Day 8 Post-Op

Today the whole left discolored area is erroded and a new scar bandaid with Neosporin was applied. The right has odor and about a quarter size of perspiration at a point of anxiety today. Today also I have very superficial nerve pain on the undersides of both upper arms like something has rubbed them raw but it only hurts when touched. Not terribly disturbing.

Day 7 Post-Op

Bottom 1/2 of left pit is still eroded. Heard from Dr. Nielson's office to put Neosporin on it and a scar bandaid to keep the air off of it. Hard to keep the scar bandaid (silicone) on a warm area. Keeps sliding off. On another note, I noticed an area about the size of a nickel under my right armpit of wet perspiration while under anxiety. Lots of odor under right today also. Bummer.

Day 6 Post-Op

Tonight after I took the pictures I noticed that under my left pit, in the area of discoloration, I have lost some dead skin and it now looks like an ulcer in the bottom 1/2 of the area. I guess this is skin erosion. It is not tender as the whole area is still numb but is kind of gross. I am noticing more soreness in the whole area of both armpits as some of the feeling is returning.

5th Day Post-Op

Today I am feeling the swelling under both armpits more than usual. Not painful just present. I am applying Neosporin to the pustules under my armpits. There are a couple under the right armpit today also. The skin is expected to stay numb for quite some time and it is not bothersome at all but only feels strange when I touch it.

4th Day Post-Op

Improvement continues.............armpits are still numb, swollen and sore but are getting better each day. Today I noticed some pustules around a very bruised area under my left pit. Not sure what those are. I finished the 5 days of Keflex this morning and so I don't think it is infection. The redness you see in the periphery is a sunburn not infection. Will check with Dr. Nielson tomorrow. Very slight sweating noted under the right armpit today after being outside for 1 hour in the 100 degree heat. Made it through church without so much as a drop of moisture. Normally waking up in the morning starts the sweating so this is a vast change.

3rd Day Post-Op

Out in 100 degree weather today and sweating from all areas on my body....except my underarms!!! My major problem has not been sweating in the heat, as all people sweat in the heat. It has been underarm sweating due to anxiety that is my nemesis. That is currently gone. The swelling and soreness is significantly lessening. So far this is a life changing surgery. I am walking around with my arms in the air showing my family that my pits are dry. It is so exciting! Thank you Dr. Nielson and crew!

Second Day Post-Op

Still swollen and tender but no pain. Still numb to the touch. Full range of motion in both arms since surgery. No sweating today, very mild odor. I have not used deodorant since before the surgery.

Still a bit tired which is to be expected but able to function without difficulty.

Bruising worse today.

First Day Post-Op

I woke the next morning with soreness and swelling but no real pain. I showered, dressed and drove to Dr. Nielson's office for a post-op visit. I had no sweating but felt just slightly moist under the right axilla (which had always been my worst sweater). The smell was very abundant though. Armpits swollen and numb.

I got in the car and drove back to Austin. No sweating...........smelly through the night though.

Recovery

I had absolutely no pain with the procedure or after. I stayed numb for about 5-6 hours. I did have numbness like when you get your mouth frozen for dental work all the way down my right arm to my ring and little finger until the 6th hour. I called Tiffani when I got back to my hotel room to let her know. She said it should go away but if it didn't I was to call Dr. Nielson anytime through the night if I had any concerns.

I was by myself in the hotel room which was scary initially but once I realized how simple the procedure was I was quite at ease. I was draining fluid into a tee-shirt I had on but I was told to expect that. Soreness under the arms started about 7-8 hours after surgery but it was nothing that required medication. I am very sensitive to pain and still needed nothing for pain.

SDLA

I drove by myself from Austin to San Antonio on July 15, 2009. I checked into my hotel and grabbed a cab to Dr. Nielson's office. I arrived with prescriptions in hand (Keflex for infection which I had started the night before, Valium 15mg, and Lortab 5/500). I was greeted by Tiffani the RN who took my vital signs and gave me the Valium and Lortab to take before the procedure. She was very friendly and set me at ease. She answered any last questions I had and took me to the surgical suite. We talked for a few minutes while she hooked me up to the heart and blood pressure monitor and pulse oximeter to monitor my vital signs during the procedure. Dr. Nielson came in to meet me and to answer any questions. He put me at ease right away. Tiffani cleansed me off with a special antibacterial solution and Dr. Nielson prepared me to start.

He injected four tiny areas with lidocaine to be used as the insertion points. Once numb he used a very tiny punch biopsy to make holes in which to insert the canula he would be using for the SDLA. He infused a solution of lidocaine, epinepherine, and sodium bicarbonate under the dermis layer of both arms. Then he started on the right armpit. I felt something like a scraping feeling as the laser was doing its work. Dr. Nielson was very attentive and kept asking me if I was doing ok. There were only a couple of times when I told him I could feel the heat. He then infused a bit more of the lidocaine solution which worked immediately and he continued with the procedure. I found Dr. Nielson to be attentive, concerned and very reassuring as he did the procedure. He kept me posted on the progress of the procedure. I felt I was in good hands all the way through.

I had arrived at 12:30 and left the office at 2:20.

When I was done Tiffany put gauze on the tiny insertion spots and taped them down. I put on my top and shoes and was released to a friend. We then went out to lunch and then I retired back to my hotel to recover.

Fear

Being in the health care field and being very cautious, I researched all I could on the SDLA procedure and Dr. Nielson. The only information I could find on SDLA was the video I mentioned earlier from the UK. I did, however, find a blog about Dr. Nielson and the complaints regarding the micro ETS procedure that had poor outcomes for the bloggers. All procedures are going to have problems for some people. Already being scared about having the SDLA procedure, the bloggers definitely had me scared about the doctor himself. As it turned out, I had nothing to fear but I did consider canceling the SDLA. Had I not already paid upfront for the procedure I would have cancelled. Instead, I gathered my courage and made the call to have SDLA done. The only day available that fit my schedule was the next morning.

The Pitch

I had contacted Dr. David Nielson in San Antonio, Texas regarding a micro ETS procedure for sweating. After further investigation I decided that this procedure would be overkill for the problem I had. Almost a year later I received by email an advertisement for a new procedure called Sub-Dermal Laser Ablation offered by Dr. Nielson. This sounded interesting so I called for information. Dr. Nielson called me back to discuss the procedure and answer my questions. It sounded perfect for my condition. I paid for the procedure up-front and then waited for a good time in my schedule to have it done.

http://www.hyperhidrosis-usa.com/sub_dermal_laser_ablation.html

The Purpose

Sub-Dermal Laser Ablation for Axillary Hyperhidrosis
I wanted to chart my journey as this is a new option for axillary hyperhidrosis (underarm sweating) in the USA. It has been advertised in the UK since March 2009 and there is a video at http://news.bbc.co.uk/1/hi/health/7939141.stm that shows the procedure being done.