Floyd's Nose Job, Blow By Blow

by Floyd Maxwell, BASc
Principal, http://www.just-think-it.com

After trying unsuccessfully for over 2 years to open up a completely closed right nostril, I finally decided it must be a "hardware problem" and set off to see my local doctor.

Only problem was, I didn't have one.

So at my next teeth cleaning visit I asked my dentist, Tom, to recommend a good "GP", preferably his own. His doctor turned out to be a Dr. Barrett but Tom first offered to "take an x-ray" to see if he could see anything.

I was dutifully strapped into a device that attempted to isolate my head and allow the x-ray source or beam to rotate around me, and send x-rays through me and into a circular photographic plate.

The first time the device ran, I was very nearly in trouble. As the head rotated around, "someone" had forgot to account for the Indian sweater I was wearing and there did not appear to be any mechanisms for detecting obstacles or for shutting down the machine if the human "resistance" suddenly increased.

He wasn't satisfied with the first x-ray and so a second was made, sans sweater.

The x-rays didn't reveal a thing.

The most interesting aspect of my visit to my "new" GP was the need to continuously rebuf Dr. Barrett's efforts at interesting me in some drugs that "might help". He even demonstrated, literally, the one that he used after locating it among a half dozen other drug dispensers in his desk drawer.

My verbal mantra became "No Chemicals!"

After the 6th failed effort to turn me into a drug consumer, Dr. Barrett gave me a brief physical, wrote something down and placed it in a envelope that was immediately sealed and handed to me with the admonition, "Take this to your Ear, Nose & Throat (ENT) specialist."

I liked the ENT, Dr. Dickson, immediately. Fast moving, without being impatient. Direct yet eager to draw a diagram or show me my own problem.

"Oh sure. No doubt about it. It's all pushed over," were his preliminary observations about my nose.

Using an incredibly simple instrument that was like a mini- funnel about 1 inch long and the diameter of your nose wide at the narrow end, he easily expanded and straightened up my nose so that with the mirror he had given me I could see for myself -- left side open 1/4", right side completely shut.

"Plus you've got an allergy or something that is exaggerating the problem."

I thanked him for that information and asked what was involved in the operation to open my right nostril.

"Oh well, we do a little incision at the base of your nose and then go in under the soft tissue and remove some material (part of the cartilage-like septum that divides your nose into two passageways)."

Fine, I said. Let's book a time.

"And you should apply something topically to your nose, for the allergy," he added.

I repeated my "No Chemicals!" message and was subtly moved to the "Bad Dog" box.

Appointment over, I awaited the operation.

The next thing to happen before the operation was that I talked to half a dozen friends about my situation. I was surprised by the range of similar experiences, current problems and the number considering a similar solution.

The result of talking with others was that I realized that this was a very common problem -- the average person I talked to either knew someone who had something done, had something done to themselves or was considering having something done and wanted me to get back to them after my operation.

Great, I resolved, now I had an ideal, a higher reason for the operation!

Nowadays hospitals attempt to minimize the duration of a patient's stay by adding a pre-admission process.

I breezed through this -- in fact, the hardest part was finding the building! Asking several hospital staff while just 75 feet away from it didn't help any -- they didn't know!

Reading out a blood pressure count of 104 over 70, even the nurse sounded a bit surprised. My bike riding was paying off.

Of course, I had a bit of fun on the by-now repetitious forms:

Occupation: "Computer Nerd"
Languages Understood: "English & Computer"
Spoken: "English"
Reason for operation: "Un-deviate my septum"

...two could play this "techno-babble" game :-)

The Anesthetist (David) turned out to be a computer nerd himself. He called an early halt to the medical questions, we exchanged a few bytes of computer stuff and I was off with his last words to the nurse, "No need for a blood test, he's just too good", ringing in my ears.

OPERATION DAY

3:30 AM
Out of bed 1/2 an hour before the alarm, unable to sleep further for some reason.

4:30 AM
No food or drink allowed today so after a slightly more dedicated than normal morning exercise program I'm out on the street waiting to catch the cab to the hospital.

5:00 AM
Dropped off a current copy of my Will..."one chance in a hundred thousand" they had said.

5:30 AM
Arrive at the hospital.

5:40 AM
Hospital. Emergency Admitting. Lady busy on the phone, don't want to interrupt. Man in uniform in a glass-enclosed booth. In case terrorists strike I assume...

5:45 AM
While talking with one of the admitting people I experience my first and only case of the willies.

5:50 AM
Following "easy" directions, I end up either totally lost or close to where I should be.

See my first person "in discomfort". Resist the urge to try to offer comfort in some way.

5:55 AM
Most employees haven't quite shown up for work and I've already glanced through the one magazine in my four bed room. Stunned at my own stupidity, I realize that I have not brought any of my own reading material!

6:00 AM
There is a still-functioning TV at my bed, without sound. I try it. And quickly realize that the only things watchable without sound are sporting events.

6:30 AM
Aaron joins me. He is having his tonsils removed. Again I choose to say nothing about the inadvisability of this, mainly because it is too late to help him anyway. It is soon apparent that Aaron is one of those people who always has something wrong with them.

7:00 AM
I share my TV with Aaron and we talk about sports.

7:30 AM
I am informed by one of the nurses that there is a no-show and so I will be operated on earlier.

I say "Great!"

She then adds that I must completely disrobe and put on the amazingly deficient, yet standard, hospital loincloth.

7:45 AM
While slowly undressing then redressing in the "in suite" washroom, I take some deep breaths and relax myself as a final preparation.

7:50 AM
Exiting the washroom, I meet Don who arrived moments earlier.

Don appears as healthy as an ox.

8:00 AM
"What are you in for?"

"Cure snoring."

"Lift weights?"

"No."

"From the farm?"

"No. Kitsilano."

It turns out he's a police officer.

8:30 AM
Action!

A small herd of technicians enter the room and wheel the ubiquitous gurney in my direction.

I gingerly climb on, holding as many pieces of loincloth down as I can with my one free hand.

8:40 AM
My favourite part, wheeling down the hallways on the gurney -- always makes me think of the Bill Cosby skit...

8:45 AM
Zero hour.

I am wheeled into a room that reminds me of "The Andromeda Strain".

More new people, pretending to be friendly and asking the same questions that others had promised would only be asked "this once". One of them is really after my veins, with a needle in hand.

I offer a greeting to Dr. Dickson. He is also trying to distract me.

Bit of tension.

Deep breath.

Oxygen mask on.

Heh, cool, I've never breathed oxygen before.

Wait a second, what's that? Smells "brown"...

Affecting different parts of the body -- can feel it "taking control".

Try to resist, wonder if I should be putting my mind somewhere else. Decide to relax and...

10:00 AM
Recovery Room

I am suddenly and vividly aware that I am ALIVE, and immediately say out loud "It's great to be alive" several times, very sincerely.

10:10 AM
Cough.

10:12 AM
Cough.

Ever notice how often you have to ask for water in a hospital?

I ask for water and get a thimble full.

10:15 AM
Cough, cough.

Ask again. Another thimble full.

10:20 AM
Cough.

Don't have to ask. Get 3 thimbles! Yes!!

Apparently, during surgery they stick something in your mouth so you won't choke or something, creating a predictable source of throat irritation. But this does not produce an equally predictable delivery of water afterward...

10:30 AM
Proceed to spend the next five minutes relating a deeply felt true story/experience with people I have never met. Definitely glad to be successfully done with the operation!

10:35 AM
My verbiage makes it very apparent to them that I have recovered sufficiently to leave the recovery area.

10:40 AM
Chris arrives to take me upstairs.

I engage him in conversation and away we go!

10:50 AM
Back at my four bed hotel, Chris is quite taken aback.

I figure I'm on a roll.

My new nurse is Ruby and I talk with her too.

11:00 AM
My two roommates come back from their surgery, a little apart.

Aaron is not comfortable. Don is silent. Aaron asks for and receives an injection of morphine. Don takes one as well.

11:10 AM
Am sipping water continuously.

11:20 AM
Ask Ruby if I can have the intravenous removed immediately. She sees that I have consumed at least 12 ounces of water already and says "I'll see".

It's removed a few minutes later.

11:40 AM
After resting a bit more, I reach for my vest. I'm mobile!

11:40 AM
Out in the hall, at a courtesy phone, I call in for messages.

6 of them, several urgent.

Thank goodness for voice mail.

Call home -- "All's well!"

12:00 NOON
My post-operative pain killer has mostly worn off but no sign of pain. Great!

12:10 PM
Ruby, in a cautiously optimistic tone, suggests that I will be leaving that evening (the normal is to leave the next day).

I say "Don't even mention the word `evening'. I talked to Dr. Dickson before the operation and he said all things being OK I could leave between 4 and 5".

12:30 PM Lunch arrives.

I nearly die laughing.

I'm not upset but its truly funny.

All those questions like "Are you a vegetarian?" have been carefully ignored (as they were on the two previous occasions when I requested Vegetarian Cuisine for myself or someone else from hospital staff).

I wonder if hospitals will be among the last places on Earth to become philosophical.

12:40 PM
Ruby kindly offers to order me a normal vegetarian meal, not just the fluids prescribed. I thank her.

12:50 PM
LUNCH arrives!

Fabulous side order of sliced and steamed zucchini.

Egg salad sandwich with double the normal amount of egg stuff in the middle -- incredible!

Tea and a slice of pear for afternoon snack.

Boy was I appreciative, having gone through the usual pre-operation starvation routine!

1:10 PM
Aaron is not comfortable.

Don is quietly getting into shorts and a T-shirt.

I decide to change as well. Fully. Go for my longest walk yet, right up to the front desk. Slowly.

My actions cause the nurses to suggest things like "Ah, you're not quite ready to leave..."

1:20 PM
OUTSIDE!!!

Fresh air! Wow!!!

Sunshine. Warmth. Familiarity. Mmm Mmmmmm!

1:21 PM
Time to do some deep breathing to charge up my body. Works great. Keep this up for 10 minutes.

1:30 PM
Pop into the gift shop.

Am admonished to leave my cup somewhere or other. Leave it on the floor. When they find out they are horrified -- "germs"! They are obviously Pasteurites...

1:50 PM
Really enjoy 20 minutes in the volunteer-run gift shop. Buy two coffee mugs (I collect them), one of which has this on it:

Most appropriate!

2:10 PM
Before leaving, I mention that I know one of the chief volunteers as I used to work with her at a previous job. Wonderful, giving person. "Betty".

They are just tickled. Want my name so they can tell her.

Awfully fine volunteering would be my summation after that visit.

2:20 PM
Stagger back to my suite with my haul requiring 3 small bags to carry it all.

I'll need a big bag when I leave...

Ruby very sincerely shares in my goodies and decides that she will also buy one of the two "quote books" I have purchased.

2:45 PM
Getting a little tired, but still no pain.

Made a bit of a mistake by getting dressed so soon. The very industrious cleaning people immediately made my bed after I got up and so I have avoided using it -- resting by putting my head in my hands for much of the afternoon.

They eventually see this and say it will be Ok if I wish to lie down.

I lie down on top of the covers a bit.

3:00 PM
Time to remove the nose "packing" that, for the first few critical hours after an operation, is meant to prevent copious bleeding.

The more squeamish among you should look away at this point.

It's not that bad, actually, when you have already suffered with a set of totally plugged nostrils for over two years. My periodic efforts at forcing some temporary break-ups of that nasal log-jam had involved about the same amount of discomfort -- its not like regular pain, but it is quite a sensory experience nonetheless.

3:05 PM
Cool down period.

Need to rest for 30 minutes to allow nose-related things to settle again.

Sneak my first, very slight, wiff of air through my new nostril! Wow! Great!

3:20 PM
Am totally ready to head out.

3:30 PM
Heading out.

Offer supportive words to my now ex-roomies. They reciprocate.

Get a larger bag at the desk. Thank them. Say goodbye in 4 or 5 languages. They can't wait to see me go!

3:40 PM
Elevator. Lobby. Call a cab.

3:45 PM
Wait briefly outside.

3:50 PM
Truly away.

THIS is great!!!

I have been holding back my feelings but am jubilant now!

I ask the cab driver a leading question and we're away...

5 days later

• if you have trouble with your sinuses, book time with an ENT specialist as soon as you can. Their methods of diagnosis are non-destructive, totally painless and immediate -- just make sure to say "No Chemicals!"
• seek and apply non-medical alternatives diligently before resorting to surgery.
• go in healthy.
• go in "calm", with feelings under control, "resigned", with the simple thought of generally intending to expedite things and get out of there as soon as possible.
• "To Live is to Give." Hospital employees are people too! It surprises the heck out of them when you turn the tables and start a meaningful conversation with them. Just make sure that your equinimity is not affected by this -- don't do it for a selfish reason or the "feeling". Clean clear survival, physical and mental, is definitely the goal of any hospital visit.

• immediately after the operation rest a bit more than I did. If you would normally have 20 hours (i.e. overnight) before you leave, then plan to leave that night (say 6 hours later) but rest more, while remaining awake if possible. Unless you like shopping!
• Almost totally ignore post-operative "advice". Mine recommended using a chemical to "help" my breathing the first week and insisted that I apply topical chemicals 4 times a day to prevent "infection" -- had I applied that stuff as "directed" I would have done more harm than good. I didn't touch my nose for about 6 days. They said "Do Not blow your nose for two weeks". I very gently blew it a little on day 2 and thereafter-- if you can cleanse it from both directions, so much the better. They made no mention of what you could or could not do exercise-wise the first week and said only to "avoid excessive exertion" for the first 3 weeks -- I packed my laundry off to the laundromat on day 4. Oh, and I was supposed to be in "pain", needing Tylenol 3 or something, for the first 5 days! Maybe that's why they left blank the sentence that read "when you are discharged, phone your doctor's office for an appointment in ____ weeks." I certainly didn't do that!

• get back into your exercise program, particularly the cardiovascular portion, as fast as possible. I did a great deal of rapid mouth breathing for the first 3 days after the operation because I could not do anything more strenuous. This charged me up and speeded my recovery. The hardest thing for me was knowing that I would not be able to do my FULL exercises for several weeks -- doing as much as I could at each stage of recovery was part of a very positive loop I created but you should definitely go easy on "maximum" exertion for the first few weeks.

Days later...

Day 4: Walked 4 miles and cycled 9 more. Slight ability to breath through right nostril, for brief periods.
Day 5: Cycled 18 miles. Nose twice as good as yesterday
Day 6: Cycled 20 hilly miles. Feeling 90%. Almost able to take a breath through right nostril.
Day 7: Feeling 95% First few breaths through right nostril. Back at work after a week off I work a 10 hour day.
Day 8: 98% Almost full power exercises. 12 hour day.
Day 6-10: Am eliminating a "smelly" clear liquid chemical from nose and down the back of my throat. Very solvent-like smell. I think it was injected or "added" during the operation, possibly to "speed" recovery by reducing tissue "reaction". I doubt that others are as able (or determined) to throw off this horrible "stuff" after their nose jobs but I have to admit that the surrounding tissue seems to have been well preserved.
Day 20: As of today I consider the operation a full success. Am able to breath through the right nostril without special effort or circumstance. Yes!
Day 21: Cycling to work normally takes about 45 minutes. Today I did it in 36! I had more energy throughout the ride and did not need to take breaks as I normally would. Ahhh, the benefits of my nose job!