Seeking Septoplasty support

[nolajoe]

Finally saw an ENT yesterday and after probing my nasal passages, he concluded Septoplasty and Turbinate reduction would help me..
Have had severe nasal congestion and bad snoring since my teens..I am now 59, have been on APAP since 8/04. Have had definite improvements with treatment..AHI index is very respectable with my Remstar auto and Encore software tracking..My problem is chronic Afrin use and waking at night to use more nasal spray..
This is my main problem: Fear and anxiety of having no nasal breathing for any period of time much less extended period...The ENT says the fear is not well founded and most of his patients say it was not as bad as they anticipated..I am planning to see one or two more qualified ENTs for their diagnosis and go from there..I know some folks on this board have had the procedure(s) along with other surgeries..Any input as far as what to expect for recovery length and tips to deal with it would be very greatly appreciated..Signed: A Coward in New Orleans....

[Thunder Thighs]

I've had both surguries and had really good results from both. I had the septoplasty done last October. Since I had been previously diagnosed with sleep apnea, I had to have it done in the hospital day surgery unit. I really don't know why. That was just the doctor's policy. I checked into the day surgery unit about 10:00 a.m., had the surgery done about 12:30 p.m., and went home about 3:30 p.m. that same day. The only bad part was waking up with my nose packed and unable to breathe out of it. They didn't tell me about that before the surgery so it kind of scared me when I woke up and couldn't breathe out of my nose. The doctor took the packing out the next morning and after that, it was much better. They leave a splint in your nose for about a week and then take it out but you can breathe through your nose with that in. I had some really bad nasal congestion for a while and had to use a saline rinse every night for about a month. I don't know how sensitive your nose is. Mine is pretty tough and it really didn't hurt much at all to me. They advise you to sleep in a recliner or on several pillows for a few nights and to put ice packs on your sinuses. All in all, it took about 6 to 8 weeks for all of the drainage to dry up. It was worth it. It's really not a bad surgery at all. The doctor gave me some Vicodin for pain and I only had to use it the first night. After that, I took regular Tylenol for a couple of nights and then I didn't need anything. I had the turbinate surgery done a couple of weeks ago. It really is nothing. They do it in their office and the worse thing is when they put the pain killer in your nose. I didn't need any special pain medications for that and only took some Tylenol before I went to bed the first night. The doctor only uses a local so I drove to and from his office. I had some minor drainage the first night and your nostrils swell up for about 4 or 5 days so you may need to use a full face mask for a few days since you will probably breathe through your mouth then but you're not totally stopped up so you can breathe a little through your nose right after the surgery. I had very minimal bleeding and didn't have to have my nose packed for this one. The drainage is almost completely dried up now and I don't have to use Benedryl anymore. Threre is really nothing to be anxious about. I know that's easy for me to say since I've already had it done and it's you undergoing the knife but it is true. I really feel it has been worth it too. I hope your doctor is as good as mine was and you're experience will be as positive also. Let me know how you're doing.

[Toth]

A scalpel is not the best tool to use to end your psychological or physiological concerns about Afrin use.

If your printouts from the APAP don't show you need surgery, why even consider it?

And why the more drastic surgery rather than the less drastic rf ablation of the turbinates?

Take your Afrin bottle and pour it down the drain. Do it on a dark, stormy night when you've disconnected your car battery and can't drive to the drug store even if it weren't pouring rain.

[nolajoe]

TOTH
I know what you're saying about the psychological aspects of Afrin addiction..Believe me..About 8 years ago I did quit using it..The congestion only moderated slightly. I was being seen by a General Practitioner who at that time had to refer me to an ENT as was my HMO rules..He wouldn't. I also tried for a sleep study at that time..He wouldn't do that either..Within a couple of months I started using nasal sprays again IN ORDER TO BREATHE!..I have a septum deformity and enlarged turbinates..Unless I'm missing something..Surgery is the option available..Thanks for your input...

[Thunder Thighs]

Getting off Afrin won't fix the deviated septum. The septoplasty will. If you don't get off Afrin, you will minimize the benefits from getting the septum fixed so you should definitely get off Afrin. As I said earlier, you will have some congestion after the surgery, but it will get better. Both of these surgeries have been very beneficial to me and I highly recommend them. Both are minor surgeries. I don't know what your pain tolerance is or how sensitive your nasal passages are but I've experienced more discomfort getting my teeth cleaned. If the doctor uses a general anesthetic for the septum surgery, it will take you a couple of days to shake that off. I never was on Afrin or any kind of nasal spray for that matter and still had constant nasal congestion. I tried turning up the humidifier on my cpap and that didn't help either. You might want to get the turbinate surgery (I really don't know why they call it surgery. There is no incision. They just put a little instrument up your nose and pulse radio waves through it for a few minutes. I had both sides done at the same time. Some people have each side done on different days.) done first. It can be done more than once if you are pleased with the results but again, it won't fix the septum and your air passsages will still be somewhat restricted. I don't like surgery either and won't have it done unless all other options are used but if they are and surgery promises some relief, I will do it. I was so scared the night before I had the septoplasty that I didn't sleep at all. When I got to the hospital, my blood pressure was way up (190 over 110) so they had to bring that down first. The only other surgery I had ever had was kidney surgery and believe me, I had reason to dread the whole ordeal if had been like that but it wasn't anything like that. Each person has to do what's best for them. I'm glad I did it. That's just my experience. You'll have to decide what's right for you.

[Less Sleepy]

The surgery won't cure OSA, but it sure will make PAP easier and more effective to use. Just don't go for the UPPP, although it sounds like your ENT hasn't suggested it. Sounds like your nasal passages are a mess and need to be fixed for you to get the full benefit of your machine. My sister had a septoplasty, and recovered with little pain and no difficulty.

[Zoo]

I had septoplasty and turbinate reduction done. Unless you have had a severely deviated septum and swollen turbinates, you may not understand that is makes it difficult to breathe well awake or asleep. It was very uncomfortable for a couple of weeks and my nose was tender for several months. But it was definitely worth it. Go for it, Joe! You will feel so much better in the long run. It's nice to be able to breathe during the day, too!

[Guest]

I had septoplasty and turbinate reduction done. It did not cure my apnea. It did allow me to breathe better whether asleep or awake. I no longer use the Afin, the antihistimes, or the myriad of other prescription and non prescription drugs that I used to need to be able to keep my nose functional. My only regret is that I didnt have this done sooner.

[nolajoe]

First my thanks to everyone who has given input..It gives me a much clearer picture of what to expect..I am scheduling another ENT next week for second opinion/diagnosis..
How long can I expect not to be able to use my nasal mask?? First ENT mentioned it would not be allowed because of possible tissue damage..I guess I could use a FF mask that I have..Not sure if that will be okay..My concern about the nose being packed for a period was somewhat alleviated finding that a small stint or strawlike tube will allow some breathing through the nose, after the packing is removed. I know the surgery is not a cure for OSA..I never hoped for that. Just want to be free of all the nasal sprays and antihistamines that don't really work well anyway, and hopefully have some normal breathing through my nose..I will be off the Afrin before the surgery..I've done that before..Thanks again to everyone for the positive encouragement and good thoughts...

[Thunder Thighs]

I was able to use my nasal pillows about a month after the nasal septoplasty. The stint or splint has to be removed before you can use any nasal interface again and that stays in for about a week to 10 days and you have to wait for your nasal passages to heal. I have a very high pain tolerance and heal very quickly so it may take a little longer for you depending on how fast you heal. I only had to use the full face mask for about a week after the turbinate surgery. Like I have said earlier, it takes a little while to heal completely but I wish I would have done it sooner. It's a great help. Good luck!!!!!!!!! Let us know how you're doing.

[MJL]

I live north of New Orleans and am near scheduling a septoplasty and turbinate reduction also. My son had the same operation 10 years ago and did very well. Like you I am a chicken. May I ask what doctors you are considering to do the surgery. One doctor I saw said he does not pack the nose and has hadno problems with it so I'm thinking of using him. Also, I believe I've read of others on this board who had the same surgery and not had their noses packed.

[JimH]

I can't believe that I had the same surgery some of you are talking about. On March 25, 2005, I had a septoplasty (my second one in the past 25 years) and a bilateral turbinate reduction. It was done under general anesthetic, (yes it is a surgery), it was not done using rf ablation, I did not have my nose packed (nor do 98% of my ENTs patients that have this surgery). I used my Spirit nasal pillow CPAP mask the day after surgery (without any problems). I had the splint removed 7 days after surgery without any numbing, and it was no big deal.
I can see why some of you are so scared to have surgery. On a scale of 1 to 10 (with 10 being the worst), I would rate a septoplasty/turbinate reduction no higher than a 2.
I guess some of you would say that I was "addicted" to Afrin (every night for 2-3 years), but it was the only way I could breath out of my nose. Since the surgery, I have not had the need (or desire) to use Afrin. So much for having an Afrin addiction. When my nose "worked" I no longer desired anything to "open it up" at night. There is no "high" when using Afrin, there is a physical addiction to being able to breath though, it's kind of gotten to be a habit.
I was able to take the "pad" from under my nose after the first night, and within 3 days the only problem I had was a "sore nose". I constantly sprayed saline solution in my nose, and kept applying an antibiotic ointment with a q-tip for the first week.
I would do this surgery again tomorrow. Did it help with my sleep apnea? NO, but from the looks of it, nothing short of an MMA/GA is going to help anyway (average AHi of 45 over the past 6 mos, using CPAP, autopap, bi-pap). I was to have a UPPP the first week of May, but because of this board, and other research, have decided to keep my uvula.
JimH

[MJL]

Thanks for the encouragement Jim! I needed that. In fact I did call today to schedule my surgery, but the girl that does it is going to call me back tomorrow. Now the only thing I need to decide is if I also want to remove the hump on my nose as well. I've heard that recovery is kind of about the same. Any comments about that?

[nolajoe]

MJL If you like contact me via nolajoe03@yahoo.com and I will give you the all the info I have on ENTs in the area most of whom use East Jefferson hospital..I have done some serious search and research..
RE- Comments of JimH..I could not agree with you more about Afrin usage..given the option of breathing through my nose or NOT..I will choose whatever med that will allow it..I am looking forward to better breathing after the procedure(s)....

[AnrkeyGrrrl]

nolajoe

I had the septoplasty and turbinoplasty surgeries yesterday ... so please forgive my Percocet induced blabbering

My report time was 0700, my surgery was scheduled for 0800. I changed into a fashionable gown, party hat, and the most sexy socks I have ever seen, straight off the runway of Paris, I'm sure! Then I was tucked into bed and was given an IV [for my happy juice]. I was wheeled into the OR and had to change beds. I took a few breaths from the face mask, and that's all I remember. My doc said the surgery took about an hour.

I went to the Recovery Room for about 45 minutes, then to the PACU where I woke-up about 1030. They started giving me Fentanyl and gave me a rolled up gauze to place under my nose to catch the blood that was dripping. I was surprised that I did not have "packing" in my nose. Then they gave me a suction thingy [kinda like at the dentist's office] to get rid of any phlegm/blood from my mouth.

My nose felt like it got intimate with a 2x4, the roof of my mouth was numb-ish, and my throat was kinda scratchy. Other than that, I felt pretty good. I was doing so well in fact that they gave me a yummy Popsicle while I waited for my room on the floor [if I did not have OSA, I could have gone home at this point].

I got to my room at 12 noon and was given Afrin, saline spray, Percocet, and Keflex. I got to eat lunch - liquids - blahhhh. I just so happen to work at the hospital I had my surgery in, so I had many visitors during my stay It's always nice to see a friendly face!!!! I watched a movie inbetween begging for my pain meds - yes, I asked for them every 4 hours!

My doc stopped in and said every thing went beautifully!!!! That's what I love to hear!!!!!!! He said he removed a few small pieces of bone, but left the tissue alone during the turbinoplasty. He said that it was any wonder that I could breathe at all He did place the splints inside my nose [attached with a few stitches]. I can kinda breathe thru my nose now, and the splints will need to come out in a week [I was afraid they would be visible, but they are not]. I am not to use my APAP until the splints come out either. He told me to sleep in my recliner if I could. No nose blowing, no sneezing [if I can help it], and no sucking snot down my throat [sorry, don't know how to be more tactful about that!]. I can use the saline as often as I'd like to try and flush the stuff out. I can use Bacitracin ointment with a Q-tip around the edges for comfort [my nose feels very raw and dry]. I asked about using a baby nasal aspirator, and it is allowed, if I am *extra careful* - I don't have one here at the house, but I may go get one.

He expects nothing but success from the surgery!!!!! He did say in time we could revisit the UPPP - I said I didn't think so. I asked him why he didn't offer to just take out my tonsils, he said they were not enlarged, that was why. He then said we could talk about a dental appliance to bring my lower jaw forward and my tongue down. I told him I'd like to try that first.

I got to eat regular food for dinner - whoo hooo!!! A few more friends came over and basically I was just trying to keep busy!!!!

I had the 2nd worst night's sleep ever [the worst was my sleep study!] ... I don't think I got more than 30 minutes continuous sleep at one time I *can* sleep without my APAP, so I know it's not because of that. I was uncomfortable and don't really like sleeping in a unfamiliar place. Plus I had a roommate who has having some issues and the staff was constantly turning the damn lights on ... grrrrrr!!!!

My doc came in bright and early and said I could go home ... yeah!!!!! They got my discharge paperwork together and I was out of there by 8am

My nose feels kinda sunburned, and achy. But it's not nearly as bad as I expected. I am *so* glad I did not get the UPPP surgery!!!!! I thank each and every one of you for your posts on that!!!!!

I have been trying to finish this post all day long, lol, so I will wrap this up. If there are any more specific questions, please ask.

Michelle