The LFB Patient Guides: Help! I’m Having Sinus Surgery and I’m Scared!

Today I’m starting a new series for the site called the Lets Feel Better Patient Guides. These guides will provide everything you need to know about a variety of topics like different kinds of surgeries, conditions, medications and treatments. They’re by a patient for a patient and maybe from time to time I’ll get a little bit of my investigative reporter vibe on and speak with some real medical professionals from time to time. Here we go.

Sinus_Surgery_adviceWhy would I need sinus surgery?

I’ve had sinus surgery for two reasons: infection and structural problems. If you have a sinus infection for an extended period of time bacteria and snot can build up in your nasal passages and make you really sick. You might also have growths or polyps in your nose (very common) and your tissue can easily become swollen or damaged and may need to be removed.

My first sinus surgery I also had to have a deviated septum corrected, and my second surgery I had to have the deviated septum corrected again because my first surgeon did such a terrible job on it.

What should I look for in a doctor when I need sinus surgery?

Of the things I wish I had known before my first surgery the most important was what kind of doctor I should look for. The first time around I chose a plastic surgeon because I was also king a rhinoplasty. I should have sought out an ENT (Ear, Nose and Throat Doctor) AND a plastic surgeon. ENTs are the most qualified to perform sinus surgeries.

What should I do the night before sinus surgery?

All doctors have different procedures for the night before surgery but a few things are the same universally: stop taking blood-thinning medications like ibuprofen ten days before surgery. You will most likely be asked to take antibiotics and you may be asked to use a sinus rinse the night before. Do not eat or drink anything after midnight. I like to prepare a space for myself post surgery—since you won’t be able to bend down and will be settled in bed for the next few days—try to prepare your room. Put a box of tissues or a roll of toilet paper by your bed, along with a trash can. Move some bottles of water or sports drinks onto your night stand. Lay out your medications on your bathroom counter top along with any sinus rinse, gauze, or other antibacterial solutions your doctor has prescribed for post-surgery. Do your laundry so you have clean clothes to wear (as lying in bed with a bloody nose can get messy, you’ll probably want to change pajamas a few times.)

Make sure your freezer is stocked with ziplock bags full of peas. They’re better than ice packs because they’ll mold to your face and help keep the swelling down.

Do you wear glasses? Invest in some paper tape to help hold them to your forehead until it’s safe to wear them again.

What happens in the operating room before sinus surgery?

Chances are your surgery will be very early in the morning (this is a benefit to you because you won’t be allowed to eat until after you

I know, gruesome–but don’t my eyebrows look good??

recover from anesthesia.) Almost all sinus surgeries are outpatient, so you may have your surgery at either the hospital or an outpatient surgery suite. Arrive early as you’ll have to fill out paperwork before heading back into the pre-op area.

When you’ve finished paperwork you’ll be escorted into the surgical facility alone. Don’t worry, your parents or friends can join you again before you go under anesthesia, but you’ll have to complete a few tasks first. You’ll be asked to provide a urine sample to confirm you are not pregnant (even if you’re sure you’re not.) Then you’ll be shown a bed where you’ll put on a hospital gown and you’ll get an IV.

If you’ve never had an IV before—don’t panic. It’s a very simple procedure that’s done by nurses multiple times a day. They’ll clean your arm with iodine then tie a plastic ribbon around your upper arm to concentrate the blood flow and help them find a good vein. A needle will be inserted and will thread a plastic, more flexible small tube into your arm. This will allow them to administer medication, start your anesthesia and give you fluids. It is painful for a very brief moment while they insert the needle, but once the IV is inserted you won’t be in pain for the duration of time that it’s in your arm.

If you’re nervous, you can ask for IV anti-anxiety medications that will make you nice and calm until the surgery. Go for it. No sense torturing yourself.

You’ll have time now to talk to your doctor and ask him any last minute questions you have, and your family will be allowed in to comfort you before your procedure.

What does going under anesthesia feel like?

Once the nurses wheel you into the operating room, they’ll begin to administer a medication through your IV. They may ask you to count backwards until you fall asleep. While you’re counting, they’ll place a mask over your mouth which will provide the anesthesia. You might feel like you’re choking, or can’t breathe for a brief second—this is because lidocane can numb your mouth, but you aren’t choking. You’re just not familiar with sensation—and within seconds you’ll be unconscious.

And I promise: you will be unconscious. Don’t panic that you will feel something during the surgery: you won’t. You won’t wake up, you’ll be a sleeping, human rock. And it’ll be the best sleep you’ll ever have.

What will I feel like when I wake up from anesthesia after sinus surgery?

You’ll wake up in phases, and you won’t remember waking up multiple times until you’ve woken up for good. You may feel like you’re fighting to wake up which may confuse or frustrate you—it’s totally normal. You won’t remember what you say or do while waking up, this is also normal.

Your mouth will be dry—let the nurses know and they’ll give you a sponge to suck on. You may be nauseas—tell the nurses and they will administer IV anti-nausea medication.

You will slowly find yourself conscious. You won’t feel any pain, just stuffy and confused. Even if your nose is packed with stuffing—you’ll still be able to breathe just fine and because the anesthesia will still be making you relaxed, you won’t worry about much of anything.

I always panicked about waking up from surgery. Would I be able to breathe? Would I be nauseated? Would I be scared? But after doing this multiple times now, I know there is nothing to fear. Everything will be fine. There are so many people around you, tending to your needs that if you just relax and give up control of the situation—let yourself be taken care of, you will be fine.

What should I do when I get home from sinus surgery?

Let yourself be moved and do as you are told. You will still be majorly stoned post-surgery, so let your caretakers handle you. You will be pretty much incoherent and won’t know up from down, so just go along with it. Sit when they say to sit, sleep when they say to sleep, drink when they say to drink etc, etc.

What warning signs should I look for before calling my doctor after sinus surgery?

You will bleed after your surgery, for sure. You’ll feel stuffy, exhausted, and may have some pain (though probably not much) if you experience any of the following call your doctor and ask what steps to take:

-Excessive Bleeding

-Fever greater than 101.5 F

-Sharp pain or headaches that are unresponsive to medications

-Increased swelling of nose or eyes

-Thin, clear fluid draining from the nose

(Keep in mind that you will be swollen, have black eyes, bruises or yellowing skin. This is normal.)

How long does recovery from sinus surgery take?

It depends on the severity of the surgeon and the surgery. My first sinus surgery (and rhinoplasty) took about ten days of pain killers before I started to feel normal. After my second surgery I was off pain killers completely in just three days. My first sinus surgery left me with black eyes for a month. During my second surgery I had zero bruising. (Can you guess who the better surgeon was?)

What happens during my follow-up appointments from sinus surgery?

If I can offer one piece of advice it would be to find a surgeon that uses plastic splints instead of cotton packing. The old (and barbaric and OUTDATED) method of sinus surgery uses an entire roll of gauze that is unceremoniously stuffed up a patient’s nose and then PULLED OUT a week after surgery. Today, doctors use plastic splints that are put inside of your nasal passage during surgery, and allow you to breathe through them while you’re recovering. This is a great new alternative to the old method and is pretty painless when its removed post-surgery. The doctor will quickly snip a stitch attaching the splints to your nasal passage and then remove them with a tweezer. You will never see anything more disgusting in your life. It’s like giving birth from your nose. Totally gross, but you’ll feel so much better once the splints are out!

Any last words of wisdom?

I’ve suffered from sinusitis and severe structural issues with my nasal passages all my life. It is so much better to go through a surgery and have these issues corrected than to live with their symptoms and high rate of infection for the rest of your life! I’m so happy with the results of my sinus surgery and even though I had some bacterial complications (immunodeficient, it happens.) I experience flus and colds so differently now that my sinuses are open and functional!