Head surgery

[OITW]

Rip, I'd like to throw this out on your board because opinions are generally better informed than down in Ends & Pieces.

Over the past several years I've had a continuing problem with sinuses, ear blockages, sinus drain--basic sinusitis. Drugs did minimal to help. Along the way, realized that my left nasal passage was about half the size as my right--deviated septum. Along with a CT scan that showed some restricted passages in my sinuses, it was easy to see why the slightest inflammation turned into a sinus problem. This has gotten better since a) moving to England where the air is much cleaner than in Naples, Italy, and b) eating Paleo with the intent of reducing general inflammation. It seems to be helping because I've dropped two meds I was on long term (Nexium and Allegra), with no resurgence of symptoms.

The question is this: the ENT wants to do surgery--fix the septum, reduce the turbinates, and open the lower sinuses in my cheekbones (lots of bone grinding). This is done under general anesthesia (breathing suspended). I am 48, have never had surgery and never been under general anesthesia. The more I get briefed on it by the docs, the less I like the sound of it. Do you, or any of your esteemed readers, have any experience with similar surgery, and would you/they lend an opinion of whether or not it's worth it? The doc is convinced I will benefit, and breathing easier would certainly be a benefit, but is it worth the shock to the system that is surgery? To make this a weight training question, I'll add they say no exercise for three weeks following.

Cheers.

[Mark Rippetoe]

I had a septoplasty/turbinate resection in 2005 under Versed and a local. I think it helped, but it was not a dramatic improvement. But I didn't have the sinus problems you have. I will tell you that the surgery was a piece of cake, there was never any post-op pain. There were some magnificent bloody boogers, but I had no other problems. If I were you, I'd probably get it done. General anesthesia has the potential to be the problem, if the guy is not good at it. The after-effects sometimes persist for days if the hand is too heavy.

[Need2Lift]

I had sinus surgery several years ago. The impetus for it was polyps that were totally blocking one nostril, but while he was in there the ENT also fixed a deviated septum and widened the sinus openings. (That last one is a paraphrase, and is probably not the medically or anatomically accurate term.) In my case I felt it made a big difference; I never really understood how poorly I breathed through my nose up to that point.

All in all, the surgery was not that bad. The worst part was the follow-up visits for "debridement," i.e., cleaning the accumulated crap out of the nose. That was no fun, frankly, but it only took a minute or two, if that.

Naturally, you want to make sure as best you can that both the ENT and the anesthesiologist are highly competent. Good luck!

[Laramie Hartmann]

I had a similar surgery about 5 months ago. It was a septoplasty and turbinate reduction. The surgery went fine, but I was in agonizing pain due to a migraine for the next 3 days. I'm not sure the cause, but perhaps it was a heavy handed anesthesiologist as Rip mentioned.
I do breathe better now and my passages are never fully closed as they sometimes were before. However, I still have some lingering sensitivities that bug me throughout the day, e.g. slight burning, dryness. I was told that it can take at least 6 months for all the tissues to fully reconstruct so I'm giving it a little longer before I make a final judgement. The surgeon did not use any packing which apparently is more time consuming for him, but offers a better final result.
You won't be able to perform the Valsalva maneuver for about a month and you probably won't even want touch weights for a couple of weeks. As said, I do breath and sleep easier since the procedure, but please use due dilligence in researching the operation. Look up "Empty Nose Syndrome" to make sure you're aware of any potential complications.
Good luck!

-L

[Mark Rippetoe]

I'm pretty sure that my nasal mucosa were not completely healed for at least six months. Constant changes for the whole period of time, and then it settled down. I'd do it again knowing what I know now.

[ivankannan]

I have the exact same problem - deviated septum and I also need turbinate reduction. My sleep is pretty bad, though I don't know whether this is the sole reason. I know I have to do the surgery sometime, but I don't want to go through the pain (as in getting admitted, taking a week off etc).

[Mark Rippetoe]

Mine was done in the office. I went back to the gym after the surgery.

[Need2Lift]

I forgot to mention that in recent years I've been prone to nosebleeds. I never asked the ENT about it (it didn't start right away), so I'm not sure if it's related to the surgery, but it wouldn't surprise me. I now use a saline nasal spray a couple times a day and it generally keeps it in check. I still think the surgery was worth it.

Mine was done in the office. I went back to the gym after the surgery.

I guess it depends on the extent of the surgery. It definitely took me a while to fully recover. I wasn't lifting at the time, so I really can't say how long it would have taken for me to feel comfortable doing so, but I do remember that anything that built up pressure in the nose was pretty uncomfortable for a while.

A second opinion is never a bad idea, by the way.

[OITW]

Thanks all, good info to consider. Interesting that Rip's was done in the office while mine involves being put under with a breathing tube down my throat, followed by two weeks convalescent leave (yeah, Air Force medicine, but that makes it sound like serious damage and recovery). Multiple warnings about nausea while recovering from the anesthetic, the undesirability of barfing with a freshly routed nose, etc. But nowhere in the long list of possible things that can go wrong that I was briefed on was ENS mentioned, and reading up on that makes me doubly skeptical. Valuable stuff you've all given me to consider, thanks.

[vivek]

i am an anesthesiologist. what specific concerns do you have about general anesthesia vs sedation?