Deviated Septum Surgery-"Nose Job"

[no1texan]

After 3 months of headaches, it appears the doctors have zeroed in on the source, i.e. my left nostril has a severe deviated septum blocking adequate breathing and drainage. I don't want to spend much time on this part of my question which has to do how to work through having my nose all stopped up with gauze or whatever they use and I have read about some people having a tube or something in their mouth. The procedure is usually done on an out patient basis, i.e. I go home after recovery. I am very concerned about my CPAP, do I try to use it as usual with my nose all plugged up and possibly my mouth? If I have the surgery, I am going to talk/ask my doctor if this could be done in the hospital where they can watch/monitor me at least for the first night. Cost is not an issue because my insurance will cover it if the doctor says it is necessary. For me, I believe it is necessary otherwise if I am at home and try to use the CPAP, something happens, better to be close to help instead of having to call an ambulance or driving.

Thanks for your thoughts/commenets. Anyone had this kind of surgery - how did you handle your CPAP?

[Wulfman...]

After 3 months of headaches, it appears the doctors have zeroed in on the source, i.e. my left nostril has a severe deviated septum blocking adequate breathing and drainage. I don't want to spend much time on this part of my question which has to do how to work through having my nose all stopped up with gauze or whatever they use and I have read about some people having a tube or something in their mouth. The procedure is usually done on an out patient basis, i.e. I go home after recovery. I am very concerned about my CPAP, do I try to use it as usual with my nose all plugged up and possibly my mouth? If I have the surgery, I am going to talk/ask my doctor if this could be done in the hospital where they can watch/monitor me at least for the first night. Cost is not an issue because my insurance will cover it if the doctor says it is necessary. For me, I believe it is necessary otherwise if I am at home and try to use the CPAP, something happens, better to be close to help instead of having to call an ambulance or driving.

Thanks for your thoughts/commenets. Anyone had this kind of surgery - how did you handle your CPAP?

Several others have had some of that type of surgery in the last few years.
I think you're going to need to plan on sleeping in a recliner and not using your CPAP for however long the doctor says you'll need to abstain from using it. Your nose will probably have some sort of "packing" in it and CPAP therapy will probably be out of the question for a period of time.


Den

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[LSAT]

After my septoplasty I was instructed to not use my CPAP for 5 days. I struggled with sleeping on a recliner without it for 3 days and then resumed the CPAP at a lower pressure. My nose was not stuffed with cotton, but I did have some bleeding.

[Okie bipap]

When I had mine done several years ago, they inserted splints in my nose after the surgery. I could actually breath better with the splints in than I could before the surgery. The splints came out about a week later and were removed very easily. I was not on cpap at the time of my surgery. In fact, it was part of the surgery I had done to keep from using cpap. the machines at that time (1996) were much larger and noisier than they are today. My job, at the time, required me to travel extensively and it would have hard to pack that large of a machine on an airplane. I was already carrying a nebulizer for my asthma.

[story1267]

I had a septoplasty and bilateral inferior turbinate reduction done 3/30/16. It was day surgery and I went home the same afternoon.

I also had splints rather than packing (packing is pretty old school so you should ask about that prior to surgery). I didn't use my CPAP for the first 2 nights but did sleep propped up on pillows.

After the 2nd night DH asked me if I planned to use the machine on night 3 - I was having events that disturbed his usually rock-like sleep.

I used my full face mask (AirFit F10) from night 3 until getting my splints out one week after surgery. That was definitely a struggle but better than nothing.

After getting the splints out I went right back to my DreamWear and am breathing freely...yay!

[49er]

Hi,

I had a septoplasty/turbinate reduction slightly over a year ago. Like you, I felt alot better being hospitalized overnight to be on the safe side. But in retrospect, I feel it was unnecessary and I would have done fine just going home to recuperate. Obviously, your mileage will vary and for what it is worth, I have moderate apnea.

Regarding using the machine, my surgeon gave me permission to use it right away since I told him was going to use the FitLife Total Face CPAP Mask due to it not touching the nasal area. I think he had me using it for about 10 days before he gave me permission to return to the Elan cloth nasal mask.

If your doctors says you will have to be off your machine for a certain number of days, you might want to ask if he would reconsider if you agree to use a full face mask that doesn't touch the nasal area.

My surgeon used splints and packed my nose the first night. Actually, it is probably a good thing he hospitalized me because it would have been a royal pain in the neck to have to return to his office the next day to get them out.

Best of luck.

49er

[McSleepy]

Actually, the problem with using your CPAP after septoplasty isn't as much in the mask touching your nose (after all, the cuts are inside the nose, not on the outside - it isn't a "nose job") but in the high pressure causing bleeding by expansion. Thus, even with a full-face mask, as long as your nose is not blocked and air can enter through it (not the case with the old "packing"), you should not be using the CPAP. Having said that, after my turbinate reductions I went on to use my CPAP (at 20 cm H2O) the same night, without any issues; then again, septoplasty is much more invasive, so I still would advise against it. However, you can certainly use a mouth mask, such as the Oracle 452 (ask JDS74, he knows all about it). I have one for backup and cases like this.
McSleepy

[Sir NoddinOff]

I had my nose done about two decades ago. They packed my nose and I subsequently tell everyone to avoid that if possible. It was a miserable six days.

[49er]

Actually, the problem with using your CPAP after septoplasty isn't as much in the mask touching your nose (after all, the cuts are inside the nose, not on the outside - it isn't a "nose job") but in the high pressure causing bleeding by expansion. Thus, even with a full-face mask, as long as your nose is not blocked and air can enter through it (not the case with the old "packing"), you should not be using the CPAP. Having said that, after my turbinate reductions I went on to use my CPAP (at 20 cm H2O) the same night, without any issues; then again, septoplasty is much more invasive, so I still would advise against it. However, you can certainly use a mouth mask, such as the Oracle 452 (ask JDS74, he knows all about it). I have one for backup and cases like this.
McSleepy

McSleepy,

I think my surgeon's reasoning was pressure on the nasal area in combination with the cpap pressure would disturb the surgical site. He knew I had to use a pressure of 14/10 because that is what my sleep doc wrote the prescription for when I asked to.

But interestingly when he finally gave me permission to go back to the nasal elan, he wanted me to run it at 11/7 for about three days which was below the 12/8 I was running it at. So who knows?

When I was looking through the long septoplasty thread, I saw many variations of what surgeons allowed which were it could be used right away vs. waiting two weeks. It sounds like there really isn't any rhyme or reason to what is a good practice regarding this issue.

[49er]

I had my nose done about two decades ago. They packed my nose and I subsequently tell everyone to avoid that if possible. It was a miserable six days.

Wow SNO, I had mine packed for one night and and any more days than that, I would not have been happy. Kudos to you for surviving that.

49er

[norestfortheweary]

I had to have the same thing about 2 years ago. Your Dr should use a splint in your nose that is small and sutured in place at the bottom of it. You will probably have some kind of gauze because your nose will drain a small amount for just a few days. It should NOT be packed tightly. The splint may make your nose drip because it is a foreign object. It feels a little weird but not horrible. I could not use my BiPAP for 3 weeks but I also had some excess tissue in my nose (turbinates) removed. You may not have to be off your CPAP that long, but you have to make sure everthing is healed before using your machine. Good luck Texan! From norestfortheweary. PS my surgery did work!

[SewTired]

When my sister had her surgery, she was instructed to sleep on her side for 5 or 7 days (I don't remember which) and not use her cpap. The advice depends on how serious your apnea is, so be sure to ask your doctor what you should do.

She is one of the few people that did not need the cpap after deviated septum surgery. She can't believe how little my cpap is. Her's was this monster thing that took up the entire nightstand.

[LET-UT]

I had Septoplasty surgery and turbinate reduction last Friday (6/3/16). It was done on an out-patient basis and I''ve slept in my recliner the last several nights as a "mouth-breather" I found that keeping a bottle of water near at hand has made it easier, but I still miss my cpap. . . enough so that I just called my surgeon to get "permission" to try sleeping with my cpap tonight. He warned me that I'm probably still to clogged up for a good experience, but said it's doubtful that I'll do any harm. It can't be much worse than the feeling of my tongue being made of stiff dry leather like it's been for the past three nights! My mask fits around my nose and doesn't put direct pressure on it so I'm not to worried. I use a Fisher & Paykel Icon machine and their Eason mask.

[chunkyfrog]

From the comments here, it appears there has been a fair amount of improvement in the procedure.