First the why:
For as long as I can remember, or at least close to 45 years dating back to my teenage years, I’ve been an allergy sufferer. Sneezing, itchy eyes, stuffiness . . . you name it. For the most part I learned to live with it. But as I got older, it got worse. When I moved to California I started taking over-the-counter (OTC) allergy pills, and then when I moved to Colorado 14 years ago, it got notably worse (dry air here.) I have tried pretty much every nasal spray and eye drop, along with OTC allergy pills and a humidifier in my bedroom. I finally decided to go to an allergist as my life was miserable.
The results were astounding. I was basically allergic to nothing. She did note that I had a deviated septum, but didn’t mention that it could be a contributing factor. So I continued living in misery and wondering what I could do. I then noticed several posts on a local FB page where people mentioned that they had better luck going to an Ear, Nose, and Throat (ENT) specialist than an allergist. Apparently, there are a lot of miserable people like me in Colorado.
However, it took me nearly 10 years to finally pull the trigger to make that appointment. I was always busy – traveling, kids’ school stuff, etc. Finally, I had the time last spring and the pandemic had settled down a little bit (we all know that has changed). So I made the appointment. I first went to the physician assistant (PA) for the ENT (not the surgeon). Guess what? First thing that came up was the deviated septum. He also mentioned that my turbinates were enlarged and that I was the perfect candidate for septoplasty with turbinate reduction. First he wanted me to do a specific corticoid nasal spray for a month to document for insurance purposes that a non-surgical approach was unsuccessful. No surprises – spray didn’t help a bit. So I came back one month later and talked with the surgeon. He confirmed what his PA had said, explained the surgery and turned me over to scheduling. I could have had it done within a few weeks but I decided to wait until all my traveling and remodeling projects were done. In a way, I wish I hadn’t waited, as recovery was easier than expected. But anyhow, it’s done now and I couldn’t be happier.
So what is a deviated septum, septoplasty, and those funky things call turbinates?
The best way to show what a deviated septum is by a simple graphic:
You may also take a look at your nose in the mirror and note that your nostrils are a different size. Here’s a lovely pic of me before. As you can see mine are a slightly different size. Not horrible. But the doc said that my septum looked worse further up. In some people it’s much more obvious as seen in the man shown below my picture
So how do you get a deviated septum? Well, a lot of people have one simply due to genetics (thanks Mom & Dad), or they have had a rough trip out during childbirth (high birth weight babies in particular.) The other is injury. And that doesn’t necessarily mean a broken nose, although a broken nose can certainly cause a deviated septum. In particular, athletes such as basketball players frequently get banged in the nose without it actually being broken. This I believe is what happened to me, although not in basketball. I had a sledding accident when I was 12 or so where a saucer sled hit me in the bridge of my nose. I was gushing blood but my nose was not broken. However, that seems to stand out in my mind as the beginning of the time I started to have allergy issues.
So what are turbinates?
According to Stanford Health, “Turbinates are small structures inside the nose that cleanse and humidify air that passes through the nostrils into the lungs. They are made by a bony structure surrounded by vascular tissue and a mucous membrane outside, and can become swollen and inflamed by allergies, irritation or infection, causing nasal obstruction and producing an excessive amount of mucous which leads to congestion.”
This part of the procedure is relatively straightforward and uses a radiofrequency instrument to reduce the size.
So what is Septoplasty?
Well, I’m not going to get into the nuts and bolts of how it is done, but the main thing to know is that it is done under general anesthesia and you will have a fun little set of internal nose splints when you are done. (see graphic below) Unlike rhinoplasty, the nose is not broken or reset but you will have some swelling and discomfort for a number of days. I will talk more about that in my next post.