Deviated septum: from post-op onward

DISCLAIMER: I am not a medical professional nor qualified in any way to give advice. These opinions are my own experience, only. I am a stranger on the internet, so take my advice as you see fit, and consult with your doctor.

If you’re a vocal performer (e.g., actor, singer), I’ve got a special section for you at the bottom.

This is a continuation of a series. For the days leading up to surgery and the first week after, click here; for how I decided to get this surgery, click here.

This was written over a period of three weeks, beginning with the day of the post-op.

Post-op appointment

At my post-op appointment, which was one week after my surgery, I got plastic casing out of my nose, and my doctor vacuumed all the mucus out. It was amazing, and only mildly uncomfortable. In my case, I had no scarring, and everything was looking good, so this was a pretty “standard” appointment.

They told me I was cleared for exercise, but nothing vigorous (e.g., running). Yoga, weights, anything that is not high impact or throwing your body around or turning you upside down is probably alright. They said “vigorous” exercise is okay at the two-week (from surgery) mark.

Here are some questions you may want to ask:

  • Is it okay to blow my nose, and is there anything I should know?
    • Hint: be gentle, and don’t pinch or move your nose around too much. I also heard you shouldn’t block off one side to blow through the other yet, but check with your doctor.
  • Do I still need nasal rinse, humidifier, and/or a saline spray?
    • How often should I do those things, and for how far into the future?
    • What’s the minimum and maximum degree to which I should do these things?
  • When should I know to schedule another appointment?

If you rely on your voice for a living (e.g., you work in a call center, you’re an educator, you’re a singer or actor), before you leave, schedule your annual laryngoscopy (the video camera that looks at your voice box). It’s essential to keep a record of how our vocal folds are doing, so we can detect issues early and resolve them. I say schedule for a year out, because I’m assuming you got a scope before your surgery.

After the post-op

I had every bit of mucus and whatever else was in there vacuumed out of my face. Probably for the next 30 minutes, I needed tissues close by. After that, the mucus production lightened up little by little. At the time of writing, I still blow my nose many times throughout the day, but I’m never running for a tissue box. As a reminder, I had my deviated septum corrected, as well as my turbinates reduced, so my sinuses and nose are going through a lot of changes. I’m at my “maintenance dose” of my allergy medication (i.e., this is the time when I should start seeing results, so it’s difficult to say why I still have excess mucus. At least it comes OUT of my nose, instead of keeping me stuffed and unable to breathe at all times, so I’ll take this hands-down).

Sleeping

My sleep, particularly, for the first 5-7 days, was not the most restful. I’d wake up with a headache, and not feel super rested. Around 5 PM I’d start feeling pretty tired. I imagine this had to do with my breathing still being hindered. But boy was it nice to be able to sleep on my side again.

Nerve issues?

I mentioned in my post about the surgery and first week of recovery that my upper lip felt different. One of my upper front teeth still feels strange–I have more sensation there than I used to. Based on some sensations I’ve experienced, I think the septum may be right around a nerve that runs through the teeth, so I’m assuming that as all of this heals, the nerve/sensations will go back to normal. If they haven’t by about a month after surgery I’ll probably call my doctor and leave a message about it.

Your nose

My nose was still pretty tender, even two weeks after surgery; you won’t be able to really dig stuff out (for lack of a better term), which can be annoying and also cause some crusting. For the first couple days, I used cotton swabs in my nostrils often after blowing my nose. My doctor also said I could use cotton swabs with hydrogen peroxide to resolve some of the crusting closer to my nostril openings.

I still use cotton swabs a month out, to help get some things out; you really have to be gentle with how hard you blow your nose, and how frequently.

Also, in at least one of my nostrils, I had what feels like an ingrown hair or a pimple, which added to discomfort. Not shocking considering how much has been going on in there!

Two weeks after surgery, my nose was still tender. I had to be careful when kissing my partner. A month out from surgery, I still have some pain when my nose gets moved in certain ways, but it’s infrequent and generally avoidable. I bleed very little and very rarely; I think I only get a drop here or there when I’ve blown my nose a lot. And as long as my partner and I don’t smash our faces into each other, we can smooch freely 🙂

Keeping your sinuses clean

My surgeon told me to use a nasal rinse once a day for two weeks from the post-op appointment. I did that, and I also used a humidifier (not 24 hours a day, but at least overnight), as well as a My PurMist. This is a vocal, portable steamer that I already had on hand. I do it for 10 minutes two or three times a day, focusing on breathing through my nose, and blowing my nose when necessary.

I was given a handout by my doctor or the hospital about aftercare that mentioned using a saline spray multiple times a day, but my doctor hadn’t mentioned it to me directly. For the first week, I didn’t use one (the handout did not mention a nasal rinse, so I thought maybe they’re a 1:1 substitute for each other). However, when I saw my doctor a week later (for reasons I go into below), something about how they encouraged me to keep using a nasal rinse made me feel like I had some nasal crusting, so I went and bought a saline spray, as well. The next day, I already had a couple bits of crusting or blood come out (one with nasal rinse, and another about an hour later, just blowing my nose). This may be related to the fact that my doctor cleaned out my sinuses when I went to see them, but I have a feeling the saline spray helped loosen it up.

This is all to say, keep your sinuses moist so that they can keep pushing stuff out to keep healing. If you have to pick between daily nasal rinse, saline spray, humidifier, and the My PurMist (or steaming over your stove), I’d say nasal rinse and saline spray seem like the most effective, as they target the areas directly. I’ll keep using all four of these things for a while, though.

Sense of smell

In all my years of not being able to breathe well, it never once occurred to me that my sense of smell was compromised. I’m smelling Los Angeles for the first time (maybe ever) at full stink, and it really is unpleasant. Also, a candle I bought a couple weeks before my surgery that seemed so subtle, now is a bit much if I’m sitting right next to it. I’m very glad to be able to smell at full capacity, and I’m sure I’ll become “nose blind” to the unpleasant stuff eventually. [A month out, I already notice smells a lot less].

Mental health

I honestly feel like I’ve been a bit calmer and more grounded, now that I can breathe through my nose. A friend told me about a book they read recently called Breath: The New Science of a Lost Art by James Nestor, and it is essentially about how breathing through our noses serves us better in many ways than mouth breathing. I’ll probably read it now that I can benefit from it!!

Exercise

I went for a run eight days after my post-op. I live in Los Angeles, so it doesn’t get as cool as some places, but it was morning, so about 55 degrees Fahrenheit. I ran nearly a mile (my usual run is a little over two miles) before I decided to call it quits; I wasn’t actively breathing through my nose, but air certainly travels in and out nonetheless, and my sinuses were feeling cold and achey. Given how moist I need to keep them in order for crusting and healing to be able to come out, it didn’t seem like the best idea to keep going.

A month out, I still feel this sensation, like my sinuses are too dry; perhaps from years of not having air flowing directly in and out of them. I might take a saline spray with me next time I run, to use throughout, and see if that helps. Maybe it’s just something one’s body gets used to through exposure. I’m not sure.

When I was worried I undid my surgery

On a Sunday, a couple days before two weeks post-surgery, I was blowing my nose and felt a weird sensation. Either like a harder piece of mucus was trying to come out, or like I was ripping something?? I then wasn’t able to breathe all that well through one side in particular, but it felt like both sides were impacted. I was 90% of the way to panic for about 24 hours before I was able to get in to see my doctor. They looked at everything and said it all looked fine (indeed, his ability to stick a camera up my nose with no decongestant or numbing agent boded well), and they guessed that my middle turbinate probably just had some healing to do.

I share this to remind you that you will be feeling unfamiliar sensations. You are probably fine. Septoplasty is a “bread-and-butter” procedure for ENTs–it is one of the first they learn, and the ENTs in my doctor’s practice all do it once or twice a week. Without question, don’t hesitate to reach out to your doctor with questions, or schedule an appointment. But just know… you’re probably okay.

Professional voice folks (actors, singers)

Before my surgery, I asked both my doctor and a fellow performer when I’d possibly be back up to singing again–I had a potential gig, so I needed to give my availability! They both said two weeks post-surgery; the performer gave the qualifier that, even then, a session longer than an hour and a half would have been too much. Having hit the two-week point while writing this, I’d say two weeks is possible, but pushing it. Personally, I still have excess mucus, which obviously affects the larynx, and my sinuses (i.e., key resonators!) are still sensitive. I don’t think I’d want to be singing anything in mixed voice right now, that’s for sure.

Sinus clicking has significantly improved. Most of the time, I don’t notice it, and I can usually control it when I focus (this is a huge improvement).

I noticed immediate clarity of tone. My voice before was muddier. It sounds much more pure and light now. I even feel that I have better control of my soft palate, so my voice is less likely to have that breathy quality that comes from air escaping.

I do feel that I have better pitch accuracy and facility at changing pitches. I haven’t sung much because I’m addressing a separate vocal issue, so the fact that I’ve noticed this must mean it’s pretty significant. It’s generally just easier to sing.

Another performer I talked to mentioned the nasality they could achieve before and after, and I noticed the same thing so I’d like to share: the quality of my “nasal” tone (whether speaking or singing) is less pinched and whiny. If you sing with this tone, or have characters on your demo who are really nasal, these are the two things you might need to re-record to accurately reflect what they sound like. I can still achieve the super whiny sound I had before, but I need to learn a new skill in order to achieve it each time.

As I mentioned, I still have stuff in my throat in the morning that has me clearing my throat, and I still blow my nose throughout the day. But it is far more under control than before, and doesn’t rule or dominate my sound. Even a month out, I know I’m still healing–I also mentioned I’m taking allergy shots–so hopefully this will improve in the coming months.

So that’s it. Have you gotten this surgery? I would love to hear about your experience, and compare notes.

Published by Morgan Bailey Keaton

Dave Barry won a Pulitzer the year I was born. Needless to say, I am hilarious.

2 thoughts on “Deviated septum: from post-op onward

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