Monday, May 6, 2013

A Pain in the... Sinus?

As many of you reading this are already aware, I had sinus surgery at OHSU on Tuesday, April 23rd. I was diagnosed with a deviated septum more than six years ago when I lived in New York City. I had been suffering from frequent sinus infections and sinus pressure that often caused migraines. I opted not to get it fixed then, partially because I had already observed first-hand what a horrible experience it could be when my boyfriend had the surgery, and also because I didn't want to use valuable vacation days.
a few hours after surgery on my hip (January 15th)
After seeing an ENT here in Portland a few months ago, I was again advised to have surgery. Since I have already reached my out-of-pocket spending limit for my health insurance plan this year (due to the costs associated with surgery on my hip in January), it made sense to go ahead and deal with this issue as well. Thus I was scheduled to have a septoplasty to fix the deviated septum and turbinate reduction to alleviate chronic nasal congestion and nasal obstruction.
The 1 - 1.5 hour procedure is done on an outpatient basis. After having no food or drink since midnight, I checked into the surgery center at 11:00am and was immediately taken to a prep room where I changed into a very stylish hospital gown. The nurse went over my medical history and ran an IV into my right hand (the first attempt in my left arm wasn't flowing properly). I was given a bottle of Afrin nasal spray and instructed to spray it in both nostrils every 30 minutes. Finally, just before 1pm, my doctor's assistant and an anesthesiologist came into the room and asked a few more questions, then had me sign some paperwork. My doctor dropped in to say hi, and soon I was whisked away to the operating room.

When I had surgery on my hip, once I was wheeled into the OR, a mask was put over my nose & mouth and I was told to start counting (I made it to seven and then blacked out). Since sinus surgery is done internally through the nostrils, the anesthetic was injected directly into my IV. They didn't even tell me they were doing it; one second I was awake, and the next I was out.
The next thing I knew, I was waking up in a post-op recovery area. My nurse was the same as I had in January (ditto for several other nurses who attended to me) and, after asking me how I was feeling (groggy but okay), we immediately started talking about beer. Yes, only in Portland! Backstory: My pre-op nurse had asked about my pastimes and, of course, one of mine is patronizing the local breweries. She had relayed this info to my post-op nurse as his wife works for Hair of the Dog brewery in SE Portland.
I only stayed in post-op for about 30 minutes, then was taken back into the pre-op area where Greg was waiting in my room. By then, it was already 3:30pm. It took another 30 minutes for me to feel well enough to get up and change clothes. Meanwhile, Greg went outside to locate a car2go to transport me home.

As soon as I started moving around, my nose began bleeding heavily. The nurse didn't seem too concerned and got me a box of tissues, a large pack of gauze squares, surgical tape and a "Dale Nasal Dressing Holder." She put me in a wheelchair and took me down to the curb where Greg was waiting in the car.
rough ride home
Unfortunately, there was heavy rush hour traffic in all directions from the hospital. We had no choice but to join the masses waiting to cross the river to SE Portland. It ended up taking us more than an hour to drive the four miles from the hospital to our house. My nose continued to bleed heavily the entire time, and I was pretty uncomfortable from the stop & go motion of the car.

The first 12 hours after the operation were awful. I thought I would have to go back to the hospital because my nose would not stop bleeding and I was in unbearable pain. It finally clotted sometime after midnight and we set an alarm to get up every 4 hours so I could take more pain meds.
frozen yogurt & a pet moose makes everything better
The surgery causes your nose to be completely blocked from internal swelling, blood, etc. meaning you have to breathe through your mouth. I tried to sleep in bed with three pillows propped up behind me but still felt like I was gasping for air. Thus, until my follow-up appointment six days later, I had to "sleep" sitting upright on the couch. I ate soup for the first few days because my teeth hurt and it was too difficult to chew & breathe at the same time. Apparently, I also had a reaction to the muscle relaxant they injected during anesthesia. For two full days after the surgery, my entire body felt like it had been beaten. My neck was so stiff I could not lift my head!

I had surgery on Tuesday and did not leave the house until Saturday evening. I didn't feel well enough to do anything other than lie on the couch and it was hard to do anything productive like writing or reading because I had to keep taking pain meds. My post-op orders said to refrain from bending, straining or lifting more than 10lbs for two weeks. I was also not supposed to do anything to raise my heart rate, which could cause more bleeding.
4 days post-op
Thankfully, I was actually feeling somewhat better on Saturday and decided I would go to the Joy of Life fundraiser that I had been invited to months ago by my friend, Cindy. As a sponsor of the event, Cindy, who publishes the Portland Happy Hour Guidebook, had paid for a table and invited nine of her friends to join her for the evening. I had really been looking forward to helping support this wonderful cause and would have been very disappointed if I had to miss out. It was truly a lovely evening and, besides having to constantly pat my nose with a tissue to catch the occasional drips of blood, I managed just fine.

these tools are NOT my friends
I stayed in again to rest on Sunday and then went to my follow-up appointment Monday afternoon. My doctor had not truly prepared me for what was about to occur. Essentially, he suctioned out all the leftover bone, membranes, blood, etc. Not just from my nostrils but from the sinuses under & above my eyes. This is called debridement and it was excruciatingly painful, even with the local anesthetic that is sprayed into the nose. I thought I was going to pass out! Luckily I was carrying my bottle of Vicodin and he told me to take one before he started on the other side.
you got all of that out of my nose?!?!
While the procedure did clear out my sinuses and I could finally breathe through my nose again, I had severe pain to the point that it triggered a migraine that lasted for two days. I did not get out again until Thursday, when I had physical therapy for my hip and then had planned to meet up with Cindy for a special Happy Hour book signing at Trader Vic's. At that point, the pain was more isolated to the nasal ridge, so it felt like I had been punched in the face more than anything (but still with no outward sign that I had recently had surgery). It was a great evening, and we capped it off by scoring free club seats to the Timbers match, care of the owner of the restaurant. So much for taking it easy!!!
enjoying Happy Hour at Trader Vic's (Credit: Charles Henry)
I did rest again Friday, mainly because my sister, Emily, was having surgery to remove cervical cancer and I wanted to be able to stay in touch with my family in Tennessee throughout the day. Thankfully she came through it okay, and was released from the hospital yesterday to continue her recuperation at home. Her pathology report will be available sometime this week and hopefully the news will be positive (meaning no further treatment is required at this time).
I love you, Emily!
I continue to do a little better each day but am still experiencing what I call "broken nose pain." My next follow-up appointment with my doctor is on Monday, May 13th. I'm not looking forward to it because he has already told me there will be more suctioning, but that it shouldn't be as intense as the last time. I think I'll take some Vicodin with me just in case!

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