The Story So Far
I’ve always had trouble with my nose. During my younger years you would often find me with Kleenex shoved up one or both nostrils stopping my most recent bloody nose. As I have grown older, the nose bleeds have gotten less numerous but allergy season got worse. I will often have complete obstruction of one side of my nose at night. When I say complete obstruction, I mean complete. You could one of my nostrils as a suction cup if you wanted to.
I’ve tried every nasal spray on the market: Flonase, Nasonex, Patanase, Rhinocort. I’ve also tried all of the allergy pills and run through more Sudafed than a meth lab. Nothing offers relief for more than a few days before it stops working. Afrin works, but I don’t want to become an addict to the stuff.
After a discussion with my ENT and a round of CT scans, we decided surgery was the only option. My scans showed several problems. I have my dad’s deviated septum (he had an operation in 98). This causes a fair bit of blockage on the right side. My inferior turbinates are significantly oversized. My middle turbinates have concha bullosa (ie. air pockets trapped in the middle). As if that isn’t enough, the CT scan show a chronic sinus infection in the maxillary sinuses which won’t respond to antibiotics. This is due to undersized or closed off passages into them.
I decided it was time to go under the knife and get the works:
- Septoplasty — removal of the deviated cartilage of my septum
- Ablation of the inferior turbinates — using radio waves to scar the tissue of the inferior turbinates from the inside out thus preventing them from swelling
- Resectioning of the concha bullosa in the middle turbinate — he is cutting off the “bubble” on the middle turbinates so they are smaller
- Intranasal Ethmoidectomy with Maxillary Windows — he is increasing the size of the openings into my maxillary sinuses to improve flow and let my body kill the chronic sinus infection and relieve the pressure I feel.
- Cauterization — he is going to cauterize a couple blood vessels where I still get bloody noses
I wasn’t worried about the risks of surgery. Honestly what really had me freaked out was the idea of general anesthesia. I don’t like the idea of being completely out of control and unaware as people do God knows what around me. The nurses tried to help by distracting me and asking some random questions. They were all very nice. I was glad that I didn’t spend much time waiting for my turn in the operating theatre.
I snorted some Afrin, filled out some paperwork, Dr. Dawson came in to ask if I had any last minute questions, then it was time to go. The nurse lead me in and laid me down on the table. I was doing a fair amount of freaking out when the nurse said, “here we go.” It felt like a gentle pressure at the back of my brain and then everything went black.
I woke up sitting in the post-op room with an oxygen mask on my face that was gently misting me with water vapor. My nose was packed with gauze. The only pain I felt was a slight sting on my septum near the tip of nose. Honestly, that’s the only pain I felt the entire time. The nurse fed me a hyrocodone and a saltine cracker then made me drink a cup of water. After a short amount of time they took me into the recovery room where my wife was waiting. Dr. Dawson came by and asked how I was feeling. He told me everything went well and I should expect a lot more air in my future. After an hour we went home.
They left me with a little elastic band that held a piece of gauze around the tip of my nose. It caught some leakage which was escaping the packing. At first it needed to be changed every 15 minutes.
Emily propped me up an easy chair and fed me some soup. I was really feeling pretty good. It’s obnoxious to breath out of your mouth constantly, but I felt almost no pain. I took a pain pill every 4 hours and made sure to drink lots of water. Swallowing was tough for a little while. It took a couple hours but I eventually figured out how to swallow with a packed nose. It became second nature.
By dinner time I was ready to eat some real food. Scrambled eggs were easy to eat. I tried a piece of toast but the crumbs kept getting caught in my throat and reducing me to a fit of coughing and hacking.
By this point I was replacing the gauze under my nostrils every several hours. I probably could have taken the mask off, but it was convenient to leave it alone.
The First Night
I didn’t sleep much the first night. It was partially due to having to breathe out of my mouth. It kept drying out and waking me up. It was incredibly helpful to have some petroleum jelly handy to cover my lips which were getting dry and cracked. It was also imperative to have a big glass of water.
The biggest obstacle to sleeping was probably having to sit upright. I took the Doctor’s instructions to keep my head elevated a bit more literally than I probably needed to. It was hard to get comfortable.
24 Hours Post Surgery
Dr. Dawson had me scheduled to come in the next day to get the packing removed. Emily drove me to his office and waited why he took care of me. To say removal of the packing was a strange experience is quite an understatement. I could feel it moving behind my eyeballs. It didn’t hurt. It was just really REALLY strange.
After the packing was out, he took the same type of vacuum a dentist would use and sucked some of the clots out. He left the septum splints in.
I could breathe out of my nose….. for about 15 minutes….. and then clots and gunk sealed me off again. I still felt little pain and even stopped taking my pain pills during the day. I took one before bed more to help me sleep than anything.
That night I slept like a rock. It was the combination of being a little more comfortable and accumulated extreme exhaustion.
3 Days Post Surgery
I went back into Dr. Dawson’s office to get the splints removed. There was a little pinch when he pulled the stiches but it was more surprising than anything. My nose was very happy to get them out. It had been trying to flush them out with snot for the last 48 hours. I was really sick of being gross and snotty.
The vacuum came back out and he gave me a thorough cleaning. Afterward I felt fantastic. I had a little blood drip but nothing an occasional wipe with a Kleenex couldn’t keep at bay.
He told me to keep it moist with saline, and surprisingly that I could blow my nose gently. He also said if it started bleeding hard that I should go to his office or the ER, but he didn’t anticipate that. He also said it was all downhill from here and that I should be careful and not overexert myself as I feel better. I was scheduled to come back in 2-3 weeks.
Strangely enough, he told me not to use a neti pot for a couple weeks. He told me to stick with saline spray. I wonder why that is.
That night I slept wonderfully. Both nostrils were flowing 25% of what I would consider normal. That was just enough to sleep.
4 Days Post Surgery
I’m getting a little bleeding down the back of my throat. It isn’t enough to be worrisome, but enough to be obnoxious. I’m still feeling a bit fatigued, but way better than the last few days.
5 Days Post Surgery
I’m getting a little worried because my right sinus is still congested to the tune of about 25% of normal air flow. It will open occasionally and give me hope. I’m afraid that it wasn’t reamed out enough and I’ll have to go back in.
I’ve searched the internet and found several posts saying that it takes a couple weeks for the turbinates to shrink after ablation. The left side is wide open. I’m wondering why the right isn’t.
My nose started bleeding this morning. I was concerned until I realized it is right near the tip at a place I can pack with gauze myself. I’ve spent most of the day with a cotton ball stuffed up there. I spritzed the latest cotton ball with Afrin to slow the bleeding. That’s a trick my ENT showed me when I was a kid. It seems to have worked.
I think the bloody nose was caused by the septoplasty incision drying out and cracking. That goes to show how important regular saline spraying is.
Other than that, I feel fantatic. My energy level is just about back to normal. I haven’t pushed myself, but I anticipate being able to go back to work tomorrow.
Tips for those about to undergo sinus surgery
- Acquire one absolutely amazing wife who will be kind and gentle and take care of you at your worst. It helps if she is really good at making comfortable nests out of pillows and blankets.
- Have plenty of soft foods ready before you go into surgery. You will be starving when you get home. Soup, pudding, and scrambled eggs are good bets.
- Have a supply of 2×2 gauze pads. They can be used to collect leakage or rolled and moistened to clean crusted blood from your nostrils.
- Have petroleum jelly or chapstick handy for your lips.
- Make sure you are working to hydrate the two days before surgery. You aren’t allowed to eat or drink the night before. Not eating isn’t hard. You’ll be glad you are well hydrated.
- Take a full week off of work. I was in no condition to leave the house for 6 days after.
Sinus Surgery (Day 6) >