Skip ahead if you don't like details about people get their faces cut open. Or at least me getting my face cut open. I dunno. People have asked me to describe the procedure and what helped/didn't help so this is that.
On May 12th, at about noon, I got a septoplasty and a turbinoplasty to fix my severely deviated septum and let me breathe again. I wanted it done before we moved in June, and I'd been trying to have this procedure for over two years now. Here's a good image of the inside of your face. If it's normal. Which mine is not. But anyway, you can see that you have three sets of turbinates and one septum.
Here's a good image of what a normal septum looks like, and a deviated septum.
So a septoplasty is a procedure where you have the septum partly removed (if it is too damaged to save), or straightened. A turbinoplasty reduces the size of the turbinates inside your nose. I'm not going to go into details because 1) I don't want to and 2) Just google it but it is gross to watch - FYI
To start with, a lot of people told me how they got these procedures done and they regretted it and everything was awful. So, that was fun to hear. You know, when someone tells you that they are getting elective surgery to fix a longstanding and painful problem and that they will now have the chance to breathe normally for the first time in living memory, you don't say how terrible their choices are. C'mon, humans.
When I saw my ENT (Ear, Nose and Throat Dr.) he ordered a CAT Scan to make sure everything was where it should be and so forth. It was, so he booked me for four weeks in the future. Four weeks was good! Very soon! Woohoo! I started making preparations. Here's what I bought/did:
Vaseline Healing Jelly with Cocoa Butter - For keeping my lips and nostrils moist, since I would be breathing out of my mouth alone and my lips would chap, and I would be bleeding continuously from my nose so I figured my nostrils would chap.
Arnica Cream - For helping with swelling and bruising. I bought A535 Brand. I think that's also for muscle soreness, which actually also applied for this situation so hurrah for multitasking.
I had flexible cooling pads in the fridge, and also clean, wet washcloths kept cold, too.
A HydraSense Neti Rinse with an extra package of saline powder. Enough to wash out that nose for days and daaaaays on end.
Extra Strength Advil and Acetominophen, just in case one was better than another. I tend to be an Advil person, but doctors always seem to suggest Tylenol, so better to be prepared.
I already owned a humidifier - A Sunbeam brand warm mist one. I sterilized it and set it up.
A comfortable recliner I could sleep upright in.
I also boiled a big jug of water for 10 minutes and let it cool for my Neti Rinse kit.
The week before the procedure I stopped taking all my medications that might affect the surgery, and the night before I took the last dose of the steroid spray I've been using for years to let me inhale through my nose. I fasted from midnight the night before - from food and liquid. And the day of I only took my two inhalers for my asthma - my maintenance inhaler that I take twice a day anyway, and then a shot of my Ventalin emergency inhaler just to make my lungs especially open for intubation. I also bathed very thoroughly and did not use any lotions, creams, hair products, anything afterwards. I didn't wear my glasses or any jewelry or makeup. I also took two Covid tests - one 5 days before, and one 2 days before. Just to be especially safe.
My surgery was scheduled for 12:15. I was asked to arrive at 10am. I was asked all the usual Covid screening questions, sterilized my hands, and switched my fabric mask for a new surgical mask. Then I went to day surgery and signed in. I waited for maybe ten minutes before the nurse took me back to the change rooms, asked me the Covid screening questions again, gave me a hospital gown to change into and a robe to put overtop and booties. I put all of my clothing into labeled, sealed bags and she put them in a locker. I had also brought my insurance card and a baggie with all my prescription medications. And a book. Everything but the book went into the locker. Then I went back out to the waiting room with all the other people sitting around in pjs to be called back.
After about 30 minutes or so they called me back to the triage nurse. She asked me all the Covid screening questions yet again, verified all of my registration info, weighed me, measured me, took my blood pressure, temperature and heart rate, made a detailed list of medications again, and then led me to the day surgery ward. That had me go to the bathroom again, and then got me into a bed. I was there for maybe 15 minutes and then a nurse arrived and we started The Great IV Debacle.
I hate hand IVs. Hate them. My veins are very deep inside my body and it never ever goes well. So first we tried the left hand, and it HUUURT and then the we blew the vein. So that didn't go well. So then we tried the right hand and she gave me a shot of Lidocaine first and that did almost nothing but there was a lot of rummaging around with the needle (I assume. This is what it felt like but I sure the heck wasn't watching.) And eventually it went in a vein and stayed in the vein and Hallelujah that was over.
The anaesthetist came in and asked me a bunch of questions. The ENT came in, we said hello, he went off to do his thing, everyone left. Then the anaesthetist came back, handed me a few warmed blankets and had me walk with him to the theatre. I walked in and put the blankets on the bed and took off my robe but kept on my gown, but undid it. Then I laid down on the bed and they put one heated blanket over my body and another under my calves and raised my legs slightly. There was the anaesthetist, two nurses, and the surgeon in the room. They had me spread out my arms on the table and hooked my IV up to a saline bag.
I commented that I felt a little light-headed and the anaesthetist laughed and said that was because he had slipped me a little something when I wasn't looking. I assume this was standard because I certainly wasn't nervous or anything and in need of 'calming'. Then the nurse put an oxygen mask on my face. I breathed deeply through my mouth - it was just oxygen. Then they said 'okay, we're all ready now Amy.' and I said 'okay, bye.' and then that was it.
My understanding was that the surgery lasted between 30-45 minutes.
I woke up in a different bed, with my head raised, in a curtained off room with a nurse. She said "Hello!" and beyond that I don't remember much of our initial conversation. As I woke up I was in a lot of different kinds of pain. The nurse explained that my neck and shoulders hurt because they position you oddly for surgery. My jaw and throat hurt because of the intubation. And I had my standard level of facial migraine pain through my teeth, cheeks, eyes and forehead. I'm used to that particular pain but if you aren't that would be something to remember. And then of course my nose hurt quite a bit. It was about a 6-7 on the pain scale. Very, very sore, but not agony or anything. I really wanted pain medication, but I was not in a panic over getting it, if that gives you any idea. I said I hurt, and the nurse gave me Fentanyl in my IV and two of...something. I think they were Advil. I think. I'm not sure, though. But they were either Advil or Tylenol. I also got some ice chips and then a glass of ginger ale. I was in that room for just under an hour or so.
My oxygen levels kept dropping and the nurse was worried about this, so I went on and off an oxygen mask for a while. This might have had something to do with the Fentanyl, since I'm really not great with drugs, but eventually everything stabilized enough to move me from the post-surgery recovery room, back to the same day surgery ward I had started from. I was wheeled there in my bed, but I could get out of bed and into the new bed on my own. My IV was detached but the port stayed in my hand at this point. I was awake but still groggy and woozy and I had some more ice chips. I also got up and went to the bathroom. The nurse shadowed me on the way there, but I walked back on my own. And my second bathroom trip was entirely solo. They changed my bandages under my nose, and someone helped me to get dressed because I was not allowed to lower my head. At this point my pain was probably about a 4. At about 4:30 (so 2 and a half hours or so) after arriving in the ward, they gave me my prescription sheet from the doctor, had me sign my release paperwork, called my husband to tell him I was released, and called a porter. The porter wheeled me in a wheelchair to the door of my car, and David helped me in.
On the way home the pain kept going down, and by the time I was home it was at about 1-2, and remained at that level until 4:30 the next morning, when it went up to about a 3-4 again, and I took 2 extra strength Tylenol. I had been prescribed some Tylenol with codeine but I didn't need any.
I probably went to the bathroom ten or so times in the first few hours, as my body flushed out the saline solution and all the extra fluid I was drinking to help my throat. Although honestly my throat wasn't that bad after the first few swallows. By the following morning it was essentially back to normal. I used my cooling packs on my face and ran the humidifier constantly beside my recliner - where I also slept. It was fine.
The most challenging part of the recovery BY FAR was the nose packing. So, my nose was entirely packed with what were essentially tampons, the strings of which were taped to my face. And then under my nose was extra gauze taped to my face to catch the blood that flowed constantly out of my nose. The tampons (they weren't called this, but let's be real here...they were tampons) were there to provide structure and support to the surgical site and also slow the blood flow and give pressure to the wounds. But they didn't stop the bleeding by any stretch of the imagination. I bled out of my nostrils and also out of the back of my throat, and there was even dried blood from my eyes. It was all just blood everywhere. I scared the children. Anyway, the packing made you feel very suffocated and I did have a bit of anxiety around this sensation, as I had been warned. I had been told not to be clearing the clots from your nose, but the large blood clots flowed down the back of my throat so I spit them out anyway. But technically the rules were not to try and clear your throat or nose.
The nose packing also prevented you from tasting your food, so everything was very bland. And you couldn't move your face normally to chew or breathe while you ate, and I could only open my mouth an inch or so, so I would NOT suggest trying to eat food in FRONT of OTHER PEOPLE. Maybe wear a bib and take very tiny bites. In short, I was allowed to eat whatever I liked, but actually it was very challenging to do so. Also, I did attempt fizzy drinks and they hurt so I didn't do that again. Parts of the inside of my mouth were also numb, specifically behind my top front teeth. I assumed this was temporary nerve damage from the surgery, which was expected and would resolve itself.
Day 2
The first night was a bit restless, and I had one episode of post-anaesthetic shaking, which resolved in a few minutes. But I woke up clear-headed and feeling good about the day. I took another 2 extra strength Tylenol in the morning and spent all day sitting in the chair, trying to drink lots of water and breathe the humid air. I was sore and uncomfortable, but not in pain, and I used my ice packs a lot. This day I started to sneeze a lot, which increased the pressure in my nose and I had to sneeze out of my mouth. Despite doing my best not to sneeze out my nose, I still managed to force a lot of thick, bloody mucous out of my nostrils. I wasn't supposed to touch inside my nose at all (not that I really could, what with the tampons) but I did clean up with gentle dabbing and careful and judicious use of a warm, wet cotton swab. I also found myself coughing up quite a bit to clear my lungs, which I expected and was pleased to see.
I managed lunch, which I ate by not chewing, and took some more Tylenol. I dozed a bit. In the late afternoon the swelling and discomfort had really gone up, so I finally broke and took a Tylenol with codeine. I also brushed my teeth, which wasn't as easy as you'd think when you can't open your mouth, and took a bath and put on clean pjs. I knew Day 2 would be worse than Day 1, and it was. The pain was around a 4 for much of the day, and I coughed and sneezed constantly. While the active bleeding was essentially over, there was a lot of mucus and clotting going on. I went through a lot of under the nose bandaging. Day 2 was when I started counting down the hours before I could take out the nasal packing. The Tylenol with codeine did almost nothing for my pain, so I took two extra strength Advil before falling asleep at around midnight.
Day 3
Unlike the first night of broken sleep, I had six straight hours on the second night and woke up really refreshed. I also woke up looking like a spittle bug because oh my land can your body ever produce a lot of face liquid after surgery. I will spare you the details but man. Maaaaaaaaan. I sounded a lot better, though, and could open my mouth about halfway now. My throat was back to being a bit sore, but the bleeding had essentially stopped completely and I started giving myself time 'off' without the gauze on my face, which was nice. Around 10am I needed 2 extra strength Advil again, mostly to manage the nerve pain in my teeth, upper lip and palate, and the slightly sore throat. I should point out that the soreness of my throat at this point was likely more due to increased coughing to clear my lungs and all the breathing through my mouth.
I didn't need to sleep as much today, but did nap for an hour in the afternoon. I went and stood in the sunshine outside again, ate well, had another bath, and generally tried to take care of myself and rest. My sneezing was still happening, but not quite as much. My front teeth and palate hurt more, and I looked it up and found that it was a very common side effect to the septoplasty. I took two more Advil around 4:30pm. I was sore again by about 10pm, but didn't want to take more medication, so I used my cold packs on my face. By the evening I could open my mouth about 3/4 of the way.
Overnight things were hard. The pain in my teeth/mouth/jaw/throat was stronger - up to about a 3-4. I ended up taking 2 more Advil around 1:30 am after 90 minutes or so of restless sleep. The pain never really went away but I did fall asleep again after 3am.
Day 4
Very excited to remove my nasal packing today! The hospital had told me to wait 72 hours, and I timed that off of surgery start time, which was somewhere around noon on Wednesday. Therefore, noon on Saturday I could remove it. I couldn't wait that long, though, so pretty much first thing in the morning, around 7am, I removed it. Here's how that went!
The nurse in the hospital told me that I should stand in the shower for a few minutes to steam everything and make it all soft, so I did that. There were two strings attached to the bridge of my nose by a piece of tape. When the tape was removed the strings would dangle out of my nostrils. They were attached to the aforementioned 'nose tampons'. I was supposed to slowly pull the string and the packing would slide out. I had to do this IN the shower. My two worries about the removal process were as follows:
1) What if the string broke and I had to try and rummage around in there and that sounds horrible.
2) What if the movement disturbs scabs or something and I start bleeding heavily again?
Removing the packing did not hurt at all, although it was a little uncomfortable. They slid very easily out and there was no blood at all. I debated whether it was better to pull them both out or one at a time, and opted for one at a time, with the right one first since my septum was deviated to the left and I figured that one would be the worst to take out. But honestly they were both fine. I also mixed up a bottle of saline solution in my Neti Rinse bottle with some purified water, and brought that into the shower with me. After I took out both nostril packing things, I thoroughly rinsed my nose and sinuses out with the sterile saline. I was gentle, and I didn't want to disturb any scabbing - only a small amount of mucus came out.
After my nose was all cleaned out, I could breathe right away. I mixed up another Neti Rinse bottle and used that over the sink, and then I used cotton swabs to very carefully wipe the outside of my nostrils of anything that came out. You can't blow your nose or pick anything out or in any way go into your nostrils afterwards, so this was my only real solution for cleaning it out.
I took especial care on this third day after surgery do not do anything too physically demanding because I didn't want my bleeding to resume. I also continued throughout the day to wash out my sinuses with the NetiRinse and to use the Vaseline around my nostrils.
- I'll stop here, and update later about the remainder of week one. -
