Doc says I need some work on my sinuses

[chunkyfrog]

Best wishes for an uneventful procedure and a speedy recovery.

[quietmorning]

Best wishes for an uneventful procedure and a speedy recovery.

Thank you, chunkyfrog! If it takes place, it will probably take place in April or May as I have a trip to Connecticut do to welcome my daughter's second baby into the world! Can't fly for a while after surgery, so surgery will have to wait. Keira is due to make her arrival (March 18th) by c-section the day before my birthday. LOL. ..I'm flying up on my son's birthday, Keira will be born on the 18th, my birthday is the 19th, then will fly back home on the 30th - my daughter's birthday.

[hyperlexis]

And I'm inclined to agree - don't expect it to get me off of CPAP - and won't be disappointed at all if I remain.

I have a deviated septum (never knew!). I originally went to see an ENT to see if the polyp I know I have can be removed. He couldn't see the polyp because my right sinus is so blocked from the deviated septum. I am to go for a CT scan next week so that he can see the polyp. I have sinus infections A LOT - so there is a high probability (If I can get my nerve up - this surgery is scary for me) that I will have the septum repaired (I broke my nose when I was 7 years old) and have the polyp removed.

So, my question is this: Have you had this surgery? If you have had it, it at least improve your pressure to a lower pressure need with the CPAP? Did it work for you? If you had it done, would you do it again? Did it help you to breathe through your nose better? (Was it worth it?)

Thanks!

Yes, I have had the surgery. No polyps but septum problem, infections, thickened diseased sinus tissue, etc. Chronic sinus disease. They have to go in and essentially remove all the inflamed tissue in the sinus, which then later heals over, and cut larger sinus openings to allow better drainage. They used something called 'image guided surgery' with a special ct scan and magnetic surgical tools to make it more precise and safe during the operation. Ask if your ent does that.

It was all before I did cpap so I don't know if it made it better. But I felt my breathing improved a lot afterwards -- eventually got congested again (months/years later), but not as many infections now as before.

I recommend one thing: do NOT let them send you home afterwards, if at all possible. Ask for a minimum overnight stay, or a 23-hour admission which is counted as an outpatient stay. And get your insurance to pre-certify you before doing anything. Get the doctor to justify it with them if needed. You will be miserable and in pain afterwards and having the nurses do all the work giving you pain injections and food and ice, bandage changes, bathroom help, etc. will make things infinitely easier. I stayed and I got over it much easier than had I been sent straight home.

Good luck!

My biggest fear is bleeding to death as the head has sooooo many blood vessels that bleed like crazy . . . so an over night stay is something that I had already wanted to talk to my doc about - just to make sure I don't end up hemorrhaging. As far as care, though, my husband will be here, and he's wonderful with care when it's needed. He was wonderful with the last surgery I went through. So, going home as far as comfort is concerned, is actually my better choice. The other thing that I think about is all those super bugs that are in hospitals. Now the hospital I'll have this accomplished at is a brand new hospital, but I absolutely dread taking my cpap machine into any hospital. (Probably just being paranoid, but I don't want my stay to be in the hospital any longer than absolutely necessary for possible complication management.)

I'm glad you could breathe better after the surgery, that's very encouraging.

It's a bloody surgery because of all the tissue being curetted out and the surgeon will pack your nose with dressings, up into your sinuses. There will be dressings outside the nose that will be taped there and need to be changed when they get saturated. You will not be able to breathe through your nose, obviously. Bags of ice may be placed over your nose and eyes to keep the swelling and bruising down after the surgery. The next day or soon after the surgeon will see you and pull out the packing. Keep your eyes closed.

Regarding the hospital, yes, they have issues but the pros in this instance were well worth it to me. Especially having the pain medication intravenously which is much faster acting than pills, and less nauseating after a surgery when the anaesthesia and the blood dripping back into your throat and stomach will already make you nauseous enough. Plus, being fed, and helped to the bathroom, and having an adjustable bed that allowed me to keep my head up to reduce the swelling were also reasons to plan to stay. My ex had the surgery a few years later and absolutely insisted on recuperating at home and did so -- it was a mess that was regretted by all concerned.... Trust me you, and your spouse, will feel less miserable and less exhausted by having you cared for 24/7 by the pros. But everyone has to do what makes them comfortable. Good luck no matter what you do.

[Redonthehead]

I am fairly certain I have had OSA for many years but only in the last month gave up and now have a APAP. But 5 years ago I went in for a septoplasty and turbinate reduction as I was a mouth breather all my life. Doc said I would need to take a week off work.

A few hours after the surgery I went home. Pain medicine took care of me that evening. The next day I felt great except for the dull ache of having the nose completely packed. The next day I went back to my desk job and no one was the wiser. No big deal.

BUT, when the nurse pulled those giant plastic splints and packing out of my nose a week later, I immediately told them I could not breathe through the left side. lots of yadda yadda later, I am basically worse off than before the surgery. At various times of the day the right side is fairly good, but the left is always plugged.

I am now considering trying it again now with a new ENT, to be able to breathe through my nose all day and also use nasal pillows with the APAP rather than a leaky FF mask. Afrin temporarily makes everything better, so perhaps I can get by with just a turbinate reduction?

[poppi2]

. . .and my employers can't afford it either, as I'm the only one that can do my job. ...

Do not worry about your employers, even if family members. At some point in your career, you must do the right thing for number one, yourself.

I gave my all to a corporation for 28 years. They sold me to another company. In two years, I was sold again. Do you think any of those sob's give a flying fig about employee loyalty.

I urge you to do what is best for your health without any reluctance. Good luck, Earl

[tuzacat]

I had a deviated septum corrected in October. At the same time I also had the cartilage in my nose bolstered up in several places and openings widened on both sides. The pain was not as bad as I thought it was going to be. I had the surgery on a Monday and by the weekend I had stopped taking any pain meds at all. After the first couple of days I only took them as needed. The doctor put a splint on my nose which did not come off for a week. ( I pretty much slept for that week.) There was no packing in my nose just a bandage underneath to catch the blood. I was able to wear my glasses sort of perched on top of the splint which was a little problematic because of course I wasn't looking through the correct part of the lenses. After my follow up appointment I was able to use bipap. At the time I was using the Hybrid mask because I needed to mouth breathe. It was hard to breathe through my nose for several weeks but I had more procedures than you are thinking about having. I was out of work for two weeks. As soon as I could I switched to a nasal mask because it put less pressure on the places I had the cartilage added. I am still a little swollen and I still get some stitches coming out. I would do it again because I have noticed I can breathe better and I am tolerating bipap better. Last night I used the Swift FX for the first time in over a year and did not get all stopped up. I had a cold recently and was able to use my nasal mask and didn't have to switch to the Hybrid. Since I'm still in the healing process I'm hoping for further improvement.

Every one experiences pain differently and heals differently. I decided not to go bad to work for two weeks because the surgery and the drugs exhausted me and while I wasn't in a huge amount of pain by the second week I was not able to breathe well through my nose. Personally, I had the sick time and I felt I needed to do what I needed to do.

Good luck with whatever you decide to do!

[msla]

The next day or soon after the surgeon will see you and pull out the packing. Keep your eyes closed.

I remember that when the Dr took the packing out, he did not warn me or give me a Kleenex to cover my nose and mouth with, I let go with a large, vigorous, mucous laden sneeze. He scolded me for not covering up. The free breathing through my nose felt very nice.

[quietmorning]

My husband and I are currently talking about this surgery - and I told him that just about everyone here agrees that I should stay a night instead of the couple of hours after surgery. He asked me to please ask you what was the hardships your caretakers and you experienced when you or someone you know came home instead of staying? He said he doesn't see how it could be a hardship compared to other surgeries.

Hubby does better with black and white than he does with abstracts, so examples would be very welcomed. Thanks!

I have a question about balance - will my balance be effected?

At this point, I'm beginning to look forward to this instead of being so afraid of it. Your comments have really helped. THANK YOU!!

[49er]

Quietmorning,

You might want to take a look at this article:

http://www.sleepapnea.org/about-asaa/po ... rgery.html

General anesthesia suppresses upper airway muscle activity, and it may impair
breathing by allowing the airway to close. Anesthesia thus may increase the
number of and duration of sleep apnea episodes and may decrease arterial oxygen
saturation. Further, anesthesia inhibits arousals which would occur during
sleep. Attention to sleep apnea should continue into the post-operative period
because the lingering sedative and respiratory depressant effects of the
anesthetic can pose difficulty, as can some analgesics.

Given the nature of the disorder, it may be fitting to monitor sleep apnea
patients for several hours after the last dose of anesthesia and opioids or
other sedatives, longer than non-sleep apnea patients require and possibly
through one full natural sleep period. Hence there is concern that same-day
surgery (also known as out-patient or ambulatory surgery) may not be appropriate
for some sleep apnea surgery patients.

By the way, I am strongly considering having a septoplasty and turbinate reaction and plan to ask the 1st ENT or his nurse about the precautions that will be taken since I have sleep apnea. ENT I saw last year who wanted to do surgery before she realized I didn't have health insurance had mentioned keeping me overnight in the hospital. This guy didn't say anything about that and I would obviously like that clarified.

Anyway, besides the excellent points that Hyperlexis made, it might be vital to spend the night simply because our apnea presents extra surgical risks.

49er

[tuzacat]

Quietmorning, originally my ENT thought he would do the surgery at his outpatient center until he discovered I had apnea and how severe it was. So he scheduled for outpatient at the hospital. I did have to stay in the recovery room extra time because my oxygen level kept going down. They kept me until it stayed consistently up. When I got home I went right to bed. I didn't have any trouble walking or getting about but everyone is different and reacts to pain and medication differently. I slept sitting up until I was able to use the bipap machine which was a week after surgery.