A New Year, A New Nose

20 01 2009

Here we go, it’s been 12 days in the making, but here’s the entry (finally!) of my exploits to turn my nose into a functional rather than purely decorative body part.

The short story.  Unbeknownst to me, I had a deviated septum.  I had no idea, and only became aware of it when my Doctor mentioned it during my annual physical examination.  Essentially, I was unable to breathe through the right side of my nose.  The deviation/blockage being so severe as to almost completely obstruct it.
As I said though, I was never aware of it.  I’ve had it so long (possibly always) that I didn’t know any different, and since I was relatively inactive, it was never a problem.  That was until I increased my physical activity.

The idea of surgery completely freaked me out, as I’d never been to hospital before, other than to visit someone, or to have an x-ray taken.  So the idea of actually having a general anesthetic and surgery made me delay for almost a full 12 months seeing the Ear Nose and Throat (ENT) Doctor I was referred to.

Jokingly the evening before my appointment for this referral I said to Mark, “if I’m going to be on the table to have my breathing fixed, I might just tweak my nose a little while I’m there”.
Mark being Mark, the ever supportive and complimentary partner replied “You should, you have a fat nose”.

Famous last words for him.  I did mention it to the Doctor while I was there and the procedure isn’t a cheap one.  Even with a discount for already being in the surgery and anaesthetized.

Anyway, the day of the referral, I met the ENT Surgeon and was examined.  Guess how excited I was to discover part of the examination included having nearly 50cm of optical cable fed through my nose, and down my throat.
He warned me it wouldn’t be a very pleasant experience, despite having my nose numbed.  Fortunately I think he built me up to expect the worst.  It was certainly unusual, but it wasn’t horrible.  The only part I didn’t like was that I couldn’t see what he was seeing. 😉

The examination confirmed my personal Doctors opinion that my septum was deviated, and that surgery would be required to rectify it.  At this point I asked about cosmetic surgery, primarily to fix my nose from being crooked.
I suspect although am not certain, that I broke my nose in my early teens when I fell breaking my front teeth.  At the time though I was in so much discomfort from my teeth that my nose was never checked.
At this point the surgeon I was seeing brought in another surgeon one who specialises in Rhinoplasty surgery.
This was Dr Samuel Lee, and as he’s skilled in both Septoplasty and Rhinoplasty surgery, rather than having two surgeons, he performed both procedures.

I met with him again in December to reassess my requirements and discuss the surgery before scheduling the actual date.

The actual day of my surgery was Thursday January 9.  I had the option of having it performed on just before Christmas but opted against spending Christmas and New Year recuperating.

In the lead up to the surgery I’d had the opportunity to speak to several people who had already experienced it, and all of them told me I’d wonder why I’d waited so long once it was all over, and that I had nothing to worry about.  Truth be told, it wasn’t really the surgery I was nervous about.  It was the anesthetic.  I’m a bit of a control freak, the idea of not being in control of my own consciousness scared me a little.  Everyone I spoke to said I had nothing to worry about, and that I should discuss any concerns on the day with the Anesthetist, which I did, and also with my surgeon.  All of which put my mind at rest.

Booking surgery is interesting, you can schedule a day, but you can’t schedule a time, you don’t actually find out when you’re being operated on until the day before.  When you do get your time, you also get reminded that as of midnight the night before you’re not to eat or drink anything, not even water.  Also for the 10 days leading up to the surgery I was advised to avoid all vitamins and mineral supplements, and any drugs or prescriptions that I may have been taking.
Fortunately, aside from a daily antihistamine tablet, and vitamins, the only drug I’d been taking was an anti-inflammatory for a back injury, which had fortunately healed to a state sufficient that I not need them anymore.

Being a diligent first time surgery goer, I followed every instruction to the letter.  To further make my life easier, I made sure the house was clean, groceries stocked, laundry all washed, dried, sorted, folded, ironed, put away etc., and thanks to my friend Lisa, also got the guest room fully set up so should I need to, I could sleep in there.

My friend Lisa drove me to the hospital on the day, and my other friend Shelly met me there as she knew I was nervous.  The procedure itself is performed on an outpatient basis, but since it’s surgery, you’re obviously not allowed to drive yourself home.  So it was the lovely Lisa who played chauffeur for the day, while the pair of them played hand holders and support team.  They got to see me in my lovely hospital garb, and take photos of me in them, very pretty.  Were there as the nursing team hooked me up to my I.V. fluids, and even when the Anesthetist Kevin came in to introduce himself.  He did tell me his name; Dr (something with 200 consonants and about as many vowels), but told me I could call him Kevin.  So Kevin it was.
The whole team, my own; Lisa and Shelly, the nurses, Kevin, and my surgeon were all fantastic and put my mind at ease, to a point where I was even laughing.  I told Kevin I was nervous about the anesthetic, and a bit of a control freak, so therefore nervous about being not in control of my own consciousness.  Such a nice man, he laughed, and said if I liked he’d let me anesthetize myself.  Of course, I laughed and told him if I was doing it myself I wanted a discount.

When it was finally time to go into surgery, I’d be lying if I said I wasn’t nervous, I said my goodbyes to the girls and gave them, and got in return a big hug, and a “see you soon”.

Oh, let me interject here.  The morning of my surgery, since I didn’t need the car, and wasn’t due at the hospital until nearly 11am I decided to sleep in.  Mark, and remember, he’s caring (refer to the fat nose comment), had the following exchange with me.

Mark:  Craig, I’m leaving.
Me:  Mmmm (Remember I was still asleep)
Mark:  See ya.

Lisa sent him a text message, or so she thought telling him later that he should wish me luck for the surgery.  Unfortunately she sent it to me not Mark.  He got the message eventually, not realising that I knew he’d been put up to it by Lisa.  I replied to his text with “Thanks Lisa”. 😉

Back to the surgery.

I was walked into the Surgical Theatre by a nurse, who introduced me to everyone, before helping me climb up onto the operating table.  A table shaped a little like a crucifix, I’m assuming so your arms can be tied down.  I’m just assuming though.  Once up on the table I was “tucked” in by the nurse with a nice warm blanket, and then Kevin entered the room and asked me how I was doing.  At this stage I was pretty comfortable, and had been chatting to the nurse about Australia.  Clever girls, not only were they legitimately interested in Australia, but the conversation also put me more at ease.  At this point Kevin told me to take deep breaths from the oxygen mask that was being put over my face.
”Oxygen”.  It didn’t taste like oxygen, I was told twice to take really DEEP breaths.  By the second breath my scalp was tingling, but the third…  Well the third for me never happened, the next thing I knew was that I was in the recovery room.

Waking up wasn’t as bad as I’d expected, but my nose felt like it was on fire, well my nostrils anyway.  My attendant nurse was lovely.  She asked me what my pain was on a scale of 1 to 10, this was a scale that we’d established before the surgery.  My reply was a solid 3, perhaps a 3.5.  So not too bad at all.  It was at that stage that the discomfort rapidly went away, and since I didn’t swallow any tablets I’m pretty sure something was added to my IV.

Post Op 4.42pm in RecoveryThen I fell in love.  My nurse, who’s name I sadly don’t remember, asked me if I’d like some ice chips to suck on, as I was overheated from the blankets and hadn’t had anything to eat or drink since before midnight.   Ice has never tasted so good in my life.  I’m not quite sure how long I was in recovery for, but I know that the surgery started around midday, and Lisa met me in recovery around 4.42pm where she took a photo of me, on my request.  So I’m guessing surgery took a good 4 hours.

The only real discomfort I had at this stage was that of a full bladder.  I highly recommend IV fluids to anyone if they’re interested in hydrating themselves, they’re brilliant, I felt great, and my skin was all nice and plump and hydrated *laugh*, but my bladder was bursting.

I asked the nurse if I could use the bathroom, she said I could either use a bottle or I could wait.  I opted to wait.  Apparently the nurse noted at this stage that my blood pressure started rising, so noted that I really needed to go to the bathroom a little more urgently than I was letting on.  She was correct, I just didn’t want to use the bottle.

In the end I conceded, and the bottle was brought.  Along with a giggling nurse who mentioned “I don’t need to see it, I’ve seen hundreds, so unless it’s particularly impressive I’m going to pull the curtains”.
I couldn’t help but laugh, and was very much relieved that the curtains would be pulled.  Not that it mattered, I couldn’t go anyway.  After a few minutes a voice through the curtain asked if I was done, to which I replied “No, stage fright”.
The nurse giggled again and then turned on the taps in the nearby sink to "help me”.  Hehe!
Still no luck.  I just couldn’t go lying in a bed.  I asked if I could at least stand and lean against the bed for balance, apparently by this stage I was sufficiently coherent for this to be possible.  Thank the gods!  Sweet relief!

Comfort restored, it was back into bed, and back to sipping fluids, at this stage they were pretty much all frozen, so I had to take small bites and chew them up to ingest them.  The nurse promised me an apple juice which I got later when I was moved from the recovery room bed to a reclining chair in the original private seated ward the day started in, and got my apple juice finally.  Two of them.  Apple juice has never tasted so good.

Open RhinoplastyIn later discussions (several of them, as I was kind of drugged out of my mind still) the surgeon informed me that the deviation in my nose was quite severe, and that the original Rhinoplasty had become a necessity, as they identified that my nose had been quite badly broken sometime in the past (I’m thinking the fall during high school) and that they’d had to perform a cartilage graft to rebuild the right side of my nose, after breaking, straightening and resetting my nose.  All performed by doing an Open Rhinoplasty.  The photo is not of me, I found it online.  But I do have the same cut on my nose and even now, 12 days later the tip is still swollen and slightly numb.  Not surprising given how it’s opened up for access like the hood of a car.

Much of the rest of the day was a blur.  Lisa drove me home with my new nose, nose case, and internal splints, where I was met by Mark and Shelly.  Mark had bought me a bunch of roses and a Get Well balloon and I got to commence the regimen of taking painkillers, and antibiotics for the next week and a bit.  Heavy duty narcotics every 3 hours for over a week.  So while I was pain free, I was most definitely not in any state to be able to “operate heavy machinery”.

Once instated on the couch, it was time for dinner, cooked by Lisa, a lovely Shepherd’s Pie.  Shelly cut it up for me so I wouldn’t have any trouble eating it.  So helpful. 🙂

It was very tasty, right up until, during and after where I fell asleep in it.  *laugh*

The very next morning I was back in the Surgeon’s office for a check up, he was happy with everything, and explained the process again.  I honestly don’t recall a great deal, as I was still pretty much stoned out of my mind from the previous day.

The following days included me cleaning my nose out daily using Hydrogen Peroxide solution, cotton buds, and a torch because it was too dark in the bathroom.  This was the fun part of the whole process.  As gross as it may sound, there’s something really satisfying about the sizzling noise hydrogen peroxide makes when it comes into contact with blood, and then being able to actively mine from your nose all the clots and secretions.  Lovely!

Oh, I forgot, through the first couple of days I got to wear a bandage under my nose, as it bleeds quite freely during the first day.  It’s a bit like a hand rolled tampon held in place under your nose by an elastic band.  Pretty!  But totally functional.

So, drugs every three hours, with the routine being that every time my alarm on my phone went off, I’d reset it for 3 hours time, take  my tablets, and then lapse back into pain free oblivion.  To describe the feeling, it’s like having your brain turned into a gelatinous mass, then wrapped in cotton wool, and still trying to use it.  Not too effective, but not overly unpleasant either.  The only side effect I hated more than anything was that the painkillers I was given can cause itching.  My god did they ever.  My nose was fine, the itching was borderline unbearable.  Fortunately it passed after 4 days.

6 days later I went and saw my Surgeon again, and had the nose cast, external stitches, and the internal splints removed.  For your viewing enjoyment I had this videoed.  I can’t quite explain the sensation of having these splints removed.  But let’s just say it’s mighty unusual.  You can feel it slightly behind your eyes, that’s how it feels, way up in your sinuses.  They’re a long way up, I could see them with the torch, but if you tried to reach them you’d be up past your second knuckle. *laugh*  Check out the video for yourself.  They’re strange things, pretty big too, but they’re much preferable to having internal packing.  They’re soft silicon splints with a breathing tube.  I could actually breathe better immediately after surgery using them, than I could before hand.  Which goes a long way to explaining how bad my nose was before, and how good the surgery was after.

YouTube video of me, having the nasal splints removed 6 days after surgery.  Complete with super short hair.  I cut it all off in the lead up the the surgery as I knew I wouldn’t be able to shower properly afterwards.

Having the cast off, stitches and splints out was a relief in itself, now the healing process continues.  Saline rinses, not wearing sunglasses for a month, massaging my nose, and just generally maintaining good health and resting to allow myself to heal properly.  This final information I didn’t take seriously initially, and 4 days after my surgery I did far too much, and paid the price for it, I was very, very ill afterwards, wanting to collapse, and feeling like I wanted to die.  So I took that lesson as learnt.

The swelling is subsiding faster than I expected, and I’ve been very fortunate to not have had any bruising, other than where the IV was placed in my hand.  This may be partially due to my taking Arnica as a supplement as instructed by my surgeon.  Clever man he is!

That’s about it.  Each day I see more improvements, I’ve been off the heavy duty painkillers for several days now, and a couple of Tylenol are all that’s required for my comfort.  The only discomfort left are where the incision on my nose was made, and the tip where the graft was taken, and right side where it was placed, and my front teeth are still slightly numb due to the disruption to the nerves in the area due to the surgery.  This is improving daily.

So there you have it.  I think that’s everything.  If I remember anything else I’ll add it later.

If you’re contemplating having a Septoplasty or a Rhinoplasty done, I’d recommend it, that is if you’re doing it for surgical reasons.  Although if it’s for vanity, and it makes you happy, go for it.  Mine was medical, but either way I’m happy with the results, I have a straight nose now, and can finally breathe through it.

Oh, and because I was remiss when I originally typed this entry.  Thanks also to Marilyn for visiting me and the lovely Tuscan Bread Soup she made (YUMMO!), Justin for checking I was still alive and not drowning in said soup (remember I was falling asleep in my meals – lol), and Brad for visiting too.  If I forgot anyone, I don’t think I did, thanks too.  Even Mark, despite his not being overly helpful, other than to drive me to see the surgeon.  Although in his defense, and despite his being less than helpful, he did take it fairly calmly while I was a little monstrous (drug fuelled mood), not too heinous, but it can’t have been fun either.  But, the medical staff did point out that if I was in pain, I’d be irritable, and I was. 😉

Otherwise, it was pretty much, and still is pretty smooth sailing.  All good if you ask me! 🙂