULARIZATION - SYMPATHECTOMY

Journal of Vascular Surgery : THE SECOND DECADE: 1957-1966 ...

Interest in cerebrovascular revascularization began with the presentation on .... Aortic Blood Flow Following Lower Aortic Resection and Sympathectomy. ...

linkinghub.elsevier.com/retrieve/pii/S0741521496702136

MIA: THERE IS NO QUESTION ABOUT IT, SYMPATHECTOMY WILL HAVE AN EFFECT OF CEREBRAL BLOOD FLOW. IT WILL REDUCE IT INITIALLY AND FORCE THE BODY TO GROW NEW VESSELS IN ORDER TO SUPPLY THE SUFFICIENT BLOOD/OXYGEN TO THE BRAIN. HOWEVER THIS REORGANIZATION WILL HAVE AN EFFECT ON THE BRAIN'S FUNCTIONING, AND CAN HAVE ADVERSE EFFECTS ON COGNITIVE FUNCTIONING BY TURNING OFF SOME CELLS THAT ARE STARVED OF OXYGEN, JUST LIKE IT HAPPENS WHEN ONE HAS A STROKE. IT CAN ALSO LEAD TO CHANGES IN PERSONALITY.
MY RESEARCH INDICATES THAT IT IS THE FRONTAL CORTEX THAT IS AFFECTED MOST AND THE FUNCTIONS ASSOCIATED WITH IT. IT ALSO INVOLVES CHANGES IN THE AMYGDALA, DUE TO THE DENERVATION OF THIS REGION OF THE BRAIN, KNOWN TO RECEIVE IT'S INNERVATION FROM THE UPPER CERVICAL GANGLION ONLY. SAME APPLIES TO THE PITUITARY GLAND. YOU MIGHT WANT TO LOOK UP THE FUNCTION OF THESE. IT IS QUITE REVEALING. ALSO THERE ARE STUDIES ON THESE REGIONS OF THE BRAIN FOLLOWING SYMPATHECTOMY.

VISCERAL AND CEREBRAL INVOLVEMENT FOLLOWING SYMPATHECTOMY: DEATH AFTER SURGERY

Vascularisation of Ischemic Limbs in Severe Occlusive Arterial ...

Eight of the 12 patients underwent sympathectomy. One patient, considered to have visceral and cerebral involvement, died. PMID: 3798265, UI: 87094501 ...
bharat_kelkar.tripod.com/sixb.htm - 117k

SYMPATHECTOMY FOR CEREBRAL REVASCULARIZATION

Neurosurg Focus 20(6):E7, 2006
The history of neurosurgical procedures for moyamoya
disease
CASSIUSV. C. REIS, M.D., SAMSAFAVI-ABBASI, M.D., PH.D., JOSEPHM. ZABRAMSKI, M.D.,
SEBASTIÃON. S. GUSMÃO, M.D., PH.D., ROBERTF. SPETZLER, M.D.,
ANDMARKC. PREUL, M.D.
Division of Neurological Surgery, Barrow Neurological Institute, St. Joseph’s Hospital and Medical
Center, Phoenix, Arizona; and Federal University of Minas Gerais, Belo Horizonte, Brazil
Almost 50 years of research on moyamoya disease (1957–2006) has led to the development of a variety of surgical
and medical options for its management in affected patients. Some of these options have been abandoned, others have
served as the basis for the development of better procedures, and many are still in use today. Investigators studying
moyamoya disease during this period have concluded that the best treatment is planned after studying each patient’s presenting symptoms and angiographic pattern.
The surgical procedures proposed for the treatment of moyamoya disease can be classified into three categories: direct arterial bypasses, indirect arterial bypasses, and other methods. Direct bypass methods that have been proposed are vein grafts and extracranial–intracranial anastomosis (superficial temporal artery–middle cerebral artery [STA–
MCA] anastomosis and occipital artery–MCA anastomosis). Indirect techniques that have been proposed are the following: 1) encephaloduroarteriosynangiosis; 2) encephalomyosynangiosis; 3) encephalomyoarteriosynangiosis; 4) multiple cranial bur holes; and 5) transplantation of omentum. Other options such as cervical carotid sympathectomy and superior cervical ganglionectomy have also been proposed. In this paper the authors describe the history of the development of surgical techniques for treating moyamoya disease.

AMPUTATION RATE HIGHER AFTER SYMPATHECTOMY

Has the clinical definition of thromboangiitis obliterans changed ...

Amputation rate after sympathectomy was higher in. females: 36% vs 22%. A revascularization procedure was performed in 15 (0.6%) ...
www.springerlink.com/index/U20N650672742U24.pdf

Changes in hemodynamics of the carotid and middle cerebral arteries following sympathectomy

http://stroke.ahajournals.org/cgi/content/full/33/5/1180

CEREBRAL ISCHEMIA FOLLOWING SYMPATHECTOMY

Thoracoscopic sympathectomy for symptomatic arterial obstruction ...

Two patients died during follow-up: 1 of myocardial infarction and 1 of cerebral ischemia, 24 and 32 months, respectively, after the operation. ...

ats.ctsnetjournals.org/cgi/content/full/74/3/885

International Journal of Cardiology : One of the most frequent ...

Nineteen of 344 (11.9%) patients died during follow-up due to cerebral ... After sympathectomy, in postoperative term, the retroperitoneal hematoma occurred ...
linkinghub.elsevier.com/retrieve/pii/S0167527306000854

ADVERSE EFFECT ON KIDNEY

Role of sympathetic neurons in biochemical and functional ...

These results indicate that neonatal sympathectomy has an adverse effect on the biochemical and functional development of the kidney. ...
jpet.aspetjournals.org/cgi/content/abstract/246/2/427 -

Acta Psychiatr Neurol. 1949;24(3-4):473-9.

Related Articles, Links

Kidney function in essential hypertension before and after sympathectomy a.m. Peet.

HILDEN T.

PMID: 15396150 [PubMed - indexed for MEDLINE]

SKIN AND SYMPATHECTOMY

Sympathectomy Protects Denervated Skin from Graft-Versus-Host Disease
Mohamed A. Kharfan-Dabaja MDa, Claudio Anasetti MDa and James L.M. Ferrara MDb
a
Division of Blood and Marrow Transplantation, H. Lee Moffitt Cancer Center and Research Institute and University of South
Florida, Tampa, Florida
b
Departments of Pediatrics and Internal Medicine, University of Michigan Medical School, Ann Arbor, Michigan
Available online 20 February 2007.

Translated: this means that sympathectomy reduces the skin immune responses. Not a good thing. There are some surgeons - who offer sympathectomy - who promise that it will aslo cure acne!!!! Quite the contrary. Your skin will have less resilience and more prone to infections as it will have a downregulated immue reponse. Just another 'euphemism' from the doctors, that is totally unsubstantiated and fraudulent.

MSAC ON SYMPATHECTOMY

The Medicare Benefits Schedule (MBS) has evolved over time in response to changes in medical practice. Medicare benefits are payable in respect of a medical service listed in the MBS where that service is:

• provided by a medical practitioner, and
• a clinically relevant service (generally accepted in the medical profession as being necessary for the appropriate treatment of the patient).

Medicare item 35003 relates to the performance of cervical or upper thoracic sympathectomy by any surgical approach (irrespective of whether it is conducted by open exposure or endoscopically). Sympathectomy has been listed on the MBS for over three decades, and permitted by any surgical approach since 1991.

The Medical Services Advisory Committee (MSAC) was established in 1998 to advise the Minister for Health and Ageing on the strength of evidence pertaining to new and emerging medical technologies and procedures in relation to their safety, effectiveness and cost-effectiveness and under what circumstances public funding should be supported. MSAC has never considered this procedure, as it was listed on the MBS prior to MSAC's formation, and is therefore not a 'new and emerging medical technology'.

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.

Symathectomy - controversial procedure

THE ROYAL COLLEGE OF AUSTRALASIAN SURGEONS DECLARES THAT ENDOSCOPIC THORACIC SYMPATHECTOMY IS A CONTROVERSIAL PROCEDURE, WITH NO INDEPENDENT STUDIES TO SUPPORT THE SAFETY OR EFFECTIVENESS OF THE SURGERY.

Insurance companies do not insure surgeons for sympathectomy

Yes, hard to believe but surgeons have to be forced in this way to discontinue performing the operation as it cost insurance companies too much money. These cases are settled before it has a chance to go to court and have some publicity. The people who decide to take the payments have to do so in exchange of a gag order. They can never speak about the operation. Not to anybody, anywhere, in any form. This kind of silencing and secrecy is perpetuating the surgeons ability to sell and perform the surgery on the unsuspecting and misinformed patient.
At least there is some change in Australia, but not all insurance companies have the same policy.
In the meantime many people fall victim to the euphemism and ignorance of the surgeons and end up having a procedure that was a predecessor of lobotomy.
It is the medical scandal of this century!!!!
I never thought that the insurance companies will play the role of protecting the patient from potentially harmful procedures. Isn't that the of the medical profession and government agencies overseeing medical procedures. Somebody failing the patients here!

Sympathectomy (coverage will not be provided for this procedure)
www.avant.org.au/public/pdf/Standard_Policy_Application_Form.pdf -

Monckeberg's sclerosis after sympathectomy

Monckeberg's sclerosis after sympathetic denervation in diabetic and non-diabetic
subjects.
Goebel FD, Fuessl HS.
Medial arterial calcification is frequently seen in diabetic patients with severe diabetic
neuropathy. Sixty patients (19 diabetic and 41 non-diabetic) were examined
radiologically for typical Monckeberg's sclerosis of feet arteries 6-8 years after uni- or
bilateral lumbar sympathectomy. Fifty-five out of 60 patients (92%) revealed medial
calcification. This calcification was observed in both feet of 93% of patients, who had
undergone bilateral operation. After unilateral sympathectomy the incidence of calcified
arteries on the side of operation was significantly higher than that on the contralateral
side (88% versus 18%, p less than 0.01). Although diabetic patients showed longer
stretches of calcification than non-diabetic subjects, the difference was not significant in
terms of incidence and length. Of 20 patients who had no evidence of calcinosis
pre-operatively, 11 developed medial calcification after unilateral operation exclusively
on the side of sympathectomy. In seven patients calcinosis was detected in both feet after
bilateral operation. In conclusion, sympathetic denervation is one of the causes of Monckeberg's sclerosis regardless of diabetes mellitus.
: Diabetologia. 1983 May;24(5):347-50.

Sympathectomy is not a permanent solution

Nerves regenerate, sprout. The operation is not about the sweat glands, they remain intact. One study says 25% of cases report occurence of original symptoms within 5 years.
We do not know what happens later. Not with regarding the original condition.

SUICIDE, DEPRESSION AFTER SYMPATHECTOMY

If you are wondering about the purpose of this website, let me give you some background information:
A recent suicide (October 2007) of one of the most active members of the support group here in Sydney, made me think of more effective ways of getting the information out there. On this website, I will publish articles, or excerpts of articles that have been published in the last 70 or so years about the effects of the surgery, or to include links to those articles. I hope it will serve as a warning, at least in some cases and will deter people from the 'irreversible adjustment' to their body and mind.
For this friend, and the many others it remained a constant source of anger and depression (among many other ailments due to the surgery) that the doctors perform the surgery in FULL KNOWLEDGE of the potential and in most cases inevitable harm it will cause to the patient. Most people feel violated in the worst possible sense, as sthey went ahead with the surgery fully trusting the surgeon, the person who would, or should not cause harm - at least not knowingly.

Some interesting facts: no matter how many statistics about the success rate you will read from the surgeons who perform the surgery, it is mainly as advertising and a form of muscle flexing between the surgeons. THERE HAS BEEN NO INDEPENDENT STUDY OR TRIAL DONE ON THE EFFECTIVENESS (ESP. IN THE LONG TERM!) AND SAFETY OF THIS PROCEDURE.
BECAUSE OF THIS LACK OF RIGOROUS TESTING, THAT IS REQUIRED WITH EVERY DRUG COMPANIES PUT OUT INTO THE MARKET, THE SURGERY SHOULD BE CONSIDERED EXPERIMENTAL, AND PATIENTS SHOULD BE INFORMED ABOUT THIS FACT, AS THEY SHOULD BE INFORMED ABOUT THE FACT, THAT THERE IS NOT WAY TO PREDICT HOW THE PATIENT WILL COME OUT AT THE OTHER END. WITH NERVES IT CAN GET MESSY....ANOTHER REASON TO CONSIDER THE OPERATION AS EXPERIMENTAL.

THE MEDICAL PROFESSION, THE GOVERNMENT AGENCIES THAT SHOULD OVERSEE THE IMPLEMENTATION OF NEW SURGICAL TECHNIQUES AND TO FOLLOW UP ON THESE FAILED THE PATIENTS IN EVERY CASE WHEN SYMPATHECTOMY WAS PERFORMED, ESPECIALLY IF IT WAS NOT PERFORMED FOR THE CONTROL OF PAIN IN CANCER PATIENTS, BUT FOR A CONDITION THAT IS DEEMED TO BE A COSMETIC AND HAS OTHER, NONSURGICAL SOLUTIONS, LIKE BLUSHING OR SWEATING. AT THE END THE PATIENTS HAVE TO TURN TO THESE ANYWAY, AS THE SO-CALLED COMPENSATORY SWEATING OR NOW RENAMED TO A MORE POLITICALLY CORRECT TERM OF REFLEX SWEATING IS OFTEN WORST THAN THE ORIGINAL CONDITION THE PATIENT SEEKED THE TREATMENT FOR.

These are the thoughts of many of the post sympathectomy patients, as they struggle to understand something that is well beyond reason.
PS: Once I have permission from the family, I will publish this victim's name, in order to add more ...authenticity to this blog, this post, and the determination behind it.