Septoplasty, Part Two, Surgery Day

Part One, Pre-Op, is here.

Surgery day had finally arrived and of course I was a bit nervous.

A few things had to be done before the surgery, or not done, as the case may be.

I was on Advil for a pre-existing back issue, and that had to be halted a week before the surgery as it would increase bleeding since ibuprofen is an anti-inflammatory. They also made me halt my daily fish oil and multi vitamin a week before surgery. I have no idea why.

Instructions were also given for the night before to have a light dinner, and no food 8 hours before surgery. Last water was allowed four hours before surgery.

So in we go to the hospital for this outpatient surgery. Check in was pretty routine. I was a bit surprised that I had to strip down to nothing (not even a wedding ring) and put on the gown. I just figured they would put a cloth over my head and go to town. Nope.

There was a delay in getting the whole show underway as there was some sort of emergency that was going on. When the train finally left the station it went something like this.

The nurse set up an iv in my arm for the later administration of drugs. He tried my hand and failed for that, and then went to the arm and it went in pretty smoothly. After that the people who were going to be working on me showed up to have discussions and answer any questions. I spoke to the anesthesiologists, nurses, and a few other people that I forget and of course the doctor and his assistant. I was fairly nervous to be honest. One nurse said that this was one of their “bread and butter” surgeries and that they do them all the time. That calmed me down a bit. I then received some Tylenol and some other pill (can’t remember) along with a ton of Afrin to open up my nostrils. Honestly I hadn’t breathed that well in a LONG time and joked with the doctor. I had of course tried that garbage in the past and had a terrible rebound effect and he agreed that it was indeed garbage and that today we will be on the way to get me breathing like I felt at that moment, all the time.

There was another delay and I told my wife she should just leave and get on with her day and she did. They would call her when everything was done. I was informed that I would receive an amnesic and a bunch of other drugs. There was another slight delay and then it was obvious it was showtime as the nurse that was helping me was excused and a bunch of gowned up people showed up in my room. One said something like “I’m going to give you some medicine to make you feel good, it will feel like you have had two to three cocktails and will take effect in approximately one minute”. I have no idea what this drug was. Probably the amnesic and who knows what else.

This was sort of a comical moment for me as after drinking, sometimes a lot for over thirty years, I stopped drinking 2.5 years ago. I told the guy that I would feel 2 to 3 cocktails probably faster than the one minute he said. And just like that I got a buzz – it took maybe 15 seconds and I laughed to myself. I felt relaxed and my eyes were going in and out of focus on different things. I remember them wheeling me into the operating room. I was talking to a young woman who was helping out. She put an oxygen mask on my face. I remembered that they did tell me that they would be doing that earlier, but it was still a bit intimidating. But hey I was buzzed and relaxed so just started talking. They also put on some lower leg massaging things that I guess were for blood clotting. Those actually felt spectacular in my state of goofiness. The last thing I remember was focusing on the light fixture above me.

When I woke up I remember that I was physically struggling with a nurse who needed a bit of help. I was on my back but had her arms in some sort of lockdown. I was told later that apparently I had decided that going for a walk was the best course of action in my haze, and that was obviously not going to work out well. They got me calmed down in short order and I was able to apologize. I felt bad but oh well, I had no idea what was going on.

In the recovery room, the worst part was where they intubated me – my throat was destroyed. They gave me a popsicle which felt great.

After a period of time in the recovery room (no idea how long, maybe 30-45 minutes), they wheeled me back to my original room where my wife was waiting. I was told that everything went swimmingly and that after I came out of the haze that I could go home.

I was in the original room for maybe another hour or two. Everything and everyone was eventually driving me insane so I rallied to the best of my ability to show everyone what great shape I was in and they let me go. In between this I had to prove to the nurse that I could walk on my own. Before leaving I remember the doctor telling me that there would be small amounts of blood that would drain out of my nostrils. Small amounts of blood appears to be a very relative thing. I thought small amounts of blood was a drop or two here and there. I had soaked through three gauze mustache bandages and asked the doctor if that was normal. Apparently the blood drips into your sinus cavity and all drains out when you start sitting up. Well, that would have been nice to know. But oh well.

So home we go. Part Three coming soon, recovery.

11 thoughts on “Septoplasty, Part Two, Surgery Day”

  1. I still have, not blood drainage, but dried blood matter. Had my septum done 25 years ago.
    Turns out it’s a function of how long you went with impeded air flow. With less air flow, the sinus tissue thickens. When flow returns, you start to slough off restricting material, and it tends to be red stuff.
    It’s not as bad, however, as the the packing that came out of the other side two weeks later.
    Seems the ENT guy missed pulling it when he did the main packing.
    Having the packing pulled is one of those ‘notable events’. Kinda like pulling off a stuck bandage, but on the inside. Owie.

  2. Ed – they say that they didn’t use any packing, which is interesting. I’m a week into this and still have a lot of swelling and can’t really breathe that well through my nose, and feel that there may be some stuff up inside that may need to come out. Follow up next week will tell all.

  3. No packing? Things have come a long way. My nosefix was more than 50 years ago, and I was young with a fresh injury. They gave me a slug of whiskey and a stick to bite, while two strong nurses held me down.

    Not. I had to spend the night of the injury more or less sedated in the hospital, properly drained and emptied, for an early morning operation. I recall the shot (of morphine?) and how it made the curtain and walls start to melt . . . then darkness and some vague noises in my head . . . then dry-throated, bleary-eyed recovery for the rest of the day.

    Home in bed for a day or so, then told not to roughhouse for a few weeks, or get water up my nose.

    As mentioned in a previous installment, the extraction of the stuffing a few weeks later was
    memorable. The sensation was less of pain than plain weirdness, to say nothing of the appearance of the fluids that came out. Any thoughts of a medical career I might have harbored (I didn’t harbor any) went out with the packing.

    My more recent surgical procedures were very akin to your description, only I’m supersusceptible to the gas they give and am out like a tired five year old after a breath or two.

    I hope every stage goes as well as the operation.

  4. Well, I had mine fixed 50+ years ago as well. It was to repair a septum sliced thru in an auto accident (I was in the back seat of a Beetle that suffered a high speed roll and got ejected along with the 2 front seat occupants. I don’t remember the repair at all. I did have sinus surgery 24 years ago to correct a chronic sinus infection problem. Packing was involved. As it came streaming out, it seemed like it was scratching an itch behind my eyeballs.

  5. Propofol, Milk of Amnesia, is given to make you not care.
    It’s routine for us, not for you.
    The trust patients put into my hands as a surgeon, to the team of nurses, anesthesiologists and CRNAs, all well trained, amazes me.
    I am grateful for the patience and trust of my patients and the skill of the people I work with.
    I have the best job in the world. Could not do it without the high trust society we have. Hope we are not losing it.

  6. I have the best job in the world. Could not do it without the high trust society we have. Hope we are not losing it.

    My partner, back in the 70s, used to say that he hoped they would not find out that he would do this (surgery) for free. It was fun even at 3 o’clock in the morning. I’m glad to have had my career then.

  7. In this context, what’s the alternative to trust? Very few of us are in a position to accurately evaluate the competence of our surgeon. In an emergency situation we may not even be conscious or have any alternative.

    In Dan’s case, I assume he had a chance to form at least a brief relationship with his surgeon and found him or her trustworthy.

    The medical profession has a not unblemished record when it comes to deciding the difference between the lower end of acceptable and the upper end of unacceptable when it come to competence. It’s not hard to find examples where much more effort seems to go into covering up for poor practitioners that weeding them out. The ongoing industrialization of medicine seems bent on limiting the messy process of patients choosing their doctors. You’ll get whoever happens to be on duty and like it. This has long been the norm for those dependent on government for their healthcare.

    Of course all freedoms are messy for those that have to work around them and the natural inclination of all bureaucrats is to limit them in the name of “efficiency”.

  8. The surgeon actually was the doc who I was referred to by my gp. He was knowledgeable and very matter of fact, which I liked. After the surgery was scheduled I asked the nurses and a few others who I knew had connections at the hospital about the guy. They all said that the doctors at the hospital all sent their kids to him for their surgeries of this type. Good enough for me. Outside of that, I really would have no idea if he was good at it or not.

  9. They all said that the doctors at the hospital all sent their kids to him for their surgeries of this type. Good enough for me. Outside of that, I really would have no idea if he was good at it or not.

    That is usually the best way. If you know an OR nurse, they know the most and have no axe to grind.

    It’s not hard to find examples where much more effort seems to go into covering up for poor practitioners that weeding them out.

    The state medical boards , at least in CA, are OK with drug abusing docs but subtler issues (like competence) are harder because the crooked docs hire good lawyers. When I was chief of surgery in my hospital, we had a new orthopod who was doing some odd things. I asked an orthopod I knew, who worked at another hospital and was not a competitor, what he thought and he said the technique was obsolete. I asked if he was willing to observe and report. (He was on our staff but did his surgery at another hospital.) He said OK and did so on several cases. His report was not good and we told the new orthopod that he was not approved for that particular procedure. We had a similar experience with a new eye doc and he went and took a couple of courses, returned and developed a very successful practice. This one, the orthopod, sued the observer and his partner. He lost the case but appealed and the whole mess went on for years. The partner, who had not even been involved, eventually left the area and moved to Palm Desert. The new orthopod lived two houses from me and was a nice guy but was obsessed with this case.

    My partner and I were sued by a dishonest surgeon and managed to survive but people who think we all cover for incompetents don’t know the truth. The hardest cases are the real scoundrels. They have the best lawyers and no ethics at all. We had a close call one time with a well known guy in Orange county. He applied for privileges and we knew it was a lawsuit if we turned him down. Fortunately, the application had a question; “Have you ever been subjected to disciplinary action at a hospital?” He answered “No.” We knew he lied and were able to prove it. I wrote him a nice letter saying that any misstatement on the application was a reason to decline it. He was welcome to reapply in three years. We never heard from him again.

    This was him. The Wiki is a tongue bath. He was a crook.

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