Rob emailed me on October 14, 2010:
I had my septoplasty carried out in Glasgow (Scotland) on 29 September 2010. I'd had increasing problems with nose-breathing for about, oh, 10 years or so. I don't ever remember bashing my nose or having some kind of injury, so it's a mystery how the septum came to be so deviated. I'd used nasal sprays for a long time - who knows if that contributed. Anyway, it was most problematic at night; I could only sleep on my left side, because if I lay on my back I snored appallingly (according to my husband), and if I lay on my right side the "good" nostril closed over completely and I'd start gasping like a fish out of water. I was waking up with headaches of varying severity almost every day, which I attributed to the mouth-breathing and dry throat I got, as well as pressure building up in my sinuses when I lay down. Enough was enough, I thought....
I was referred to the local hospital by my General Practitioner (GP) for an ENT opinion. I had an endoscopy on the day of the clinic appointment and the consultant agreed that I had a pretty severe deviation to the left. "Nasty" was the word he used, actually. He asked me to try nasal steroid sprays in the first instance for 2 months, but said that I'd most likely need surgery. He said that if, after a month of the sprays, I was seeing no difference, I could call his secretary and he'd put me on his waiting list for a septoplasty.
So I tried the sprays, knowing pretty much in my heart that they weren't going to do much for me, and sure enough they made absolutely no difference to my symptoms. At the start of August I phoned the consultant's secretary and was put on the waiting list. I got a letter through at the start of September to tell me that my surgery was scheduled for 29 September. Almost immediately my stomach started spinning like a washing machine on full cycle - the last time I was in hospital was when I was young, and it wasn't so much the surgery that scared me but the pain I thought I'd be in afterwards.
I started researching the procedure on the internet and found various peoples' stories. I ignored a lot of the "horror" stories as I know that people who've had no problems at all tend not to rant about it online! I figured the horrors were the exception, rather than the norm. However, I did find it really helpful to find a few good, honest accounts.
On the day of the procedure I arrived, as requested, at 8am to the Day Surgery Unit. Fortunately I was first on the operating list for the morning, and I walked down to theatre at 9am, resplendent in my hospital gown and shower cap. I lay on the trolley and an anaesthetist gave me a mask with oxygen/nitrous oxide. Just as he said "Now, you might start giggling, as this is laughing gas..." I started giggling uncontrollably. Weird! I was told to just take a few deep breaths, then it was lights out....
When I woke up I was disorientated. I could feel that I had an oxygen mask over my face, but I had no pain and I didn't feel like I'd had anything done to me. A nurse came over and I actually asked if I'd had the operation! I had no nausea whatsoever, and I believe that this is due to big advances in anaesthesia - rather than a "one-off", knock-you-out dose, the anaesthetist constantly administers just enough anaesthetic during the procedure to keep you under, so you're not being overwhelmed with it. It certainly works!
One GREAT thing I must highlight here is that I had NO SPLINTS, and NO PACKING. My consultant had said pre-operatively that it wasn't necesssary, that there's a technique which does away with the need for packing or splints, and this made a world of difference. Certainly from my online research I knew that most people found the splints/packing to be the worst thing about the whole experience, so I would urge anyone undergoing a septoplasty to check if their doctor now uses the "no splints, no packing" method.
Having woken up from the anaesthetic at 11:30am I was eating a sandwich at 12:15, and was discharged home at 1:15pm, complete with a "trough" under my nose to catch any rogue bleeding/drips. My parents had come to collect me and were surprised at just how "together" I seemed to be - I chatted all the way home and seemed to be in good spirits. My nose didn't feel too blocked at all, which was a (short-lived!) relief. I also had no visible external signs of the surgery - no black eyes, and my nose wasn't even that swollen-looking on the outside. My husband, just home from work, was waiting for me when I arrived, and was hugely surprised at how well I looked, considering just a couple of hours earlier I'd been "under the knife". I was, however, pretty tired, so I just got changed again into my PJs and fell into bed. I slept on and off for the rest of the day.
Day 1 post-op I was surprised at how little pain there was, although my nose was now pretty blocked up. I had quite a bit of pain in my two front teeth, and on the soft palate directly behind the front teeth - apparently the nerves from here go right up to the sinus area, so they get "jarred" with the surgery. I'd been given just paracetamol and ibuprofen, but this easily controlled any discomfort. I was still out of sorts from the anaesthetic - I felt tired, a little emotional, and I didn't really know what to do with myself. I was like this on Day 2 post-op as well, though I was starting to feel more normal all the time.
Day by day I felt things improving in my nose, although on the left side (where the deviation was) I was still completely blocked. By the eighth post-op day the rest of my nose was feeling great, but I had no improvement in my breathing on the left. I had a bit of a look up my nose in the bathroom mirror, and saw something "bulging" out from the septum. I wasn't sure if this was still just swelling or not, but I felt in myself that I should get it checked. I made an emergency appointment with my local GP, who saw me the next morning. She felt that there was a bit too much swelling, and sent me to the hospital with a note.
I went to the ENT ward at the hospital and, coincidentally, saw one of the doctors who'd assisted my consultant when I'd had my procedure. After a LOT of prodding, and a couple of other doctors coming in to have a look up my hooter (I felt like a museum exhibit by the end of it), they concluded I had a SEPTAL HAEMATOMA, which they said is a rare complication. The septum has a lining over it, and the haematoma is essentially where a collection of blood forms between the lining and the cartilage of the septum, causing a bulge. This was what I was seeing in the mirror. The problem with any collection of liquid (water, blood, whatever) is that when it collects, it eventually stagnates/becomes infected. A haematoma can be dangerous because, untreated, the blood becomes infected, gets into your blood stream and can cause septicaemia, so it's important that it's identified and treated as soon as possible.
The doctors wouldn't even let me go home to pack a bag - I was kept in immediately. Initially they were going to take me back to theatre that evening for the haematoma to be drained under general anaesthetic. However, because the haematoma was only on one side (I believe that it more commonly occurs on both sides of the septum), the doctors decided - gulp - to incise and drain it under local anaesthetic, i.e. while I was awake. So I sat in a chair, much like a dentist's chair, knuckles white as I gripped the sides, while I had a shed-load of local anaesthetic puffed up my nose, then they cut into the haematoma with a scalpel and drained it. After that I had the nostril packed, which was "fun". The experience wasn't painful, thanks to the anaesthetic, but it was nerve-wracking and very uncomfortable. I then had to stay in hospital for IV antibiotics. Overall, I stayed in the hospital from the Friday afternoon until the Sunday evening, then I was discharged home with more oral antibiotics.
Since then I'm pleased to report that my nose is healing nicely, and already I notice a considerable difference in my breathing - finally I can, after at least 10 years, feel air going up the left passageway! I go back to work in a couple of days, and was off in total for about 17 days. I think I'd have been back at work earlier had I not had the setback with the haematoma.
To anyone who is thinking of having a septoplasty - just have it done! After the surgery you'll have 2-3 days of discomfort more than pain (I actually found Day 3 post-op the worst, but not as bad as I'd feared), but the pain meds (even just paracetamol) keep things under control. I shamelessly admit that I'm the worst patient imaginable, so if I got through it without freaking, anyone can. My poor husband was an angel, running out to the shops every time I had a hankering for something ("Could you get me some tissues with balm?", "Oh sorry, I forgot to ask if you could get me some soup - could you go back out again?" etc. etc.), so I didn't have to do anything more strenuous than stay in bed reading or sit wrapped up on the couch watching daytime TV while I was off work!
There's not much online about patients' experiences with septal haematoma, so I wanted to highlight this too. I think you know in yourself when something's not quite right, and I certainly felt that the rest of my nose was improving day by day while the left side remained completely blocked. But even the complication of a haematoma wasn't that big a deal, and it was caught just before it really took hold.
I LOVE being able to sleep on my back now and not snore, or sleep on my right side (which feels really weird, since I haven't been able to sleep on that side for years!). I've still got a way to go before all the swelling goes down, but being able to breathe more normally is the most fantastic feeling. Finally, the NHS in the UK gets a lot of criticism - yes, it has its faults, but I can't fault the care I received from start to finish, and I was very well looked after by every doctor and nurse I came into contact with. They do a very difficult job!
Here's a quick update from March 26, 2010:
I'm doing fine these days, although if I'm being 100% honest the result is maybe not just as good as I'd hoped for. It definitely is a lot better than it was, though. I saw my consultant for a check-up in January and he said I was still healing - after a haematoma it does apparently take a bit longer for the tissues to heal - but he's willing to do a revision septoplasty later this year if I want it. I'll wait and see how I feel in the autumn, but I don't think I'd be put off about having the op again - it was a lot easier than I'd expected, it was just the complication afterwards that sucked big time!