The surgery itself of course is done under general anesthetic (with its own risks and side effects, but whatever). While you are still under your nasal passages will be 'packed' to keep them open and reduce bleeding. You will also be intubated. This sounds innocuous but when you wake up choking on a throat full of tubing and with a face full of packing, it's not pleasant. (All pain 'ratings' are of course subjective, but are given on my personal scale of one to ten, with one being 'needle prick' and ten being 'in labour'.) Dazed from the anesthetic and unable to breathe temporarily, the initial awakening rated a seven in terms of pain and discomfort.
The tube will be removed promptly, leaving your throat sore and your teeth feeling loose. The packing will remain in for more than twenty-four hours, and the pain/sensation is similar to an untreated sinus infection or sinus migraine. (I rated it five to seven on the pain scale, but it went down to a bearable 3 - 4 with the various analgesics and painkillers they put into me, though.)
You will constantly be dripping blood through this packing into a gauze pad taped across your face below your nostrils. This pad will have to be constantly replaced, probably by you, anywhere from every ten minutes to every two hours. Your cheeks will become chafed from the tape but there aren't too many other options to keep your pillow from becoming blood-soaked in short order.
You will be able to breathe only through your mouth, quickly dehydrating your mouth, throat, and lips. Did I mention the IV that needed to be in for three days? It will be difficult to swallow because not only are your throat, jaws, teeth and lips sore, the pressure from your blocked nose makes it painful. After about forty-eight hours (maybe less at your hospital...) you'll be taken down for packing removal, at which time they assure you the sinus pressure will cease and most of the pain. This is true. What they will not tell you is that removing the packing is one of the most frightening and painful experiences you can have in a hospital.
DO NOT CONTINUE TO READ IF YOU ARE OF A SENSITIVE DISPOSITION - this is graphic and prejudiced. Do realize that this is one person's experience in a large hospital of an excellent reputation. You'll have to make up your own mind.
You will be seated in what looks like an upright dental chair. The gauze strip will be removed yet again. Then you will be approached with a speculum (which stretches your nostril open) and a pair of thin forceps/tweezers about six inches long, four inches of which will be in your nasal passage at one point. The packing will be grasped with the tweezers, then pulled steadily and firmly out with the assistance of a suction tube. This results in a horrific and painful sensation which feels as though brain tissue is being removed from a point beneath your eyeball. It is not only excruciating, it is quite terrifying to realize that the points of the tweezers are indeed that deep in your head: your nasal passages extend past your eyeballs. (This was almost an eight or nine in terms of sheer agony. Thankfully it was brief, but debilitating and demoralizing.)
Pause, to see a finger-size wad of sanguined foam packing dropped into the kidney basin which you are holding beneath your own chin. Repeat on other side. Experience same intense pain and disgusting sensation of grey matter being sucked out of skull. Feel blood and mucus gushing out down your upper lip, over your chin, into the basin.
The tweezers go back in again with small strips (about a half-inch wide and about three inches long) of anesthetic/disinfectant-laced gauze. They are fed along the nasal passage; again, the tweezer points go deep into your skull.
What exactly happens then I am unsure, as this was the most painful part of the entire experience and I nearly blacked out. I cannot describe it without sounding melodramatic, but it was literally the most frightening and intense pain I have ever felt in forty years of my life (and I am including the thirty-four hours of mostly unmedicated labour, the spinal epidural, and recovery from an emergency C-section). Possibly the residual clotting was being 'dabbed' away from the raw areas, or the nasal passages 'cleaned up' with the gauze, because I do not remember those strips staying in and having to be removed later.
I went into shock while sitting there, trying to keep myself upright in the chair, holding the clotting basin under my own chin, shaking and trembling and crying. Perhaps you're made of tougher stuff. The children and teens who were ahead of me and after me (they did all the packing removal for the surgery patients in the same hour one evening) were screaming in literal hysteria during the proceedure, and even the older males (who pride themselves on toughness and have been through compulsory military service) were coming out looking dazed and shaky. (Please bear in mind again that this is no back-alley plastic surgery clinic but a major hospital of good reputation in its country).
I was led out to the waiting room almost unable to walk and left with the other bleeding, dripping, basin-clutching recoverees for about twenty minutes (as the staff had previously informed us would be the case) while the bleeding slowed. The anesthetic began to numb my top lip and throat (post-nasal drip bleeding) and finally got to the nasal passages. I was then taken in to see the doctor who (promising me THIS wouldn't hurt) used a nasal endoscope to check the results. I gave him a truly filthy (as in glaring, bleeding, red-eyed) look of disbelief and he had the grace to inform me that, yes, polyp surgery and recovery was one of the more painful proceedures on the hospital's list - not something they had advertised in their earlier information to me on the subject.
Recovery time: shuffle back to room with huge blood clots forming in nose and gauze pad taped back under nostrils, pushing the IV shakily. Lie down on one side or other so that blood does not drip into back of throat and get swallowed (bad for you, makes you quite nauseous). Change gauze every ten minutes, request painkillers (though the pressure pain is drastically reduced once the packing is gone, there is still the raw surgery spots and septoplasty pain to contend with), try to get some sleep in ten to fifteen minute blocks. You will still need to keep rehydrating your mouth (your tongue will literally dry up and stick fast to your palate while you are sleeping, and you cannot pull it loose. Don't try, just grab a mouthful of water and let it soak into those dried tissues) and keeping chapstick or something similar on your lips unless you want cracking and bleeding.
Wait another twelve hours under observation (I had a slight fever, which they considered 'normal' for this operation) from post-surgery on through the next two days) with antibiotics and vitamins and anti-adhesion meds and painkillers in your IV. You may or may not still be dripping blood by the time you are released: I had to keep the pad on and change it every four hours or so as the blood slowly became the consistency of loose gelatin. Now, Thursday night, after saline irrigation (don't ask because I don't want to describe any further horrors) and rest at home, the bleeding has dwindled to a slight trickle and the gelatinous clots have stopped forming. I will need to take five different pills three times a day for the next week (various antibiotics to prevent infection, adhesion, etc.), irrigate the nose with saline solution, and.... consider the possibility that the polyp(s) may grow back.
If you can prevent polyps, treat them alternatively, or live with them, please consider whether or not the time, cost, and pain is truly worth it.
Still experiencing discomfort (on a scale of 1 to 10, about a 2) and pressure in the passages and sinuses.
Blood clots to the consistency of stringy gelatin, which seem to keep constantly forming in the sinuses or higher up and trickling down - they wash out with saline irrigation or 'pull out' when wiped with tissue at the base of the nostrils. Overnight these clots dry to hard crimson crusts / scabs, sharp-edged and painful. They can be softened and removed through saline irrigation as well.
Saline irrigation (not described previously) involves taking a large plastic syringe (about the size of a supermarker or jumbo gluestick) with a stubby plastic nozzle about an inch long, filling it with 50 ccs (about a shotglass's worth) of commercially-purchased saline solution, and squirting it up into your nostrils. The saline should drain through the back of your throat and be spat out, or if you are unable to do that, out through the other nostril. It's mildly uncomfortable (1 or 2 on my pain scale) but relieves the pressure of the clots, disinfects, and cleans the whole area out.
I am taking four different kinds of medication, not including a throat spray and a nasal spray to be used once or twice a day:
- Klaricid XL - treats bacterial infections
- Sudafed - provides relief from sinus congestion and inflammation
- Surfolase - used in the treatment of sinusitis
- Soleton - nonsteroidal anti-inflammatory
I have learned after the fact that this type of surgery can have certain side effects:
- temporary or permanent loss of your sense of smell
- may affect your vision - blurring, double vision, etc.
While I cannot currently smell anything, my vision is normal. However, I have noticed that some of my facial muscles have been affected: my top lip does not move normally when I speak or smile, giving me a stiff, prosthetic-like (think Jack Nicholson's Joker) appearance. This may 'wear off' as the swelling decreases and as the nose and associated muscles/nerves/membranes heal. I certainly hope this is the case and will be speaking to my doctor in my post-op followup next week.
Last, in cleaning my nasal passages this morning, I was able to view the lower part of the nostrils' interior sans blood for the first time. There appears to be a translucent, hatched, tiny plastic 'splint' curving along the septum on both sides. Presumably this is to support the re-deviated (corrected?) septum in the correct shape and position while it heals: it may also be responsible for some of the stiffness and discomfort I am experiencing. I don't know when that will be removed; possibly in the followup next week.
Web research seems to indicate that this 'followup' visit is used for inspecting the surgery, checking the process of healing, and 'debriding'. Debriding is the process of removing scabbing and unhealthy flesh: it may have been the extremely traumatic experience I described above in the previous post, as it seems to be one of the more painful proceedures that medical technology still possesses - apparently without alternatives, but positively medieval.
Will continue to update this if anyone is interested.
I went back today for my three-week followup appointment.
Have been on antibiotics (see previous post for pill list) for the last two weeks, flushing the nasal passages with saline regularly. The bleeding stopped about a week ago and I've actually been able to blow my nose (gently!) and sneeze. However, I've experienced sinus congestion and the concurrent pressure/pain for about the past two weeks, non-stop. My sense of smell was non-existent for quite some time; in the past three or four days I've been able to detect strong scents like fresh garlic, frying onions, and so on, but nothing more subtle yet.
My doctor (actually also the nose-ear-throat surgeon who performed the operation) took a look at both passages and then sat me down and drew me a little sketch to explain what he was going to do next and why (English is not his first language...). There is a nasal turbinate (look it up, a picture is worth a thousand words!) which should be free-hanging in the nasal cavity. Mine was 'adhered' to the side of the passage: apparently (yet another thing I wasn't informed of ahead of time) this is the MOST COMMON after-surgery result (they refuse to call it a complication) and most patients will need to have this seen to, despite taking 'anti-adhesion' medication. The raw surfaces stick together, just as a scab might form to bind a deep cut in your hand, restricting the range of motion or possibly even growing together.
Having it 'seen to' was, no surprise, both scary and painful. Here we go with the gory details:
He put three-inch long strips of bandage soaked with topical anesthetic into the left passage (thankfully this proceedure only needed to be performed on one side!). Of course, having the tweezers and the bandages in that far was temporarily painful (about a four out of ten) but the anesthetic began to work almost immediately to numb the surface areas. I was sent back out to the waiting room for the next five minutes while he saw other patients and the anesthetic began to work.
Back in the chair - he removed the strips with a gentle tug, uncomfortable but not to be compared with having the packing removed (see above posts). He then picked up a syringe with a very long, thin needle attached - it resembled a fine piece of stripped telephone wire about six inches long - and informed me that he would use local anesthetic inside the nose. The needle was injected several times deep inside the nasal passage, at one point squirting stinging anesthetic down my throat and numbing it to the point that swallowing was nearly impossible. Owing to the sensitivity of the site, it was more painful (about a five or six on my personal scale) than a similar dental needle, though it had roughly the same effect: my four front teeth and the left side of my face from my left nostril over to my left cheekbone became numb with that faint itching that signals 'freezing'.
The next part was grotesque: I had my eyes tightly squeezed shut so I can't describe the tools he used, but the sensations - and sound effects - were quite horrible. Although there was no sharp surface pain, as in prior proceedures, the pressure was intense, plus the vibrations of various tuggings, crackings, and at several points rapping, travelled through the bones of my head with highly unpleasant results. Literally, at one point, he inserted a tool between my septum and the turbine at the area of adhesion and then 'flicked' or struck the tool sharply as if chiselling or prying apart a bit of wood. I thought I would vomit; tears sprang uncontrollably to my eyes and I began shaking, unable to catch my breath. I think it took about six to eight minutes in total to work on this one area, with some suction, scraping, and about a thirty-second break for me to stop shaking (with the shreds of willpower I had left holding me upright in the chair). There were cracking, crackling sounds which suggested that my newly repaired septum was in danger, a flow of blood outwards from the new raw areas, and the constant postnasal drip of blood on top of the anesthesia in my throat.
He finally withdrew the various tools and reassured me that he was finished, but then the nostril needed to be repacked - gently and not too far in - with some sort of treated bandage to a) control the pain and b) stop or slow the bleeding.
My doctor informed me that he had separated the turbine and "removed a sinus"! I still don't know how/if that was actually what he did or we were just having language issues - I was too groggy to clarify.
I was sent back out to the waiting room for another ten minutes or so, then called back in to have that packing removed and to be dismissed with yet another appointment for two weeks from now.
The injected anesthetic wore off rapidly, like dental freezing, with the same sort of itching and subsequent pain. Thankfully I was driven home - in the next hour it felt like a sinus migraine, until the two Tylenol I took (not prescribed) kicked in and I was able to get some rest. The bleeding continued in a slow, dark trickle from the one nostril, while some sort of yellowish fluid (excess anesthetic from the injection or the packing?) flowed out quite quickly for that hour, soaking several large tissues.
Last grotesque detail: When I got home, I sat down and tried to clear my throat, as there was a lot of mucus, anesthesia, and clotted blood that had run down the back (post-nasal drip) passage and I felt as if I were choking. I experienced a sudden sharp pain right at the back of the throat, coughed, and spat up - along with some bloody clotting - an actual chunk of something that had been cut away from inside my nose - a kernel-size bit of cartilage, turbinate, sinus, I-don't-know-what!
It is now seven hours later - the pain has settled right down into a slow throb, only about a two on my personal scale, without medication - and the bleeding has slowed but not stopped (about a 'drop's worth' every thirty seconds to a minute, so I need to keep a tissue handy to keep blotting it. I'm required to continue taking two kinds of medication (antibiotic and anti-adhesion, I think) and irrigating for the next fourteen days. I was not able, obviously, to eat lunch, and I had soft food for dinner as a) it still hurt the entire area to chew (or talk, or laugh, etc.) and b) the nostril bleeds more quickly when the head or jaw is in motion. Luckily I still have some of the gauze pads with tape on them for tonight, so I can wear one of those on my top lip to avoid getting blood all over my pillow.
This cost me 1.6 million won - approximately 1500 dollars (Canadian or American, take your pick. I'm not sure of the exchange rate atm) - for the operation, another several hundred for the required hospital stay, pain control and food, and about fifteen to twenty dollars per followup visit. Just having him stick the otoscope in and look around costs an additional eleven, according to the receipt I got today...
Worth it? I hope I'll be able to answer that more positively in a few months, if/when my sense of smell returns, my breathing is free, and my sinuses unblocked. At this point I know I will not be willing to go through it again, should the polyp regrow as I have been informed it might!
Again, please let me emphasize that this is only my experience, my reaction, and my pain threshold - it might have been very different for another person in another hospital who did not have the septoplasty (correction of deviated septum) done as well. Discuss your concerns and fears with your doctor individually and tell him I said so!
In general, in my experience, medical expenses are less here than in Canada - dental is far less (two hundred for a root canal, say), and glasses cost about thirty to a hundred dollars, frames and lenses together. No idea about the American system or its costs. I do know that expatriate Koreans schedule medical treatment (and dental and vision) in Korea during their once-a-year family visits, or even fly back just to get work done, since the cost of an air ticket is less than the proceedure in many cases. That should tell you something, considering what flying costs these days.....
I've suffered from polyps for maybe 3 years now - in that time sneezing, sniffling nose red raw with people constantly asking if i had the cold. Unable to smell or taste for most of that time.
After maybe a year and a half the polyps were diagnosed - through my own research! Steroid treatment worked amazingly but then they grew back - nose sprays and tablets were also tried, worked wonderfully then stopped working. Miserable - surgery was the next answer.
Seemingly I had a severe case of polyps now removed under general anesthetic through a polypdectomy. A little pain after waking then over the next 2 days i couldn't beleive how great i felt. Third day everything is moving a little - blood clots and a little pain. I don't want to touch my nose and gross as it sounds you can just spit out the blood clots. I'm soon moving to a warmer climate which i'm sure will really help and i'm confident of the polyps not growing back so aggressivily. There will be lots of meditations on concentrating on the nose and the body healing itself. Currently i live in scotland and i think a wet damp climate (especially when you have asthma) is a breeding ground for polyps after years of non specific rhinitis.
I realise that some will have pretty gross experiences with their polyps but so far the surgery hasn't been too bad.
I feel for those having to pay for this as being in the UK we have free health care.
You have mentioned your surgery was performed in a foreign country. Could you tell me if that country generally has pretty advanced medical service and equipments?
I understand in general Sinus surgery post-op is not very pleasant, but I can't find any other personal experience as horrible as your experience on internet, assuming they are performed in U.S.
Thank you for your response
The combination of deviated septum correction and nasal polyp removal might cause this "horrific" story.
Deviated septum correction here takes 3 days in hospital and is done with local anesthetic. Polyp removal - the same. Most of the people do not report such severe pains and long recoveries. This observations are from my time spent in year-nose-throat clinics.
About my experience with nasal polyp removal:
Had couple removed from both sine and nose. It was done with local anesthetic. The pain was low and faded fast. The problem was more with the sensation of the manipulations deep inside the nose.
I will never forget the feeling when my "packages" were pulled out - it was not the pain, but the flow of cool air in the nostrils that stroke me.
Had a nasal polyp regrowth in 3 years and it was removed before 12 days. The operation took 5-6 minutes, local anesthetic, no pain, mixed sensation from the doctors manipulations in the nostril.
The manipulation matches completely Bard Judith's second.
After the operations I had no pains, the removal of the "packages" was more unpleasant then painful. Now treating the nose with steroid cream.
Visiting the doctor 2-3 times a week to manually clean blood strains. According him the recovery takes 20-25 days.
In general - the ability to breath through my nose worths the discomfort of the operation(s). Will do it again if this bustard grows again %-)
The action took place in Bulgaria XD
Could you explain why Nasal Polyps can be life threatening? I have read many articles about Nasal Polyps from credible website, I haven't found any of them mention it can't be life threatening.