Thursday, September 29, 2011

Information for Australian ETS patients wanting to investigate making a formal complaint

Here are links for the various health complaint bodies in Australia.

www.hrc.act.gov.au
The Australian Capital Territory Human Rights Commission (established on 1 November 2006) has absorbed the functions of the former ACT Human Rights Office and the Community and Health Services Complaints Commissioner's Office, as well as having new functions in the area of disability services, and in relation to children and young people.

www.hccc.nsw.gov.au New South Wales Health Care Complaints Commission

www.hqcc.qld.gov.au/Pages/Home.aspx Queensland Health Quality and Complaints Commission

www.healthcomplaints.tas.gov.au Tasmanian Health Complaints Commissioner

www.health.vic.gov.au/hsc/ Victorian Health Services Commissioner

www.healthreview.wa.gov.au West Australian Office of Health Review

www.hcscc.nt.gov.au/ Northern Territory Health and Community Services Complaints Commission

Plus this is a useful site:

http://www.safetyandquality.gov.au/internet/safety/publishing.nsf/Content/contact-us-1lp

Friday, September 23, 2011

A natural treatment option for those suffering from severe/disabling compensatory sweating after ETS

Please follow the link below to the second ever post that was published on this blog, which is Briton Chris Carter's account of how he recovered, over a period of approximately one year, from ETS side effects - including severe compensatory sweating - by making long-term changes to his eating habits.

http://kiwietsgroup.blogspot.com/2010/01/in-case-anybody-reads-comments-on-above.html

"After one-and-a-half years of all these terrible side effects, I started to research the human body, starting with the ETS operation. Coming from an engineering background, I like to find solutions and answers to problems. After looking at all my side effects and what causes the same conditions in people who have not had ETS, I started to work things out from the results of all my tests and scans and I began looking at the op and the sympathetic nervous system in more detail.

"It took me about a year to fully come out of ETS side effects by changing my diet and lifestyle. For the last year and a half my body has been rebuilding. I was only going to get better as a result as coming out of the state of fight-and-flight...."


Thanks to Chris Carter for sharing this information.

A revealing published medical study on compensatory sweating after ETS (46 patients studied)

Below you can read the abstract (summary) of a study done in the United Kingdom and published earlier this year in the International Journal of Surgery. The study was also presented previously to the Annual Scientific Meeting of the Association of Surgeons of Great Britain and Ireland, Glasgow, UK (13th–15th May 2009).

Here is the link to the study's online abstract:
http://www.sciencedirect.com/science/article/pii/S1743919111000720

An analysis of the natural course of compensatory sweating following thoracoscopic sympathectomy

A.C. Currieb, J.R. Evansa, P.R.S. Thomasa

Department of Surgery, Epsom and St Helier University Hospitals NHS Trust, Wrythe Lane, Carshalton, Surrey SM5 1AA, United Kingdom

Department of Surgery, Division of Surgery and Cancer, Imperial College, London W2 1NY, United Kingdom

Received 28 March 2011; revised 12 April 2011; Accepted 13 April 2011. Available online 22 April 2011.

Abstract

Background
To evaluate the long-term results of thoracoscopic sympathectomy in the treatment of hyperhydrosis.

Methods
Theatre log books were used to identify all patients who underwent thoracoscopic sympathectomy between 2000 and 2006. Details of pre-operative symptoms, surgical procedure and post-operative complications were collected from the patient notes. Each patient was sent a questionnaire regarding success of the procedure, compensatory sweating and overall satisfaction.

Results
46 hyperhydrosis patients (34 females) age range 14–57 years. 20 patients suffered with hyperhydrosis in a combination of areas, 14 in the axillae alone, 9 palms alone and with 2 facial symptoms. There were 2 early post-operative complications, 1 haemothorax which required a chest drain and a chest infection. 3 patients required redo procedures. Of follow-up of 42 months (range 6–84), 32 (69·5%) patients reported complete dryness or a significant improvement in symptoms and 15 a substantial improvement in quality of life.

However, 43 patients (93%) suffered with compensatory sweating, of these 27 had to change clothes more than once daily. Compensatory sweating was graded as severe in 18 and incapacitating in 2.

Of note only 5 patients noticed an improvement in the compensatory sweating over time.

Only 26 (56%) would recommend thoracoscopic sympathectomy to others with hyperhydrosis.

Conclusion
Thoracoscopic sympathectomy is effective in the treatment of hyperhydrosis. However, compensatory sweating seems unavoidable and infrequently improves with time. Patients need to be carefully counselled before committing to surgery.

*****************

While this is but one study, it would be fair to say this is just one of many published studies on the side effects of ETS that shows ETS surgeons frequently do not reveal the true risks of the surgery to patients before they have the procedure.

Most ETS surgeons tell their prospective patients that the chance of developing compensatory sweating is around 1%, and that if compensatory sweating is experienced by the patient post-ETS, it will be 'mild' or 'just a little bit of sweating on your back or stomach'.

Monday, September 5, 2011

A reminder about the option of making a Treatment Injury Claim to ACC in New Zealand

This is just a reminder for NZ ETS patients who have made an official complaint about their surgeon or who are considering doing so.

Here in New Zealand, the Health and Disability Commissioner (HDC) essentially deals with investigating complaints and 'educating' medical practitioners if they deem it necessary. The HDC does not pay any sort of compensation to patients, even if they find a medical practitioner has not provided a reasonable standard of care to the patient.

To seek financial compensation for injuries/health conditions caused by a medical treatment, a patient needs to make a Treatment Injury Claim to ACC.

See more info here:

http://www.acc.co.nz/PRD_EXT_CSMP/groups/external_claims_care/documents/form/wcm2_020603.pdf

The Kiwi ETS Group contacted ACC in early 2010, to ask them some basic questions about the Treatment Injury Claim process. At the time, ACC informed us that seven people in New Zealand had to date made treatment injury claims in relation to sympathectomy surgeries, and six of those seven claims were accepted.

Sunday, September 4, 2011

Photos showing just how severe and disabling compensatory sweating can be post-ETS

An anonymous Italian ETS patient created this web page to document the severity of their compensatory sweating (CS) post ETS.


http://www.ago972.altervista.org/index.html


These are not the kind of photos ETS surgeons show prospective patients - but they should. Regardless what the chances of developing this level of CS are, patients should be informed that the side effects of ETS can be much, much worse than the original condition.

Thank you to the patient who created this web page, for sharing your story.

Update on second complaint made against Auckland ETS surgeon Dr Murray MacCormick

As discussed in this post from April this year, the second complaint in a 12-month period against Dr Murray MacCormick was made earlier this year by a patient who had ETS for facial blushing.

The patient's complaint focused on the lack of information they were given on the risks of ETS during their sole ten-minute consultation with Dr MacCormick, and the impact the side effects they developed post-ETS (such as severe CS, inability to sweat on the head and face, insomnia, and reduced exercise capacity) have on their daily life and quality of life.


During the Health and Disability Commissioner's (HDC) short investigation into the patient's complaint, Dr MacCormick refuted, via a letter, the patient's assertion that their consultation with Dr MacCormick lasted only ten minutes and that the only potential side effect of ETS mentioned by Dr MacCormick during this consultation was Horner's Syndrome. Dr MacCormick also stated in his letter to the HDC that of all the health issues the patient has experienced since having ETS, "only a few would be a likely result of sympathectomy."

Dr MacCormick also wrote in his letter to the HDC:
"As is clear from the files, I readily accept that this intervention was poorly advised, and patient selection on my part was inappropriate, something which I recognised in retrospect."


It is not clear what exactly in the patient's files Dr MacCormick might be referring to but he does appear to be freely admitting that he should never have performed ETS on the patient.

After hearing Dr MacCormick's version of events in relation to this patient's ETS consultation, surgery, and resulting side effects, the HDC decided to take no further action on the complaint.

From the HDC's final decision letter to the patient:

"It is clear you had an unfortuante outcome to ETS surgery and Dr MacCormick "accepts that this intervention was poorly advised".

"While I do not doubt that this outcome has caused you a great deal of anxiety, I must take into account the fact that your surgery took place over a decade ago. Given he amount of time that has elapsed I do not feel it would be practicable for me examine your complaint further. Further, ETS surgery techniques have changed considerably over the past decade and I do not feel it would be fair for me to assess the care Dr MacCormick provided to you based on current ETS knowledge."

The HDC's assertion in this paragraph would appear to expose bias or ignorance - the techniques used for ETS have not changed considerably or even moderately since 2001. There was a significant change in ETS surgery technique in the 1980s, when it went from being an open procedure involving a long hospital stay to an endoscopic procedure that can be done as day surgery, but there have not been any major changes in how the surgery has been performed since then. (Though there has been much internal debate among ETS surgeons on which levels of the thoracic chain should be operated on, such as T2 + T3, T2 only, or T4 only, but this debate does not involve changes in surgical technique.)


If any NZ ETS patients wish to make a complaint against Dr Murray MacCormick, you are welcome to reference this most recent complaint in support of your own, the HDC reference code for which is:

C11HDC00233


In addition, you are also welcome to reference the earlier complaint, made in 2010, in support of your own, the HDC reference code for which is:

C10HDC00679


Readers can refer to all posts on this blog labelled 'Dr Murray MacCormick' to read the background on the 2010 complaint made against him by a patient who had ETS for wrongly diagnosed hyperhidrosis.