5 posts tagged “nasal polyps”

I think this about satisfies the update interval on the sinus surgery recovery.

FROM A READER:

Sean,

I loved your blog on your sinus surgery experience. I went through the same procedure 8 days ago and your level of detail in it really helped me understand what to expect beforehand.

On your blog (D-Day + 2: Friday) you noted that you had noticed increased resonance in your voice. I am going through the same thing now and mine is quite noticeable especially over the phone. I had a pretty normal voice before so having it sound as it does now concerns me quite a bit.

My question is, did your voice go back to normal or is the increased resonance still there.

I appreciate your response.

MY RESPONSE:

thomas,

thanks for reading.  i did it for you.  meaning, i wished that level of detail was out there for me beforehand.  i couldnt not blog it.  i even tried to get a videographer client of mine in the room to shoot it.  he was willing to sign whatever waivers, cause he too had the same surgery.  but hospitals bristle at the notion of video cameras within their op rooms.

ok, the voice.  its totally different.  not in a dramatic way.  i mean, i dont sound like a muppet.  but i dont sound the same.  i too notice it more on the phone, because all phones amp your voice into your earpiece.  i get it more on my "N" or "M" sounds.  like: "a bag of m & m's".  my friends and co-workers alike are polite & they hold-back in their candor, but they all agree that yea, something is different about the way i talk.  that: i sound normal, just different.

whats weird is that from the perspective of my physiology; the architecture of my new sinus cavities, i totally understand why.  but i am only just now, 2+ months on, getting used to it.

my doctor isnt evasive, but he's also pragmatic, insisting that its not fair for him to either provide an answer after only 2 months, or for me to be getting settled-into the fact that this is forever.  i love him for this: he reminds me that the healing process for this may be closer to 10 months than 2.  i dont know what you had done, but i had my entire ethmoids reconstructed.  the pathology report reads bone + cartilage removed as well as tissue/polyps.  so i'm prepared to wait for shit to settle down.

but keep in mind: for me anyway, if the change in the tenor (if thats the right word) is the downside to this, then i'll gladly accept it.  for i can smell again.  i havent felt this healthy since college.  i'm biking my commute 16+ miles a day, i get up when i wake up, and mentally, i am clear as a bell.  the success of the surgery has positive cascade effects i have yet to realize.

i have perhaps reverted back to the state of things long before i knew that Anosmia wasnt forgetting things when you hit your head.  That place where i spent more than 30 years as an organism that could faithfully interpret information from the nose & the mouth.  Its an easy place to fall back into.  Its precisely where smell & taste work their magic: where you dont notice them until they're absent.

A month & change post-op.  5 weekly appointments with Dr Rust.  Each less grizzly then the last.  Each with me leaving having heard that i am healing beautifully, that he could park a car up there, and that no, i cannot resume swimming laps.  Regardless of how well i am healing, its too early to speculate let alone start asking questions about my sense of smell or the return of the bastard polyps.

I did have a touch of an infection up there 3 weeks ago, which Dr Rust said was not only mild, but totally expected in the weeks & months following such surgery.  So after a quick taper of Prednisone & 14+ days of antibiotics, OF COURSE i can smell & taste.  That always happens when i shove those two drugs up me.  So its double-down tentative to take stock in how well i can smell these past few weeks.  For inside of 1-2 more weeks, i could be back to 10%.  So day by day.  I'm enjoying what i can while i can.  Changing a diaper when i squeal in delight cause i can smell it from across the room.  Dragging 2-fingers under my nose after pumping gas.  And being San Francisco, smelling delightfully kind weed being smoked quite near-by on my walk to the ferry in the afternoons.

Pretty much, for the past 2-3 weeks, everything smells & tastes like they did on this day.

Per doctors orders, i've continued the nasal rinses.  But they're horribly disappointing just now, arent they?  No more debris. No more clottia. Just the same damned saltwater i've just mixed & squirted up there.  On an interesting note however, is how much of that rinse gets up into the difficult sinuses it never reached before.  After each bottle, after i stop dripping then blow, i can get a full 1/2-ounce more simply by bending over for 10 seconds so the cavities can drain.  I then can smile at people for the next 30 minutes as fast-dropping dribbles can unexpectedly evacuate my new nose.

Of all the things the past 5 weeks have given me, i would say the best has been the mornings.  Once i would wake up and not know which direction my nose would go that day.  If it started compacted, i was doomed to that fate all day.  If it was oddly clogged, i might have a chance of breathing well from at least one of the pipes.  Either way, mornings sounded like audio feeds from a rendering plant, with matching discharges into the shower or 12+ kleenex blows before i left the house.  i now wake up with both barrels bored-out and free of matter.  Which isnt to say that the shape or architecture of my sinuses are in a fixed position.  Because from one morning to the next, the air-flow is simply different up there.  Its either going to be something i can feel or something i can hear.  But either way, its clear and mostly dry.  Which is a dream.

I have moved from 1x weekly appointments with Dr Rust to every other week, with my next on Tuesday 5/19,

Certainly one of those moments in life where a week has certainly not gone by.  But the calendar doesn’t usually lie. 

I’ve spent more than enough time lying down and resting and not exerting myself.  This is getting really old.  But I understand why it’s necessary.  For just when I think I’m well enough to pop out to the store or to run an errand, I’m slowly washed over in this dull ache of lethargy and apathy.  All I want to do is lie down.  Is this the lingering anesthesia?  Is this just my body sacking reserves and resources as it performs whatever internal repairs? 

A week on, I can cite some evolutions in my symptoms.

Alternating moments of spunkiness which beget lethargy
As noted above, I get these winds of normalcy, where I simply must get out of bed & pull weeds or filter Jude’s room of toys greater than X months old.  And just as quickly, my knees are taken out from under me.

Alternating conditions of wet sinuses followed by dry sinuses
Imagine for a moment that we don’t live in a humid climate up here in Marin County.  My sinuses are behaving like a dish sponge.  Soaking wet after my rinsing, followed by a slow drying up over the next 5-6 hours till the next rinse.  But just like that sponge, I can literally feel my tissues and cavities shrinking and hardening over those hours.  Where the septum stitches are, this is at times painful, especially when I smile or open wide.  But mostly it’s just a general feeling of contraction.  I can feel it when I press my tongue hard to the roof of the mouth.  As well as when I look hard-right or hard-left.  Hard to explain any more than that. 

These moments follow the nasal rinses, which I must say, save for the tampon removal, have been the most satisfying of my recovery.  Even a full calendar week on, I am getting significant debris flushed out of each nostril.  Black jellyfish the size and probable weight of silver dollars, which only seconds before were, or were attached to, the very dryness and crustiness mentioned above.

Headaches
Prior to the surgery, I used to 2 and only 2 different kinds of headaches:  {A} the hangover brand, which seemed to nest itself around the base of my skull in the back, and {B} the eyeball kind, which I would get if I spent too much time in bright light without sunglasses, or after long days with contacts.  But since the surgery, I am getting a different kind, one that seems to be a mix of the eyeball headache, but centered high and forward on the skull.  It’s as if the pain is a focused core just on the other side of my forehead.  I’ve had 3x of these in the week since, 1x of which was severe enough to prevent me from walking upright and seriously considering mainlining one of those Vicodins.

Boredom
I hate TV.  There are simply loads of crap on, regardless of time of day.  The later the day progresses into night, the worse it gets.  Nothing but mind-numbing, spirit-crushing crap that people I love are by every definition hooked on.  Perhaps I should have temporarily upped the number of Netflix discs I could have out at any one time.  But there have been days where all 3x discs are in the mail, and I’m left only with the telly in the bedroom, which was Anna’s childhood TV.  I can spend 30-45 minutes at a time sitting at the computer with a comfy pillow under my ass, before the waves of fatigue wash up me.  Reading has helped pass the time, but I’ve so far been unable to focus on the development of plot.  And I haven’t the energy to get behind my workstation such that I can string a network cable all the way into the bedroom (why can I not make a VPN connection over wireless again?).

Grumpiness, Irritability
Ok, those two terms described me fairly accurately before the surgery.  But since, I’ve been more so then usual.  I have less patience for many of the same types of situations around the house.  Be it Jude perpetually forgetting that Charlotte is asleep, or simple things like inanimate objects not doing as they’re told, I feel myself getting close to the snapping point.  Which may all well be the lack of regular medications I’ve been suspending whilst I recover, which I take for some wicked ADD.  It’s called Concerta and I must include the lack of this medication as a likely culprit.

I’m writing all this down in with so much detail because this is the kind of post-op account I wish I would have found beforehand.  I only found one blog that provided the level of detail I needed on the special kind of surgery for which I was scheduled.  If any of that guys’ account was going to be true for mine, I was in a better headspace after reading it.  Turned out that his recovery, save for some pain involved with septum splints as well as some GI issues, and has tracked fairly closely with how mine has.  Again, certainly NOTHING like the blogs & comments on others’, where pain and severe discomfort and warnings of such were all that I could find.  Hope my details and description of the passing of post-op time helps you should you find yourself staring down the business end of endoscopic sinus surgery.

Today I feel like shit, but not really because of the nose.  I have those achy bones funny feeling in the back of my throat that seems to always preceed either a cold or sinus infection.  And here I am with what I am sure amounts to open wounds up in my sinuses.  Insane to think about getting an infection up there so immediately following surgery.  But I am on antibiotics, so there’s hope.

The numbness of my general nose region is starting to wane.  Or, at least change.  Prior to today, I literally couldn’t feel my nose unless I was touching it.  Certainly no pain.  But now, I am acutely aware of a few things:

An increased volume or capacity of airflow.
I was told this would be an immediate effect.  When you think about how the surgery removed so much foreign matter from the middle sinuses, the pipes are 75% wider.  We’re talking bandwidth here.  Even though only the right side seems to be free-flowing, overall I can take deeper breaths faster thru the nose then before.

An increase in resonance
Without having Dr Rust confirm this specifically, it feels as though there’s more space for my voice to bounce around.  It hasn’t changed so much as simply feels like its coming from a larger resonance chamber.  When I first noticed it, I was speaking whilst looking closely into a big mirror.  So I just assumed it was the echo from that surface I was hearing.  But I’m hearing it again & again, at rest and whilst vertical. 

Stitches
When Dr Rust did the septoplasty, he basically cut into the cartelage separating my nose, removed some of that, realigned the septum true, then stitched the new structure in place.  Odd at first, the deviation was to the right, but the stitches are on the left.  Makes sense now.  As my nose de-numbs, I am totally aware of these stitches.  They’re down in the crook of my nose, right above the lip of the left nostril.  Which makes anything close to a smile or a wide-mouth some of the first real elements of pain thus far.

Blood in my spit
At will I can tounge-scrape the back of my throat and spit a half-and-half mix of saliva & blood. Sometimes, this will occur when I involuntarily do a swift nose inhale (sniffle?).  We all do this.  We get a bit of something, mucus, debris, boogs, and we either swallow or spit.  Yes you do.  Sometimes, we get more then we expect, or more then we wish to swallow.  So, in our own way, we make haste for a trash or toilet or sidewalk and spit.  Only now, mine have been somewhat volumous, and dark crimson.  This must be more of the same or at least a lingering effect of the tampon removal yesterday.  Like bloody stalactites in my sinuses breaking free.

And on that topic, perhaps the most anticipated milestone in this recovery will be the nasal rinse.  Dr Rust says starting Saturday (tomorrow), I can resume a twice daily rinse.  I have for years been using the NeilMed mixture packets and the squirt bottle.  Even if you’ve got brilliant sinuses, I would recommend this product.  Basically, you mix a pH balanced isotonic solution (saltwater, really) with a pint of warm water, then squirt it up one nostril.  Well, you best lean clear over a sink, and tilt your head.  Because the only place for the salt water solution to go is out the other nostril.  Again, strange at first, to voluntarily be exercising that human pass-thru.  But what comes out the other side is the crap and debris and hangers-on that typically generate or are byproducts of sinus maladies.  I cannot wait for the sinus rinse.  I can feel a lot of foreign matter up there, clinging on for dear life.    

Overall feeling just about mid-range today.  Not too weak, not to ancy.  I watched Gonzo: The Life & Work of Dr Hunter S Thompson this morning with my mom.  Then, felt well enough to drive her to the Marin Airporter.  Some left-over pasta and a 3 hour nap.

At or around 7:30 tomorrow morning, a well-compensated anesthesiologist will jack into my IV and inject a solution that will inside of a few seconds put me to sleep.

When I wake, roughly 3 hours later, other well-compensated people will have violated my sinus cavities.  Breaking cartilage (septoplasty), snipping tissue here, cauterizing tissue there.

Most specifically, they are going to remove the extensive and significant level of polyps I have growing in my nose.  A full polypectomy.  Literally caking the turbinates, these bulbous outgrowths have for years acted as a clogged drain, backing up the main sinus cavities with gunk.  It’s these polyps and the gunk they begat that must go.

Most significantly , they're going to create an opening between my two frontal sinuses: the ones above & behind the eyes, working millimeters from the brain.  And once back there, the doctor will most likely be taking a look at the sphenoid sinuses, behind the ethmoids.  Now we're talking more or less about the geographic center of my head, where the optic nerves and some fairly important blood vessels meet the brain.

I’m sort of past the elements of concrete fear that clouded my days 2 weeks ago.  I am now more on auto-pilot then anything else.  Just getting things wrapped up at work for what will most likely be 2x weeks of sick leave recovery time.

Those fears included all the rare exception cases of brain infection, injuries to the eyes, and a total loss of my sense of smell as a direct result of the procedure.

For the past few days including today, I am focused on preparing myself for the recovery.  I’ve had 5x root canals in the past 10 years.  So I am preparing myself for at least that level of discomfort.

Strange, but what I am really most interested in is the peculiars of the procedure.  I wish I could film it, or in some way view the video feed from the scopes that they will undoubtedly be capturing.  Those little bastards up there have caused me all manners of hell.  And knowing they're gone is one thing, and I am happy with that.  But seeing them snipped off, sucked out, and burned shut would be a very satisfying bon voyage for the little motherfuckers.

http://sinusinfocenter.com/sinus_treatment_endoscopic.html