Surgery coming up Wednesday

[Dareman2]

I can get over just how many names there are for turbinate surgery. I have mine Wednesday and the doc calls it a turbinectomy. After reading all the horror stories on here I'm beginning to wonder if I should. My doc kind of played everything down but he did tell me that the operation entailed going into the nose, breaking the bones in the turbinate cavity, then tucking the turbinates back and trimming some off of each. It doesn't sound like fun, but only takes a half hour (day surgery).

So what's the diff between a turbinate/septoplasty and a turbinectomy. Anyone know?

[Billinseattle]

Semantics,

A turbinatectomy is the ablation/cauterization/ or removal of the inferior turbinate.

Add a septoplasty and they make a tiny incision, tweak your very thin bony septum and straighten it out with a fine instrument that looks like a small swizzle stick.

Overall, not a bad operation. 20-30 minutes in the OR. Most commonly, they are done together for OSA. It won't cure OSA, but it will help with your CPAP.

The most difficult part is the congestion post-op. The packing/ splint removal is not any fun...but done quickly. Usually this operation is not very painful. It is more annoying than anything else. The majority of people don't have trouble with this procedure.

Good luck,

Bill

[Billinseattle]

Semantics,

A turbinatectomy is the ablation/cauterization/ or removal of the inferior turbinate.

Add a septoplasty and they make a tiny incision, tweak your very thin bony septum and straighten it out with a fine instrument that looks like a small swizzle stick.

Overall, not a bad operation. 20-30 minutes in the OR. Most commonly, they are done together for OSA. It won't cure OSA, but it will help with your CPAP.

The most difficult part is the congestion post-op. The packing/ splint removal is not any fun...but done quickly. Usually this operation is not very painful. It is more annoying than anything else. The majority of people don't have trouble with this procedure.

Good luck,

Bill

[snork1]

What horror stories? Mine was great, by whatever name they called it. Slice and dice of the turbinates (and other stuff in there that added up to a 3 hour surgery.)

I was using CPAP the same night and it only got better and better.

I can't emphasize enough how important it is to do the saline flushes they recommend, no matter how gross and scarey the flushing process is!!!!!!!!!
Flushing will GREATLY improve your results and the overall healing process.

Just hope you have a surgeon with steady hands! HAHA!

Good luck and speedy healing! I am EXTREMELY glad I had it done!

[Guest]

Dareman if I'd known thats what the surgery entailed I would have thought it about it a bit longer. I had no idea they broke the bones. I am happy with my rebuilt turbinates. I like breathing through my nose!

[Dareman2]

I'm assuming that the bones he is talking about aren't very substantial, perhaps more like heavy cartilage. He did give me a whole raft of instructions about what to watch for after surgery, and when and if to call him. He does a whole lot of these operations so I am assuming all will be well. It sounds to me as if the anesthesia is the most dangerous part of the whole thing.

[Less Sleepy]

Good luck with your surgery. Hopefully this will clear your congestion once and for all.

Thanks again for your good "Swift" advice. It works really well with occasional switching off to my NAII. Each interface has its own irritations, and knowing I can switch makes each one easier to live with.

[Dareman2]

I'm hoping more than anything that this surgery will once and for all get me off the Afrin. I have been using it every night for nearly five years now.

About the Swift. I now use it every night. I didn't think that anything could ever dislodge the Breeze and Activa, but the Breeze is permanently out of the picture, and the Activa is languishing in a ziplock back on the dresser. I don't think any company will ever be able to top the Swift for overall comfort.

[Billinseattle]

Dareman,

Yes the septum is barely a bone, it is more like a chicken pelvis. The instrument used is like a spatulated swizzle stick. The incision on the inside of your nasal mucosa will be 2-3 mm...and may be the only source of minor pain.

As for your Afrin use...You should try to get a peri-op steroid taper to help. Many folks use Afrin (oxymetolazone) to help with their congestion peri-op. Frequent saline irrigation will help (as per SNORK, the poster-boy for this procedure); a week-long steroid taper will help the swelling as well (which is how some folks get "broken" from their Afrin addiction in the non-OSA world).

I found the rebound congestion (lasting 2 days) from my peri-op Afrin use was just as bad as anything the surgery did (which in retrospect wasn't bad at all, considering).

The nice side-effect , if you will, about this and other sinus surgeries is that afterward your nasal mucosa will be inhibited (don't ask how, I'm not sure) from reacting to some allergans. That benefit saved me from a lot of grief this spring as I was recovering from other surgeries. My first (non-OSA) sinoscopy & polypectomy in 91' did the same thing for 2-3 years...almost zero seasonal allergies.

Anyway, good luck,

Bill

[Guest]

Dareman I wish you the best during your surgery. I know you will do very well.

Glad you will be able to let go of Afrin as I know you have not been happy having to use it. We'll all wait to hear from you regarding your experineces at the hospital and we expect no less than a full detailed report from you.

You being a CPAP pioneer, I suspect your knowledge and enthusiasm for this treatment has helped inform many here, thank you for that too.

Good luck.

James

[Dareman2]

My main worry is not the operation but the aftermath. I am very aware that there will be post op swelling, and this combined with the temporary packing is going ot cause a type of misery I avoid with the CPAP machine, that of not being able to sleep because I can't breathe. I can only pray that it won't last long because I will become one cranky dude if I go too long without sleep.

The lessening of allergy symptoms sounds very appealing to me, especially this year. I am very allergic to mold and this spring has been a terror in this regard, with all the rain we are getting. I've had some real doozy sneeze events recently, and I just worry now that this might occur after the operation. The way I sneeze could create a real blowout.

As far as reporting how it goes, you can rest assured that I will give a complete and detailed rundown of the whole shebang. Now, I await Wednesday with open mind and clogged sinuses. Let the games begin.

[Guest]

Dareman,
after the surgery you will be sleeping sitting up for a while. Lying down puts all kinds of pressure on your sinuses. They gave me an ice pack that I kept on my face all the time. I did not take the narcotic type meds- I think those will increase apnea. Stock up on tylenol, bottles of water and have a little cheese. They told me to eat a slice of cheese and it helped with the nausea from the anesthesia. Don't eat a lot of dairy it will make more mucous and you will have plenty. I said bottled water since it tastes good and you will want to stay hydrated. I had pressure and swelling in my sinuses but really wasn't awful. Plan to eat soft food as any move you make will make your nose bleed for a week or so. Keep yourself occupied with videos and reading and you'll be back on your feet before ya know it. I also used a humidifier in my room for months after the surgery, your nose will be scabbing and you want don't want the scabs to dry up and create clogs in there.

Sending positive healing thoughts to you. Don't judge the result too soon, it will be worse before it gets better.

[Dareman2]

Nawchem, you mentioned many things I haven't heard about before. I hope I don't have to go through all those things to get to the other side. My surgery is relatively minor as nose jobs go, but I do know I will be facing some daunting hurdles. I just hope they pass by quickly. The way my sinuses clog now, I would go through almost anything to make them better.

[Vix]

Hi there!
I had surgery on my turbinates too - although I also had my deviated septum fixed and some masses removed from my sinuses at the same time... and all of that wasn't really too bad. I came home the same day, and had packing in my nose for 2 days, which was really more uncomfortable than anything. It took a few months after the surgery for my sinusus to clear out (which consisted of some congestion and post-nasal drip which I had before the surgery anyway, so no biggie) and approach normalcy, but you shouldn't really have that problem, since it's just your turbinates you're having done. The MD told me to take a few days off work, which I did (and I was happy I did). You look a bit funny with the packing in, because it enlarges your whole nose. And when they remove it, you'll be amazed at how much they cram up there - it was like clowns in a funny car at the circus when they took that stuff out. Anyway - don't worry - it's not too bad. And do follow the advice of snork1 who recommended the saline flushing post packing-removal.

[Billinseattle]

Dareman,

The surgery will be annoying; but will go fine.

The limitations on eating and activity , I haven't experienced. People get nauseated from blood that they've swallowed (which is almost unavoidable) in surgery. This usually occurs immediately peri-op and shouldn't be an extended issue. There are newer anti-nausea meds that they can give to you in the OR and in the PACU to help with this.

People also get nauseated as a side-effect from pain medicine (opiates). Some are worse than others for this. Some people are more sensitive than others (the most sensitive population to opiod induced nausea are generally young women...Post-op Nausea/Vomiting has been extensively studied and written about in anesthesia circles...so I'm not making this up).

If you have pain, coat your stomach with food, jello, or crackers and take something. Don't let it get in a vicious cycle. For lighter weight relief, take tylenol products. Ibuprofen , naprosyn , and aspirin can inhibit clot formation (not desired). You should have food in your stomach to avoid gastric irritation from pain meds.

Stay hydrated ! That will help prevent bleeding as well (indirectly by keeping your tissues moist all around). There should be no big restrictions on eating. You may feel anorexic the first couple days (which is common after any procedure), but you should eat or drink a protein supplement (Boost, Ensure). Hydration and nutrition are important after any procedure.

Activities to avoid. Your surgeon should cover this, but....in general you are at risk for bleeding. So any activity that will increase your venous pressure can "pop" a clot off and cause you to ooze or bleed. This would include lifting heavy weights (greater than 10-15 #), stooping or squating activities, severe straining in the bathroom, face or head down activities in general. Heavy chewing could be included here; but I've never heard of it before. You will feel your nose "engorge" and kinda know what's bad anyway. How long to "chill out" ...a week or two depending on how it goes.

Packing is nasty and is worse than the surgery. Typically it is out in 2-4 days. Ice may help deal with this...and the swelling...but it ain't morphine. Copious and religious nasal saline irrigation will help you avoid problems down the road. You may have a plastic stent in your nose as well...that usually comes out in about 7-10 days. It won't be nearly as bad as the packing.

My surgeon, bless her heart, didn't use either packing or stents in my nose. I had severe OSA and also had some previous sinus work done. It helped a ton in avoiding congestion post-op. This is not common though. The downside to this was that during my big operation (jaw advancement), I was naso-tracheally intubated and it was discovered that one nostril had developed synechae (scarring) since the surgery. Perhaps from the lack of stents...maybe from the lack of irrigation (I tapered off earlier than I should have). Since I no longer have OSA, there is no need to have a procedure to take down those web-like scars.

Anyway, honestly, it is not as bad as it sounds. It is like having a bad one week head cold. Things will work out.

See you on the other side,

Bill