Endoscopic Thoracic Sympathectomy

• Pain
  You should expect a certain amount of pain which is localized in the chest cavity and at the back in between the shoulder blades. Patients often describe it as a heavy pressure on their chest which gradually goes away within 24 hours. Generally speaking it is not that severe and is well controlled with oral medications that will be prescribed to you. Obviously the pain threshold is different between people but it is safe to say that tolerated well. One should expect the pain to decrease a few days after the operation.

  From time to time even years after the ETS operation patients sometimes call and complain about an unknown source of pain which manifests itself in between the shoulder blades or somewhere in the chest cavity that is connected to certain types of exercise activities. It can also happen while at rest with deep breathing movements. Our opinion is that the source of this pain is scar tissue that was produced at the time of ETS. Physiologically and functionally there is no downside. Even the pain that is produced is some sort or pain/discomfort is not associated with any functional disability. Simple treatment with anti inflammatory agents such as advil or similar will suffice. Anytime when surgery is done (for any case) in any body cavity some adhesions or scar tissue can be produced and there is currently no way to avoid it.

• Activity
  It is recommended that your physical activity be kept to a minimum for the first few days and then gradually increase to your normal day to day level. For strenuous physical activity (jogging, basketball, gym) one should listen to his/her body with regard to this type of activity. There are no rigid rules about it. No muscles have been cut in this operation so the healing process should be fast. For the first 2 to 3 days you should be careful in your movement from lying down to the standing position due to changes in the vascular bed which is the result of sympathectomy. It does not happen very often but one should be aware of it.
• Incisions
  All incisions are closed with absorbable sutures. They are completely safe and have the benefit of the patient not having to see a doctor to take them out. They consist of chemical components that at times can cause some redness. This does not indicate an infection but merely the process in which the sutures are dissolved. At times the process of the sutures dissolving can bring a white spots on the incision which are not puss but instead the component of the suture. Simple cleaning with water is enough to clean the healing wound.
• Shower / bath
  Shower or bath can be taken the day after the procedure. The band aids can be removed and new ones can be applied (your decision). Most of the time patients are comfortable with replacing their band aids for a few days. Use of soap or skin lotions are fine.
• Food
  After Endoscopic Thoracic Sympathectomy normal food can be consumed.
• Phantom Feelings
  Patients sometimes describe getting the sensation that sweat is going to come back or is present even though it does not. This is a phantom type sensation which is best explained by the fact that our brain has become so accustomed to these sensations of excessive sweating for so long. Patients experiencing this should expect these phantom sensations to diminish over time.
• This is intended as a very general guide. Please call Dr. Reisfeld with any concerns or questions. You are also welcome to e-mail us with questions and or pictures illustrating your concern. We love to hear back from our patients so please consider writing a testimonial for us.
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