Septoplasty and Turbinoplasty to Ease Chronic Sinus Infections - Quincy, MA

After years of chronic sinus infections and...

After years of chronic sinus infections and allergies, I'm taking the plunge and getting my deviated septum repaired and getting a turbinate reduction at the same time. My insurance will be covering the procedure, so I don't know the cost to quote for you - sorry! If I remember I'll try to find out and add it to my updates. Dr. Ambrus ordered a CTScan to see if my sinuses needed any work while he was at it, but it looks like they aren't too bad so we're going to skip that.

Dr. Ambrus explained the risks involve anesthetic reaction (I haven't really had problems with in the past aside from nausea, so hopefully no big deal again this time), bleeding, infection, hole in the septum (which I'm told could make a whistling sound when I breath through my nose), persistent sinus problems (already have those), continued nasal problems, snoring, nasal crusting / drainage problems (he said I'll encounter this during the healing phase), continued headaches, persistent allergies (already have those), and possibly loss of smell (my sense of smell is fairly weak at the moment - something has to have a particularly strong odor for me to catch it - which more often than not is a good thing actually).

The pics I've posted don't really show how severe the deviated septum is - the closure is more noticeable inside the nostril, up close. You can see that one side is much more narrow than the other. But when I took a closer picture there were like a gazillion nose hairs... I didn't feel like sharing that one with the world. LOL - so just take my word for it. The pics I did include show that my nose curves to the side.

I'll post more pictures after the procedure, and provide more feedback throughout healing so you'll have a better idea what you are in for if you are considering these procedures.

Day 1 - Day of Surgery

***WARNING: if you don't like the sight of blood, don't click on my pictures!***

OK so I was up before the birds this morning to get into the hospital by 6:30 AM. My son came with me so he could drive me home. A little after 6:30 AM a nurse came back and took me to get ready for my surgery. She verified my information, and what procedures I was having done, and by who. Then she had me get dressed into just a hospital gown and slipper socks. Oddly comfortable attire! Each staff member I came into contact from there on performed this same verification process for obvious security and safety reasons.

They had a hard time placing the IV at my wrist because I have itty bitty veins - I wasn't surprised - this happens to me all the time. I hate having blood drawn and having IV's placed in because my veins put on a stellar hide and seek performance every time! She ended up placing it up at the inner elbow instead - it went in easy there.

I met with the Anesthesiologist and he was very nice. He reviewed my history and told me because of my medical history he was going to throw the kitchen sink at me to try to make sure I wasn't nauseous or have a reaction to the anesthesia. I am hypothyroid, have a history of nausea after Anesthesia and even Novocaine, and also have nerve damage to my spine because of a car accident in 2014. So I'm sure these things probably make his job more challenging. I felt a lot better knowing he took note of these things without me having to remind him or bring them up first. Then I told him I saw that movie "Awake" with Hayden Christensen and he laughed and told me "Not a chance!" - LOL... OK here's my first piece of advice for any of you scheduled to undergo any surgery. Do NOT do what I did (and probably will do over and over again because I am a glutton for punishment).

1. DON'T Youtube videos of the procedure
2. DON'T Youtube videos of first-hand accounts of the procedure
3. DON'T watch Hollywood thrillers like "Awake" (or that episode of Nip/Tuck) and then Google "anesthesia awareness" Just don't...

All 3 of these things will leave you paranoid about these extreme "what ifs" and seriously contemplating skipping out on your surgery. Now I needed this surgery - I have (hopefully now I can upgrade that to "had") sinus infections that never cleared up, I had to over-medicate to keep them at bay, I couldn't breath properly and was unable to perform even the light physical activities I can enjoy - swimming being one of them, I got lightheaded a lot because of lack of oxygen, and it played a factor in my inability to feel rested after a good night's sleep. So scaring myself out of the procedure would have been a real bonehead moved and a huge disservice to myself! So DON'T do what I did!

OK moving on. :-) I was unable to remove my nose ring. I desperately tried, but that sucker had been in for almost 2 decades. It wasn't going anywhere. The Nurses, Anesthesiologist, and even Dr. Ambrus watched me try and they all grimaced and told me to stop! LOL - and these folks see people cut open every day! But no one wants to see you trying to yank a piercing out of your nose - it's not the funnest thing to experience or apparently watch others experience. Haha - so he said he would try to remove it while I was under, and if not he asked me if I would be upset if they had to cut it off. I said I'd be bummed cause of sentimental value, but I'd get over it. Possessions are fleeting!

So the Surgical Nurse came over and gave me a starter cocktail and wheeled me into the room for surgery. They got me all comfy and we chatted a bit. A nice young nursing assistant asked me if I'd like her to try to remove my piercing when I fell asleep if she could, rather than cut it. I thanked her and said I'd appreciate that. Next thing I knew I hear people calling my name and I'm being wheeled into recovery... WOW! I didn't even feel myself go under! Now THAT is impressive!

Initially upon waking, I could actually breath through my nose. I told them this, but they told me to breath through my mouth. They had me on oxygen for a while, but the mask starting feeling a little heavy on my nose, so they removed it and placed it on my chest right under my mouth so I could still take some in. Initially my pain level was at a 7. So they gave me Dilaudid through my IV. That helped bring the pain down - basically cut it in half for me. I didn't even need the whole dose. I was draining / bleeding and needed to change the dressings several times before they released me. I wasn't released until close to 1 PM for a few reasons. They wanted to monitor the draining and make sure it got under control, they also were waiting for the effects of the Anesthesia to wear off. I kept falling asleep, and when I finally woke and could stay away I was trembling for a while - I believe that reaction was related to my preexisting nerve damage in my spine. They monitored me and waited for the trembling to subside then helped me get to my feet. I was a little shaky at first, but was able to get to and from the bathroom with little assistance.

While this was going on my son went downstairs and filled my prescriptions at the pharmacy. That narcotic law took effect just the other day, so I was unable to get as much pain medication as my surgeon would have preferred. But he got me enough to get me through until I see him again in a few days. I was prescribed pain medication, antibiotics, medication to help me sleep and to treat any nausea I might experience, and saline drops to keep the inside of my nose most so when he flushes my nose out in a few days it will be less painful.

Before I left I spoke with Dr. Ambrus. He was very pleased with the outcome and told me that he was confident I would be happy too. I asked him what I should expect as far as drainage between now and when I see him because I didn't want to panic if there's no reason to. He said the drainage would be on the heavy side for the next 2-4 days. He said I should expect to change my dressing several times a day. He did not pack my nose, or apply a splint. He did this for my comfort. The nurse told me that he cleaned me out real good and she said in a about month I should feel the full benefits of the procedure. I can't wait! she said he did her surgery too and she was very happy with her outcome. I was glad to hear that. When other professionals go to you for this kind of thing, they must really trust and respect you as a surgeon.

They told me to avoid doing anything too strenuous, including bending over. Use an ice pack for pain and swelling as needed - they said a bag of peas or a gel pack just to the side of the nose will help. Make sure you don't apply either directly to the skin - at least put a paper towel between the pack and your skin. Try to eat soft food for the first day or so. And if you have access to a humidifier, use it, because breathing through your mouth will dry out your throat and make you super uncomfortable. If you don't have one, crack a window to let some of the moist air outside in. Don't blow your nose until after your post-op visit with your doctor, and if you have to sneeze open your mouth wide so you don't injure your nose with the pressure from the blast! I'm also to sleep with my head elevated a bit - so I just tossed a couple extra pillows under me. The nurse gave me all the dressings I'd need to get through the next few days, and some crackers I could nibble on before taking my pain medication. And a bottle of Afrin I can use if the drainage is too heavy - it helps to stop the bleeding a bit. But you can only use it for 2 days, and not more than 3 or 4 times each day. I haven't had to use it since I got home.

Before I left I thanked Dr. Ambrus, the Nurses, and the Anesthesiologist for their help - they were really fantastic and took very good care of me so I'm glad I got a chance to thank them. That was my first experience ever with Carney Hospital and I have to say it was excellent!

Since getting home, I've changed my dressing three times. As you can see, all three look about the same for drainage, but the first one was changed about an hour after they changed it in the hospital. The second was two hours later. and the third was 7 hours thereafter! So the draining is starting to slow for sure. I've been drinking a lot of water, and my husband surprised me with my favorite strawberry shake with extra whipped cream from Dairy Queen! I should have day surgery every day! :-D I was able to watch a little TV with him, but I've had to rest a lot. I think only being able to breath through my mouth is making me more tired - try eating, drinking and talking when you can't breath through your nose. It can be exhausting! Also, yelling out for help is virtually impossible! I tried calling to my husband when he was upstairs and the louder I called out, the more pressure I felt in my nose. So we've agreed I will message him on his cell rather than yell for him for now.

As for pain levels, I feel GREAT! Not "high" great either. I'm using the medication as directed, and I am probably benefiting from the leftover meds from my IV at the hospital. So maybe I'll feel awful tomorrow. But for the most part I feel as comfortable as one could hope after having their nose gutted. ;-) This is another reason I suggest you avoid those YouTube videos because everyone was saying things like "I feel like someone hit me over and over in the face with a cast iron pan!" Even at my initial pain level, I didn't feel that bad. So I got myself all worried for no reason.

Anyway, I'll let you guys know how I'm feeling over the next few days, and if I have any other tips or advice I can share with you. I'll tell you how my post-op cleaning goes too. And I'll post more pics for your viewing pleasure of course! :-)

***WARNING: if you don't like the sight of blood, don't click on my pictures!***

Still doing pretty good...

It's been 2 days since my surgery and for the most part the pain has been pretty minimal. There's still some bloody discharge but I'm not changing the dressing nearly as much as I had to the first day. Today I felt pretty crummy - sinus infection crummy. My ears were popping and everything. Make sure you take the antibiotics they give you! I struggled to keep my eyes open today - I almost fell asleep while I was folding the laundry and a few other inopportune times. I think only being able to breath through my mouth has a lot to do with it. Like I said, it makes talking and eating a little more challenging cause you're kind of fighting between taking bites and taking breaths. So you just have to be mindful and try not to rush through everything like I do. aside from feeling very tired and feeling like I have a sinus infection, there really isn't much else to note. All in all it's not nearly as painful an experience as I thought it would be. On Tuesday I'm going in for a post-op appointment and he's going to clean my nose out - then I can finally blow my nose again! I never thought I'd be excited about the prospect of blowing my nose, but there you have it! :-) I'll let you know what that appointment is like so you'll know what to expect.

Today is the big day!!!

In the morning I'm heading back for my post-op appointment. Not much bleeding anymore. Mostly clear drainage with a tinge of blood. I can breath through my nose a bit too! Mostly through my right side, but my left side is starting to open up too. I can't wait for the doctor to clean it out so I can breath clear! I was told the cleaning can be fairly painful, so it's a good idea to take a pain pill before. I don't know how accurate that is, considering a lot of what I was told to expect for pain so far has been greater than I actually experienced. So I'll let you know how that goes too - and if the doctor tells me anything else that would be helpful to pass on to you guys, I'll let you know! Two more pics - 1 to show how the drainage has lessened over the last couple days, and the other is just me - my nose is a smidge swollen, but all in all it's coming along nicely! :-) Time to get a couple winks before I head out! Night all!

Healing Nicely

This will most likely be my last post on the subject. Tomorrow I go in for what I assume is my final post-op appointment. Last week the ENT literally vacuumed out my sinuses. It didn't hurt, because he numbed the area, but it definitely felt uncomfortable and sounded unpleasant. I could feel the pressure, which was again, unpleasant. But there was no pain because the area was numbed. He sprayed novacaine into my nose and packed it with cotton for a bit, then came back in and removed it all and vacuumed me out. I could breath clearly right after - it was definitely a welcome change! Since then my nose has stuffed back up a bit again. I think I caught a cold. :-(

Today I woke up and the right side of my nose felt like someone punched me in the face. It's hard to see in there, but it looks like it's swollen and still raw. Doesn't help that I can't stop touching it (on the outside) - but it feels like something is lodged in there so it's really bothering me. Hopefully when I see him tomorrow he takes care of whatever is going on. If anything major happens, I'll post again. Otherwise this is my final update. I leave you with this gorgeous picture of me with my nose packed with cotton! LOL
Peter S. Ambrus, M.D., P.C.

Dr. Ambrus is fairly pleasant, although not overly engaging. He took the time to answer my questions though. He explained how he performs the procedure - inside the nose - and he does not use packing or splints, so he said I can expect a little more drainage than I would otherwise, but that it is ultimately more comfortable for the patient to do it this way. He told me I will tape gauze under my nose to sort of catch the drainage. I'll post pictures and let you know how that goes. My PCP and my chiropractor both told me Dr. Ambrus is a very good surgeon - and I posted on a local town page on Facebook to get feedback about him too - a vast majority of people who responded had good experiences with him. Two people complained that he was too abrupt for their liking - I can see that a bit. He's not rude - he just says what he has to say and nothing more. If you have questions, you need to be comfortable asking them, otherwise you may not get the answers you're seeking. Just ask - he answers. A friend who used to be a surgical nurse also said she didn't really care for him in general - she just didn't think he was anything special. So it seems he's a good surgeon who lacks in the bedside manner department - I can deal with that. I'm more concerned that he does a good job than whether he'd win Dr. Congeniality. Finally, He has had a recent complaint against him for a tonsillectomy procedure, but I am not getting a tonsillectomy so I'm not facing those kinds of risks or potential adverse outcomes. So I mainly based my decision to go to him because he accepts my insurance, two doctors I go to and trust recommend him, and several of his past patients were happy with the (similar) work he'd done for them. I hope I will be just as happy as they are!

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