With some of her sweat glands stuck in the "on" position, Rebone, 24, has devised all kinds of tricks and adaptations to deal with her condition, known medically as hyperhidrosis.

As an engineering consultant, she meets a lot of new clients. To avoid having to shake their hands, she keeps her hands occupied with something like a laptop computer.

She was put under general anesthesia. Two dime-sized port holes for a surgical device and a video camera were cut on each side of her chest. Her lungs were collapsed. And inch-long segments of nerves in her rib cage that control sweat glands were cut out.

At first glance, this might seem a drastic and expensive solution to a minor cosmetic problem, the latest trendy medical indulgence in a society preoccupied with appearances. But hyperhidrosis can be miserable for many of the estimated 7.8 million Americans, roughly 2.8 percent of the population, who have it. People with the condition produce four to five times the normal amount of sweat.

Doctors tell of patients whose sweating was so bad that it shorted out computer keyboards; of a police officer who had trouble holding his gun; of a young mother who was reluctant to hold her baby for fear the infant would slip; of a 12-year-old boy whose classmates called him "Swamp Thing."

She stayed away from weddings and other events that required a lot of hand-shaking. She avoided holding hands with her boyfriend. She could not wear sandals or high heels because she would slip out of them, and she couldn't walk barefoot because she would leave wet spots on the floor.

At 7:56 a.m., she got a kiss from her boyfriend before she was wheeled down a hallway to the bustling pre-operative area of Froedtert Memorial Lutheran Hospital in Wauwatosa, Wis. Nurses fitted her with identification bracelets and put in IV lines, including one for a sedative.

The surgery to correct hyperhidrosis is known as a sympathectomy. It involves cutting out a section of the sympathetic nerve chain, which activates specific sweat glands.

For Rebone, whose primary sweating occurred in her palms, about an inch-long piece of nerves that runs between the second and fourth rib is removed.

The surgery has been around for decades, but doctors say the number of has increased substantially in recent years with the advent of minimally invasive, video-assisted endoscopic surgery.

Until about four or five years ago, only a small number of centers offered the surgery, but now, dozens of hospitals all over the country have it, said Mark Krasna, a professor of surgery and chief of thoracic surgery at the University of Maryland Medical Center.

Between 400 and 1,000 of the surgeries are done each year in the United States, Krasna estimated. He has done nearly 500 himself and now trains other doctors to do it.

Daniel O'Hair, a cardiothoracic surgeon at Aurora St. Luke's Medical Center, said he, too, has seen an increase in sympathectomies in the last couple of years, partly because patients are seeking out surgeons who do the operation.

Insurance companies, grudgingly, will pay for the procedure, although doctors say insurers sometimes will not authorize surgery until an appeal is written.

The cause of so-called primary hyperhidrosis is unknown, but it is thought to involve a dysfunction of the sympathetic nervous system and its connections to the brain. That, in turn, leads to an over-activation of some of the 2 million to 5 million sweat glands in the body.

A family history of the condition is found in 25 percent to 50 percent of cases, so there's a one-in-four chance that Rebone will pass the condition on if she has children.

In as many as 5 percent of patients, a complication known as Horner's syndrome can develop as the result of nerve damage that causes eyelid drooping and an enlarged pupil.

Between 5 percent and 10 percent of patients might develop gustatory sweating, which is sweating brought on by eating. Essentially, the brain and nervous system are overstimulated by the taste and smell of food.

"The vast majority of people are happy with the tradeoff," said Keith Naunheim, chief of thoracic surgery at St. Louis University Health Sciences Center.

It is 95 percent effective for hand sweating, about 75 percent for underarm and facial sweating, and 25 percent for foot sweating, according to the Society of Thoracic Surgeons.

If it works, the benefit occurs almost instantaneously, as soon as the nerves are removed. For many patients, the surgery can be a life-changing experience, doctors said.

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