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 portholes 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 like 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 7.8 million Americans, or roughly 2.8 percent of the population, who are estimated to 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."

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

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

The actual cause of so-called primary hyperhidrosis is unknown, but it is believed 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.

"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.

And 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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