septoplasty and turbinate surgery

I use a full face mask. It's tough-I usually use the Breeze. My nose is still congested.

I hope you have a good night Friday after the splints are out.

Soooo...ladies and gents I had a septoplasty/endoscopic sinus surgery/turbinate reduction yesterday and I'm (to my pleasant surprise) feeling quite well. Had no probs w/general anesthesia. Woke up from in w/in an hour and within another hour of it I was wide awake, drinking water from a straw, eating graham crackers and joking with the nurse. One note: as soon as I started ciming to from the gen. anes. I felt a horrible wave of nausea, told the nurse and she immediately injected my IV w/an anti-nausea drug. Haven't had a problem since. I was bleeding from my nose, slightly, after surgery and til about 8 last night. I just kept replacing the gauze which was held under my nose w/a little sling that had elastics that go behind my ears. Today I just have dripping b/c I've started frequent sinus irrigation to clear up clots etc. Just have a very slight pressure/pain in my nose which is NOTHING compared to the chronic pain I had daily w/sinus headaches, allergies etc. I'm takung 1 vicodin every 6 hrs. and am not having any side effects. The nose is def stuffy and blocked but I'm so used to mouth breathing (have sleep apnea) that I'm fine. We found that I had the deviated septum when I originally tried the cpap w/horrible results (eardrum rupture, throat chaffing, extreme sinus pain)My ENT was horrified that the sleep specialist had never bothered to look up my nose. Ah well. Anyhoo I have an air purifier and cool mist humidifier running in my room to keep it ultra clean & moist for healing. I also purchased a 12" wedge pillow and a fabulous product called The Mattress Genie to keep me upright on couch and bed to promote drainage and avoid swelling. I'm drinking from straws and putting on ice packs frequently (bought frozen peas and put them into sandwichs bags to make mini-icepacks) So far no swelling or bruising either. I'm eating normally but can barely taste anything. I had a chopped up pkain hamburger last night w/butternut squashed. I'm thrilled, so far, w/how I'm feeling. Walking around, even washing dishes....lol! Some things NOT to do: no hotshowers, no hit food or drinks could cause bleeding. No bending over or lifting things over 10lbs. fot 10 days. Do use ice packs, sleep at a 45° angle, take your meds, and start saline rinses as early as Doc says you can. Happy healing!

Good for you Guest. It's nice to hear the good stories. I had a similar good experience and now enjoy a good nasal airflow 24 x 7.

Now I have a craving for ground beef and butternut squash.

Guest wrote: I'm taking 1 vicodin every 6 hrs. and am not having any side effects.... I'm thrilled, so far, w/how I'm feeling.

Well, vicodin has been known to have that effect. I'll hope you'll keep us updated as to your status after you're off vicodin, can breathe through your nose and taste normally.

I'm curious about why you feel your deviated septum resulted in the CPAP problems you described? Many people with deviated septums are using CPAP without experiencing any of these problems.

I had mine in April of this year, and like many others, was PLEASANTLY surprised at how well I felt the first 24 hours. After that I regressed, but I hadn't been diagnosed with sleep apnea yet. Thus, I probably felt more fatigued and crappy because of sleep issues than the surgery. I never took anything more than standard Tylenol. Given that I have a long history with anxiety issues, I was expecting the worst. The only part that was uncomfortable was the debriding, but it only lasts a few moments.

The packing used by the surgeon was a product called MeroGel by Medtronic. He likened it to the can of spray foam you buy at the hardware store in that it expands quickly and in this case absorbs like 10X its weight in blood. The best part is that is dissolves rapidly (in under two weeks).

I could breathe better right after waking up from anesthisia than I ever had before, and that was with a nose full of packing and swollen tissue. Best of luck to you, I'm quite certain all will go smoothly. I can tell you nobody did more research about this procedure than I did before committing to it. It is extremely safe and the success stories are too often grossly under reported.

Dear Guest and Lazyface (cute picture BTW)...do you know what turbinate reduction procedure you had done? I'm scheduled for a turbinate reduction using a microdebreeder on September 29th (am very nervous about it). It's akin to a mini-liposuction and is supposed to have less post-op issues as they just make an incision at the front of the turbinate, not removing any mucosa or bone, and most of the time (99%), no packing is required. Only odd thing is I need reduction about half-way back on the turbinate, about to the front of the middle turbinate. Not sure if that is typical or not. I, too, have done TONS of research, probably too much, as I've scared myself silly...LOL! But did find a great surgeon who specializes in this particular procedure.

Glad to hear you are both doing well. Please keep us posted on your progress.

Hi Folx,

Have been reading through the multiple years of info in this thread. Saw an ENT today and he feels I need septoplasty and possibly turbinate surgery. Need to figure out how to determine when someone really needs turbinate though the septoplasty is obvious. My septum blocks almost the entire left nostril and I cannot breath through it without significant strain (thus I am a mouth breather).

For the most part, what I have gathered from my reading of all these posts is that:

- many people have very good luck with breathing significantly better after the surgery
- the surgery is much better and more successful and less painful than it used to be
- I could very well continue to need cpap after the surgery but am hoping that a combination of this surgery and some weight loss to my ideal weight might reduce my apneas

My surgeon does roughly 100 of these a year but I am getting a second opinion just to confirm what should be done and how it should be done. Do most people get a CT or other scan before getting this surgery? I haven't yet but am wondering if it is necessary. My septum is nearly touching the left edge of my nose so clearly that's an issue (along with the breathing). He says it is a very major deviation (I hardly have any septum behind the middle of my nose because it is so shifted over).

Any comments or suggestions would be appreciated.

jccameron wrote:.......... Need to figure out how to determine when someone really needs turbinate though the septoplasty is obvious. ................

.........

A trusted ENT should run a scope up both nostrils and look at everything from your turbinates down to your vocal cord. Most of them have a display beside the chair for their viewing and a display in front of the chair for your viewing. The doc should describe to you what you are looking at. I could see that my turbinates were very much enlarged and taking up much of the nasal airway space.

The doc made me use a nasal steroid spray for six weeks to see if the turbinates were enlarged from inflammation. They were not inflamed and they did not shrink in the six weeks. He did a second scoping and I could see they were as enlarged as the first time. Neither of us thought from the first visit that they would shrink since they did not look inflamed. But it was a good precaution to use the spray.

jccameron wrote:..........

- I could very well continue to need cpap after the surgery but am hoping that a combination of this surgery and some weight loss to my ideal weight might reduce my apneas

.........

If you have read my posts you know my surgery (septum correction and turbinate resectioning) was fairly easy and the results were great for me. However it did not cure my apnea and did not allow me to lower my pressure.

Don't get your hopes too high that the surgery and weight loss will cure your apnea. I had the surgery and through diet and intense exercise dropped my BMI from 25 to 22 presently. I still need CPAP.

But - I just now returned from from a ten mile trail run with a 2400-foot ascent over two little mountains with humdity of 91% and no breeze. Three years ago I would have been exhausted from just thinking about something like that.

Hey Rooster...finally having my turbinate reduction on Tuesday. Mixed feelings about having it done as I'm nervous, but am truly hoping things will be better in a few weeks after I heal. A couple of questions for you (some of which I may have asked you previously):

1. You had turbinate reduction on all three sets. My inferior turbs are swollen all the way back to the front of the middle turb (so about half way back on the inferior turbinate). Do you remember how far back yours were swollen? A little freaked because one surgeon told me he wouldn't touch it half way back because of possible knicking of a branch of the sphenopalantine artery. However, the new surgeon who is performing the surgery at Stanford (head of the department) said he often performs the surgery half way back without problems. (He's looked up my nose with a scope many times with me watching with goggles...pretty interesting actually.)

2. How long after surgery did you have oozing of blood? I'm having a procedure where the surgeon uses the microdebrider, so he is not removing bone and there won't be a large open incision.

3. I've noticed that many people post here right after surgery, but then never follow-up. I find it a bit frustrating because I wonder if they don't post again because their experience was so bad or because they feel tons better and just don't even think about it anymore. Any thoughts?

4. How long after surgery did you have a sore throat due to the intubation tube?

Thanks, in advance, for taking the time to read this.

Cheers...Per

To per-turbed in San Jose-

I've posted here on this thread a few times about my deviated septum surgery & turbinate reduction surgery. I'm doing great & it was probably the best thing I did. I must have had had 7 meetings with the surgeon.
He's got the largest ENT practice in Seattle. My surgery took place on July 20th, 2009. The surgeon operated on my inferior turbinates which were three times the normal size. He reduced them by roughly half. Because of the Apnea, it necessitated a long, sleepless overnight stay in the hospital. I was discharged the next day with packing in my nose. The packing is used solely to stem the blood. Additionally, I had two clips further up in the passages, to hold the septum in place. The clips were removed July 31st, 2009. I flushed 4 to 5 times a day. It wasn't until the 3rd week that the bloody mucus stopped.

They warn you not to blow your nose, for about 3 weeks. I did and a blood vessel ruptured in the nose. I had to go to the E.R. to get the bleeding under control, which meant I had the nose packed again. Within a week of that and almost a month after the original surgery, there were no signs of blood during the flushing process. Currently, I am flushing once a day. In spite of my visit to the E.R.. I regard this surgery as one of my best decisions. Before the surgery, my head would hit the pillow at night and one nostril would be completely closed. I would recommend this surgery to anyone. For those with a low tolerance of pain, this is the ideal surgery. I took Percocet only once following the surgery, since I was feeling no pain.

Bob

I had a septoplasty, turbinate reduction and cartiledge batten grafts put in my nasal walls three weeks ago. I sure wish I had found this thread right when I had it done. My recovery is pretty much as mentioned here. I still have some scabs etc and I think I'm at about 75-80% clear in my nostrils. I don't have any shutting down of my nasal passages like I used to, They just stay open as long as i do my nasal rinces. I'm doing about 5-6 a day. Long showers and then a nasal rince really flushes out gunk. I, however, had a horrible time with sleeping. I use a nasal mask/CPAP and I could not breathe through my mouth to sleep. I had 7 days of 1-2 hours sleep and I was miserable. I rigged my mask to use on my mouth, which sort of worked, but I would wake up constantly with horrible dry mouth. If I could have gotten some decent sleep, this would not have been too bad but with no sleep, as I said, I was absolutely miserable. I go in next Friday for a 1 month flush and post op check. So far I think I have a nice improvement in my breathing and I'm happy I did it.

per-turbed in san jose wrote: ......Do you remember how far back yours were swollen? ....... However, the new surgeon who is performing the surgery at Stanford (head of the department) said he often performs the surgery half way back without problems. (He's looked up my nose with a scope many times with me watching with goggles...pretty interesting actually.)

…….

Not sure about how far back, but they seemed to be blocking about 80% of the air space. It sounds like you have a good surgeon who has performed this surgery many times. That is what you want!

It’s funny that God made humans in such a way that we can find it interesting to look up our noses with a scope. I was fascinated with those little vocal chords which can make so much racket. He had me speak a couple of words to see them vibrating in various directions.

Why has he scoped you so many times? If it was a digital prostate exam I would be worrying about the doc.

per-turbed in san jose wrote: ………
2. How long after surgery did you have oozing of blood? I'm having a procedure where the surgeon uses the microdebrider, so he is not removing bone and there won't be a large open incision.

……….

The surgery was on Tuesday morning. I wore a mustache bandage until Friday morning when the splints came out. No more bleeding after that. Wednesday and Thursday mornings the CPAP mask was quite a sight with blood in it. But only small amounts as the mustache bandage is effective.

Since they are not removing bone you may have less bleeding.

per-turbed in san jose wrote: ……..

4. How long after surgery did you have a sore throat due to the intubation tube?

……..

That was the only bad part of the surgery. When I awoke in the recovery room, my throat was hurting badly. I kept telling the attendant, she kept checking my BP and calling the doc. The pain continued and the BP kept going up. The attendant said the pain was causing the BP to rise. At the one hour mark she gave me a shot of morphine. Maybe she disregarded the doctor’s orders or maybe he told her to give me a shot at the one-hour mark if the BP did not go down.

When she gave me the shot, I thought in five minutes things would feely groovy. They did not. The pain was severe for another hour and then was suddenly gone and never came back.

I spoke an unpleasant word to the anesthesiologist when he later visit me in the transition room. He said his tube did not cause the pain and that it was probably the blood dripping into my throat. I am skeptical about his statement.

per-turbed in san jose wrote: …….

3. I've noticed that many people post here right after surgery, but then never follow-up. I find it a bit frustrating because I wonder if they don't post again because their experience was so bad or because they feel tons better and just don't even think about it anymore. Any thoughts?

……

These may be non-CPAP users who found this forum with a search engine and have no interest in posting again. (Note to self: “Deceased jokes inappropriate at this time. )

per-turbed in san jose wrote: Hey Rooster...finally having my turbinate reduction on Tuesday. Mixed feelings about having it done as I'm nervous, ...... ……

This is like “buyer’s remorse”. There is something you want badly for a long time. As soon as you sign the contract to purchase it, you think you don’t want it and regret signing.

You did your homework. Now your job is to relax and turn control over to the doctor and staff.

Good luck and please post back.

Hi Bob...thank so much for your post. And I'm really glad that you are doing so well after your surgery and feel like it was one of the best things you've done for your health. I'm three days post op and feel amazingly well. I had a conservative procedure using a microdebrider instead of a scalpel. My surgeon thought he might have to remove some bone on the right side because I have a slight deviation (and refused to have a septoplasty because they told me it would be more like an open rhinoplasty due to the type of deviation I have, even though it is only slight), but turns out he did not have to. He was able to make a good reduction in the soft tissue. Because I had swelling about half way back on my turbinates, he thought he might have to use gentle cautery, but I didn't actually bleed very much so he didn't have to do it. My main concern was that he might hit an artery, but he was no where near close to one, which was a blessing. He told my husband that the surgery went better than he expected and that he actually expects excellent results, which would be great as this is the last procedure that can be done on my turbinates (I had radiofrequency done in May with limited results). I am hoping and praying that like you and Rooster, I will be able to say that this is one of the best things I've ever done for my health. Cheers!

Anne (Per-turbed)

Hey Rooster...well, I'm 3 days post op and feeling amazingly well. I haven't had much bleeding out of the front of my nose, but rather down the back of my throat, which has been a bit surprising. It has slowed way down, so I think things are on the mend. What surprises me the most is that I'm actually able to breathe through my nose and sleep. The only problems I had was right after surgery in post op. I woke up in a lot of pain in my nose and very sick to my stomach despite them giving me anti-nausea meds. After giving me all of the fentanol they could give me, they switched to Vicodin. Both the pain and nausea subsided by 7:30PM the night of surgery and I haven't taken any more Vicodin.

The surgeon has scoped my nose about 4 times prior to surgery. We kept trying different meds to see if anything would reduce the swelling, so he kept taking a peek. And yes, I'd be concerned, too, if it was a prostate exam...especially since I'm female!

I only had a slight pain in my throat after surgery for about an hour from the intubation tube, then it went away. I was expecting it to be much worse as the anesthesiology intern was supposed to be the one who was inserting the tube. Call me old fashioned (or maybe just "old") but I was a little nervous about an intern doing so many important things before surgery, but it was all for not as he inserted my IV with no pain. Amazing!

I'll post back in another week or so and let you know how I am progressing. I always wanted to know how people were doing weeks and even months after surgery as that's when you truly know the outcome of the procedure.

Cheers!