Septoplasty

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Septoplasty Fun!

On April 30th 2001 at approximately 08:30 in the morning I underwent a
septoplasty and submucous resectioning operation.
This was not my idea of a good time.

It has now been almost eight years since my surgery and I am feeling much improved. In the time since I first put this page up I have received over a thousand inquiries about this procedure and my results. It turns out that there are not that many resources about septoplasty online. In particular there are not many which relate the details of what is involved in the procedure from a personal perspective.

I have been very flattered by this and have striven to answer all the questions as the come. I will continue to do so.

I do have to say however, that I am in no way a medical professional and in no way qualified to give any medical advice. I can tell you about what happened in my case and what I found to work or not work in my case. For anything more than that, you must needs see your own doctor.

That being said, please read on and drop me a line with any questions you might have about septoplasty surgery!

This is a side view of that shows the general position of the septum in relation to the facial structure. The septoplasty only dealt with the septal cartilage and did not affect the bones in my nose.

My septum had become deviated. That is to say it bowed out to one side in its growth. This had the effect of almost entirely blocking the airflow into that side of my nose. This is not a good thing.

This blockage was leaving my sinuses on that side without enough airflow for them to ever dry properly. As a result, the nasal fluid which was being produced kept them too wet and also flowed down into my throat. This had several effects.

First off it has left me more susceptible to colds. Prior to my surgery I would usually come down with four or five colds a year. All too frequently this would also lead to a sinus infection and sometimes to bronchitis as well.

Also, whenever the seasons changed and/ or the humidity varied greatly, my sinuses would react. Without any room on the right side to expand, this meant enormous pressure in that area and that meant for some whopping headaches on my part.

Finally, the near constant flow of excess nasal fluid down my throat kept me with a almost constant mild cough. That left me more susceptible to the bronchitis.

To make matters worse, my left side nasal passage was also becoming blocked. Not from the septum growing into it but because the septum was growing away from it. Along the fleshy portion of the insides of your nostrils are glands called the Turbanates. These are there to warm and moisten the air passing through your nose before it reaches your sinuses. Because my septum had bowed over to the right, that left more space on the left. Space with the Turbanate on that side began growing into. Once the septum was straightened this excess Turbanate growth on the left side would serve to block my nasal passage on that side. So, I was being short changed on both ends! The solution was to cut loose the Turbanate on that side, shave it down so that it was much thinner, and then reattach it. This meant that both sides of my nose would be a mess for the time it took them to heal.

However, the surgery on both my septum and Turbanate will hopefully correct my breathing difficulties, my constant drainage difficulties, and my over-susceptibility to colds, sinus infections and bronchitis. That is the game plan at least. I will have to wait for it all to heal up before anyone can tell.

The surgery itself went fine, near as I can tell. The recovery was pretty standard with no complications. That however, doesn't mean it was fun or easy. In fact, it was one of the more miserable times of my life.

The first day I was very doped up from the surgery. The anesthesia left me very out of it and then the Vicodin that I took afterwards left me feeling very wired. I was exhausted from the surgery and in need of sleep yet the Vicodin was keeping me awake. That was my particular reaction to that drug. After the second night I stopped taking it because of that.

My surgeon told me that I should sleep in an upright position so that my sinuses would drain properly and also so as to reduce the circulatory pressure on the surgical incisions. For the first couple of days I was wearing a "mustache" gauze pad dressing over the end of my nose. This was to catch the near constant flow of nasal fluid and blood as my nasal passages recovered from the operation. After a couple of days I was able to dispense with wearing this during they day, I just had to keep blotting the end of my nose constantly. I would only put on the dressing at night so I didn't make a mess of things on my pillows.

Sleeping was extremely difficult for me in those first few days. I had propped up some pillows so that I was pretty well supported in an almost seated position. I was able to catch some sleep in that position but only some sleep. I would usually be able to doze off for about two hours or so at a stretch. Then I would wake up. I would wake up with just enough energy to not be able to sleep again for a while and then doze off again. For about two or three days I was unable to get any good, solid sleep. Certainly not any REM sleep and I was really feeling its lack. In short, I was exhausted. My body ached I was so tired.

Yet for the first two nights I was also very wired from the Vicodin pain killers I had been prescribed. I tried switching to Darvocet but got much the same reaction. It was a jittery sort of feeling for me. Much like you'd get from having one too many pots of coffee. This isn't good if it is sleep that you need the most.

Finally on Wednesday night/ Thursday morning at about 03:30 I had had enough. I couldn't take trying to sleep in that position any more. I had to lay down. So, I did. I first laid flat out on my back. I did feel some increase in pressure in my nose but not much. Then I went for the gusto and tried rolling over on my side. That is my preferred sleeping position. I did it! I was able to lay on my side - and do so without my nose exploding all over my face! I was elated! This was the first time I was able to be in this position since the surgery. At last, I could now get a real night's sleep. And that I did. I slept for about four hours that night, the longest straight through time since the surgery. Things got better after that.

Another thing which was very helpful to reducing the pain I was experiencing were these gloves. One of the nurses at Mercy Hospital gave them to me as I was leaving after my surgery. They are filled with frozen peas. A very clever thing that. Had they been filled with crushed ice they would not have been nearly as effective. The frozen peas did the job of cooling my nose and therefore reducing the swelling. Once the peas had warmed up is where their utility really came through.

I would simply put the gloves back in the freezer and the peas would once again freeze up - and do so without changing their shape. Had the gloves been full of crushed ice, that ice would have melted as it warmed. Refrozen, it would not have been able to conform to the contours of my face. The frozen peas were able to wrap around my pained nose and cover it all. The individual fingers of the gloves also helped with this.

In short, this was a very clever and very low-tech way of providing relief and I really appreciated it. Also, the frozen peas inside the glove would look really cool if I let them sit outside of the freezer for a bit, as in this photo on the left!

Even with the frozen pea filled gloves and the ability to get some real sleep I did have some weird experiences after that though. Thursday night/ Friday morning I awoke in the middle of the night to find myself shivering. I was deeply chilled - and this while I was under sheet, blanket and comforter! I was shivering so badly my whole body was physically shaking. This was very strange. I got up and moved around my house hoping that this would warm me up. It didn't. I was shaking worse now. So I tried a trick I learned from watching a science program on TV. No, I'm not kidding. It was a cable show that had been on a few years back and it was called "Beyond 2000."

In this one episode they were demonstrating some of the new equipment for dealing with cold weather accidents. One of these was a device to more effectively treat hypothermia. Whereas most previous methods only warmed the body from the outside in, this one warmed it from the inside out. A much more effective and faster means of doing the job. To get about this they used steam. They had a small burner and water container. The idea was to get the water heated quickly and then have the victim inhale the steam vapor. This would get the hot vapor into their lungs. That would both warm the chest cavity with the vapor's heat and it would warm the blood in the lungs which would then course through the rest of the body warming it as well. All in all this is a very neat idea. So, I tried to emulate it.

I put some water in a saucepan and turned up the heat beneath it. In a short while it was steaming and I was breathing in directly over the pan. I quickly realized that I was probably inhaling gas vapors as well so once the water was well steaming, I turned off the burner. The water continued to steam off and my inhaling that really did the trick. In short order my shaking had stopped and I felt much warmer. I was able to go back to sleep soon thereafter. The next night I also experienced a chill while in bed but it was nowhere near as severe. Strange indeed.

Monday, May 7th, was a big day and one that I was much looking forward to. That was the day I would go back to my surgeon's office and he would then remove the splints he had placed in my nose. They were there to keep the septum together and straight as it healed. I wanted that to happen as I didn't want to have to undergo this procedure again. I also wanted those damned things out of my nose as well. Mostly because I knew that it would be a major milestone in my being fully healed. Those things had been up my nose for a week and it was high time to be done with them!

The Real Thing!

The Splints and Some of the Suture Material

Hard to believe this is what was up my nose for a week. Gross huh? Yes, I did clean these off before I scanned their image in - you don't think I'd want to mess up my scanner do you?

Even more amazing are some of the details. These splints are actually pieces of a whitish translucent flexible plastic sheet. Cut to shape to fit the inner contours of my nasal passages. Each splint is about a sixteenth of an inch thick, and inch wide and about two and a half inches long!

Details

The numbers in the photo above show where the suture went through the splints to hold them in place. To do that they also ran through my septum. There were six such punctures. That meant they had to run through my septum cartilage six times. Through one side and out the other. Six times. Ouch!

This also means that I now can say that I have had my nose pierced! And not just one little old piercing but six!

I'd like to see anyone with some piddling little 10 gauge nose ring try topping that! Hah!

You'll notice I also pointed out some "grip marks." Those were the down side of these splints. I have been told in no uncertain terms that having splints up my nose for a week was a helluva lot better than having a surgical packing up my nose for a week. Packing my nose would have meant stuffing gauze dressing up my nose. Lots of gauze dressing. Yards of it in fact. No, that is not an exaggeration. Gauze is thin enough and there is enough space in the nasal cavities that most packing does involve yards of the stuff. Not a pretty thought and even less pretty when it comes out after a week!

Luckily I didn't have to go through that. So the week I spent with these splints up my nose was not made more uncomfortable by their being there. It was the removal of them that was problematic.

You'll notice there are six holes in each splint where the single long suture strand was placed to hold the splints in place. The suture was very effective at doing that. Perhaps the job could have been done with just two or three "anchoring" cross through punctures. Perhaps. Six though, served to anchor those puppies in there but good.

On Monday my surgeon looked up my nose, sprayed some Neosenephrine up there to dilate things and then sprayed some Novocain up there to numb things. Then he set to work removing the suture. That was not a particularly painful thing. The Novocain was helpful in this and the suture itself was pretty easy to remove. When you got to it.

Satisfied that he had gotten to them, my surgeon then picked up his forceps, locked them in place on one of the splints, and pulled it out. Or at least he tried. And he tried pretty hard. Several times. On both sides. He failed. Badly.

They wouldn't budge. They didn't move. They were still anchored in place. I was in pain. REAL pain. A deep, grinding, howling pain - and howl I did! I think everyone in that multi-story medical office building heard me yelling in pain. My surgeon heard me too. Good thing, that. I was covered in a cold sweat and I was panting for breath it hurt so bad.

"Sorry about that. They usually come right out. I think I need a longer pair of scissors" he said and then left the room. A few minutes later he was back with that longer pair of scissors. Some more Neosenephrine, some more Novocain a little bit more work with those longer scissors, and then it was back to the forceps.

I braced myself for more pain and was relieved that it didn't happen. Instead, the splints came out. Not quite "right out" but close enough considering what had happened just before. I was relieved that this was over and amazed to see what they looked like.

I also realized that the good doctor had screwed up. He had missed cutting loose one or more lengths of the suture thread he had placed in my nose to hold those splints in place. That is why they wouldn't budge when he yanked on them. He gripped them hard enough to leave those "grip marks" in the plastic. And he pulled really hard. Those lengths of missed suture anchored those splints in place like they were welded there. Lucky me. Is this what medical malpractice suits are made of?

In his defense though, it was rather easy to miss one or more of those things. There isn't a lot of space (width wise) in your nasal passages. With the nasal fluid and swollen glands obscuring things it is hard to see what you are doing up there. Also, the ends from one length of suture threaded through my septum could have easily blended with the ends of another length and the suture thread itself was of a color that didn't stand out where it was placed. Still though, this was not a fun thing to have to go through. Although it does at least it make for a good story.

Closing things up, I would like to thank some folks who were very helpful to me in my going through all of this. Sharon was a real sport in not only picking me up once my surgery was done but also in having gotten up at the crack of dawn to drive me down to the hospital. She even offered to sit with me until I was called in for the surgery. Once I was back home she called me and checked in several times. I really appreciate that. Tony Lindsey (a.k.a. Papa Tony) also was very helpful after my surgery. I needed a place where I could crash out for a few hours but be under observation in case I had an adverse reaction after the surgery. Had I family here or a lover than that would have fallen to them. I don't and Tony was gracious enough to open his house to me when I needed his help. Thank you.

All in all, this has been an experience which I WOULD wish on my worst enemy! (If I had such a thing) I don't like medical scenes in general and I particularly don't like them when they are real and involve me! I'm glad I'm through the worst of it and I am very hopeful that this will improve my life. I'll let you know in the coming months.

Follow-up

June 2007: It has been over six years now since my surgery. My progress has been very good. I have achieved all of the major goals I wanted from this procedure. With both of my nasal cavities properly opened, both of them can properly breathe and air out. This means that there is no longer a constant flow of nasal fluid dripping down the back of my throat. That means that my throat is no longer constantly agitated and that means I am no longer constantly coughing.

Also, my sinuses are no free to expand and contract as the humidity and seasons change. I really appreciate not getting so many sinus related headaches. I also appreciate not getting so many colds, sinus infections, and bouts of bronchitis.

In mid-March of '02 I worked through the first sinus infection/ cold that I had since the surgery the previous April. That is unusual for me. Prior to that surgery I could have expected to endure three or four colds and infections each year. That this is the first and is so mild is something I am very thankful for.

All of this has combined to let me say that I have greatly benefited from my septoplasty surgery.

From all of the emails that I have received as a result of this page, I know that my results place me with the majority of folks who have also undergone this surgery. The vast majority of the people who have had such a procedure and who have also written me about it have reported positive results as well. Not all of them, for there have been a couple of negative results. This is a serious procedure and there is much that can go wrong. Every person is different and every doctor is different too. I know that I was fortunate in that my surgeon really knew his stuff about this procedure and that he has been doing this for many years.

So, would I do it all again? Not if I didn't have to! However, there are a number of things which I would have done differently had I the knowledge of them beforehand. Finding the right painkillers that wouldn't leave me unable to sleep and also finding a comfortable way to brace my head up such that I could sleep sitting up would be the two main things I would do differently.

One other thing which I've been asked is whether the procedure changed the shape of my nose as a result. Well, my surgeon did notice that my nose had a slight bend to it and asked if I wanted that fixed. He'd already be in there doing the Septoplasty so throwing in a bit of a Rhinoplasty at the same time would be no big deal. I also had noticed that slight bend and had actually grown accustomed to it. It was my nose and my nose had a bend to it. So, I declined this offer to unbend it.

After the surgery and after the swelling had gone down and after I was healed enough to think about such things (about a week after the splints came out) I was looking at my nose one day and realized that the bend was gone. Either my surgeon had gone ahead an unbent it on his own or, and much more likely, in the process of undeviating my deviated septum it had also served to straighten out the appearance of my nose in general. Thus, the appearance of my nose did change as a result of my Septoplasty. However, most folks would be hard pressed to tell the difference and it's something I am well able to live with.

And there you have it. This page was originally intended as just being a way to show my friends what I'd been through. I'm flattered that it has proven useful to so many other folks who are facing having a Septoplasty of their own. Please bear in mind though that what I've related here is just a bit of my personal experience. I'm not a doctor nor am I any sort of medical professional. I'll be more than happy to answer what questions you might have about the Septoplasty I went through but for specific medical advice you'll need to ask your doctor. With that in mind, please feel free to drop me a line about this procedure and what I learned from it.

If you would like to know more about this adventure I had, then just ask! Click on my email address here:
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This page was last updated on: 24 February 2009

Unless otherwise noted, all photographs and images on this page are copyright protected property of Madoc Pope. If you would like to use any of my images you must contact me first before you do so.

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In the meantime, I hope you have enjoyed your "stay" at this site. Check back again to see what new images I have added. Until then, stay well, play hard, play safe, and have fun!

Madoc