Sinus Surgery Tips and Tricks
September 3, 2014 9:22 AM   Subscribe

In seven weeks, I'm having sinus surgery that *fingers crossed* will finally allow me to breathe! It's going to be a septoplasty (to correct a deviated septum that includes a (free bonus!) bone spur) and a submucous inferior turbanite reduction. I'm very excited and have waited a long time for this. If you've had either of these corrections before, please tell me about your experience.

-- What should I expect in terms of the experience of the surgery itself, and in terms of recovery?

-- How should I prepare?

-- Do you have any tips for making recovery easier or faster?

-- Did have this kind of surgery affect your nasal allergies or chronic rhinitis, and if so, how? (Sinus rinses are very difficult for me to use, pre-surgery, because of the way my sinuses are structured, but I should be able to use them post surgery. Right now I try to control this through gargling salt water and OTC anti-histamines).

-- What does *breathing freely* feel like and when should I hope to be able to do it?!

Basically, my sinus anatomy is just incredibly messed up. Happily, though, the actual sinuses are pretty healthy, just built wrong, and correcting things like my ludicrously asymmetrical septum will *touch wood* finally allow me to breathe freely. Both the ENT who is doing my surgery and the ENT who I got my second opinion from (just in case!) think that I'm an excellent candidate for the surgery and that it will make a big difference in my breathing and therefore in my quality of life.

Also, I haven't had a sense of smell since before I can remember, and my ENT thinks that it may be because my sinuses are so convoluted/my nose so non-functional that the chemicals that compose smells aren't able to work their way through my sinuses to get to my olfactory nerve -- but that my olfactory nerve itself seems healthy. So maybe I'll be getting a sense of smell, too?! Has anyone ever gained a sense of smell as an adult after a lifetime of...uh, being a non-smeller?

My ENT is great and I trust her. She's also been very communicative with me about what's going on with my sinuses and what recovery from the surgery will be like -- but, of course, she's got a doctor's rather than a patient's point of view. Please let me know what undergoing sinus surgery is like, as the patient! And how to make the experience better, or at least as pain-free and fast as possible. EXTRANEOUS DETAIL WELCOME.

*I've read all the previous questions about sinus surgery that I could find, and they've by and large been very helpful, but they have tended to either be very general and touching on all aspects of all sinus surgeries, more than five years old, or very specific and focused, for example, on one post-op symptom that the Asker is experiencing, etc.

*Request: please don't mention Empty Nose Syndrome. It's frightening and horrible but I have gone over this risk and made the educated decision that surgery is still my best option.
posted by rue72 to Health & Fitness (18 answers total) 7 users marked this as a favorite
Best answer: The surgery itself wasn't bad. The recovery was initially a little rough (the pain over the first 1-3 days was medium to high), but got easier quickly, especially with painkillers at the ready. I recommend buying a lot of gauze and skin-soft tape (such as Medipore) in advance. Soft foods such as soups and puddings are good to have stocked up, too.

Go to your follow-up appointments. I was irresponsible and missed one and my results probably suffered a bit.

Be prepared for grossness during healing. I coughed out blood clots, was constantly dripping out blood and mucus from my nostrils, and was generally gross-ish to be around for a week. You'll want to keep a gauze sling taped below your nose for most of the recovery, to catch any fluids.

I can breathe easier now, though I still occasionally deal with postnasal drip. I have not had a sinus infection since, though, and I snore a lot less. I am happy I got it done.
posted by rachaelfaith at 9:32 AM on September 3, 2014

Best answer: I had a septoplasty, rhinoplasty, turbinate reduction, and tonsillectomy all in one morning. I was told that my nose was essentially demolished and rebuilt. Good times.

Experience: Your standard hospital surgical thing. A lot of questionnaires, strangers fussing over you and poking you. At some point they will get you onto a table, the Versed will sneak into your veins and *bink* into the darkness you go. You will probably wake up with no sense of time having elapsed. Then more strangers will make sure you have more cognitive function than a three year old on too much cough syrup, making you wait and wait, and then out you go. You can cut this time short if you can irritatedly juggle three items in the recovery room, but only if you could juggle beforehand.

You will probably have a wee plastic splint way up in your nose, which will be a bit numb for a while. You won't notice the splint, honest, because you'll be too busy noticing all of the gauze jammed up in there. The whole schnozz will be tender for quite some time. Avoid bopping it or allowing others (small children with flaily hands) to bop. Perhaps a month.

Preparation: If you drink caffeine, lay in a bunch of those little cannisters of Starbucks in a mini-fridge, which will also be stocked with bottles of water and some sort of watered-down Powerade of a non-acidy flavor which is not red-colored. Stock snacks. Pudding, etc. Completely minimal preparation stuff. Lay in some fiber pills if opiates tend to stop you up.

Buy a humidifier for your bedroom and many, many gallons of distilled water. I think this was more helpful for the tonsillectomy than anything else, but essentially you have a lot of traumatized tissues in your airway which would like to be kept nice and moist. The more you keep them moist, the happier they will be. Happy tissues are fast-healing tissues less likely to whine about how things hurt.

Find some towels you do not like. You may be producing a variety of noisome fluids. Aim them into the towels. You didn't like them, anyway.

Buy a bedrest pillow, where you can sit up. You can kind of fold over it and hang your head, then drip whatever you need to drip into the towels. Aren't they nasty?

Find a not-particularly-challenging television show to marathon while you drool and drip.

Aiding recovery: Water, water, water. Liquids. Broth. I took the painkillers only three times because they made me feel ... dry. I just dealt with the pain.

Don't do shit. Do all of your shit before the surgery. Anyone who wants you to do shit can piss off, that includes yourself. Just allow yourself to completely zone out and recuperate. At some point you will feel antsy and restless: that's when you have some energy coming back. You will then have the foolish notion to Accomplish Things, but instead you will end up accomplishing a shower and maybe dragging out the trash, after which you will be bushed.

Take a shower, at least once a day. You'll feel nice. Twice is nicer. Fresh clothes all the way around. As you look in the mirror after your shower, brushing your hair back into place, repeat the mantra: "I ain't doin' shit today." Deodorant is a good idea.

Breathing: They won't take the plastic split out until a week later or so and then the oxygen hits. It will be like being high. Really high. Glorious blasts of fresh air will course over your tender, newly configured sinuses and, properly moistened, launch into your lungs. You will feel like someone just hit the Turbo button on the dash. Vroom vroom.

You're going to be able to not be a mouthbreather. This is exciting but takes practice. Previously, had someone put duct tape over my mouth, I'd have suffocated in short order, but no longer. Bonus: it makes you look smarter. Like, glasses-level smarter.

My already sharp sense of smell got better afterwards. I had the whole "one nostril, intermittently" thing going on and now ... lots of things to sniff.
posted by adipocere at 9:52 AM on September 3, 2014 [14 favorites]

Best answer: I had a turbinate reduction on one side a few years ago. The results for me were a little underwhelming but the experience itself was not bad. I have a somewhat deviated septum and they tried this first.

Basically the surgery was not a big deal. It's like other surgeries, pretty mellow if you let it be with the standard problems that you have to go a whole day without eating, drinking coffee, etc. I was lucky and did not come home with packing or a splint so I just had a piece of tape under my nose and pain that required painkillers for only about a day. Be super on top of things with medicines. I was put on steroids (for healing) and antibiotics (for non-infections) and neti-potting (for keeping things moving and moist). The steroids made me feel sort of HULK SMASH a lot of the time and gave me a moon face. The neti pot helped me expel huge clots of ooze from my nose, super gross. I had very little post-surgical bleeding. If you wind up with more than light spotting, go back to the doc and they can sort it out but know that it is not normal. Bloody snots: normal. Free-flowing blood: not normal. I have a slide show of the gross ick that came out of my nose, it was so fascinating.

I went back to the doc every month and he would pull more stuck mucus out of my nose. Every time I went back I would still be all "This does not feel totally better yet" and he'd be like "oh keep waiting..." and eventually I stopped going back. So, I have not had a sinus infection since I got the reduction but I still don't have full function back in that side of my nose (I have better function than before the surgery) and will probably have to go back and get my septum fixed. Really the worst part was just general surgical anxiety and dealing with my doctor's flakey office and staff. The rest of it was very textbook and not bad at all. I watched some of the surgeries of this sort of thing on YouTube and it helped put my mind at ease. If you don't find that stuff totally awful it might help.
posted by jessamyn at 10:06 AM on September 3, 2014 [2 favorites]

I had surgery to correct a deviated septum about 10 years ago - I agree with rachaelfaith on this:
The surgery itself wasn't bad. The recovery was initially a little rough (the pain over the first 1-3 days was medium to high), but got easier quickly, especially with painkillers at the ready. I recommend buying a lot of gauze and skin-soft tape (such as Medipore) in advance. Soft foods such as soups and puddings are good to have stocked up, too.
I didn't have much of a change in allergies or snoring, but I no longer get nosebleeds, which happened on a regular basis before the surgery. I definitely get less sinus infections, too.

I had a bad reaction to the anaesthetic, which translated into extreme nausea when I woke up after the procedure... but that went away pretty quickly.

My Dr. left actual gauze in my nose to stop the bleeding after the surgery (I think that there are better solutions, like dissolving pads, etc now, but he was a much older guy that didn't know or care about these), so in my case the absolute worst part of the whole thing was the follow-up appointment to have that removed.

I guess my Dr. was a "yank the band-aid quick" kind of guy, because that's what he did with the yard+ of gauze that was packed, dried and crusted into my tender nasal passages. That hurt a LOT. I saw a white-hot flash in the ensuing burst of what was, literally, the worst pain I've encountered in my life, and when it faded I realized that I had unconsciously cocked my arm back, ready to K.O. the white-haired, 80+ year-old department head of a University hospital. I'm not a fighter at all, but apparently pure caveman instinct took over.

So maybe double-check that your Dr. isn't a crazy old man? Good luck!
posted by sluggo at 10:11 AM on September 3, 2014 [2 favorites]

Best answer: I also had a tonsillectomy, turbinate reduction, and septum repair all done in one day. The advice above is all excellent.

Most of my pain was from the tonsillectomy and not being able to eat or swallow properly, so I think you'll bounce back pretty well. You'll be pretty woozy for the rest of the day of the surgery -- ask for the antinausea pills they give out if you feel queasy, because those things are the bomb.

Do NOT poke around in your nose like I did -- it won't mess anything up, but it can get pretty goopy in there. For weeks afterwards, when you blow your nose (gently!), all sorts of gloppy, bloody nose goblins will emerge.

You will have gigantic plastic splints in your nose that have stitches in them to hold them in place. (If you are like me, you will spend a lot of time with a hand mirror, trying to look up there to see how it works.) When I had them removed two weeks after surgery, it was pretty painful -- they were shaped like surfboards and my nostrils are only little.

Afterwards, being able to breathe through my nose all the time was really weird at first. I felt like there was a huge sucking hole in the middle of my face that cold air was rushing into. Now I think it's fantastic. I can sleep with my mouth closed, which means I don't snore anymore.

I have sinus meds that I use infrequently, and haven't had any problems with those. I haven't tried a rinse, though.

tl, dr: A week or so of discomfort and ooginess followed by immense relief and delight at being able to breathe.

Good luck!
posted by vickyverky at 10:12 AM on September 3, 2014

I've had a septal deviation repair and my husband has had that plus turbinates and polyp removal and I don't know what-all; he's a mess. Recovery for me felt a bit like coming back from a punch in the face (which I also have experience with); most dramatic part by far was having the packing removed. That wasn't painful (had it done before going home) but very high on the gross-out scale. You have no idea how much will fit up your nose, man.

Husband and I have both seen some improvement in breathing, infections, and severity of allergies, but we were, I think, more borderline cases than you seem to be. If you do any singing, you might be prepared for a change in your head voice. Hope your sense of smell returns!
posted by helpthebear at 10:17 AM on September 3, 2014

Best answer: I had both of those surgeries done. I wrote some about it here.

I've had broken bones, been stabbed, been tear gassed, been maced, tasered, been in a bunch of fights. The septoplasty was far and away the most pain I have ever experienced. It is manageable with pain killers, but I was wholly unprepared for that level of pain.

When the packing and splints came out I felt so much better. They aren't bad the first few days - you won't even notice them. After 5-6 days, when the swelling diminishes, you will really feel them in there, and it's unpleasant.

Get a good Neti Pot and make up some salt and baking powder solution ahead of time. My Doctor had me pouring 1.5 gallons through my face for the first few weeks. This will really help reduce healing time, because it keeps it all nice and clean in there.

It took about a year before my nose felt like my nose again. It wasn't painful, just foreign, because things were moved around. It was tender for about 6 months - avoid babies.

All of that said - I would do it again in a heartbeat. I can breathe! I can smell! So much breathing and smelling! There is this whole universe I was missing out on. And I basically never get sick anymore.

Good luck!
posted by Pogo_Fuzzybutt at 10:21 AM on September 3, 2014 [1 favorite]

I've had the turbinate reduction done, but not the rest of it. Recovery was ok, but involved many days of breathing through my mouth, which made everything feel terribly dry. End results were... meh. I honestly can't feel a difference.
posted by MsMolly at 10:26 AM on September 3, 2014

I had septoplasty done... wow, it was about fourteen years ago. Anyway, the recovery period was one of the worst experiences of my life. I wasn't in a lot of pain, but out of sheer discomfort I couldn't eat, I couldn't drink, I couldn't sleep-- if someone had offered me a bullet, I would have taken it. It was hell.

Fortunately, life became bearable again after the packing was removed. That experience was rather like... remember that scene in Total Recall? When Arnold pulls the tracking device out through his nose? Pretty much. Like helpthebear said, you have no idea how much stuff can be crammed up there.

As for the long-term effects, near as I can tell... not a damn thing. My septum decided it was supposed to be crooked, surgery be damned, and that's how it healed. My left nostril has less than half the airflow of the right, same as it ever was. Worst of all, before the procedure, I could do this trick where I could smoosh my nose and make the septum bend in the opposite direction, which would let me breathe through that nostril, and I can't do it anymore. I experienced three days of pure suffering and I'm no better off than I was before, arguably worse, and out the copay for the surgery anyway.

I'm sorry.
posted by Faint of Butt at 10:52 AM on September 3, 2014

Best answer: an easy way to ice your nose without putting ice on the rest of your face (which causes painful ice cream headache) is to fill up three fingers of a disposable latex exam glove with crushed ice and water. lay one on top and one to each side of your nose.
posted by fingersandtoes at 11:18 AM on September 3, 2014 [1 favorite]

Many people have had either success with this type of surgery, or ultimately no noticeable effect/sorta the same. I would say I fall in the latter of the two; and I had really no bad recovery from this surgery, mostly just ickiness from blood and oozing for a couple of days and some bigger-than-usual inflammation. In an attempt to improve overall sinus health and breathing, if I had to do it over again, I would likely do it again based on the known risks, and really trusting my doctor after asking all kinds of questions.

However - (hate to be 'that guy', buuuut) some people are definitely worse off than when they started.

While I get the feeling that way more ENT's these days have heard the term empty nose syndrome , there may be some who haven't (or just plain dismiss it). There's plenty of information on that web site you can read up on, if you like; basically the problem is overzealous surgeons who think removing "more" is better, or who have overdone multiple surgeries on the same person's nose.

Since I am always wary about... well, everything ; ) I might ask my doc/surgeon whether they err on the side of conservative turbinate reduction and think this is a good idea (which it is!). Obviously, no one wants to have multiple surgeries, but I can tell you that since the last time I checked, there is no known reliable fix for annihilated turbinates. I believe there are some docs experimenting with experimental implants, as well as hyaluronic acid injections.

(Sorry I just noticed you had already looked up ENS, but I felt obligated to mention it.)
posted by bitterkitten at 11:41 AM on September 3, 2014

I had sinus and septum surgery. I don't remember it too well, but I do remember that my nose was plugged up for days after the surgery with gauze and stuff, which was unpleasant. I don't recall any pain or anything, just the discomfort of not being able to breathe. After my gauze was removed, there was blood or some sort of packing in my sinus that came out many days later. It was a lot of burgundy snot coming out. And then after that, I had no additional effects and was back to normal.

I will say that visually I was happy to see my nose look a bit more symmetrical. Do not expect it to make your nose perfect. Improvements will be slight. My nostrils are now basically the same size, although I think my doctor did something specifically for the nostrils not related to straightening out the septum. As far as my sinuses, the help was very minimal. I think there was a bit more room to breathe, but the chronic rhinitis I had was still an issue. I honestly got better relief from being prescribed Flonase and Azelastine after I still got sinus inflammation after my surgery.
posted by AppleTurnover at 12:14 PM on September 3, 2014

There is so much more air in the world than you know.

Well, initially you'll be breathing the smell of bloody gauze. Eventually, though, you'll feel like a different kind of animal with a bigger nose.
posted by Lesser Shrew at 12:16 PM on September 3, 2014

My answer to a similar question, previously.

tl;dr: Life-changing and awesome.
posted by bassomatic at 2:10 PM on September 3, 2014

Best answer: I had sinus surgery to correct a deviated septum, enlarge the openings to a bunch of sinuses, and remove polyps.

It was the single best thing I have ever done for myself. It was life-changing.

I used to lay down on the floor in my office for 15 minutes ever 3-4 hours, with my head tipped to one side or the other to open up my sinuses so that I could sort of breathe for the next couple hours. After the surgery, I could breath deep. It was amazing. I went from having 4-5 sinus infections a year, to having basically none. Maybe one every 3-4 years.

The only slightly negative thing from the surgery is that I get a lot of ear infections now. Maybe 2 a year, usually in both ears at the same time. It's kinda like the sinus infections became ear infections. I personally find the ear infections more tolerable, and I get fewer of them. Also, spicy food is a lot more spicy than it used to be, and brushing my teeth makes my ears itch.

Basically, the negatives are minimal, and the benefits were HUGE.
posted by OrangeDisk at 6:48 PM on September 3, 2014

i had only moderate benefits...

I wish they had sent me home with valium and o2 - the swelling, pain, and reduced airway were pretty anxiety-inducing and miserable.
posted by j_curiouser at 7:59 PM on September 3, 2014

Take care of your face, as Pogo_fuzzybutt warns!!

Some years ago I had surgery to fix my deviated septum. I had splints up my nose for a week, and laid on the couch the whole time. I read "Moby Dick" and sometimes dropped the book onto my chest as it put me to sleep, which was fine. What was not fine is when my toddler hit my nose half-way through the recovery, and apparently knocked my tender nose askew.

Now, sadly, I can touch the end of my nose to my cheek on one side, but very much not on the other: it healed crooked and I am pretty much Damaged Goods. :7(
posted by wenestvedt at 1:07 PM on September 4, 2014

Best answer: I had this exact surgery about 4 years ago. (Wow, has it really been that long?) I had it done because I was 21 and had sleep apnea and all sorts of related mood issues -- and I couldn't bear the thought of being on a CPAP at that age. It has helped tremendously, and I don't regret it for one minute. There has been zero downside for me.

In terms of the surgery and recovery:

I went in, they got me all situated in the bed with IVs and monitors and everything, then they pumped in the Versed, and I woke up in the recovery room. I was allowed to sip water or Sprite until they were confident the anesthesia had worn off completely, then I changed into my street clothes and was driven home.

They had put in splints and given me lots of gauze with a little sling thing to hold under my nose, and I bled for maybe the first day or so. After that, I didn't need the gauze any longer. I had to sleep sitting up until they removed the splints (maybe a week?) -- I used a big, comfy reclining chair and a couple of pillows, but it wasn't the best sleep I've ever gotten.

I took Tylenol with codeine for a couple of days, which really killed the pain and got me a little high. They gave me stool softeners for the constipation, since pushing/straining too hard would be bad for my nose. After that, I think I was just taking regular Tylenol until the pain subsided. They gave me an Afrin spray for 3 days (but no more, or you run the risk of rebound congestion), and then told me to use normal saline nasal spray for as long as I thought I needed it. I think I was also using a neti pot, but I don't think I was told to do so. I didn't believe the amount of gunk that came out of my nose in those first couple of weeks.

I don't remember whether I was allowed to shower in the first couple of days, but after the bleeding had mostly stopped, I think I hopped right in. Be careful not to tip your head backward or forward too much in the shower, and be gentle washing your face. I ate mostly soft stuff (with lots of liquids) for the first 24-48 hours, because chewing and moving my mouth hurt quite a bit. Do NOT use a straw!

Removing the splints was surprisingly painful. My doc ripped out a stitch that I didn't even know was in there and then yanked the splints out. Not crazy painful, but more than I expected. I was mostly back to normal after the splints came out, and then maybe another week or so before I felt totally like myself again. Not bad, all things considered.
posted by Ragini at 4:42 PM on September 4, 2014

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