Dr. Deven C. Patel, MD, MS

When excessive sweating is the main complaint and is not related to any other condition, it is called primary hyperhidrosis. There is no known cause, but it does tend to run in families. Secondary hyperhidrosis is sweating that is caused by another medical condition, such as anxiety, cancer, hyperthyroidism, or menopause. Sometimes treating the underlying condition can improve this type of sweating.

There are tests doctors can use to diagnose hyperhidrosis. One involves simply soaking up the perspiration with paper and then weighing the paper to measure how much extra sweat is being produced. Another test, called the starch-iodine test, involves covering the body with powder. This powder turns blue in any areas where sweat is produced.

Treatment depends on the severity of the hyperhidrosis and the areas affected. Some options are:

• Prescription antiperspirants, which contain aluminum chloride and work by plugging the sweat ducts. This signals the sweat glands to decrease sweat production. They work for moderate cases of hyperhidrosis and are relatively affordable.
• Lontophoresis, a procedure that uses small amounts of electricity and a tray of tap water to decrease production of sweat glands in the hands or feet.
• Botox, which can be injected into the nerves that control sweat glands in the underarms.
• Sympathectomy, a surgery for severe cases that can be performed to cut the nerves that stimulate sweat production. Sympathectomy is most effective for hyperhidrosis of the hands. It may cause new symptoms of sweating elsewhere on the body.
• Surgery to remove sweat glands, most often in the underarms.

Hyperhidrosis is a serious medical condition that causes both physical and emotional distress. Treatments are available, and support groups exist to help patients cope.

Contrary to popular belief, lung transplant is rarely used to treat lung cancer. It is a more common treatment for patients with other advanced lung diseases, such as cystic fibrosis, sarcoidosis, pulmonary fibrosis, and chronic obstructive pulmonary disease (COPD). Lung transplant is a serious operation and is generally used as a last resort for patients who have only a short time to live without surgery.

During a transplant, an incision is made on the side of the chest (for a single lung) or in the middle (for both lungs). Patients may be hooked up to a heart-lung bypass machine, which will do the work of moving blood and oxygen through the body during the procedure. After the diseased lung is cut away from the main airway and blood vessels, the donor lung is stitched into place. Surgery may take as long as twelve hours, and a hospital stay of two to three weeks after surgery is not uncommon. For the first hours or day after surgery, patients use a ventilator, or a machine to help them breathe. Tubes will be inserted into the chest to help drain excess air and fluid. During recovery, physical therapy and breathing exercises are used to help the new lung work as well as possible.

Lung capacity is carefully monitored for several months after surgery. Patients who have had a transplant will also have to take anti-rejection drugs for the rest of their lives. These drugs stop the body's immune system from attacking the new lung. The main risks after a transplant are infection and rejection (when the immune system attacks the 'foreign' lung). A healthy lifestyle, including maintaining a diet high in vegetables and lean protein, not smoking, and getting enough exercise, is important to keeping the lungs functioning as well as possible. With proper care, many patients can live ten or even twenty years after a lung transplant.