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Amer's Cheering Thread!

4076 Views 52 Replies 9 Participants Last post by  cobalt60
:banana: We have our forum :D Amer's next event is the Tulsa Challenger.

Come on Amer! :bounce:
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I recently read something about the commercial surgery called "ETS" which is used to cure excessive sweating in the hands amongst other things. I then realized Delic had this surgery, which shocked me. The surgery is very effective in stopping sweating in the hand and other areas, but it is very drastic in the sense that it destroys a large part of the autonomic nervous system in the body, which has effects on a very large number of organs and body parts, most of them negative. Especially for a sportsman it may cause problems. I hope this is not the case for Amer because that would be some nasty shit to take.
My understanding is that ETS is only used as a last resort and that most of the drawbacks/risks occur at the time of the surgery. I have yet to read about any long term risks and it DOES NOT destroy "a lot of the autonomic nervous system". It is microsurgery and typically only involves destroying one to two levels of the thoracic sympathetic chain.
It has been used for over a decade with excellent results and minimal acute complications. No where in my reading did I read about any longterm complications that would hurt a sportsman.
I am sure Amer was counseled properly.
From reading Amer's blog/website he was well aware of possible negative side-effects so it was a conscious decision to have the surgery.

There have been very few thorough medical studies on the subject. The surgery is notable for commercial private doctors in the US that have been actively solliciting patients. There has been a backlash against this surgery by people who suffered long-term side-effects that have started a large number of "warning/support" websites against ETS with full description of the long-term negative side-effects.

The Swedish doctor who pioneered the surgery stopped doing it and has now dedicated his career to tying to help people who suffer long-term side effects, and it has been banned in Sweden.

When thinking of possible drawbacks to a sportsman, I am considering for example the fact that the surgery destroys the sympathetic autonomic nervous system connection to the heart, which could interfere with the regulation of heart rate for excersize (sprints etc).
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Actually many of the centers I know about are in academic centers with a long history of performing the surgery. I am always leary of so called "warning websites" in this regard. And the surgery when done right ;) only cuts off the
thoracic sympathetic chain number 3 and rarely also number 4. This of itself should not affect the heart rate. Since I am well aware of how the medical system in this country works; I am extremely doubtful that any surgeon would ever perform this on anyone in this present climate of " sue the bastard" here in the states let alone on a sportsman. Not sure I understand where you get your information. Anyway I am quite done on this subject :lol:
Well, I admit to using Wikipedia's description, which certainly suggests that the surgery is not without controversy and there is a difference of opinion even in the medical field. When performed by academic centers on delibitated patients (who suffer from severe social/psychological problems associated with hyperhidrosis or social fobia) certainly I can imagine that the positive effects of the surgery far outweigh the negative. But it doesn't quite seem to be the minor surgery with limited side-effects that is sometimes portrayed.

The history of medicine is filled with treatment strategies and methods that at one time were considered benign and highly effective and later discredited. I'm not saying ETS is all bad, but there's certain reason for caution.
Since I am well aware of how the medical system in this country works; I am extremely doubtful that any surgeon would ever perform this on anyone in this present climate of " sue the bastard" here in the states let alone on a sportsman.
I think the surgery at the moment has an "approval" rating for certain indications by the governmental medical authorities in the US, and is generally reimbursed and covered by insurance. As long as a doctor documents a condition for which the surgery is officially indicated among his patients, he will feel legally protected since most of the blame would fall on the authorities in the event of a legal backlash.
Well, no, people here still go after the doctor too, if anything happens :lol:
Yes, I did have the impression that lawyers and lawsuits are 10x-100x more common in the US compared to Europe for example. :lol: But I think what it is issue here is primarily vague long-term complications (5-20 years) rather than immediate complications due to surgery. In Sweden the surgery was introduced 10-15 years before the US and there was a lot more experience with long-term side-effects and patient satisfaction and subsequent controversy and eventually outlawing of the surgery. If the Swedish experience is anything to go by I suspect in 5 to 15 years there will be more controversy and litigation related to the long-term effects of the surgery in the US, especially related the subset of doctors that are actively commercializing and soliciting patients for the surgery.
You obviously do not live in the US nor are you part of the medical system.
Doctors get sued and lose all the time even when the case is poorly substantiated.
I guess this means as a doctor in the US you have to pay an extremely high insurance premium to protect yourself?

I am not a medical professional but the situation is quite a bit different in the Netherlands as far I can discern:

- Legal cases in the regular courts are very rare. It is very difficult to prove a claim (note that there is no jury in our legal system).
- Doctors generally still enjoy a high level of immunity in the legal system and are highly esteemed, which is due to the legacy of being part of the historical elite.
- There is a court of medical arbitration but it only concerns itself with disciplinary action against negligent or incompetent doctors and does not award compensation to victims. In the vast majority of cases the doctor is not found to be in error.
- Doctors generally do not report errors and medical errors are often covered up, not mentioned in medical records and hospital staff do not report on colleagues.
- Doctors are highly organized in trade organizations and protected by the legal entity of the hospital.
- Until recently the concept of errors being made (especially in a hospital setting) was virtually unheard of.
- General Practitioners are open to discussion with patients and more vulnerable to criticism but in general medical specialists (including surgeons) have their practice in hospitals and are held in high esteem, often authoritarian to patients and other hospital staff, highly legally protected, make a lot of money (much more than all other hospital staff), and considered virtually infallible.

I think the more emancipated position of doctors like in the US is better in many ways (they are considered professionals, not an untouchable part of the elite), but being inundated in legal suits is the other extreme. I think a big drawback of the Dutch system is that incompetent doctors (especially specialists) will often not be identified in their protected position and continue to practice. There is very little public information about the relative merits, success rate or experience of doctors.
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I should make a commment on my previous message, I had a discussion with Stupid Dream afterwards who knows a lot about the subject, and she confirmed what I outlined in the message. She also illustrated the key point, however, which is that the Dutch (medical) legal system deviates a lot from even some neighbouring European countries. What is comes down to is that the Dutch legal system retains a lot of archaic heritage that is still providing a lot of legal protection/immunity to the historical "elite". In this context the "elite" includes professions like doctors, the legal profession itself, and notaries (which are still legally required for many types of transactions and charge indiscriminate fees).

Observe that the Netherlands is virtually the only country where there is no jury-based law whatsoever. Law is adminstered by the "elite" itself, which may explain why over time the legal system has resisted changes that would reduce the legal immunity of the elite.
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