Sinus surgery?

[FloridaJim57]

Over the past two years my sinus headaches have grown more frequent and more painful. Also, I almost always wake up very early because my nose is so clogged I cannot breath. I know I have a deviated septum from boxing many years back. I have an appointment to see a specialist in early June. I understand there are a few procedures that can be done to remedy this. Has anyone had any experience in this area? Thanks for reading and sharing.

 

[pacergal]

What have you tried in the past? Any allergies?
Using a net pot at night before sleeping and possibly Flonase nasal spray for allergies might help if that is the cause.
Is the specialist an ENT? (Ear, Nose and Throat doc) or an Allergist?
I have no experience with sinus surgery, just severe sinus issues from allergies. Its amazing and frustrating how much of our overall health is related to the nose!
Best wishes for better sinus health!

 

[kevink]

I had a deviated septum (as it turns out) from the first, due to an upside-down birth aided by forceful use of forceps. I just lived with not being able to breathe all that perfectly through my nose but over the decades working in dusty environments and long periods of nightly use (which is to say abuse, since they're not supposed to be used for more than 2-3 days) of Afrin and other sinus sprays caught up to me. That history combined with putting on pounds resulted in low-level sleep apnea and my ENT persuaded me that surgery to repair the deviated septum was essential.

The surgery was no picnic; you need to be prepared to be largely out of commission for a week or more afterwards, and while I could breathe better afterwards the results were honestly not all that I'd hoped for. You'll want to have your ENT look for things like nasal polyps and seasonal allergies, both of which may require use of specific nasal corticosteroid sprays. I see you live in Florida so you'll have wet climate/high humidity challenges which are the opposite of mine here in Tucson. I have found regular use of Xlear non-prescription nasal spray to be far more effective than Neti pots (which actually dry out the tissues if used too often) or other alternatives. I'm able to forego Afrin and the like most of the time now and get by with a simple non-medicated menthol Vicks inhaler at night and no longer have the mild sleep apnea and none of that would have been possible without the surgery. Bottom line: make sure you have a good ENT and follow their advice to the letter both before and after surgery.

 

[tfudtuckerpucker]

I'll weigh in here, since I've had sinus surgery twice. My congestion issues are caused by allergic rhinitis, which I've had since childhood. Lately I've had very good success by using a neti pot and aller-cort (Costco). A doctor can tell you if there's an obstruction from a deviated septum, but I would strongly suggest first trying that approach, before surgery, if it's allergic rhinitis.

 

[EastWest Gal]

Pacergirl has some good suggestions. I may be telling you stuff you already know:

Have you discussed this with your family doctor? An ENT physician will be more likely to recommend surgery, although, fortunately, in my experience, otolaryngologists are one of the few surgical specialties where they prefer to handle problems nonsurgically. It's what they do. Also, a majority of people have at least a little bit of a deviated septum.

Nasal surgery won't necessarily relieve nasal congestion. If you have a deviated septum, then one side should be clogged and not the other. If you are using nasal decongestants regularly, stop-there is usually rebound congestion from overuse. Same problem with pain relievers. Consider nasal steroids such as generic Flonase, and/or saline nasal spray or washing.

I had chronic sinusitis for about 4 years, from 1987-1991. A CT scan showed a malformed turbinate and a deviated septum as well as opacification of some of my sinuses. I started doing nasal washings with double strength saline and minimized antibiotic use. It worked surprisingly well. 30 years later I'm much better.

Also, reflux can cause night time nasal congestion. I had a 10 year old patient that had chronic sinus congestion, literally cured by acid blockers and elevating the head of the bed.

Morning congestion suggests reflux and/or dust allergies as a cause. Have you thoroughly cleaned the dust in your bedroom? Think vacuuming the box springs, under the bed, moving furniture and really getting the dust level down. Maybe get a new pillow even.

I speak from both personal experience as well as professional experience. Pediatricians and FPs see sinus issues, allergies, and headaches all the time. Very few patients undergo sinus surgery.

This advice is free, but it does come from professional experience.

 

[kevink]

Thanks EastWest Gal! Your advice is very helpful. Wish I'd had you as my doctor before (and after) seeing the ENT.

 

[RetiredAndLovingIt]

I had it done as out patient surgery about 13 years ago and had a bad cardiac reaction.
I know I was never told and it was not in the paperwork but some doctors use medical cocaine to control the bleeding. They could not wake me up in the recovery room but I could hear everything the nurses were saying about me and I could tell they were concerned. One whispered to the other that they think the problem is the cocaine and I'm silently screaming no I've never taken cocaine in my life as I struggled to wake up and couldn't. It was the most terrifying thing that ever happened to me.
Finally they were able to wake me and they let my son in to see me. He was a paramedic and I could see he was upset and had been crying and he explained I was having extra heartbeats, they're called PVC's and had to go to the hospital as a precaution. I was there for 4 or 5 hours before everything calmed down and they let me go home.
The next week was pretty miserable because of all the nosebleeds, I thought it would never stop but once it healed it was amazing the amount of cold air that blasted though my previously blocked nose.
So yes the surgery was a success and I'm glad I had it, but I would caution you to ask lots of questions about possible side effects.
https://www.enttoday.org/article/cocaine-safe-topical-agent-use-endoscopic-sinus-surgery/
To this day I'm still paranoid about being put under for any surgery although I've been assured that no one uses cocaine any more.

 

[Dash man]

Nasal surgery changed my life and I wish I hadn’t waited so long. I had a deviated septum combined with allergies. I tried just the allergy meds before the surgery, and while they helped, I still had trouble sleeping. After the surgery about five years ago I’ve been sleeping like a baby.

 

[rt-texas]

Had my nose "roto rootered" about 18 years ago. Best thing I ever did. I would say 85% success. The difference in breathing was phenomenal.

Still use Cosco brand of Flonase before bed and use a Neti pot after being out in nature a lot.

Recovery time was about 10 days. Probably three months before all internal swelling was completely gone and breathing to the new normal. But the difference in sleep quality is worth it.

 

[REWahoo]

Had my nose "roto rootered" about 18 years ago. Best thing I ever did.

^ Me too, about 20 years ago - with the same positive results.

I thought many/most sinus surgeries had been replaced with balloon sinuplasty. Sounds like a much less invasive process to me but I have no first-hand knowledge of the procedure.

 

[buckskinbowman]

I had this procedure last June. The post-surgery was not pleasant. I had mine done on a Friday, and I was out of commission for the weekend and still not great the next couple of weeks. It take a good 3 months before I felt "normal" again. In the end, it didn't really help me all that much. I do not breathe much better than before, and still have mild snoring/apnea issues that this was supposed to take care of. I've heard stories of how this procedure changed lives, but I unfortunately I wasn't one of them.

 

[Chuckanut]

I had this procedure last June. The post-surgery was not pleasant. I had mine done on a Friday, and I was out of commission for the weekend and still not great the next couple of weeks. It take a good 3 months before I felt "normal" again. In the end, it didn't really help me all that much. I do not breathe much better than before, and still have mild snoring/apnea issues that this was supposed to take care of. I've heard stories of how this procedure changed lives, but I unfortunately I wasn't one of them.

I was also advised to have sinus surgery to correct a deviated septum. After reading information from various people, such as above, who have had similar surgery, I realized that it seems very hit or miss. Instead, I learned the art of 'nasal lavage'. Every morning I run about a cup of warm salty water in one nostril and out the other. This flushes out accumulated mucus from the night before and is keeping the sinus infections at bay. During the day I often give my sinuses a squirt of saline solution to keep them moist.

FWIW, I was tested for allergies by the ENT and none were found.

 

[erkevin]

I had a ceptoplasty many years ago. While it did straighten my nose a bit and improve my breathing somewhat, the surgery was very painful. I have been told that I need another surgery, but have not pursued that.

 

[W2R]

New Orleans is a terrible location for anyone with sinus trouble.

Frank has lived here his entire life, and I have lived here for a quarter century. Between the two of us, we know dozens of people who have had sinus surgery. Despite the painful recovery period most think it's a life-changing miracle for the first year or two, and then their sinus trouble comes back as bad as ever. Maybe the local sinus surgeons here in New Orleans are all terrible and the ones elsewhere are all brilliant and gifted? I don't know.

I just know that neither of us plan to ever have sinus surgery and we never recommend it to anyone.

I don't do anything for my sinuses which are not as bad as Frank's. Mostly I just grin and bear it, and work at staying well hydrated. Also I have found that a rare diet Coke gives me a bit of relief for some reason although I seldom indulge in them due to the caffeine.

As for Frank, he does the various non-invasive treatments involving saline and whatever as others above have described (I forget exactly what his doctor has him doing as I find it a bit icky to think about). I am not that miserable yet.

 

[Bongleur]

TLDR - apply an electric current to the septum, and the cartilege becomes plastic. Press it with a properly shaped mold, turn off the current, septum retains new shape. Simplicity.

>
Cartilage Remodeling:
International Edition: DOI: 10.1002/anie.201600856
Angew. Chem. Int. Ed. 2016, 55, 5497 –5500 Ó 2016
Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim
5497

Controlled-Potential Electromechanical Reshaping of Cartilage
Bryan M. Hunter, Jeremy Kallick, Jessica Kissel, Maya Herzig, Cyrus Manuel, Dmitri Protsenko,
Brian J. F. Wong,* and Michael G. Hill*
Abstract: An alternative to conventional “cut-and-sew” cartilage
surgery, electromechanical reshaping (EMR) is a molecular-
based modality in which an array of needle electrodes is
inserted into cartilage held under mechanical deformation by
a jig. Brief (ca. 2 min) application of an electrochemical
potential at the water-oxidation limit results in permanent
reshaping of the specimen.

Highly sulfated glycosaminoglycans
within the cartilage matrix provide structural rigidity to
the tissue through extensive ionic-bonding networks; this
matrix is highly permselective for cations. Our studies indicate
that EMR results from electrochemical generation of localized,
low-pH gradients within the tissue: fixed negative charges in
the proteoglycan matrix are protonated, resulting in chemically
induced stress relaxation of the tissue. Re-equilibration to
physiological pH restores the fixed negative charges, and yields
remodeled cartilage that retains a new shape approximated by
the geometry of the reshaping jig.