symposia

I thought I’d write down my thoughts and experiences, not only for my own ‘looking back on’ in future, but for others who may be contemplating taking this procedure in future or are also going through the (rather terrible) post-operative recovery phase. For the uninformed, a septoplasty is to correct a deviated septum - the cartilage that runs down the centre of the nose - which should open up my airways. The turbirectomy is the removal of the inferior turbinates, which should also help this goal.It is definitely not a nose-job, even with the implication (these are known as a rhinoplasty).

I was admitted into Casey Hospital in Berwick, after a year’s wait on the Elective Surgery list, at about 8:45am on Wednesday the 13th of February 2008. Here I waited for another hour and a half before I was wheeled into theatre. I was quite anxious about this surgery, and the presence of my partner Melissa really did help (so in other words, bring someone supportive along). Surgery commenced at around 11:15am, with the routine being hooked up to various instruments and then given a gas mask to breathe through, being told that it was simply air (it’s not). I remember dreaming some trippy shit towards the end of surgery and woke up in a significant amount of pain in Recovery. In response to my cries of pain, the helpful people there gave me a dose of fentanyl to kill the the pain. I was told that it was weaker that morphine, but on further reseach when I got home, it turned out to be 80 times more potent! Whatever the case, it did a damn good job at numbing the pain.

I came back to Ward A complete with nostril packing (this is lots of dressing stuffed up both nostrils) and splints (pieces of plastic to hold my septum in place). I also came with a large amount of blood all over (so much so that the nurses offered a new gown). This was at about 1:30pm and I was quite woozy at this stage, and drifted in and out of sleep. It wasn’t really until about 3pm or so before I was semi-coherent. I was given a few sandwiches for lunch which I couldn’t taste (so I don’t know what they were!). Not much changed between then and 5pm, when Mel had to leave (but was replaced by my brother). Dinner was then served and gave me a very harsh lesson in how I must eat for the next few days. As you’d know, the process of opening your mouth wide to eat a large chunk of food also involves the movement of the nose. This, obviously, was not possible in my state. So it hurt. A lot. Lesson learned.

At about 7pm, both brother and mother left and I was left alone to rest. I promptly fell asleep. It wasn’t very good sleep as my nostrils were both blocked. It was ‘lights out’ at 10pm but due to a combination of nostril issues and the nurses barging in on our sleep every two hours for obs (a la army barracks) meant a very unpleasant night of sleep. Even so, I needed to change the dressing outside of my nostril to catch the blood and discharge dripping from my nostril ever hour or so.

Post-Op: Day 1 / Valentine’s Day

The next morning was a time I was really looking forward for two reasons: I would be seeing Mel, and the packing was coming out! The surgeon came to my bed at 8am or so, and proceeded to take out the dressing. This has got to be the weirdest (and strangely painful?) experience I’ve had in a while. They’d packed this nostril quite heavily (picture about 1m of fabric up a nostril, and then you’re just starting to an idea) and it was heavily blood clotted to the surface of the nostril overnight. The feeling of rough fabric in your sinus area is just plain weird. The right nostril came out quite easily, as it has been pumping out ‘clear’ discharge all night but the left had been dry all night. This one refused to come out because it’d adhered to the nostril wall and need a bit of convicing to come out. This convicing, however, sent me to tears. Not because of the pain (because it didn’t actually hurt that much) but more so because of the link between the nostril and the tear ducts being irritated.

Mel and mum arrived an hour after this incident and took me home (I was discharged at around 9:30-45am). I was prescibed some Panadeine Forte and FLO (I’ll explain later).

When I got home, I immediately hit the sack. I was in a tremendous amount of pain, my dressing to catch the flow of bloody discharge was drenched and I was tired from the sleepless night. I left Mel to play on my computer (how romantic). Before I forgot, though, I gave her my present. I bought a heart-shaped locket with our pictures inside and engraved on the back ‘Remember; you’re loved.’. It was then time for lunch.

I was informed not to have anything hot because it would encourage bleeding. So I had cold spaghetti bolognase. Not too bad actually…we then proceeded back to my room of rest and adrenalin where I subsequently fell asleep (how romantic). I woke up at around 2pm, when it was almost time for her to go home.

Now it was time for a nasal irrigation with FLO. It is basically a soft plastic bottle that I fill up with lukewarm boiled water and reconstitute a osmostic fluid that resembles the fluid in your nose. I then pump it up one nostril, have it go through my sinus, and then have it exit via my other nostril or my mouth. This stuff feels great inside (it doesn’t sting / burn) but the process of getting in there is annoying. Because the nostrils are so inflamed post-surgery, it is essentially blocked anyway. Trying to pass fluid through this requires a bit of convincing, and my general inexperience with this meant that I often ended up giving up with the nozzle still in my nose - creating a suction which was quite painful. That said, the shit that comes out the other end lets me know that the pain is very much worthwile (a lot of old blood and gunk).

The rest of the evening was relatively uneventful.

I decided to get an early night at 10pm, after a hit of codeine to help me get to bed. I, however, woke up at 12:30am…which was annoying because I often am unable to go back to sleep after such events unless I rotate beds. So I did so, and was woken up again at 3am. Stayed in there again till 7:15am, and again at 9am.

Then I got out. I had a fever of 38 degrees…although I can’t say I’m surprised.

Post-Op: Day 2

Mel decided to arrive at around 11am. She has this funny effect on me when she’s around…the pain suddenly goes away. Anyway, I let her play some Portal (yeah, we don’t have any cake) while I lay in bed generally suffering. There was less blood coming out of my system now, but a lot of blood tainted discharge. My nostrils are still blocked, but I can pass air through my right one. More irrigation later, and I get more blood out of my right nostril. Left one is still blocked (but I was able to get a whistle out of it at around 2pm).

There was a patient next to me by the name of Peter. He was a bladder cancer patient in the bed next to me. He’d mentioned that the third day after anaesthesia is always the worst - with lethargy and whatnot settling in. I guess he was right (coming from a cancer patient, I guess I should’ve trusted his experience). I was really tired, but never actually went to bed. I just lay down.

I did get fevers during the day…I hope it’s a transient thing or I might have to run to ED.

My last irrigation at around 10pm really cleared up the blood (and the first irrigation I did right!) and resulted in no more blood flow (just blood-tainted discharge).

I might go to sleep now.

Post-Op: Day 3

A relatively uneventful day compared to the first two. I got a decent amount of sleep (about 7 hours or so, with interruptions) but still feeling tired, as expected. The codeine really does put you to bed!

I’ve settled into a bit of a routine with irrigation and medication. I’d have two panadols around meal times, and two panadeine fortes (2 x 500mg paracetamol, 50mg codeine) just before I go to bed. With irrigation, I’d have one when I wake up, one at around 3pm and one before I go to bed. After getting the hang of the irrigation (and the psychological block of stuffing liquid up my nose), I’ve really come to appreciate the benefit of doing the douching. It gets rid of the stale blood in there and helps clear things up a little up there. Not to mention that it should prevent any infection, hopefully bypassing the need for antibiotics…

There was a bit of bleeding in my right nostril when I woke up this morning. I decided to take an aggressive approach to bleed control and packed ice on it straight away - I soon learned that I had to do this after each irrigation and I did so.

An otherwise relatively uneventful day passed.

Towards 10pm that night, my right nostril opened up! Kinda…it did feel like heaven breathing through it at all. But, being able to breathe carries another benefit (a double edged sword). Smell! It’s great being able to smell and all, but I smelt the stench of the crap that’s up my nose. NOT PLEASANT!

I’ll probably go irrigate it again and see what the results of that are..and then get some sleep. Negoitating with Mel on whether she’ll come over tomorrow (in one day, I’ve managed to get her addicated to Portal).

Post-Op Day 4:

Nothing much to write home about today, very much routine. Bleeding has really slowed down, all I’m getting now is smelly yellow discharge which I’m told is fairly normal.

Post-Op Day 5:

Pretty much the same as Day 4, following the routine of irrigation and generally keeping some nose hygiene. Not really using the gauze ‘moustach’ dressing anymore.

Had my first decent trip outdoors today - went into Monash today to meet up with some jaffies (just another f*ing first year [jaffy]). It was good in general, except I was feeling quite exhausted when we hit the lounge. After many attempts of Mel trying to get me to leave (I was quite comfortable where I was!), I finally left for home at 4pm. I was extremely exhausted at this stage (it had been a hot day).

I had a lay down when I got back and everything seemed fine up until dinner. However, after a slightly warm soup for dinner, I had a blood nose. This blood nose wasn’t your typical one either….it just flowed and flowed (but was clearly capillary in nature, as opposed to arterial). It took two bags of ice, a cold compress and a good one and a half hours to stop. Any longer, and I probably would’ve ended up in ED. I left my last irrigation as late as possible, worried that it could loosen the weak clot that would’ve formed.

Let’s hope nothing bad happens while I sleep.

Post-Op: Day 6

Hooray! No bleeding overnight!

Again, another fair uneventful day…dreading tomorrow’s splint removal on the account of pain! Had Mel come over again today, fun times…then we had lunch and then I ended up at her place. Still a fair bit of discharge coming out, but there hasn’t been any bleeding as yet.

We’ll see how things go tomorrow…