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Medical Forum / Diseases and Disorders / Sinusitis / August 2006Surgery Aug.11th
Hello All: I have been suffering from allergies, which have made my sinuses unbearable. So after many sinus infections and about 4 antibiotics given from my primary care I decided to go to an ENT. I went to his office the first time a little over a month ago and on the first visit it did a little numbing in both sides of my nose and looked in with a scope like instrument. He then left and said go have a CT scan done and come back. So, I had the CT done and went back a couple weeks later. Now this is my second visit, he says my left maxillary is blocked about and size of a pen hole and something he wants to do to my anterior ethmoid and "concha" (not really sure I am reading the doctors hand writing), and he also wants to remove my turbinate's on both sides. All this is found by the second visit. I have always known that I have suffered from allergies, headaches, and fatigue. But I never thought I would have to have surgery to fix it. I really want to know if you are really better 5 days after surgery and can you really go back to work. As it stand now I am off for 5 days and my boss thinks I will be back on the 6th day. Also, he is taking my packing out on the 5th day. My surgery is on Friday and I have post op on Aug. 16th... Is that strange? Will I be able to breathe? That's my biggest fear... At least out of one side I will be happy with... And is it painful Will it help??????? > Hello All: > [quoted text clipped - 12 lines] > suffered from allergies, headaches, and fatigue. But I never thought I > would have to have surgery to fix it. You don't!! Have you really let the first ENT you saw schedule you for a near immediate surgery?? If the allergies are causing the thick mucus and blockage, try aggressive allergy desensitization, first! It's been miraculously effective for me in reducing symptoms, congestion, sinus inflammation, along with allergen detection and prevention in my home and sleeping area. I urge you to consult an allergist and only work with one who will desensitize you on a 3-6 month, not a 12-18 month schedule of full desensitization. > I really want to know if you are really better 5 days after surgery and > can you really go back to work. As it stand now I am off for 5 days and > my boss thinks I will be back on the 6th day. Some folks here report good results from surgery, but most still seem to have their sinusitis and need to actively treat it. Perhaps those with actual polyps fare much better post FESS, though, and those who get well don't feel like hanging around here. > Also, he is taking my packing out on the 5th day. My surgery is on > Friday and I have post op on Aug. 16th... Is that strange? Will I be > able to breathe? That's my biggest fear... At least out of one side I > will be happy with... And is it painful If you're still just as allergic after your surgery as before it, it really doesn't matter what he does. What's the harm in irrigating to keep it clear, using Astelin nasal spray, decondestants and an allergist to see if you even need surgery after all? Susan Susan, I have been on allergy medicine for about 2 years. I take it all you name it and I take pills in the night, morning and afternoon. My doctor really didn't give me much of a choice actually he gave me nothing but here is my card and someone from the office will call and schedule you for a appointment for surgery. I am really nervous. I don't know what to do. I have known about this appointment for about 2 weeks and now a week a way I am wondering if I am making the right decision. > x-no-archive: yes > [quoted text clipped - 48 lines] > > Susan > Susan, I have been on allergy medicine for about 2 years. I take it all > you name it and I take pills in the night, morning and afternoon. My [quoted text clipped - 4 lines] > weeks and now a week a way I am wondering if I am making the right > decision. Waitaminute; there was no evaluation by you of your surgeon nor discussion of your other options? Do you know if this surgeon is the best in your area, or even any good? I'm not talking about allergy medications, I'm saying you should be desensitized by an immunologist with regular shots, after allergy testing for several months. The improvements can be dramatic. Susan >Waitaminute; there was no evaluation by you of your surgeon nor >discussion of your other options? Do you know if this surgeon is the >best in your area, or even any good? Right - really it is best to get several opinions before surgery and also research to find the best and most experienced surgeon.... >I'm not talking about allergy medications, I'm saying you should be >desensitized by an immunologist with regular shots, after allergy >testing for several months. The improvements can be dramatic. >>Waitaminute; there was no evaluation by you of your surgeon nor >>discussion of your other options? Do you know if this surgeon is the >>best in your area, or even any good? > > Right - really it is best to get several opinions before surgery and also > research to find the best and most experienced surgeon.... Not yet, in his case, though. He hasn't tried non surgical interventions first at all. It sounds like he found a quack with a payment due on his equipment. Susan This is my first surgery I really don't know what to do. This week I am going to get with the doctor and see if there is any other options.. > >Waitaminute; there was no evaluation by you of your surgeon nor > >discussion of your other options? Do you know if this surgeon is the [quoted text clipped - 6 lines] > >desensitized by an immunologist with regular shots, after allergy > >testing for several months. The improvements can be dramatic. Personlly, if this is the first ENT you have seen, I would at the very least postpone the surgery and get a second opinion with another ENT. If they have the same opinion then you can always go ahead with it later. Like others said, you can't undo what has been done and if he really wants to remove the turbinates, then I would really be skeptical. It seems like to me he is in too much of a hurry to do surgery without trying other treatments. I know you don't want to be on systemic steroids for a long period of time, put perhaps a burst like a dose pak might even help. There are also a lot of other options to consider before surgery. I'm saying this less than 2 weeks post 2nd surgery, but I tried vertually ALL options before hand. And especially if this is your first or even second or third bout with sinustis, I don't think surgery is a good first option unless absolutely necessary. Kathyw > This is my first surgery I really don't know what to do. This week I am > going to get with the doctor and see if there is any other options.. [quoted text clipped - 9 lines] > > >desensitized by an immunologist with regular shots, after allergy > > >testing for several months. The improvements can be dramatic. Nope I wasn't given any other options. He was recommended to me by my regular doctor. I have seen this man twice and on the second time he said surgery and 2 days later it was scheduled. I am calling him today to set up another meeting time to ask questions. Any suggestions as to what to ask? > x-no-archive: yes > [quoted text clipped - 16 lines] > > Susan > Nope I wasn't given any other options. He was recommended to me by my > regular doctor. I have seen this man twice and on the second time he > said surgery and 2 days later it was scheduled. I am calling him today > to set up another meeting time to ask questions. Any suggestions as to > what to ask? It's hard to know what you should ask without knowing what you've tried in the past, if anything, that may've failed. If you haven't tried regular irrigation, allergy testing and desensitization, Astelin nasal spray, decongestants and lots of drinking of H2) with possible mucus thinners, along with removal and cleaning of obvious allergens in your sleeping area, it's hard to see how surgery would be indicated as the first, rather than last resort. You can always have surgery later, after having researched and interviewed the best surgeons in your area, if none of the above helps. You cannot very easily undo the damage of a potentially unnecessary or not very skilled surgeon. I'm just a lay person saying this, but if it were me, I'd cancel the surgery and do a lot more homework about allergic fungal sinusitis, irrigation, and I'd get an allergist who will desensitize on a rapid schedule, no more than 3-6 months. This along with Astelin nasal spray might negate the need for surgery, since so much of what you describe as contributory is allergic reactions. If none of what we've all discussed here works, you can always have surgery later. Any ENT who schedules you for surgery without first trying to treat the root cause of your sinusitis is not acting in your best interests, in my opinion. Susan > x-no-archive: yes > [quoted text clipped - 10 lines] > desensitization, Astelin nasal spray, decongestants and lots of drinking > of H2) Uh, that would be H20. Susan OK I called my doc and I will be meeting with him tomorrow. I also spoke with some people around here at work who had a similar procedure. They also encouraged me to talk with the doctor and get my feelings out. I hope that I can get some relief soon. I have had a headache now for 4 days, behind my left eye, teeth aching, and you all know the rest. I will let you all know how things go tomorrow. Thanks for all of your help!!! > x-no-archive: yes > [quoted text clipped - 33 lines] > > Susan >OK I called my doc and I will be meeting with him tomorrow. I also >spoke with some people around here at work who had a similar procedure. >They also encouraged me to talk with the doctor and get my feelings >out. Getting your feelings out may of some value but more important may be to get enough information to start to decide whether to go ahead with the surgery now. Just realize that *you* are the one who has the final responsibility and absolute right to make that decision, amd you will be fine..... >I hope that I can get some relief soon. I have had a headache now >for 4 days, behind my left eye, teeth aching, and you all know the [quoted text clipped - 40 lines] >> >> Susan > If you haven't tried regular irrigation, allergy testing and > desensitization, Astelin nasal spray, decongestants and lots of > drinking of H2) with possible mucus thinners, along with removal and > cleaning of obvious allergens in your sleeping area, it's hard to > see how surgery would be indicated as the first, rather than last > resort. Well said and suitable for the FAQ!  SignatureAlison Chaiken "From:" address above is valid. (650) 236-2231 [daytime] http://www.wsrcc.com/alison/ Evolution whispers within us. It does not shout orders. -- L.A. Times editorial, 05/10/06, via gtb I would ask: 1) Explain the exact nature of the procedure you plan to do, and why are you doing it: have him show you on your CT scan what he is planning, and why. 2) I would ask why the packing needs to be in for 5 days. Is it standard packing or is it gel foam, which is not occlusive, but should be absorbed. 3) I would ask how many surgeries he's done and how many he does currently 4) I would ask him why he feels that surgery is your only option at this point 5) Possibly, I'd ask if he can give you a name for a second opinion--but that may be totally counter productive. I'd get the second name from your doctor or other people you know who are satisfied. Often operating nurses have a very good idea of who is the best surgeon. 6) I'd ask all the possible complications and risks. 7) I'd ask if he has any suggestions about maximizing your medical management--and if he'd be willing to help you aggressively medically manage your sinuses, and it that fails, then consider (not necessarily procede to) surgery. Bring someone with you, it always helps, because it's really difficult to remember everything that's being said to you, and another person who is not potentially facing surgery will be able to assist in remembering the conversation, and potentially advocating for you. (Let the other person ask the questions that may seem "rude" or questioning--it takes the heat off of you.) Feel free to let him know that you are feeling rushed into the surgery and have some qualms: you are the person who will be operated on, you have every right to a full explanation and to feel comfortable with the decision and participate in the decison-making process. So, just some suggestions. Judy > Nope I wasn't given any other options. He was recommended to me by my > regular doctor. I have seen this man twice and on the second time he [quoted text clipped - 22 lines] > > > > Susan > 5) Possibly, I'd ask if he can give you a name for a second >opinion--but that may be totally counter productive. I'd get the second >name from your doctor or other people you know who are satisfied. Often >operating nurses have a very good idea of who is the best surgeon. Right I would spefically avoid asking him for a referral for a second opinion. In all liklihood he will refer to a friend. Operating nurses do know but failing that, he can try a major University Medical Center and research who is the most experienced there. Surgery may well still be helpful in his case eventually but not right off and perhaps not with this surgeon..... >Hello All: > [quoted text clipped - 9 lines] >ethmoid and "concha" (not really sure I am reading the doctors hand >writing) Concha is the Latin name for turbinate. >, and he also wants to remove my turbinate's on both sides. Total removal of the turbinates is not part of standard medical practise (it can cause major problems later) so if he recommended that he is to be avoided. Probably you have it wrong though. It is really not done any more except by a very few. He might want to reduce them though. Call his office and get more details on what he proposes. His nurse can give them to you. >All this is found by the second visit. I have always known that I have >suffered from allergies, headaches, and fatigue. But I never thought I [quoted text clipped - 3 lines] >can you really go back to work. As it stand now I am off for 5 days and >my boss thinks I will be back on the 6th day. Well it all depends - personally I would take 2 or 3 weeks off, mainly to avoid bleeding all over everybody and to rest... >Also, he is taking my packing out on the 5th day Some surgeons remove it the morning after surgery, some later..... >. My surgery is on >Friday and I have post op on Aug. 16th... Is that strange? Will I be >able to breathe? That's my biggest fear... At least out of one side I >will be happy with... After the packing is out anyway. You can always mouth breathe..... >And is it painful Not much usually. >Will it help??????? It should. Empty nose syndrome is found when the inferior and middle turbinates have been removed. These patients have very severe symptoms including terrible dryness and thick post nasal drip and discomfort. There is a web site on empty nose syndrome does any one have their address? >Empty nose syndrome is found when the inferior and middle turbinates have >been removed. These patients have very severe symptoms including terrible >dryness and thick post nasal drip and discomfort. >There is a web site on empty nose syndrome does any one have their address? Your own site is good http://www.ent-consult.com/emptynose.html I've had 5 surgeries, and only allowed packing on the first, and it came out the next morning. I've never heard of leaving packing in for 5 days. The concha is a "concha bullosa" a turbinate with a swirl of bone within it that creates an enlarged turbinate and can obstruct the ostea. It's a normal variant, but can cause obstruction. My thinking is: surgery is irreversible. Never feel rushed into anything you don't feel comfortable with and don't fully understand. Actually, he hasn't even really gotten informed consent from you because you don't understand the procedure, risks, aftercare, etc. Seriously, there's no rush here. I'd get another opinion, or at the very least make him sit down and explain his plan. Packing for 5 days is not at all common in my experience. Recently two surgeons suggested surgery for my daughter, and both told her she wouldn't be packed. Even when I had extensive surgery at Mass Eye and Ear they didn't pack me--although in that case they should have--my husband is still traumatized by the bleeding that occurred. But, it was a huge surgery, and the ENT was only going to leave the packing in overnight--and they kept me inpatient for the night, it was that extensive. Judy > Hello All: > [quoted text clipped - 23 lines] > > Will it help??????? >I've had 5 surgeries, and only allowed packing on the first, and it >came out the next morning. I've never heard of leaving packing in for 5 >days. I agree. It could be a sign that this surgeon lacks confidence in his work and expects a lot of bleeding (unless there are special factors). > The concha is a "concha bullosa" a turbinate with a swirl of bone >within it that creates an enlarged turbinate and can obstruct the >ostea. It's a normal variant, but can cause obstruction. A concha is just a turbinate. That is standard medical terminology. A concha bulosa is indeed the enlarged variety you speak of. Now, maybe sometimes people do use "concha" as a short form for concha bulosa, but if so it sounds like sloppy terminology to me. (I am not saying you are being sloppy - of course you are just saying what you think was probbaly meant and you may well be correct). I had surgery a few weeks ago-no packing-very lttle bleeding-just huge clots for the next few days that I gushed out with my Grossan Hydra Pulse...much better than the bottle device the ENT wanted me to use!! Kindest personal regards, Ray The Travellin' Man.....Ray Armstrong your eyes and ears on the Tweed!! Let's Keep Music Liiiiiiiiiiiive!!!!!!! > >I've had 5 surgeries, and only allowed packing on the first, and it > >came out the next morning. I've never heard of leaving packing in for 5 [quoted text clipped - 15 lines] > being sloppy - of course you are just saying what you think was probbaly meant > and you may well be correct). |
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