My Septoplasty Adventure

I have several friends thinking of getting their deviated septums fixed who wanted to know about my experience so I figured I’d document it here in my signature painstaking detail.

For many years my nose has bothered me. Always feeling like there’s something in it or it needs to cleared even when that’s not the case. I first had an ENT check it out in 2012, I think. That’s an Ear, Nose, and Throat doctor, not a big sentient tree from Middle Earth. At the time, I don’t think my insurance was going to cover it and it was going to cost me around $1500 (I think, but it was a long time so and maybe I’m just making that up). He said there were no health risks with it, it was strictly what is known as a “Quality Of Life” improvement so it was really up to me as to how much it bothered me. I decided it didn’t bother me $1500 worth.

Fast forward to 2021. It didn’t really get any worse, I don’t think, but a slight annoyance for almost 10 years or more really starts wearing on you. I’d lay in bed trying to sleep and sniffing and snorting feeling like my right nostril had some bogeys up there, but there were none. It was just simply that my right nostril was so narrow due to my crooked septum that there was hardly any clearance between the upper walls. Having dipped my toe in the surgery pool for the first time ever with my colonoscopy a month or so ago, I decided, hey, why not keep that train a-rolling and check back in on this deviated septum bid’ness. My doctor said insurance would most likely cover it.

So I went to see Dr. Joseph Leary at the Austin Regional Clinic Far West. He took a look and said that on a scale of mild, moderate, or severe, mine was a “moderate.” Again, it was up to me. He said that in addition to the septoplasty, they usually also did a turbinate reduction which reduces some of the inner nose tissue to increase airflow even more. These two procedures generally come as a package. If I wanted to schedule the procedure within 30 days, this appointment would count as the pre-op, so I went ahead and did that.

The week before the procedure, I get calls from the doctor, the hospital, and the anesthesiologist. My insurance will pay 90% and my 10% comes to about $700. I’m not thrilled but at this point I’m all in. How it was $1500 in 2012 and now $7000 total, I don’t know, but whatever. Yay, American Health Care System.

The night before the procedure there was the usual “No food or water after midnight” but unlike Gremlins, I could be around bright lights if I wanted, so take that Gizmo. The next morning at 6am, my roommate dropped me off at the surgery center. I got into my gown and some sweet slipper socks WHICH YOU GET TO KEEP (SCORE)! The pre nurse came to insert my IV. Now I’ve been told time and time again that I have great veins that are super easy to find. I’ve done medical research studies where I had to have blood take with ridiculous frequency. Once, when I was reflexively squeezing my hand into a fist, which they usually ask you to do, I was told “You don’t need to do that.” So of course, this poor nurse can not get the IV to go into the vein of my right hand. It just won’t advance. She theorizes it might be because of a valve. She tries the left hand. Same thing. She feels really bad about it and I tell her it’s fine, these things happen. She gets another nurse to come over who is going to try my right forearm. She asks if I want some Lidocaine to numb the area. I say “I don’t know. I guess? What do you think?” we decide to go with it and she gets that IV in just fine. Phew! The anesthesiologist and doctor come by at different times to check in and talk to me. They wheel me into the Operating Room and have me shuffle from the bed onto the operating table. And then they must have turned on the anesthesia, because that’s the last thing I remember.

I started coming to in the recovery room. A nurse was asking me how I was doing. “I’m really tired.” I slowly came out of my stupor. I had been told beforehand that this would be a deeper level of general anesthetic than I had for my colonoscopy and would actually require a tube in my throat while I was out. As I came to, she gave me some Ginger Ale and some water. I felt a bit nauseated and she gave me a bag which I threw up into a little. A minute or so later, I threw up again in a second bag. Much more this time and she said it seemed to be a lot of blood, but she didn’t seem terribly concerned about that. I’m guessing because inevitably blood gets down into the stomach during the procedure. After that second one, I felt a lot better and they shot me up with some anti-nausea medication. I had a handy, dandy nose bra on that is like a little sling/mask that holds some gauze under your nose. I got dressed and was wheeled out to my waiting roommate. On the way home we stopped drove through CVS to get my antibiotics and pain meds.

For the first few nights, they recommend you sleep elevated, so when we got home, my roomies offered me a “Husband Pillow,” which was a term I had never heard before but was one of those bed pillows with a back and arms for sitting up in bed. That ended up being perfect for my convalescence. I laid back on it and took a nap. For that first week, you have plastic splints in your nose that are sutured to your septum and you are supposed to take it easy. No exercise or bending over, and you are supposed to do sinus rinses 4-5 times a day with something like a neti pot or my choice, a Sinus Rinse. They had told me to start doing them late that afternoon and I was expecting a horror show for my first post-surgery rinse. Much to my pleasant surprise, it was mostly clear.

For the first 2 days, I didn’t do much. Lots of sleeping, sinus rinses, watching some shows, listening to Yacht Rock Radio. I took my antibiotics and pain meds and kept my nose bra on, changing out the gauze frequently. A little bleeding but not much at all. Sleeping elevated was a bit weird, but I didn’t have much of an issue and that “Husband Pillow” helped a lot, though you could easily use a couple of pillows as well. By the third day, the nose bra’s elastic strap was starting to irritate me above my ears, and it didn’t seem like I really needed it any more so I stopped wearing it. Somewhere around this point, I started experimenting with laying off the pain meds as well. I hadn’t felt any pain at all (probably since I had been taking the Hydrocodone) and for the rest of the week, I would only take one if I felt I needed it. Usually due to a headache as opposed to any actual pain in the nose itself. Somewhere around the fourth or fifth night, I discovered that flipping the Husband Pillow over and putting my pillow on the sloped back of the Husband Pillow made for a better sleeping arrangement.

My recovery seemed to go perfectly and while it wasn’t fun, it certainly wasn’t miserable or anything. I was tired a lot. The most annoying part is the splints in the nose which make you feel totally stuffed up the whole time and you mostly breathe through your mouth which dries out your mouth, especially at night. I slept with a humidifier on and also bought some mouthwash specifically for “dry mouth” but I don’t feel like either were major successes, but they helped some. Toward the end of the week I was feeling pretty normal aside from the annoying stuffiness of the splints. They only tell you to sleep elevated for the first couple of night, but I’m an over-achiever so I figured if it promoted better healing or something, I was going to do it all week, and I did. I got no awards or recognition for this, though inside I knew I was awesome.

7 days later came my post-op appointment. Dr. Leary said everything looked good and really clean and he could tell I must have been rinsing frequently. When I told him about how I’d slept elevated all week, he said that was mostly just for you own comfort at the beginning with drainage and such. Again, no kudos or accolades for my extra credit. He snipped the suture and easily pulled the splints out which didn’t hurt at all and actually didn’t even really feel all that weird as I expected it to. It was glorious. All that airflow in my nose. I vowed to breathe ALL THE AIR that day. I celebrated with some paneer tikka masala and a giant pile of naan, then I had a glorious nap laying flat and breathing through my nose. I have my final post-op in another 10 days and am still supposed to take it easy and slowly ease back in to activities as things are still healing, and keep doing the rinses every day. For me since my case wasn’t all that bad, it’s not a major change for me but I do notice the difference and am glad I did it.

As a post credits slightly possibly disturbing scene: I was inspecting my nose after a rinse and saw what seemed like a lose piece of skin the night after getting my splints out. I gently probed with some tweezers and thought I’d pluck it off. It was surprisingly tenacious. It didn’t hurt at all though I just felt a little pressure as I tugged and I was really surprised how well that little piece of skin was hanging on. Finally I gave it a stronger, more aggressive tug, and pulled a 3/4″-1″ piece of leftover suture from my septum. Again, no pain at all, but a very weird sensation that left me a little freaked out and that I would think about for the rest of the night. And now you probably will too.

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