Monday, August 08, 2016

My Lovely Sinus Surgery Synopsis

What I THOUGHT I was going to go through and what most people get when you mention "sinus surgery" was what's known as Balloon Sinus Dilation, a minimally invasive office procedure performed under local anesthesia where the doctor inflates small balloons into your sinus pathways to restore drainage, which are then extracted a few days later.  That's not what I got.

I was told by friends who said they had gone through sinus surgery that it was relatively pain-free and that the most jarring part was seeing the packing they are able to pull out of your nose following.  That's not what I got.

I expected this to be simple and instantaneously relieving.  That's not what I got.

So I needed clarification.  I sent an email through the Northwestern portal to the ENT to ask for a consultation because I felt I was owed a more full explanation of what kind of surgery I had and what was found. I admitted that this information may have been shared with me previously, but that I was only now in the proper state in which to hear it.  Within 2 minutes of sending the message, the doctor called me on the phone.

In short, I had pansinusitis.  There are a total of 8 sinus cavities in the face, 4 on each side.  All 4 on my right side were completely clear.  All 4 on my left were completely clogged.  Since sinuses tend to fill and discharge on both sides simultaneously, the doctors knew there was a bigger problem since there was such an imbalance in mine.  In all 4 sinus cavities on the left side, there was infection and pus.

Here's the official synopsis:
  1. Nasal/sinus endoscopy, surgical; with ethmoidectomy, total
  2. Nasal/sinus endoscopy; with maxillary antrostomy
  3. Nasal/sinus endoscopy,with maxillary antrostomy; with removal of tissue from maxillary sinus
  4. Nasal/sinus endoscopy, surgical with frontal sinus exploration, with removal of tissue
  5. Nasal/sinus endoscopy, surgical with sphenoidotomy; with removal of tissue
All this mean they cleaned out the Maxillary cavity, which is the one in the cheek area, as well as the Ethmoid cavity, which is the one just above the eye, close to the nose (the one that had swollen and caused me to go to the hospital).  The Frontal cavity, the one above the eye on the forehead, was also filled, however the plan was to allow that one to drain on its own, now that the two cavities below it were empty.  Also, based on my anatomy, the drainage tube from the Frontal down through my nose is not a straight shot, as it is for 99% of the population.  My tube has kind of a zig-zag, which causes for slower drainage.  To fix this, the doctor would need to drill up into that cavity, which he only wants to do if absolutely necessary.  It still might have to happen, but with luck, it will eventually drain on its own over time.  By the way, remember that all of this was done through my left nostril which is pretty amazing when you see where each of these sinus cavities is located.

The really big issue was the last cavity, the Sphenoid, which is located deeper in the skull behind the eye.  While the infections and blockages in the other three cavities were recent (the infection contracted back in May) the infection in the Sphenoid had been many years in the making.  This problem did not initially make itself known on the original CT scan and was only discovered during surgery.  The doctor cleaned out mold and fungus balls that had been building for years.  Because mold does not need chlorophyll to survive, it's apparently easy to grow inside your body as it feeds off of other organisms.  So from ALL of the sinus infections that I have had over the last several years, this mold and fungus had been growing exponentially.  Symptoms would be alleviated due to antibiotics, but the infection itself never really left and would lay dormant until slightly triggered by something like a ride in an airplane when my sinuses would work to balance the pressure in my head.  This is why I would almost always get a sinus infection after a flight.

And this is also why the doctor wondered why I wasn't in more pain that he expected.

Hearing all this actually made me feel better, in a way, because I was wondering why I was having such a difficult time dealing with and healing from what many of my friends considered a simple procedure.  I felt justified somehow, and ironically relieved knowing that this was not as simple as I was initially told and expected.

So where are we now, 18 days following surgery and 10 days after the follow up:  Overall I feel pretty good.  An occasional headache will pop in, mostly on the side or top of my head.  They're not too intense anymore and I no longer feel the need to take Aleve or Tylenol to combat them.  I am still performing sinus rinses twice a day and will continue until my antibiotic (now on Doxycycline) runs out in another 5 days or so, then I'll just do once a day I guess forever.  My energy is coming back, as is the weight I lost over the course of the ordeal.  I get a stuffy nose on the left side and wake up about 4 hours after I go to bed every night.  I get up and walk around to alleviate the pressure and then eventually go back to bed.  We're going to put a humidifier in the bedroom to see if that helps at all.

I have another follow-up with the doctor sometime in September, but everything is pointing to a successful albeit slow recovery.  We are going on another European trip the end of August and if working at Make-A-Wish taught me anything, it's that one needs to have a goal in order to heal.  So that's what I am shooting for.  And I hope I make it - if even by a nose.