A septoplasty is an operation to straighten the septum, which is the thin piece of cartilage and bone in the middle of your nose, the bit that means you have two nostrils instead of a trunk.
I had a deviated septum – you could see it sticking perkily out of my left nostril, plain as day – meaning I could only really breathe properly through my right nostril. I also suffer a lot from colds, congestion, migraines, blocked sinuses, you name it, and the doctors thought that all this might be eased if I could breathe properly. (They also discovered that I had a fracture up there too, so an operation was kind of necessary.)
The Operation – Wednesday 5th January
I got to the hospital for 8am, no food or drink after 9pm the night before, and was shown to the waiting room (which was so full of patients and visitors all the chairs were taken and I had to lean against the wall) and then after a quarter of an hour or so was taken to the ward where my bed was waiting. The nurse asked me a bunch of questions (name and address, did I have crowns on my teeth, any allergies, etc.). Then the surgeon came round and curtly informed me that the operation probably wouldn’t cure any of the breathing problems I’d been referred for – which didn’t do much to raise my spirits – and got me to sign the disclaimer forms so I couldn’t sue him afterwards.
A little later the anaesthetist dropped by, which gave me a chance to plead brokenly for anti-nausea drugs and some stimulants to wake me up after the general anaesthetic. (Usually I get very sick and drowsy for hours afterwards.) He promised to give me everything he could think of that might help and then asked me all the same questions the nurse had.
I was fitted with wrist tags (my details duplicated on each wrist and another tag (red) with my penicillin allergy clearly marked), measured for surgical stockings (very fetching but a very tight fit and a bugger to get on) and finally asked to strip down to my (cotton) underwear and put on the surgical gown. Then I got into bed about 10.15 and was wheeled down to the theatre by a couple of nurses, the bed hilariously catching in several swing doors on the way.
There was a slight hold-up at anaesthetics, so we parked in the corridor outside the theatre for a couple of minutes. I was transferred to the care of a couple of theatre nurses who moved me onto another bed, and then wheeled me into the pre-theatre ward, which consisted of just a reception desk and me. Two more nurses checked my details against my wrist bands and asked me all the same questions all over again.
After a short wait I was wheeled into the anaesthetic room where five or six people in scrubs were bustling about. I was fitted with various electronic tags and a needle was inserted into the back of my hand. At this point the anaesthetist realised they hadn’t established my height and weight to calculate the exact dosage to give me. He asked me, but I only know it in imperial, and all their charts are metric. So they spent an entertaining few minutes trying to convert the numbers by mental arithmetic. Finally they were satisfied and I was given oxygen to breathe and told to take some deep breaths to clear my lungs. Soon after I felt a cold sensation crawling up my arm as the drugs were bled into my body. The anaesthetist asked me how I felt. For a time I felt normal, no change, then warm and a bit fuzzy, and then I must have blacked out. (It was a rather gentler experience than the last time, when I was actually aware of losing consciousness – this was more like falling asleep.)
When I woke up around noon it was all over, and I was in yet another ward. The nurses asked me if I knew where I was, but I was too far gone to do much more than blink and stare at them like a very sleepy cow. There were three or four nurses in the room, chatting to each other while they waited for me to wake up. (At one point one of them said, ‘What’s he had?’ and another picked up my chart. ‘Wow!’ she exclaimed. ‘He’s had everything!’) They kept talking to me, and taking my blood pressure every few minutes.
After perhaps 15-30 minutes I was deemed well enough to be returned to my original ward. The whole middle of my face, from below my eyes to above my chin, was completely numb. My brain too, of course.
It took me about three hours to wake up enough to get bored, which was a major improvement on the last time I had surgery, when it took three days. I was pretty groggy for much of the time, very tired and remote, but I felt no nausea. I had a drip of some kind going into my hand. I was given iced water to sip, and after a while I felt the need to empty my bladder. I got up, feeling very light-headed, and made my way to the bathroom, but painful squeezing could only force out a few painful drops – the usual fasting-cum-general-anaesthetic experience.
The consultant looked in to say it had gone well, but it had been a rather complicated procedure. He’d dealt with the fracture, and he hadn’t had to cut the skin as it had all been done from the inside. He’d put a splint up my left nostril which would have to remain for a week or so until it had healed.
A few minutes after lying down again I was aware my nose was dripping. When I dabbed it with a tissue it came away red with blood, and I realised that I’d been dripping blood on the sheets and pillows too. I hailed a nurse who explained it was perfectly natural, there were scabs and blood inside my nose from the operation, and the nose was trying to flush it all out, plus I’d loosened things up when I got up to go to the bathroom.
He said he’d get me a nose bag, a little pad that sits under the nostrils and ties round the back of the head (the sort of thing you can imagine Hercule Poirot wearing to protect his moustache in bed). This catches any drips and prevents mess. Unfortunately he didn’t come back again and by the time another nurse got me one my sheets and pillow looked like props for a Tarantino movie.
By four o’clock I was well enough to eat. They didn’t have any vegetarian food, so I had a couple of pieces of buttered toast. That was when I discovered I’d lost my sense of taste and smell (hospital food may be bad, but it’s not that bad).
Margaret came to pick me up around half past four. We had to wait – the consultant was supposed to discharge me – but in the end as he was running late they reckoned it was all right for me to go. I was given a paper bag with a couple of clean nose bags, a letter for my GP and a shedload of painkillers, which seemed ominous. But for the time being I was in no real discomfort, was awake enough to help Margaret navigate through rush hour traffic, and felt pretty good, all things considered, well enough to have some soup and a mug of tea and watch TV till bedtime.
The First Night
That state of affairs didn’t last. I got about an hour and a half’s sleep that night, and it was pretty horrible. I had to lie with my head propped up, with my nose (protected by the nose bag) not touching the pillow. All night I had heartburn as mucus drained down my throat; it felt salty and when I spat it out it was red, so I was swallowing bloody mucus all night, and trying not to choke or be sick. Added to that, the drugs they’d given me to wake up after the anaesthetic seemed to really kick in after midnight, like your mouth only goes completely numb after you’ve left the dentist’s, so my heart was pounding in my chest like an engine overheating, thump-thump-thump-thump all night. I would fall asleep, but wake up again after a few minutes, over and over; and so the long night wore on.
Thursday 6th January – D-Day +1
Next morning I woke up with a splitting, axe-in-the-skull, end-of-the-world kind of headache. I also had some aches and pains in my chest, arms and legs (“flu-like symptoms” as they say). My nose was very sore, a dull aching throb. I painfully peeled off the crusted nose bag, which was uncomfortably filled with dried blood and mucus, and took a look in the mirror. The inside of my nose was too dark to see properly, and too sore to touch, but the outside wasn’t swollen or distended at all. And it looked straighter right away, which was encouraging.
I got up unaided and took some paracetamol, then went back to bed. As the day dragged on I got more and more tired, but couldn’t sleep, so I listened to audiobooks and classical music radio in a sort of doze. I started the recommended process of half-filling a bowl with boiling water and breathing it in under a towel for 10 minutes, three times a day. My nose was completely blocked, but I consoled myself with the knowledge that the steam must be helping. I deliberately didn’t wear the drip bag through the day, but as my nose occasionally dribbled pink mucus I used tissues to mop it up. After a while the tickling trickle inside my nose began to drive me mad, but you’re forbidden sticking anything up there or blowing your nose for at least a week, so I had to keep dabbing away.
As the anaesthetic wore off my nose started to hurt more and more – hence the painkillers I’d been given – but my lips and front teeth remained numb, and my sense of smell and taste was non-existent.
That night I slept from about 11.00pm – 3.00am, then lay awake till just before the alarm went off at 7.00. Not helped by occasionally catching my nose with my hand as I replaced my glass of water, which made me see stars.
Friday 7th January – D-Day +2
A truly horrible day, just awful. Definitely the lowest point.
I woke up very groggy, very remote, almost semi-conscious. I had another splitting headache, more aches and pains, and could barely sit up unaided. I took some paracetamol again, and felt well enough to sit up and have some breakfast, but as the pills wore off I lapsed back into a sort of vegetative state.
My scribbled diary entry reads: “Nose still blocked & v. sore. Unbelievably uncomfortable and unpleasant. No sense of taste, nose just a huge blob of swelling pain, tired, semi-conscious, dripping bloody mucus, headache, constipated, can’t breathe properly, maddening itching inside nose, swallowing mucus all the time, can’t sit up properly or for long, sore throat, chills, aches and pains, sore teeth, numbness around lips and teeth, mouth ulcers from the oxygen tube.”
But then, at 11.30 that night, the blockage in my nose suddenly shifted and I felt something pour warm and wet into the drip bag – which was pretty unpleasant in itself, but it meant that I was able to begin to breathe through at least one nostril at a time.
Saturday 8th January – D-Day +3
I may have been able to breathe but I still couldn’t sleep. By daybreak I had yet another headache, and the same feeling of remoteness and distance, but not as bad as yesterday. My stomach was fluttering, and my legs were shaky, so I once again I pretty much stayed in bed till teatime, when I got up for a while. For the most part I dozed and slept and listened to audiobooks (Dickens and Patrick O’Brian, god bless them).
But there were more encouraging signs – the pain in my nose, though still distracting and very sensitive if I accidentally knocked it (ouch ouch ouch!), was noticeably less by teatime, definitely not the throbbing agony I’d had till now. And for most of the day I was able to breathe through at least one nostril, the one on the right (the one without the splint) – at least when it wasn’t blocked.
I was still constipated, though this was not (yet) a problem. Even though I couldn’t taste anything I found I only wanted to eat boiled rice with milk, yoghurt and fruit juice, and toast.
Sunday 9th January – D-Day +4
I fell asleep almost immediately but woke up shivering at 2.00am. The sheets, pillow and duvet were soaking wet and very cold. I still had some sweat running down my back, but was surprised to find I was actually quite warm and comfortable, and no remaining trace of fever whatsoever. I actually felt pretty good, for the first time since the operation, and my nose wasn’t very blocked for once. It was very strange. I lay a while, luxuriating, and went back to sleep.
When I woke up next morning it was back to the usual headache, blocked nose, sore nose, and feeling faint and light-headed. But I still felt better, somehow.
I got up after lunch and felt a bit more awake. Found (with relief) that constipation was no longer a part of my life. When I lay down again around 4pm my right nostril cleared up for about 40 minutes, then blocked up again. But obviously the blockage was beginning to break up, like an ice floe in spring, and it was just a matter of time now; later in the evening it cleared again when I lay down.
That night the nose bag was so uncomfortable and itched so much I had to take it off around midnight. (We put a tea towel under the pillowcase just in case, but nothing ever ran from my nose onto the pillow after that.) I didn’t wear one again.
Monday 10th January – D-Day +5
I woke up very congested again, as usual. The left nostril was very gummed up with dried blood and mucus, but the right nostril was clear by 11.00am. The good news was, I could almost taste my breakfast if I sniffed; the bad news was, I could now taste the unpleasant mucus too. (It was a bit like when the squirrel died in the ceiling space at work that time, the same all-pervading unpleasant sickly sweet taste of decay.)
More good news, when I dabbed my nose through the day the tissue came away mostly with yellow mucus, very little blood at all.
Still felt light-headed when I stood up, same fluttering stomach and weak legs, though I was less drowsy lying down now. But I still couldn’t get up for long.
Curiously, I had a sore throat and my nose was throbbing painfully again, after a couple of days of feeling better. Why now?
Tuesday 11th January – D-Day +6
No nose bag to annoy me overnight, and no drips on the pillow, though I had to keep dabbing at my nose with a tissue as it ran on and off all night.
Woke up with the usual headache, but felt MUCH better, MUCH more myself. This was the first time I almost felt I had my head back – and about time, too. I was still light-headed when I stood up, though, and consequently spent much of the day in bed. But I was able to pick up a book and read, I wasn’t forced to lie back with my eyes shut listening to music and audiobooks.
My nose was less painful than yesterday, though still pretty sore. No blood to speak of, just more of the nasty-tasting yellow mucus. Occasional hints of taste and smell, but still mostly absent. Front teeth and lips still numb, too. Sometimes I could breathe fine, other times completely blocked.
Wednesday 12th January – D-Day +7
Slept fitfully, woke up with headache, dealt with by paracetamol. Nose still painful to the touch. Slimy yellow mucus, just occasionally mixed with blood. Still mostly congested, breathing through the mouth. Sore throat, teeth, lips and upper palette still numb and a bit sore. Every now and again, though, a tantalising suggestion of taste.
Thursday 13th January – D-Day +8
Despite not sleeping well (again) and waking with a headache (again), felt much better, almost back to normal. Head a bit congested, but fully compos mentis, awake and alert. The tip of the nose is till sore, but for the first time the congestion eased to the point where I was actually aware of the splint – I could feel I had something up my nose. Nose dripping yellow mucus.
Friday 14th January – D-Day +9
Went to Lauriston Place to get the splint removed. The consultant put a large magnifier on his head and took a pair of scissors and cut the stitches. Then he reached inside my left nostril with forceps and pulled the stitches out, which made my eyes water, and the sensation as they slid from right to left was very peculiar.
Finally he reached in and pulled out the splint itself. He gave me a wad to hold under my nose (“it might get a bit messy”). It was over very quickly, but while it lasted it was like someone pulling a small mammal out through my nose, very unpleasant but such a relief when it’s over. There wasn’t too much mess till he told me to blow my nose gently and then all this bloody snot sprayed out, like opening the trapdoor to a disused attic and getting showered in mess and droppings. The splint was surprisingly large, three inches plus and kidney shaped, large enough to wonder how they got it up there in the first place.
The consultant told me I had an infection which was making my nose swollen and tender inside and gave me some antiseptic to put on it, on condition I didn’t let anyone see on the way out, as they weren’t supposed to give stuff away.
And that was pretty much that. In and out in ten minutes.
After that it blocked up again soon enough – and 9 days further on it is sometimes clear when I lie down, but mostly my sinuses are just clogged, so even when I can breathe it feels very stuffy and congested in there. But it’s early days yet and patience, so we’re told, is a virtue…