Day 11

Day 11 of Post-Op

Ok, I'm crawling my way in to week 2 of recovery.

I just want to give some warning about the nasal rinse. When you think you got all the "drippage", you didn't. It will also come out of your mouth sometimes so don't freak out because that's normal.

That rinse really gets all up in your sinuses. No matter how long I stand over the sink, which way I tilt my head or how I blow my nose I will always have more of that salt water rinse drip out a couple hours later at the most inopportune time.

For example one, I was doing my homework and leaned down to get the pencil I dropped. I sat back up, water spilled right out of my nose onto my notes. Ugh. Could be worse.

Example two, I went to the Dr on Monday this week right after doing my morning nasal rinse for my normal checkup and just as the nurse goes to wrap the blood pressure cuff on me, water drips on to my lap. I laughed it off (nervously with a hint of embarrassment) and explained the situation. She said she understood but who knows haha.

So yup, just prepare for that. Here's a diagram of why that happens exactly. I think the excess is coming from when the frontal sinus drips out whenever it feels like it. I found it quite interesting. The arrows are the sinus rinse solution going in then out of the nose as it flushes it.

Clipped from NeilMed video.

In other news, the stitches are still there and my nose is still super sensitive to being touched or stretched. You know when you go to lick your lips, it stretches the top lips all the way up into your nostrils actually, yeah it stretches the area of my stitches which isn't really a pleasant feeling if I'm being honest. There's very little blood now, I can tell the holes are still healing and trying to close up though because the most blood I get is during the morning nasal rinse when I wake up. It's no where near the amount as the first time I did the rinse, just a tiny bit.

I think I might actually keep doing this even after the 3 months are up, that rinse seems like it would be great for when I'm sick and congested.

I did get sick this weekend though, based on most common illness incubation periods, it was probably at the hospital when I got my surgery (most places here don't wipe the pulse oximeter, that device that clips on your finger, after each patient. Hands carry a shit load of germs, especially under the nails.). Throwing up grilled cheese sandwich and tomato soup was not pretty. I know it wasn't he antibiotics because I also had a fever and other symptoms.

I finished the amoxicillin thankfully, that stuff tends to make me nauseous half way through and I often forget to ask for Zofran. I love that stuff. Knocks out the nauseous feeling without knocking me out for two days like Phenergran does.

Anyway, I figure if the stitches aren't out this Friday, I'll call the ENT and see what can be done. I can't wait till my nose isn't so sensitive so we can start going to the Amusement park that we bought season passes to. We've only gone 2x since buying them, not even enough to make the purchase worth it.

I do have to say, the ENT I have seems really nice and professional. He knows his stuff! A Dr that seems confident and can make a patient feel at ease is a huge plus in my book. I rarely find one these days.

Day 5

Day 5 post-op:

I was nervous all the way to my Dr.'s office to get the stents removed and check on the healing. Well, I was nervous and worried for nothing. The removal of the stents wasn't even painful. Just... odd and gross feeling. I did take 2 of my Norco though (after a couple surgeries in the last 10 years and several medical issues that I've been prescribed narcotics I've built up a little tolerance to it so I need a stronger dosage to get the desired effect) about 1 hour prior to the appointment and made sure I ate something.

I got seated in a room and the nurse gave me a numbing agent that is sprayed 2x per nostril and they let that set in for about 5-10 minutes to take effect.
My Dr then came in and checked inside to make sure it was healing properly, even praised me for using my nasal rinse because he could see that I was and that it really helped the healing, clearing out the passages and would make the stent removal much easier.

So anyone reading this that's getting ready for nasal stent removal, word of advice, USE YOUR NASAL RINSE. I used mine 2-3x daily, depending how congested I felt. I feel like this made a huge difference.

He tells me, he's going to clip the stitch in my right nostril and start with removing the stent from that one and I immediately thought "Woah woah woah, I had a stitch in that nostril?! I only felt the ones in the left!" So he used whatever tool he grabbed and pushed against the septum then clipped and pulled that stitch out. That was slightly painful, probably because it was against my septum and the stitches from the left one were right on the other side. 

Then really quickly he pulls the stent out and then just as quickly pulls the other one out. The best way I can think of describing it is that someone was pulling a slug from the back of my throat through my nose. Really gross.

He then suctioned all the gunk, it hurt for a second or two when the suction tool pressed against the stitches and most likely where some of the incision was made. I looked at the video of it and that tool went in pretty deep, I'm still amazed about how deep our nostrils go.

Afterwards, a huge pressure felt like it had been pulled from inside my nose and the congested feeling was much better. 

There was some blood but not a lot at all. When I started breathing through my nose it was like a night and day difference; not only from being congested feeling during recovery but also from before the surgery. I can take deeper breaths and I can feel the air coming in through both nostrils. The only issue that I have is the left nose, I don't really feel the air leaving through it. Dr said this was normal and should resolve in 3 months. It's because that's where the incisions were made mostly so they've got to heal and that takes about 3 months. At first I was a little upset (like a toddler who can't have another cookie) that it would take so long but then I realized 3 months isn't that much in the grand scheme of things.

He didn't remove the stitches because they're dissolvable (I didn't know that, they feel harder than the dissolvable stitches I'm use to) and will dissolve in a couple weeks. I just keep picturing pieces of them coming out over time during my nasal rinse and the grossness of that image makes me laugh.

The left nostril, with the stitches, still stings a bit. The pressure like something is pushing down through my sinuses to the roof of my mouth towards my tongue is still there combined with the feeling like my front top teeth are getting pulled out (pressure not painful really). That's expected to go away in a couple weeks too.

I'm to expect a lot more clots with my nasal rinsing now that the stent is out apparently. Also with the stitch that was holding the stents in place creating a small hole the rinse will feel different.

No follow up appointments unless something concerns me but he said I can return to normal activities today. I think I'll give it a couple days though since I'm still pretty dizzy, it's worse when I go up the stairs and I can feel a pressure pushing on my sinuses when I go up there.

Since the main stuff is over I'm only got to post progress about once a week now until the 3 months are up (unless I'm healed completely before then).

We got video of the stents being removed so WARNING for those that are easily grossed out or get queasy.

Day 4 Post-Op

Day 4:

I can tell even with the bit of congestion (probably because of the stent tubes right now) but I am breathing WAY better. More than I'm use to. I get dizzy if I breathe too deep though because my body isn't use to it so I'm sure that will be an adjustment.

I had mint ice cream for breakfast with apple juice. I woke up with my throat in so much pain so the ice cream really soothed it. That is one thing about being in recovery, Ice Cream!

When I stretch my lips or anything that stretches my nose I can feel the stitches pulling and it's not so pleasant but it's not really all that painful. You never realize how many nerves or how much you use something until it hurts or it's out of commission.

I have my appointment tomorrow with my ENT to remove the stent and stitches. I was concerned about it not being a full week but they said it should be fine. I figure once he looks it over, if he thinks it's not OK he'll have me wait a little longer.

I've read in some blogs and forums that the removal of the stents can be pretty painful and some people nearly pass out afterwards. I talked to my Dr's office about that and they said as long as I use the nasal rinse like I'm supposed to, the moisture should help with the extraction and I can take my pain killers about an hour before the appointment to help. I'll need a ride home and will probably feel pretty weak or exhausted for the rest of the day.

I'll report back after that's done, maybe with some pictures. I wanna post a couple videos we have of my coming out of the anesthesia haze.

Day 3 of Post-op

Day 3:

Towards the end of day 2 I was down to 1 gauze and barely needed that. I did however have to keep using a wet cloth to clean dried blood just inside the nostril.

I can feel the tubes when I use tissues and the stitches in my left nostril. The stitches creep me out the most. I was patting the inside because I felt some blood dripping down and the wetness caused the tissue to break and my finger touched the tube and that was weird as hell.

I started the morning with the Nasal rinse bottle, following the instructions and it was so strange. Almost worse than finding the tube. I did it though and was so glad I had. Some blood clots and stuff came out and it was gross but I felt much better for a few hours.

If they give you Afrin or similar, you can use that (During the 4 day time they say you can) about 30 minutes before your Nasal Rinse to help open the passages though.

Around 2p I was feeling really cooped up so we went out to get some chick-fil-a and I got nuggets and an awesome milkshake. I can not tell you enough how great ice cream and cold pudding feels on my throat. After that we went to go pay a bill and grab some crafting material. It was around the 2nd hour that I started feeling faint, dizzy and my head was pounding but I left my pain killers at home. We went home early even though I could spend all day in a craft store.

I went back to my couch and falling asleep in the middle of doing things haha. If you have a sleep number or a bed that can fold up I envy you. Sleeping sitting up on a couch sucks but during the night I had gone to lay down and that was not a mistake. The congestion was worse, my throat hurt even more and my nose hurt.

I didn't have to use any more gauze today and my cheeks are doing better from the tape.

Ordered pizza for dinner and I was sad because I can still barely taste anything.

Day 1 and 2 Post-op

Day 1:

I don't remember much so I'm going on my spouse said.

On the way back home, I was craving a McDonald's Caramel Sundae really bad because it was cold and the caramel always had a way of coating my throat which hurt. I remember that. So we got one and I ate it so slow that half of it got all mushy and frothy and gross haha.

We got home and I had a spot on the couch all ready because you have to sleep sitting up for the first week. I fell asleep constantly in the middle of doing things like checking my texts, or drinking water. I was able to change my own gauze though which needed to happen about 3 times an hour. I was allowed to use a wet cloth to gently dab the crusted blood away from the outside of my nostrils.

They sent me home with plenty of precut gauze and medical tape. A word of warning about the tape as you change it, it will constantly pull at your skin and can start causing your skin to get irritated so if this already happened, use some Neosporin and a non-scented deep penetrating lotion then use some of the gauze to cover it until you can stop wearing the nose gauze. I suggest this Eucerin. I also used it on my lips which got super dry and cracking then sealed it with Carmex (my lips, not my cheeks haha).

 I have a picture of what I did with the cheek gauze to get an idea.

My lips are still a bit swollen.

I slept a few hours at a time, was dizzy when getting up to do things like going to the bathroom.

Day 2:

I was a bit more lucid though I'm still taking the pain killers every 4 hours. I've eaten soup with crackers and now changing my gauze about 2x an hour instead of 3.

My s/o hasn't seen American Horror Story but I have so we figured my recovery time would be a good opportunity since I'm still in and out of it.

I feel congested, my throat hurts because I can tell the stent tubes are in, my lips are dry and cracking, my head hurts something fierce and I feel like I really need to blow my nose but I'm not allowed. Changing the gauze has me push against my nose some and if I don't have the pain killers it hurts and makes my eyes water.

The roof of my mouth hurts including my teeth. They said this is normal, especially with the stents in and the pain should be relieved a couple weeks after the stents are removed.

Diagnosing

Getting diagnosed with a Deviated septum and enlarged turbinates:

I decided to start a blog to maybe help clarify any questions or concerns someone might have for getting Septoplasty and Turbinate Reduction surgery. Keep in mind, I can only relate and answer questions based on my experience and the information shared to me by my ENT (Ears, Nose and Throat) Dr.

Right now I'm on day 4 of post-op recovery but I'll get to each of the recovery day experiences in a bit.

Let me start with what lead up to me getting diagnosed because it is quite a process.

I was about 14 when I noticed I was having pretty bad sleep issues. I wasn't snoring mind you, but I was waking up choking a couple times a month. I felt tired all the time and constantly had headaches that sometimes turned to migraines. I often slept in class, on the bus, where ever. It took several months but I finally convinced my parents to take me to the children's Dr.

At first, the Dr had no reason to suspect sleep apnea because I was under weight and had decent blood pressure so he had a brain pet scan ordered. They found nothing abnormal and then another few months went by with no follow up until he decided to run a sleep test. Maybe I had restless leg syndrome.
The sleep study returned with possible sleep apnea but they wanted to run another test for comparison. My parents didn't see the need. I never went back in until this year (2016) in May.
My PCP referred me to a pulmonary specialist who then ordered a sleep study. Ya see, advances have been made over the last 14 years. They've discovered that even people who aren't over weight and don't have high blood pressure can have sleep apnea. They've discovered so many possible causes as well. I am no longer under weight mind you (after getting away from the abuse I was able to work on getting myself healthy). It's rare that people who aren't overweight have sleep apnea, but it happens. The specialist said it's normally from jaw development or a neural source.

Another sleep study was ordered. I was diagnosed with mild obstructive sleep apnea where I stopped breathing on average of about 8x per night. Keep in mind, most people don't sleep well during these studies, what with being in a different room and bed, hooked up to wires and patches that tangle around you while you toss and turn (I'm a toss and turner haha). So they were going off of maybe 3 hours of my sleep.

I want to say this now. If you suspect you have sleep apnea, tell your Dr. The effects of this can be pretty bad. It can cause depression or make it worse if you have it already and so many other dangerous things like nightmares/night terrors, sleep deprivation causing you to fall asleep at the most inopportune times like driving. It can cause severe fatigue, muscle weakness, memory loss, mood swings, irritability, and tons more. Not to mention, you stop breathing. I even saw a documentary on murders or attacks by people suffering from sleep apnea who had no idea what they were doing but the sleep deprivation lead to it.

Anyway, back on topic. After getting diagnosed I was told to talk to an ENT so that they could look in to the underlying cause while I waited for my next appointment which would fit me with a CPAP device a month from then. This was great because I was thinking about seeing one in regards to my constant bloody nose. Ever since moving from NC to UT, the bloody nose issue has only gotten worse. I was blowing out blood clots and gross goopy string of blood with mucus, the inside of my nostrils were almost always raw and sore like they were cut inside and ever since I remember I have never been able to breathe well through my nose. The Sleep apnea test, they told me, also revealed that I'm a very shallow breather. I laughed because how are you supposed to work on that in your sleep?

So I set up the appointment. I was then diagnosed with a deviated septum and enlarged turbinates as well as a grade 2 overbite which was most likely the main contributor to my apnea concern. We talked about options on what to do about my nose but with the sleep apnea determined it best to get a surgery called Septoplasty and turbinate reduction. I would have to see an orthodontist about the overbite which most likely meant surgery to bring my jaw forward and open up my airway. Until then, I'm focusing on my nose. See the septoplasty would work on straightening my deviated septum and the turbinate reduction would reduce the size of my turbinates, allowing more air to flow in and out of my nostrils as well as reduce sinus headaches. I was guaranteed this would not alter the outward appearance of my nose which was a relief. I'm fine with my nose.

The surgery was scheduled for 2 weeks after that initial appointment. I will tell you now, don't be afraid to call your Dr's office during that time to ask any questions or express any concerns you might have. It's surgery afterall, you're allowed to be anxious and they're there to help you and out you at ease. If they get at all irritated with your (unless you call like 10x a day of course) questions or your worry, find another office or express your concern to your Dr about their behavior.

My pre-op instructions included:

• No unprescribed blood thinning medications which are things like aspirin, ibuprofen (advil, motrin, aleve) at least 5 days prior to the surgery date.
• Stop smoking and drinking at least 3 weeks before your surgery (I advise as soon as you find out you're getting surgery but then again I'm not a smoker anyway and I can't comment on the difficulty of quitting).
• Immediately tell and list all medications and supplements you're taking to your Dr. This includes informing them of the dosage, how often and when (ie, morning, noon, bedtime) and what they're for.
• DO NOT eat or drink ANYTHING after midnight the day before surgery. This includes water, gum, hard candies, mints. Your Dr may tell you that you can have a sip of water to take any prescription meds though.
• Ask someone to take you home after the surgery and for someone to help nurse you for the first few days. The sooner you set this up the less inconvenient it will be for your friends and family so that they can work their own schedule around for you and less stress on you to scramble last minute.
• Invest in a Sinus Nasal Rinse. Probably not a Nedi Pot but I would recommend the NeilMed Nasal Rinse bottle. You can get it from a local pharmacy like CVS, Walmart, etc. Like this:

How to video 1: 

How to video 2 This one is really cute and gives a more realistic idea of how it works.

So this is an out-patient surgery, unless you have some concerns that the Dr may want to admit you for a day just to keep an eye on you. Mine was a simple out patient where they used general anesthesia.

I came in in the morning and provided a urine sample then went to a curtained room that would be my pre-op and post-op area. They set me up with an IV in the hand to give me fluids which they described as clear Gatorade. I was wearing a decent hospital gown, with hospital socks and a surgery hair cap. I confirmed and filled out more paperwork. They had the Dr come in and confirm the surgery and answer any questions I may have had then the anesthesiologist came in to let me know how general anesthesia works and what to expect when I come out of surgery.

They injected a sedative before wheeling me on my bed from the pre-op room towards the operating room. I remember going through a couple hallways, passing a Dr who greeted the nurses at my side, going through a few doors and that's when the sedative kicked in. I was in a hall then suddenly my bed was next to an operating bed and they were moving me to it then I was out.

After I woke from surgery they put me in one of those brief recovery rooms until taking me back to the pre-op room they gave me and brought in my spouse. She had a great time recording my post-op haze as I fell asleep in the middle of eating half a cracker and talking about how the roof of my mouth felt like I ate a hot pizza too eagerly and burned it.

I had no black eyes, only thick gauze folded under my nose held there by medical tape to my face and it was getting soaked with blood which is completely normal. The nurses were there to keep changing it out and checking on me. 

The surgery lasted about 1 hour and the post-op to let the anesthesia wear off some is about 2 hours. It depends on what you're having done and the amount of surgery required that will determine how long your surgery lasts. I was still pretty out of it when I was getting released, I barely remember the rest of the day except for bits and pieces. I remember the Dr telling my spouse that I had tube stents in my nose and would need to schedule an appointment to get them removed in about a week. That I would crave more cold things than warm because of my throat and that I should get a nasal rinse. He recommended a brand called NeilMed Nasal Rinse about 3-4x a day a few days after surgery to help clear out the blood, mucus and clotting.

After Operation Instructions:

• Don't use blood thinning medication after surgery, your Dr will tell you for how long.
• You should be prescribed an antibiotic. I was given amoxicillin 2x a day. Because I've been on antibiotics most of my life, within the last 5 years I noticed that I tend to develop yeast infections after. If you are worried about this or you know it happens to you, don't feel ashamed to let your Dr know. I was given Diflucan for this.
• Take all medications as prescribed.
• Follow all Dr's instructions.
• Expect some swelling and pain in your mouth and nose.

I spent the next couple days in a painkiller haze, I was given Norco and I tried not using it but ended up being in pain with my nose. I noticed that at some point, probably right after waking up, that I must of scratched my cornea while rubbing my eyes. Anesthesia always makes my face feel like the skin on it is crawling and my eyes dry yet watery. So I spent the first couple days with a wet eye gauze patch on to let it heal. My face was covered in gauze which was pretty funny.

The wet gauze helps keep the eye moisturized and speed up the healing.