Home already - Surgery this morning, 6/22/2010

[Skier757]

Hi forum,

I am leaving for my surgery in a few minutes. Having outpatient surgery to correct my septum, a concha bullosa, and turbanate reduction. While I was waiting to leave I came here to read a bit for comfort, you are all like a big family now.

I'll post again tonight when I am home and let you all know how it went.

Brooks, aka Skier757

[OceanGoingGal]

Prayers and good wishes for you.

Laura

[Skier757]

Hi Forum,

I am home now.

I have to say things went GREAT. I was very lucky with my surgeon, he does not use packing or splints. I'll share my experience for those who are thinking of this surgery.

Background:
I have had trouble breathing though my nose for as long as I can remember. After several years of sleep trouble, I was diagnosed with sleep apnea in Jan of 2009. I admit I was in total denial, and rather than go right to CPAP, I wanted to try to improve my breathing first. Before starting CPAP I underwent a year of allergy shots, and had a CT scan of my sinuses. My ENT, Dr Macaluso in Central PA is very conservative and despite seeing a large Concha Bullosa on the right, and a severely deviated septum, caused by the Concha pushing it over, he proposed waiting until I reached maintenance level with my allergy shots to see if that would give me enough relief before resorting to surgery. In Feb of this year, while I was breathing better, Dr Macaluso said to suck it up and go get titrated for CPAP. I was very lucky to end up with a great DME and a PR System One Auto and a Swift FX which had just come out the week before my titration study. While my first three months of CPAP went well, I was still having good and bad nights, my breathing was not great, and allergy season killed me making CPAP miserable. The Dr and I agreed that clearing up my breathing passage by correcting the Concha and the Deviated Septum along with a bi-lateral Turbanate reduction would allow me more room in my sinuses and give me some improved ability to deal with allergy seasons, as well as improve my CPAP efficacy.

Surgery:
The surgery was outpatient at the Pinnacle Health surgery center in Mechanicsburg PA. I have had several diagnostic procedures there so it was familiar territory to me. The staff is really nice and caring. When I arrived at 8:45 Am they checked me in and verified my medical history, medications, and they did ask about Sleep Apnea. Normally they would have had me bring my CPAP machine, they even have it printed in their patient material, but since I was having sinus surgery that was not needed, or possible. Once checked in I waited only a few minutes before being called back. First they weighed me and verified my height, I guess for the anesthesia. Then it was change into a hospital gown, open in back and nothing at all left on underneath. Then I was escorted to a curtained off area in the surgery staging area and I got on a gurney. First they verified all the same information all over again, and had me verify my date of birth, my surgeon, and the surgery I was having. Since I was having so many things at once they started saying, " septolasty and a lot of other stuff". They had me lay back on the gurney and started an IV. They hooked up heart monitors and a blood pressure cuff. Took my temperature and let the monitors do their thing. Then it was sit and wait with a warm blanket. Luckily I brought a magazine with me, because I learned the Dr was running 45 minutes behind and they already have you get there an hour early. After a while my Dr came by, he was in a great mood which reassured me. I was reading a Mountain Biking magazine, and he said. "hey, no biking for at least a week". He verified that I had not had anything by mouth after midnight, and that I had used Afrin in the morning per his instructions. He explained the procedure again, and said he did not plan to use any packing, but in very rare cases it might be necessary. He wrote a RX for pain meds, but said I should not need much and should switch to Motrin after 48 hours. He said I would have a fair amount of bleeding and drainage, and should use Simply Saline at least ten times per day until I see him next, and Afrin twice a day for a few days to help with the bleeding and swelling. No CPAP until my next appointment. After the Dr visited, I sat and read for an hour. Eventually I had to use the rest room, which was a hassle with the IV and monitor wires, but the wait, the IV, and my nervousness indicated it was time to go. They were cool with that, and soon every patient that as waiting asked to use the restroom. At 10:50 AM, the anesthesiologist came to see me. He again reviewed my medications, medical history, discussed the sleep apnea and asked if I was compliant with my machine use. Last he gave me an injection in my IV which he said would relax me and make anesthesia induction smoother. With that he pulled up the sides of the gurney. A few minutes later the OR nurse came by, verified my name and date of birth, and surgeon and surgery procedures again. I was still pretty with it, relaxed, but still fully aware of what was going on. We wheeled through the corridors to the OR, my Dr was waiting outside, texting on his blackberry of all things. I was asked to move over to the OR table, and lay down. The nurse then put on a new warm blanket, and then put a strap over my legs, which was a bit anxiety provoking, being strapped down so to speak. They put an arm board on the left side where my IV was and secured my hand to that as well. Then the nurse came over to my other side and leaned in, securing my other arm, and said she would just hold on to me while I went under. The Anestesiolgist had already put a mask on my face to give me Oxygen and asked me to take several deep breaths. He then said he was injecting some medication, and that it would be cold in my arm, and might burn a bit. It was very cold, but did not burn, and then that was it, I was out.

Recovery:
I woke up in the recovery room to another nurse telling me my surgery was all over. I was totally out of it, very woosie. BUT I could breath !! I was breathing through my nose better than I every have. I looked at the clock and it was exactly 12:00 noon, which made sense as I was told my surgery would be 45 minutes or so. I dosed on and off for 30 minutes before I started to feel like myself again. My wife was able to come back and wait with me in the recovery room. I had no pain at all initially when I woke up. My throat was soar, from the anesthesia tube, and my teeth started to hurt, but I had no pain at all in my sinuses or nose. In fact they did not even have anything under my nose, but gave me a box of tissues as I started to wake up and started to have some drainage and bleeding. After another 15 minutes they made a gauze mustache for me so I would not have to keep dabbing with the tissues. By 1:00 PM I was coherent enough to get dressed and head home. I still had no pain at the surgery sites. One unexpected thing was pain in my left calf. That troubled the nurse, she was concerned about a blood clot, but there was no swelling and no heat, so she let me go and said I should call them if it did not resolve this afternoon. The leg is feeling better sitting here, so I guess that was just a position thing as I was asleep. As I walked to the car, and on the ride home I had more bleeding. I have gone through several gauze pads. The more I move around, the more I bleed but sitting still writing this, I have not had to change my pad, so I guess the bleeding is really well controlled.

One interesting note on Sleep Apnea. When my wife came back, the nurse made a point of telling her and me, "You definitely have sleep apnea, and need to keep up with your treatment." She said she had to hold to stay with me and hold my chin up to keep my airway open until I was fully awake as I was having apneas as soon as I arrived in the recovery room. She said the anesthesiologist commented on it too, so he must have seen some apneas in the OR. In the future I will have to make sure I bring my CPAP to any future surgery or diagnostic test performed under sedation.

Well, it is about 3:00 Pm now, starting to have a dull ache in my sinuses, guess the local is wearing off, but still I feel really great, and can still breath well. SO far, I am totally satisfied, and I am really glad I went through with this.

I'll write more later,

Thanks for letting me share my story

Brooks. aka Skier757

Overall, I am stunned and surprised how well I feel this soon after surgery.

[mgrunk]

congrats on the surgery - I just had sinus surgery on Thursday (a revision from a previous surgery 4 years ago). Just make sure you keep up on the pain meds the first day - I only needed them on Thursday and Friday. And, be sure to keep using the sinus rinse religiously- it will keep the scabbing down so they don't have to work so hard to debride the area. And, expect that as the day wears on, you'll feel more congested - the Afrin wears off and the sinus passages do swell some more. I only needed Afrin for the first 3 days. I too didn't need packing or splints - yay! for not having to have that stuff removed - I think that was in part what make sinsus surgery so particularly painful. But, it gives you a great idea of what to expect congestion wise once everything is settled down. I had forgotten what it feels like to have air hit the back of my nose. Oh, and don't be surprised if you can't smell or taste, it generally clears pretty quickly. I could smell and taste immediately, but at day 4, I can't.

I wish I had known to complain about my sinus issues 15 years ago - I suffered needlessly for over a decade. I finally had surgery because my asthma had become difficult to manage.

[rosacer]

Hi Brooks

Thanks very much for the detailed information about your surgery. I'm very glad for you, that all was so nice, wish you a fast recovery as good and nice as your surgery was.

I really appreciate all the explanation you made about allergies and the purpose of the surgery. I have allergies too (smog, temperature changes, seasonal, etc) and a moderated deviated septum. Last night I wake up in the middle of the night with the sinuses stuff enough to kept me awake for 2 1/2 hours and need to change mask model.

I see this procedure could be used to fix my problem too as you Dr. suggest to you. Please let us know if the fact of enlarging your sinuses opening help you when the allergy season affects you.

Thanks, very very well explained, I appreciate a lot.

Take care an let us know how you are doing.

Rosie

[jazzer4]

So happy all went well.
Good post.
Susan

[cpapernewbie]

Brooks
congrats on your successful surgery and thank you for the Lessons Learnt

[Muse-Inc]

Thanks for posting the details. I might have to have this if my congestion issues continue without relief...I was pretty much dreading even thinking about it. I hope your good results continue.

[frh]

Skier, I stopped putting it off and made an appointment with an ENT doc for Thursday morning. I'm not sure if I would have been willing accept what I know he is going to recommend without reading your post. So I would like to add my thanks.

[PST]

Thanks for the post, Skier, and have a quick recovery. It is reassuring to hear how often your identity and the procedure to be performed were double checked. It sounds like both the surgeon and the anesthesiologist explained things clearly and understood sleep apnea and CPAP.

[Skier757]

Hi Forum,

Day one, and I am doing great. I did have an adventure at the ER last night, I put up a separate post on that. 'How to go in for sinus surgery, and come out with crutches'

With regard to my surgery, I am doing great. I have no pain at all. I only took two Tylenol this morning. My bleeding has stopped, and I only have drainage when I use the simply saline I hydrate my sinuses with every two hours. I am congested now, but it is only as bad as a really bad allergy day. I am so glad I had a day of clear breathing to let me know the surgery had worked.

The interesting part of my current breathing is that I can breath better out of the side of my nose that had been 99% blocked. I guess they did more work on the other side to remove the bone from the concha bullosa in addition to the turbanate and septum work. SO I can now breath out of the one side of my nose that I never could before, while my previously clear side is congested from the surgery trauma.

Still, I am very happy, and I know things will get better and better. To be in no pain with so little drainage after all they did in my sinuses is a miracle to me.

To anyone who is thinking about this surgery, if you have a great surgeon, and do it for the right reasons, I definitely recommend it. I am very satisfied so far.

Now, I am not so happy that they send me home from the surgery center with leg pain that ended up with me in the ER to check for a blood clot last night, but that is another story, and turns out to not have anything to do with my actual sinus work.

Thanks for the support, I'll let you know how I am doing from time to time as I continue to recover.

Brooks, aka skier757