Fake websites in the service of the ETS industry - who protects the patients?

Mia:
Many surgeons compete with each other for the attention of the 'costumer' in the saturated market of the www. Adaptations to a business model raises ethical questions that should have been explored long ago and should have raised the ire of the medical community. The occasional whimper of discord is silenced by the cacophony of (ignorant) enthusiasm. Not quite the scientific behavior one would expect.

How does the entrepreneurial aspect of medicine impact on the information patients are given? In the area of elective procedures, is it in the interest of the service provider to provide full disclosure? Does self-interest influence and modify how the information is conveyed? How information morphs into little facts and more emoting. to appeal to the irrational in all of us. To be seduced.

Fake websites that pretend to be independent,  informative, with the sole raison d'etre to praise the surgeon's skill, expertise and experience, - and to hook the patient into reading more on the surgeons' website, with many obvious links to the surgeon on every page.
Why are predatory practices of medical professionals tolerated?

ETS surgeons claim that their procedure is extremely safe and effective,

- even  'almost miraculous' -, so why is there a need to devise a modified procedure, if the results are as unprecedented as they all claim in their articles/websites?


Why is there a need to devise a procedure where the "rate of embarrassing and disabling compensatory sweating was significantly less..."?! Disabling? After an elective surgery? These terms did not enter the vocabulary of the previous ads of the ETS industry. 
The surgeon claiming great success with his new "SUPER SELECTIVE ETS'  also claimed excellent results with his old, non-super selective procedure... He did NOT mention his patients being disabled by his elective procedure or the need to devise a better procedure previously. His results were excellent then but they are not excellent in hindsight? How is that possible that unprecedented successes morph into disability?



"In this method, the main trunk of the sympathetic nerve are left intact, however, the rami communicanes which connect the sympathetic ganglia to the peripheral nerves are cut. In one study that compared the conventional ETS to the super-selective ETS, the overall rate of compensatory sweating was similar in both groups; however, the rate of embarrassing and disabling compensatory sweating was significantly less in the super-selective ETS. This further illustrates that the more selective the surgery is, the less chance of disabling compensatory sweating."

In 70 % compensatory sweating severe, recurrence rates were 15% and 19% at 1 and 2 years after surgery

They will not tell you this:

In T2 and T3 resection, all patients experienced Compensatory Sweating and over 70% of the patients felt it was severe. Even in T2 resection, 90% of patients experienced CS and in 50% of these it was severe. High rates of CS are reported in Asian countries with hot and humid climates.

In T2 resection, recurrence rates were 15% and 19% at 1 and 2 years after surgery.It was not rare for a patient to experience recurrence more than 3 years after surgery.
Motoki Yano, MD, PhD and Yoshitaka Fujii, MD, PhD

Volume 138, Issue 1, Pages 40-45 (July 2005)

bradycardia and other cardiac complications are common side effects?

The most common side effects of sympathectomy are compensatory sweating, gustatory sweating and cardiac changes including decreasing heart rate, systolic-diastolic and mean arterial pressure. The mechanism of bradycardia and other cardiac complications that develop after thoracic sympathectomy are still unclear.

http://tipbilimleri.turkiyeklinikleri.com/abstract_54802.html

very severe discomfort and hyperhidrosis in the neighboring non-sympathectomized regions occurred with alarming frequency

and what he will not tell you:

After thoracoscopic sympathectomy for hyperhidrosis, very severe discomfort and hyperhidrosis in the neighboring non-sympathectomized regions occurred with alarming frequency and intensity.
(p.879)

Cousins and Bridenbaugh's Neural Blockade in Clinical Anesthesia and Pain Medicine by Michael J Cousins, Phillip O Bridenbaugh, Daniel B Carr, and Terese T Horlocker

Wolters Kluwer Health
Edition: 4 - 2008

Cautiously worded, yet it still means the same: ETS = Lobotomy

Knowledge of the elimination of embarrassing physical symptoms in social situations helps the patient to expose himself to formerly impossible situations, and success in them also causes psychological symptoms to subside. But the relief of psychological symptoms may also be due to direct a biological effect of the operation on the anxiety-mediating areas in the nervous system. The only meaningful side effect is compensatory sweating of the trunk, but not even that is significant when modern surgical method are used. (sic!)

http://informahealthcare....0.1080/08039480310000266

Lack of disclosure to ETS patients is unethical and would be criminal in a just society

It is the doctor's moral and ethical duty to provide you with full and honest disclosure of the facts prior to surgery. The whole doctrine of informed consent is to prevent patients from having to realize they made a mistake in hindsight. You shouldn't have had to find out from a former patient's wife that the surgery would cause drenching sweating on your back. It was Garza's job to do that. He completely lied to you regarding the supposed reversibility. Anyone who goes through medical school knows that can't crush a nerve with a metal clamp, remove it later and have the nerve return to normal functioning.

Although it is not possible to predict exactly what will occur in each individual case, there is nearly 100 years of published scientific and medical research available on the effects of sympathectomy. That research paints a very different picture of the effects of this surgery than the one presented to patients considering this surgery. That's the issue. Generally, they lie and tell patients that CS is inconsequential in all but a tiny fraction of cases and simply fail to disclose a huge number of verified adverse effects of the surgery. They take advantage of the patient's ignorance on medical matter. It's unethical and would be criminal in a just society.

In short, you do have a way of knowing what will likely occur as a result of the surgery before you have it done. All the information necessary to make an informed decision exists. It's just not getting to patients.

http://etsandreversals.yuku.com/reply/22927/Would-you-do-it-again#reply-22927

Pathophysiology of cervical and upper thoracic sympathetic surgery

What your ETS or ESB surgeon will not tell you during the consultation:

T(2)-T(3) ganglionectomy significantly decreases pulse rate and systolic blood pressure, reduces myocardial oxygen demand, increases left ventricular ejection fraction and prolongs Q-T interval. A certain loss of lung volume and decrease of pulmonary diffusion capacity for CO result from sympathectomy. Histomorphological muscle changes and neuro-histochemical and biochemical effects have also been observed.

Clin Auton Res. 2003 Dec;13 Suppl 1:I40-4.

Instead, you will be told:

"Usually the surgery is used to treat sweating in the palms or face. The surgery stops or turns off the nerve signals that tell the part of the body to sweat too much."
http://www.nlm.nih.gov/medlineplus/ency/article/007291.htm

or this:

"The procedure turns off the signal that tells the body to sweat excessively. It is usually done on patients whose palms sweat much more heavily than normal."

or this:

"This method does not involve the cutting of the sympathetic nerves. Instead, the surgeon interrupts their activity by applying a titanium clamp to the nerve, thus stopping their activity. The clamp exerts pressure on the nerve and the signals the nerve produces don’t reach the sympathetic nerve endings. This is method that has a positive effect in the sense that the sympathetic ganglia are not destroyed. This leaves the patient with the possibility of having the nerves reconstructed in the future by simply removing the titanium clamp."
http://www.hyperhidrosis.us/ets.php

All the above statements are carefully crafted to make the surgery appear harmless, easy and safe. Yet, ETS and ESB procedures disrupt the nerve signals not only to the sweat glands but other structures and systems in the body, most notably the heart, resulting in Bradycardia in patients, who are unaware that they are signing up for a surgery that potentially will impact on their neurocardiology.

The response of the heart to stress is much attenuated by upper thoracic sympathectomy

What your ETS or ESB surgeon will not tell you:

“The response of the heart to stress is much attenuated by upper thoracic sympathectomy.”
European Journal of Surgery See Also: British Journal of Surgery Volume 164 Issue S1, Pages 37 - 38 Published Online: 2 Dec 2003

prevents them from responding to reflex or emotional changes in the central nervous system

Your ETS or ESB surgeon will not tell you:

“...cervical sympathectomy or some pathological condition, isolates all these sympathetic ganglion cells from the central nervous system and prevents them from responding to reflex or emotional changes in the central nervous system.
Cunningham's Manual of Practical Anatomy: Volume III: Head, Neck and Brain (Oxford Medical Publications) 1986

Parallels between Lobotomy and Sympathectomy

Both surgeries were obscure and unpopular until a "minimally invasive" version led to mass-marketing.

Both surgeries featured positive stories in the media. Walter Freeman had several glowing write-ups in the New York Times and Life Magazine.

Both surgeries featured dubious published studies touting the safety and effectiveness. One very large 1962 study said that 28% had been cured by lobotomy, another 25% significantly improved, 20% showed no change (from lobotomy!!) 4% died, and only 2% were made worse off.

In both instances medical professionals were reluctant to openly criticize their colleagues or speak up about undisclosed harmful effects of the procedure.

http://etsandreversals.yuku.com/reply/9783/Lobotomy-Barbaric-surgery#reply-9783