does surgery for deviated septum help?

stevej1234 wrote: ↑

Wed May 15, 2019 9:03 am

I would love to go forward with it, but I have a mortal fear of general anesthesia and fear of not waking up , and also fear of being unable to observe or react to what's happening to me. It has not helped reading more about it, since I understand now that general anesthesia is actually a medically induced coma, though a temporary, reversible one. Maybe.

Which sources have you been reading? Maybe the wrong sources? Here's an extract from a study published by Health and Human Services. Read the entire article, but the gems in there are:

...anesthesia-mortality risk has declined from about 1 death in 1000 anesthesia procedures in the 1940s to 1 in 10,000 in the 1970s and to 1 in 100,000 in the 1990s and early 2000s.

The rate of death is thought to be even lower presently. Also, note that the elderly (over 85) are skewing the mortality rate upward.

stevej1234 wrote: ↑

Wed May 15, 2019 9:03 am

I have a mortal fear

Get the surgeon to prescribe a sedative to take as soon as you arise on the day of the surgery. You could also visit a mental health counselor or even a hypnotist.

stevej1234 wrote: ↑

Wed May 15, 2019 9:03 am

I was diagnosed with moderate OSA in 2015 but have remained untreated for years since i cannot keep the mask on at night. I am more and more ever tired.

Not to scare you, but the effects of untreated OSA are much more likely to kill you prematurely than the anesthesia/surgical procedure.

I hope to hear soon that you have overcome the irrational fears and have excellent results from the surgery.

Thanks. I had a ENT appointment where I agreed to the turbinate resection alone (10 minute office procedure), but I declined to set a date once I got the call that my insurance approved it. I was thinking of taking an anxiolytic not just for the day of surgery, but for the call where I must set the date , and especially for the office visit where I agree to the operation. And maybe gather some people to go with me who I would be embarrassed in front of if I turned back to run the other way.

mrcrayola wrote: ↑

Sat Jun 09, 2018 9:23 am

I'm contemplating getting a septoplasty, but my primary doc says that it's likely any benefits will be short-lived, because the cartilage and nasal tissues will shift back into the previous position. Bummer.

Consult an ENT. I had a deviated septum, and my left side was completely blocked. I had the septoplasty done 19 years ago, and a second surgery a year later finished the cleanup of my sinuses.
I've had no issue with my nose trying to revert to its old shape... that sounds very questionable indeed.

That said, I do have reduced ciliary function due to the years that my sinuses were completely blocked.
I do a daily nasal wash with a neti pot and will likely continue that for the rest of my life.
It only takes 15 minutes a day, though, and keeps me healthy, along with walking, sensible eating and all the other things that help maintain a healthy lifestyle.

stevej1234 wrote: ↑

Wed May 15, 2019 12:56 pm

Thanks. I had a ENT appointment where I agreed to the turbinate resection alone (10 minute office procedure), but I declined to set a date once I got the call that my insurance approved it. I was thinking of taking an anxiolytic not just for the day of surgery, but for the call where I must set the date , and especially for the office visit where I agree to the operation. And maybe gather some people to go with me who I would be embarrassed in front of if I turned back to run the other way.

I can relate to your fears. It is not easy to overcome them, and hearing all the rational reasoning is not helping since fears are not rational. If you can find a good counselor, it be great. Otherwise, think of general anesthesia this way: not as a coma, not as sleep, but more like a temporary suspension of your physiological functions. It is not exactly that but it is close - just listen to all the people having had GA, explaining it as "I fell asleep, and then immediately woke up... and it was all over!" For example, even though most people list their main fear as "not waking up", it's rather what's being done to their body while under: your consciousnesses and awareness are being suppressed and you're being "cut up" at will, and you're helpless. Even worse - all those fears about unintended intra-operative awareness. But with today's techniques the source of that is all but eliminated - your mind is simply slowed down to a halt (unlike sleep!) and you are simply not recording whatever may be happening to you at that time; it's like it never happened! But only a good therapist could find the exact source of your fears and help you overcome them. Before my first surgery, I was much like you. I did hypnotherapy and other counselling (not good ones!) and it only made it worse; I took sedatives and anti-anxiety medications - the whole work-up made it much worse. I suffered from its effects months and years after the surgery. Then I slowly started realizing what it's all about and eventually completely overcame my fears. Last October I had another surgery and it was a walk in the park. I'm also approaching my septoplasty/turbinectomy two weeks from tomorrow with complete confidence and calmness. The mysterious ways of the human mind!

McSleepy

Nice reply. I would like to know how it goes for you. Do you think this operation could eliminate someone's need for FLONASE, or does it depend? My ENT suggests the answer is yes. Flonase gives me dry mouth which is awful. I also have another med to help dry mouth when its especially annoying.

stevej1234 wrote: ↑

Fri May 17, 2019 9:28 am

Do you think this operation could eliminate someone's need for FLONASE, or does it depend? My ENT suggests the answer is yes.

What is the condition of your turbinates? Normal or chronically enlarged?

Do you have nasal allergies?

Flonase is used to treat nasal allergies and reduce the swelling of tissues. It will not treat a deviated septum per se.

What I am getting at, it sounds like you have something going on in the nasal passages besides a deviated septum. Eh?

Yeah. My turbinates show as enlarged/inflamed so the spray helps a bit. I think my GERD is contributing as I understand that stomach acid can get up to the nasal passages, particularly as a result of eating late which I am often guilty of.

I guess the idea is that treating septum would make more space for the airway despite enlarged tissues surrounding it.

stevej1234 wrote: ↑

Fri May 17, 2019 10:41 am

Yeah. My turbinates show as enlarged/inflamed so the spray helps a bit.

But, your ENT is not recommending turbinate reduction surgery? They normally only do it if the turbinates are permanently enlarged. If the spray reduces the turbinate swelling, surgery is not necessary.

stevej1234 wrote: ↑

Fri May 17, 2019 10:41 am

I think my GERD is contributing as I understand that stomach acid can get up to the nasal passages, particularly as a result of eating late which I am often guilty of.

Do you have the head of your bed slightly elevated? It can be a big help. Blocks of height three to four inches can be made or Bed, Bath & Beyond and other stores sell them.

There is some good information on reflux at Mayo Clinic's website - https://www.mayoclinic.org/diseases-con ... c-20361940

Yes to both questions, though I don't notice a difference by elevating the bed.

stevej1234 wrote: ↑

Fri May 17, 2019 9:28 am

Nice reply. I would like to know how it goes for you. Do you think this operation could eliminate someone's need for FLONASE, or does it depend? My ENT suggests the answer is yes. Flonase gives me dry mouth which is awful. I also have another med to help dry mouth when its especially annoying.

I will report after my surgery. I am currently on Fluticasone and Azelastine, and not because I have allergies (I don't), but - based on the recommendations of my previous ENT - because those drugs have anti-inflammatory effects that help shrink the soft tissue around the turbinates and the lining of the nose. It's not much but it helps. Of course, I'd like to get off of those medications, if I can. If my airways are significantly larger after the surgery, I see no reason why I wouldn't be able to do that.

I have a question for those who have had the surgery. Yesterday I had the pre-op visit with my surgeon and there is one thing he said that worried me. He said that I should avoid putting any pressure on the base of the nose - not just during the recovery process, but forever, as that could case the septum to deviate again. It took me a while to process this, so I didn't think of asking him, but I will after one of my future visits. But, I'd like to hear members here who have had the surgery - what kind of masks do you use and in what position do you sleep? Especially those on the nasal-pillow masks as most other masks shield the base of the septum. I don't know if anyone here is quite in my situation, where I use a rigid mask (the Breeze) and sleep face-down, so often I find myself with the mask planted to my face. Granted, most of the effort falls on the upper jaw, not the septum, and my obstruction is mostly turbinates, not the septum, but it is still concerning. I will have to find out after the surgery, but I don't know that I could retrain myself to sleep in other positions, after so many years (my whole life). Soft nasal-pillow masks, like the Dreamwear, would not be a problem, but I just couldn't keep it on my nose. Maybe after the surgery I'd be able to lower the pressure enough to make a difference.

McSleepy

I read many surgeons will pack your nose with gauze to keep the tissues together after the procedure for healing. However, some do a quilting technique with dissolvable sutures that eliminates the need for packing. Do you know which one you're getting?

stevej1234 wrote: ↑

Fri May 17, 2019 2:13 pm

I read many surgeons will pack your nose with gauze to keep the tissues together after the procedure for healing. However, some do a quilting technique with dissolvable sutures that eliminates the need for packing. Do you know which one you're getting?

My surgeon did neither.

He used "Doyle Splints" AKA "Shark Nasal Splints", one for each nasal passage with a suture to keep them in place. They have a "Shark fin" side to keep the nasal/septum in place and a tube that allows you to still breath.

They stay in for a week to 10 days.

stevej1234 wrote: ↑

Fri May 17, 2019 2:13 pm

I read many surgeons will pack your nose with gauze

I believe that is very old information. Gramps had his surgery about 15 years ago. The doc used splints. The splints were taken out three days after the surgery.

McSleepy wrote: ↑

Fri May 17, 2019 1:54 pm

But, I'd like to hear members here who have had the surgery - what kind of masks do you use and in what position do you sleep?

Gramps uses nasal pillows and is all over the place in the bed. Back, sides, stomach. On the stomach, he turns his head to the side as anyone should.

He's also rough on his nose in general (I'll spare you the details.).

YMMV.

I had my surgery in August 2017 (septoplasty and turbinate reduction). I was diagnosed in November and started on CPAP January 2018. My doctor used splints, not gauze packing. I was amazed to find that I could breathe better than I could ever remember immediately after surgery! The splints remained in place for at least a week ( I don't remember exactly. I am a side/stomach sleeper and finally have found a mask I can use, the Bleep. Before that, I used the PilairoQ, which I "settled for" after trying over a dozen masks and giving up on them for one reason or another. The PilairoQ was the lesser of all evils. The Bleep works well for me, solves a lot of issues I had. And I am STILL able to breathe, through both sides...it's a great feeling!

stevej1234 wrote: ↑

Fri May 17, 2019 2:13 pm

I read many surgeons will pack your nose with gauze to keep the tissues together after the procedure for healing. However, some do a quilting technique with dissolvable sutures that eliminates the need for packing. Do you know which one you're getting?

He said splints with channels inside that are sutured and removed 6 days later (when my post-op is scheduled).

Thank you, all, for responding! This morning I once again woke up with my nose buried in the mattress... We'll see how it goes.

McSleepy