As some of you may recall, a few years ago I began having a lot of dental work. I needed a lot of work and decided to get some implants in the lower right of my jaw. One thing I didn’t tell many is my Oral Surgeon had located what looked like a tumor in my left sinus and recommended a ENT Doctor evaluate it further. I later found out it was a mucous retention cyst. A lot of people have these and have no idea, for the most part, they aren’t harmful.
However, in the same ENT appointment, I confirmed a suspicion I have had for a while – I have a deviated septum. It was the only explanation for my inability to breathe all these years, and possibly for me being such a loud snorer. On an unrelated note, I had just had a MRI of my brain and the imagery revealed my turbinates are also enlarged, contributing the problem of nasal aspiration.
Without getting too ‘medical-termy’, turbinates help warm the air as you breathe in, keep your nose moist, among other things. Your nose cycles every 6 hours (roughly), as this happens the turbinates swell with blood. In most people, the nasal passages shrink a little, but you can still breathe through both passages. In mine, they couldn’t get the smallest endoscope up my nose. My nasal aspiration was very restricted. Finally, I opted for surgery to fix the deviated septum (septoplasty), reduce the size of the turbinates (turbinoplasty), and endoscopic nasal/sinus surgery (to remove the tumor in my left sinus cavity).
If you’re in a situation like mine and have considered surgery but aren’t sure, I hope this well help.
Location, Location, Location and Doctor, Doctor, Doctor
All of my medical care, primary and specialty, is at Mayo Clinic in Jacksonville. They are consistently rated as one of the best hospitals in the US with award winning care teams. My ENT Doctor, Dr. Bolger, has been awarded “Best ENT Surgeon” for a number of years running, and is also a professor of his practice. To me, this says he stays in touch with the ever changing surgical arena and is familiar with the latest treatments. It would be senseless to choose another facility, in my opinion. Additionally, the Anesthesiology team at Mayo is one of the best, employing people with experience beyond the required norm.
If you’re considering surgery, always evaluate your options. I recommend finding a facility that’s integrated, so you have one (1) bill in the end. In this example, your surgeon, his medical team, the anesthesiology team and their assistants, as well as the facility will work for the same place, instead of multiple places coming to a surgical facility licensed to them for the day. This avoids bills from various groups of people, eliminating confusion when the bills come in.
Speaking of bills, both of my insurance companies approved this, and I hope to have very, very little out of pocket when all is said and done. Your insurance company is probably different than mine. Generally speaking, these are not “cosmetic or plastic” procedures.
Surgically speaking – what should I expect?
Surgery is surgery. This procedure involves general anesthesia, i.e. they put you fully under, not like dentist. I suppose they could do this under local anesthesia, but I’m sure it wouldn’t be pleasant at all. I arrived at the hospital on October 28 at 10:30 am. At 11 am hospital staff had me back in pre-op, changed clothes, and got an IV ran. Aside from my family to wish me luck, the hospital had me sign some anesthesiology consent forms. A few minutes later, I chatted with the Anesthesiology Doctor, and asked for something for my anxiety.
If you find yourself in this position and have had IV-based anti-anxiety medication before, take it. I requested Midazolam, or “Versed” if you prefer brand names. It takes effect in a few seconds. You feel like you’ve had a few glasses of wine. But, you don’t remember anything beyond that, as it interrupts the part of the brain responsible for making new memories. Following this, they wheeled me into the OR where I swapped to an operating gurney/table. Finally, they placed the mask over my face and I was out like a light.
According to family, I was in recovery until around 5:30, so the surgery was a couple hours, as was recovery. Unfortunately, my heart rate and blood pressure were still high and had them worried, so they had me admitted to a hospital room overnight. I was actually wanting this anyway, in case something went wrong, blood clots formed, etc. Due to the distance from my home to the Mayo Clinic, it would be inconvenient to get home and have something happen.
I’ve not stayed overnight in hospital in a very long time, so I can’t speak much in terms of comparisons. But the care I received at Mayo was 5 star, it was like being waited on head/foot at the Ritz-Carlton. Every time I pushed the nurse button to go to toilet, get something to drink, or request more pain medicine, they were there within minutes. They brought me toothpaste/toothbrush. At one point, I began experiencing mild chest pain and stomach sickness. I asked the nurse to stay with me, citing I was scared. I remember an episode of The Big Bang Theory was on, and she sat with me, holding my hand the whole time. I’ll never forget that.
It’s not that my family didn’t want to stay, they had to work the next day, so it wasn’t possible. At no point did I feel alone or forgotten in the hospital. Also, I had access to all the gelatin desert (strawberry or orange) one could desire, provided I could keep it down. Who doesn’t love gelatin desert?!
Checkout & the First Day Home
The next morning, I was feeling considerably better. My heart rate had stabilized, blood pressure was relatively normal, and I was no longer feeling like I was going to throw up my organs. Though I didn’t get much “resting” sleep, I was able to rest. The nurses only came in every few hours to change the bandages under my nose, as it was still leaking blood. But, I would knock out right away. This said, I was ready to go home at 8 or 9 the next morning.
Dr. Bolgers Physician Assistant came in and asked if I was ready to have the packing removed. Dr. Bolger had placed a slurry of surgifoam and gauze up there to absorb bleeding, and continue homeostasis (preventing excessive bleeding). Think of them as tampons for the nose, hah. There are no videos of her pulling my packing, but if you’re curious, YouTube has a nice compilation. If you watch that and think, it can’t hurt that bad…. no. It was one of the most painful things I’ve ever felt in my life, and I’ve had some crazy accidents/health problems. A few seconds, some tears, and a lot of blood later, she had removed them, and I was nearly ready to go home. She also advised me I could begin the irritation process on Sunday or Monday.
Day One at home was spent in my living room recliner, sleeping due to the pain medicine and just general exhaustion. The anesthesia took a lot out of me. For two days, I wasn’t able to lift my arms, to reach a cup in a cupboard, or turn on the water, for example. Same with my legs, to get in the bath tub. I felt itchy all over, my hair felt crusty, and it wasn’t pleasant at all. I just felt gross, but the fatigue for a while kept me from taking a shower. That, and the fact that I was paranoid that the warm water would allow the blood vessels in my nose to dilate and I wouldn’t be able to stop the bleeding. That didn’t happen, fortunately!
Days Two & Three at Home
Days two and three were a little easier than the first. The fatigue wasn’t so bad, fortunately. I kept having hot and cold flashes, which the Doctors said is part of the anesthesia leaving the body. We have a comfortable bath tub, and If I could have lived in it the whole day, I would. I was supposed to go back to work on this day (Friday), unfortunately, with the amount of fatigue and the pain medicine, it wasn’t possible.
Saturday, day three, I sneezed and thought I popped a stitch in my nose. Fortunately a quick call to the Physician Assistant allowed us to deduce it was likely some cartilage moving back in to place.
The hospital gave me this long list of instructions on making your own saline and a bulb irrigator (much like the kind you’d use on your ear). Essentially, you flush your sinuses and nasal passages with warm saline. This keeps the wounds from crusting over, since you can’t peel the scab away. It also helps remove the blood and mucous, or other discharge (a jelly like substance) that is the result of the surgery from the body. Unfortunately, I didn’t have good results with this turkey-baster like bulb and opted for something easier to use and far more practical. I bought this. (See right) I also picked up a refill box of the saline packs, since I knew I’d be doing this 2, 3, or 4 times per day.
Essentially, you buy distilled water, pour 7-8 ounces of the water into the bottle, then add the packet and shake. Nuke for 17 seconds or so, to warm it but not make it hot. Also, be very careful with heating distilled water, as it won’t boil, you can cause explosions by putting objects cooler than the water into containers of distilled water which have been heated for some time.
Stand over your sink, look down a little, and squeezing the bottle, squirt the water into the nasal cavity. It may come out the other nostril, and it may come down the throat. It may also have blood and mucous in it, and of course, you want to spit that out or let it fall into the sink.
Tonight was the first night some of the blood and such came out. It’s nerve-wracking in a way, I’m worried I may open the stitches and cause a bleeding issue. So far, things are fine!
Irritation after irrigation is normal. It is mildly salty water and you are pouring it over open wounds, after all. But it doesn’t last long.
Other weird issues
The Doctors told me I may lose sensation from my teeth and or tongue. This happened, and is slowly coming back. Also, I have next to zero taste at the moment. In fact, tonights dinner (red beans, rice, and beef stew) was the first thing I’ve been able to taste since the surgery.
Closing Thoughts; Tips, Tricks, & Recommendations
Would I do this again?
No. The way I felt post-anesthesia was just not pleasant. It’s not the fault of the anesthesiology team at all, just how I reacted to it.
Would you recommend the procedures?
If you have problems breathing, snoring, or keeping up while being active, yes. While I can’t tell you the surgery has changed my life (nose is still stuffy), I’m confident it will.
Should I research my Doctors and surgical team?
Yes. Yes. Yes! Do as much research on them as possible. Have they ever had a medical suit, complaint, do they do this procedure often? Get second opinions when possible! Stay in the same hospital group as well for convenient OR location and billing.
Bring lip balm to the surgery.
And I mean GOOD lip balm. I used Hemp Lip Conditioner from The Body Shop because it’s super moisturizing and lasts for a long time. When you have the surgery, you won’t be able to breathe through your nose. Using this kept my lips from chapping while I was sleeping.
The kind kids eat. Fruit-ish flavored, long plastic tube kind. The floor of your sinuses is the top of your mouth and the cold induces vasoconstriction (shrinking of arteries and such), which helps minimize the bleeding.
Buy a good, hard pillow to use as a base, and just ride it out. After a few days, laying down won’t be miserable.
I mentioned earlier, I wouldn’t do this again. That really encompasses any surgical procedure with full/general anesthesia. The concept of anesthesia freaks me out, we have no idea how it works, just that it does, and that makes me super nervous. That aside, I didn’t react well to it, and I’d rather have mumps or pneumonia than feel that way again, to be honest. It was horrible.
If you’re thinking about this type of procedure, I hope my post has helped you. If you have any questions, please let me know!