Septoplasty & Turbinate Reduction

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About 3 weeks ago I underwent surgery to repair my deviated septum and to have my turbinates reduced. A few of my friends have mentioned that they are in need of these surgeries as well, so I wanted to share a bit more detail about how my surgery went and the recovery process.

Warning: This post is extremely long, oops. I really didn’t mean for it to be this long but I figure more info is better than less for those considering the surgery for themselves.

Let’s start at the beginning: A few years back I was having some trouble with my nose, in particular breathing and some bleeding due to what I thought was just dryness, so I made an appointment with an Otorhinolaryngologist or as most normal people call them an Ear, Nose, and Throat (ENT) Doctor. The Doctor took one small look at my nose and voila I had a diagnosis – I had a deviated septum. It was pretty darn deviated too, he estimated an 80/20 airway distribution between my two nostrils.

The Doctor asked if I had injured my nose at any point… nope I don’t think so! I mean, ask anyone that knows me, I’m fairly clumsy and constantly walk into things… so it’s possible I injured my nose and I just don’t remember it. But it’s also equally possible that I’ve had a deviated septum since birth. And no I have never done cocaine despite the many dumb jokes that Anthony makes. 🙂

At that point the Doctor and I discussed surgical options to repair my septum and I quickly learned that the price tag was a bit beyond what I could spare at that point in my life. I was a college student and although I had insurance due to my job with Geek Squad Online Support, I still couldn’t afford the surgery (it was something like $3,000 after insurance) and that that point it wasn’t absolutely essential to my quality of life.

Fast forward to 7 or so years later and I’d been noticing lately that I cannot, under any circumstances, lay on my left side. Not even for short naps or cuddle sessions! See, my left nostril was my “good” nostril, and my right nostril didn’t get as much airflow. So when I laid on my left side, that nostril would naturally close up a bit and I would be forced to breathe through my restricted right nostril – not good enough.

After giving it some more thought, I realized that I have much better insurance now with Automattic (pst we’re hiring), so my mind started to wonder how much it would cost at this point. According to the online treatment cost estimator for my insurance it would be around $125-250 so I immediately booked an appointment with Dr. Tarasidis at Virginia Ear Nose and Throat.

From the moment he entered the office I could tell this guy was silly and funny. He had me cracking up through the whole appointment. The appointment was pretty quick, we talked about the limitations I had due to my deviated septum and what I’ve tried (we laughed for a bit at the fact that some insurance companies think allergy medications and Breathe Right strips are going to help). He explained that if we go forward with surgery that in addition to the septum repair he’d also reduce my turbinates so I can really breathe.

I left there with some brochures about the technical nature of the surgeries, and within a day I had called to make my appointment for surgery – July 16th, 2018.

The technical terms for the two parts of my surgery are:

  1. Submucous septal resection and septal reconstruction
  2. Ablation of superficial submucosal soft tissue of both inferior turbinates

A few weeks later and it was time for surgery! Because of our amazing open vacation policy, I was able to take off a much-needed week and a half off to focus on surgery and recovery. There weren’t any medications or other preparations to take other than no food or drink after midnight the night before.

Before we proceed: Some photos are a bit graphic. You can’t even see the inside of my nose really, but there is blood.

Surgery day: July 16th

I arrived at St. Mary’s hospital in Richmond and checked in at the front desk at something like 8 in the morning. We were then escorted to my surgeon’s office where I waited for a bit then was processed. I received my hospital bracelets, went through all my health history, and was placed back into the waiting room. Only half an hour later I was taken back for surgery prep. where I changed into my gown, gave them a urine sample (for a pregnancy test), and was shown to my hospital bed.

The nurse I had was sooooooo awesome, super friendly and we talked about all sorts of things. She did a fantastic job of inserting my IV. Before inserting it she spent a good while checking out places on my arm that would be a good candidate (they don’t do it on the inside of the elbow apparently), and I eventually told her that I thought the best place was on top of my hand as that’s where my mom and sister always have had the best success as well.

Once that was all set, she hooked up my hospital gown to this warm air vent thing (not the technical term I’m sure) so I was nice and toasty. All I know is I want one of those for my bed at home now, but apparently that wasn’t something insurance would pay for.

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After getting settled in, they brought Anthony back to help pass the time before my surgery. Dr. Tarasidis came back to chat for a moment and we discussed pain medications. I had a pretty violent (read: a lot of vomit) reaction to Codeine in the past when I had my wisdom teeth removed about 8 years ago. Apparently that is the best medication to have post surgery though, so I agreed to give it another try along with some anti-nausea medication. Dr. Tarasidis left and Anthony and I continued to talk for a little bit then he left back to the waiting room – it was time to get this show on the road.

They administered IV anesthesia and wheeled me to the operating room. The last thing I remember was shuffling from my hospital bed to the operating table and bam, I was out.

After surgery I woke up alone back in a hospital bed in the recovery suite. I was a little annoyed that no nurses were paying attention to me, because I was SO THIRSTY!!! After what seemed like an eternity (probably 2 minutes max) a nurse checked on me and offered me some ice. She spoon fed me ice but not near fast enough for me, I kept begging for more. After a while of this, she offered me an applesauce – music to my ears!

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When a nurse brought me one of these, my eyes must have lit up.

At this point I was awake enough to hold the applesauce cup and a spoon so I basically shoveled this apple sauce into my mouth as fast as I could, it was basically the best food I had ever had in my life. I made a mental note that we did NOT have this applesauce at home, that would be a problem, and that we would need to remedy that asap.

A little while later, Anthony appeared at my bedside. I noticed a clock on the wall when he arrived and apparently it was about 2pm, which seemed insane because it felt like it was still 9am, but I did just have a pretty intense nap.

After recovering for a little while more, the nurse I had prior to surgery helped me get dressed (thankfully because Anthony is useless when it comes to hooking bras and this woman was a pro). She then helped me out of the bed and we took a short walk to the second recovery room, which there might be another name for but if so I have no clue.

While we were there I woke up a bit more and listened to the nurse giving me all the post-op instructions for pain medication. She had a packet of information to go through, and was highlighting things and making notes. Here are the biggest takeaways:

  • Do not bend over/pick things up off the ground
  • No lifting things over 20 lbs for a few days
  • Take the antibiotics
  • No driving while on the Codeine, and don’t get addicted to it as it’s an opioid
  • Take a stool softener, the pain meds cause constipation

She then showed me how to replace the gauze that was taped below my nose for blood to drip onto, and let me know I’d need to do that a few times a day. After that, she had valet pull our car around and Anthony drove us home.

I should note that on the way home Anthony and I stopped at Walgreens to fill my prescriptions. They took FOREVER (much longer than the 20 minutes they initially estimated, more like an HOUR. I was pretty miserable by time we got home, but I did manage to play on my phone for a bit while waiting in the car and took this lovely photo:

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Once we got home, Anthony helped me up the stairs and to the guest room bed where I figured I would be out of the way and wouldn’t have to worry about being around the dogs. At that point I propped my head up with a bajillion pillows and napped on and off the rest of the day. Snuffy came to visit me and so did Mackey and Splotchy (one at a time, very calmly) to keep me company. But even though I was laid up, I didn’t get a chance to watch any TV like I had planned, I was in and out of it too much.

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That’s pretty much all for the day of surgery, just a lot of resting, taking medications, and eating the applesauce I made Anthony run to the grocery story for.

Tuesday, Day 2

By Tuesday morning I was miserable due to the packing in my nostrils. Just look how swollen and uncomfortable I look:

Good thing that morning I had an appointment with Dr. Tarasidis and he did one major thing: he pulled the packing right out using the string you can see in that photo. OMG IT HURT LIKE HELLLLLLLL. So just to give you an idea, the packing is like a tampon but LONG, basically twice the length of an ordinary tampon. I was freaking out a little (internally) because 1. it hurt and 2. I don’t know how something that big/long was up my nose. But as soon as he pulled those out I felt so much better.

Then came the realization that there were silicone stints in my nostrils as well – those would come out at my next appointment on Friday. At this point I was to start saline spray in each nostril 6-8 times a day:

This day was pretty uneventful after that. I just continued to take my medications and the coolest part is by this point I realized I wasn’t having an adverse reaction to the Codeine, no nausea at all. Of course, I was taking anti-nausea medication but I figured I would have at least felt a little nausea, but nope!

Wednesday, Day 3

Nothing really happened this day, apparently I didn’t even take any photos of my nose.

I just continued to spray my nose a lot and things were pretty uncomfortable but with pain medication it was manageable. After each saline spray I would change the cause pad, I was still bleeding some but not near as much as previous days.

I watched a lot of TV and just hung around the house except for a short trip to Starbucks just to feel like a human for a bit. Fun fact: I could not smell Starbucks at all, which was a really weird experience.

Thursday, Day 4

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Same thing as Wednesday, just hung around the house and relaxed, watched TV, ran a few errands with Anthony just to get out of the house and feel somewhat normal.

In this photo you can see the plastic stents (they have little straws to help me breathe) and the blood in my nostrils. After using the saline spray, the gauze drip pad would go right back on as I was still seeping a little bit but not horribly, less and less each day.

Friday, Day 5

By Friday morning I was as uncomfortable with the plastic stints in that I was when I had the packing in! Thankfully my follow-up appointment for the stint removal was in the morning, so I eagerly headed over after taking my last hydrocodone pill.

Dr Tarasidis said he was very happy with my progress. He snipped some stitches holding the stints in place (um, were those stitches going through my septum? Tried hard not to think too long about that) and pulled the stents out. In my opinion, that actually hurt worse than removing the packing a few days ago!! The stents were hard and the straws built into them were filled with blood and gunk, no wonder it was getting hard to breathe through them, not that I was breathing much through my nose anyways.

He said he wanted to see me back in 2 weeks, and I was sent home with the instruction to continue the saline spray 6-8 times a day. At the follow-up appointment in 2 weeks he would clear out anything not yet cleared out of my nose, basically it was in my best interest to stick to the saline spray and get what I could out on my own with moisture.

Saturday, Day 6

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Finally by Saturday I no longer was dripping blood so I didn’t need to continue wearing a drip pad. From this point on I carried around a lot of tissues though to keep my nose from dripping snot while talking, eating, and drinking. Not allowed to blow my nose!

I’m going to get a tad TMI here: It was on this day that I finally pooped. Please listen to your nurse when they tell you to take a stool softener after surgery from the beginning. When you notice you haven’t pooped in a few days, it’s too late to start taking the stool softener, I learned that the hard (no pun intended) way. Pain medications tend to bind you up, I’ll remember that next time I have surgery.

Sunday, Day 7

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By this point I started to be able to smell some things, but I still had a good deal of pain in my nose and could not smile – please note the awkward non-smile in this photo. I continued with my antibiotics, saline sprays, and TV binging.

Monday, Day 8

On this day I noticed that my septum didn’t seem very even… that was the whole point of this thing right? (Spoiler alert: it’s just swelling causing things to look uneven at this point).

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I also noticed that a stitch from my incision was sticking out and when I wipe my nose it was getting in the way. So I took some tiny scissors and trimmed it just a little.

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This day ended in the most glorious way: I slept on my left side. I was still propped up by multiple pillows but I turned onto my left side and as soon as I did I was OUT.

Tuesday, Day 9

Nothing really happened this day, just continue meds, saline sprays, etc.

Wednesday, Day 10

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A week and a half after surgery I was feeling a lot better and things were looking closer to even as you can see in the photo. Notice how a lot of the blood and other crud is cleaned out too!

This was my last day of antibiotics and this night I slept without being propped up for the first time after surgery. It was wonderful.

Thursday, Day 11

No pictures of my nose this day, it was time to go back to work! This wasn’t without it’s challenges, but mostly because my coworkers are hilarious and kept me laughing throughout the day. What’s wrong with laughing, you ask? Well, when your septum is swollen, so is your upper lip and other parts of your face. So for a little while there it was hard to smile or move my face in some ways, so laughing (yes I actually LOL while I work sometimes) was a bit rough. All-in-all the workday went well and without complications. I was glad to be back at work!

Sunday, Day 14

After taking two weeks of from exercising, it was finally time to head back to my workout class! I was so ready to go back to my Pilates/Yoga infusion class at the YMCA, I was so bored and missed the workouts. Some of my workout buddies noticed I was back and were super kind asking how I felt and all that.

The instructor (Karen), seemed so excited I was back – maybe she thought I had given up? She made sure I knew I could modify a lot of the moves in case there was too much pressure on my nose. Overall it wasn’t that bad, there were a few moves that I sat out on but it was still definitely worth the exercise.

After the class Karen said I looked great and she wanted a photo with me. I obliged even though my smile wasn’t the best still. Sorry, the photo lives on her phone and I look horrible so you won’t see it here. She was pretty excited to learn that while I was out for my surgery I hit the 30lb weight loss mark. I guess eating a steady supply of unsweetened apple sauce helped put me over the edge.

After this point life was pretty normal, I just continued the saline spray and gently cleaning out my nose. Around day 19 I started to apply a little bit of Neosporin inside both nostrils just to keep the crustiness at bay, it really did help. Neosporin in your nose might seem weird, but to someone who has had nose issues in the past, this is no abnormal thing. It makes your boogers really weird and it doesn’t smell all that great but it gets the job done.

Tuesday, Day 23 (three weeks post-op)

Today was my final check-up with Dr. Tarasidis, barring any unforeseen circumstances. He took a quick look at both nostrils and said they were looking fantastic. He then removed two small pieces of “crust” from one nostril (the side that did not have the incision) and said I was all set. Dr. Tarasidis asked me to keep doing the saline spray for another few days but other than that I’m all set. The entire appointment took about 10 minutes, including the wait and walk back to the exam room.

And here are the final results:

Well, maybe not the final final results as there is still some swelling and you can see the incision that is a little red. But close enough for you to get the picture.

I still have a bit of tenderness at the tip of my nose and down to my upper lip (though as you can see I can smile again). This is all normal as the septum is still healing.

In the end, I’ll say that the recovery was much more intense than I had planned for. Who am I kidding? I really made no preparation for the recovery other than telling Anthony to buckle up and that he would be my nurse for the unforeseeable future. He did great, by the way. He took care of everything (and I mean everything) for two days. Here’s a list of just some of the things he did for me: Fed me, kept my water refilled, helped me walk everywhere, literally had to pull my pants and undies down and up every time I went to the bathroom (as you can’t bend over after surgery for a while), applied tape when I replaced the gauze drip pad, fed and pottied the dogs entirely on his own, driving me anywhere I needed or wanted to go, and soooooo much more. Seriously, love you babe for taking good care of me even though I was pretty rough on you!

At this point we haven’t received any bills regarding the surgery yet, so I’m cautiously optimistic regarding the insurance aspect of things. We’ll see what happens with regards to that…

If you have any questions about my experience with this surgery, leave me a note in the comments and I’ll do my best to answer your questions.

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