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.

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.

So you’ve decided to get septoplasty! I also got a turbinate reduction, as well as a Latera implant to address a nasal obstruction, so if you’re addressing any or all of these, you may find some of the below helpful.

This is a continuation of a series. For how I decided to get this surgery, click here; for the post-op appointment and subsequent weeks of recovery, click here.

Some additional background/disclaimers:

• I had the immense privilege of being able to take an entire week to rest and recover. If this is in any way an option to you, I’d recommend it.
• I live alone, but have a supportive partner. I spent the vast majority of my time at home, alone. I was able to take care of myself because I planned ahead, but my significant other did stay with me the first and second night, helped me run an errand or two, and I visited them a couple times.

The day or two leading up to surgery

Poop happens, you guys. Sometimes it doesn’t. I dream of living in a world where talking about literal everyday activities we all have in common is acceptable. People generally fall into two camps–prone toward loose bowels, or prone to constipation. If you’re the latter (and maybe even if you’re not), I’d recommend taking some extra action in the day or two leading up to surgery; surgery is full of reasons for constipation: you don’t eat or drink the day of, you may be stressed, general anesthesia causes constipation (and can cause vomiting), pain meds cause constipation (and your other meds may, as well). You’re already going through a lot, so best not to be constipated if you can help it!

One option: I’ve used laxative tea from Triple Leaf Tea before–you brew and drink a cup before you go to bed, and it stimulates a BM in the morning–very effective. This may be good to do the night before surgery–I wasn’t allowed to eat or drink after midnight, so there will be nothing else in your system to help! However, you may not be able to predict when it will happen–my surgery was at 1, so I think this was acceptable. If your surgery is first thing in the morning, give it a careful think.

Another option: magnesium. I’m told that it’s not habit-forming, and you can just keep taking it until it stimulates a BM. Calm from Natural Vitality is a powder you mix into water. This product I would recommend testing out even a week before as it can take a day or two to find your correct dose–everyone has a different dose that works for them, so you want to know where your baseline is (i.e., what dose will not give you diarrhea) before you know how much to bump it up.

Either of these are good to keep using throughout your post-op recovery.

Do a grocery run so that you have easy food on hand. Make a big pot of stuff before your surgery. Ask loved ones if they wouldn’t mind sending you a meal or running an errand for you. You won’t be able to taste as effectively since you won’t be able to smell for a week, keep in mind. You’ll also need to stay hydrated. If water doesn’t do it for you, or you worry you’ll get bored, get some seltzers, some tea you can brew, kombucha, coconut water, drink powders. Any of that. Nothing too sugary or salty because that may just dehydrate you more!

If you are unfamiliar with or if you dislike nasal rinses (e.g., a neti pot), I strongly urge you to make your peace with it in the days leading up to your surgery. Get some salt packets from the store (if you feel like it stings, try the packets from Xlear, which have xylitol in them; I’ve found they’re gentler). In my opinion, nasal rinsing is essential to this recovery process.

Day of surgery

Wear comfortable clothes–these will be the clothes you wear out of the hospital when you’re likely feeling miserable. I recommend a crew neck or button-up–don’t wear clothes that will come anywhere near your nose when you put them on and take them off. Bring something that occupies your time (I brought my eReader), and something comforting. I have a plushy who’s become my health buddy over the last few years–they’ve been with me in MRI machines, hospitals, and now an operating room!

My surgery was at a hospital, and my surgeon also had a very full day with me toward the end, so I spent far more hours there than I anticipated. My surgery was supposed to be at 1 PM, but it didn’t happen until about 4:30. You may wait less if your procedure is at an outpatient facility, but ask your doctor or surgery coordinator what to expect.

Afterward, I think it’s safe to say you’ll be pretty out of it. Working the general anesthesia out of the system takes a while. Given COVID, I wasn’t allowed to have someone with me. After the surgery, there are a lot of after-care instructions and cautions that can seem overwhelming. Make sure to get documentation, and have them write down anything you talk about that isn’t already on the printouts. You can ask to record your conversation to refer to later when you’re more cogent. Advocate for yourself. Call your doctor’s office if you have questions before or after the surgery–better to feel silly than to threaten your recovery.

The hospital I went to gave me gauze and tape to use at home, so I recommend asking for supplies if you don’t automatically receive them.

You will need someone to drive you home. My team recommended not being alone the first night, just in case anything goes sideways. If you live alone, think of a loved one who can be with you overnight, and where you’ll be comfortable. If it’s not your own home, make sure to give belongings (e.g., glasses, favorite pillow, retainers, vitamins, etc.) to them ahead of time so they’re there for you.

First week of recovery

Provided you don’t have complications, recovery–in my experience–was very quick. There were some low points for sure, but after my post-op appointment, I felt so remarkably better that it put in perspective how short a time a week is.

Medicine

Your pain medications may have warnings about driving. Mine said not to drive until I know how it affects me. Luckily, my significant other drove me around the times that I left the house–I think I would have been able to drive, but I did feel a little out of it, so played it safe. Have a plan B for transportation in case the medicine makes it unsafe for you to drive.

Sleeping

My doctor recommend sleeping on my back at a 30 degree angle–pretty steep! I’m a side sleeper. I am normally physically incapable of sleeping on my back, but I was able to for the first four or five nights. On night three, I think, I’d wake up in the morning with my BUTT HURTING. I could not figure out a better way to position myself or my pillows to take pressure off my butt, so it did hinder my ability to sleep as much as I would have liked to, but I still got enough rest. During the day, I spent a lot of time on my stomach because my butt was honestly that sore.

Here’s another thing I’ll say just to give a full scope of the experience: your body’s purpose shifts very strongly to being a snot factory. It is unconscionable sometimes how much comes out of your sinuses. There were two nights I was up until quite late because there was so much going down the back of my throat. I did my meditation, did visualization exercises to calm and distract myself… I gave it my darndest. But it was absolutely disgusting. KNOW THAT IT WILL PASS. Stick with it. Sometimes our goal is no more than “get to tomorrow.” Your body is doing exactly what it should to help you heal and adjust.

Nose dressing

No, this is not a weird salad.

Dressing, meaning the gauze that goes under your nose to catch mucus and (hopefully far less) blood, is essential. The first few days, it was great. I didn’t feel like as much was coming out of my nose, so I wasn’t having to change the dressing as much. In the latter half of the week, though, there was so much movement that I generally just held a tissue to my face instead. It was easier, more convenient, and felt better. As I told my significant other, I had some moments throughout the first week where I could not think of a time I’d felt more disgusting in my life. Having hours where I didn’t have a snot rag taped to my face was very humanizing! But sometimes you gotta have your hands free, and you also need to have on a dressing if you’re wearing a mask.

As I said, the hospital I went to sent me home with enough gauze and tape to get me through the week, so ask about supplies if you aren’t handed any. If you do have to buy some, it seems like an open weave is best at absorbing mucus. I’d recommend making the gauze a bit wider than your nose, and I folded mine about three layers thick–then I used “paper tape” to hold it to my face. The tape irritated my skin sometimes and actually pulled some off once, so be mindful of this and be kind to your skin. You may need to try another type of tape, and handle the piece first so it loses some tackiness.

Stay hydrated

You’re recovering. You’re regenerating tissues. You’re fighting constipation from medicines. And you are producing a LOT of mucus. Drink a lot of water. If water gets boring for you, try coconut water, seltzer, or kombucha. I did a Costco run beforehand and that was helpful.

A cold (not steam) humidifier was also recommended to me. I feel like it helped.

Nasal rinse

At my post-op, my doctor told me my healing looked better than the average patient, and they credited my nasal rinsing (e.g., neti pot). My doctor recommended doing a nasal rinse 6-8 times a day. I don’t know how people don’t do it!? The pressure that builds up in the sinuses gets intense. It also was nice from time to time to have water dripping out of my nose for a bit, instead of mucus.

I recommend one of the nasal rinse bottles that you can squeeze, as it gives you control over the amount of pressure. Use only boiled tap water (obviously cooled to a tolerable temperature) or heated distilled water. Tap water can have bacteria in it, which is harmless to us if we drink it because our stomach acid kills it, but our nose has no such defense.

The first couple days, I would spend minutes at the sink. It was slow going. Sometimes the goal was to get any water at all to come out of one side. Be patient. The more you try to rush or force it, the more water you’ll get in your ears, or even through your soft palette! I would do two bottles in a row on one side sometimes–once I got water through, I’d get hooked on seeing if I could improve on it (and I always could, it just took time). It was time well spent because I at least got the pressure to go away for a while.

My doctor also told me at my post-op that I had no scarring. I’m sure the nasal rinse was instrumental in this, as it keeps the area cleaned out and staves off bacteria.

Eating

Just a reminder that you will only be able to breathe through your mouth, even while eating! Don’t take bites that are too big. If you have a dressing taped to your nose, drink with caution–so annoying to get coffee or water on the gauze.

Smelling

Just an acknowledgement that you will not be able to smell for a week. If something is burning, you will not know, so pay attention when cooking.

Numbness and jaw tension

Again, this is just my experience but I lost some sensation or movement (or both) in my upper lip for the first several days. Mobility also was impaired because of the packing my my nose. It was hard to purse my lips (e.g., to spit out water when brushing my teeth, or get my mouth on or around some foods.

I also noticed a lot of jaw tension and/or pain. Particularly in the morning. I don’t know if sleeping on my back did it, or if things shifting in my face caused it, or what.

Sneezing

I had the equivalent of hay fever on roughly days 5, 6, and 7 (leading up to my post-op). I was so stressed about sneezing at first. In my experience, it was virtually no different from sneezing before surgery. Just make sure you don’t do it with your mouth closed, and have a tissue ready!

Post-op appointment

My surgeon put some special tape on either side of my nose to keep things in place, and then “packing” inside my nose–I think it was like a little plastic cage to keep the nostrils’ shape and protect the septum? At my post-op, we checked in about how it’s gone–I honestly didn’t have anything to report other than sneezing a heck ton for a couple days. Then the doctor took that stuff out of my nose and then VACUUMED ALL THE MUCUS OUT OF MY NOSE AND SINUSES. IT WAS AMAZING (and did not hurt or feel uncomfortable). To go from being so congested that my dressing had soaked through, to being 100% clear was a seriously night-and-day experience for me. I quickly got *some* congestion back, but only about 10% max of what I’d just had. Most of the runny nose I had wore off after about 30 minutes, and then I was just a little sniffly and congested (I’m still healing, and am still a little congested, but this should clear up in a week or two).

The aftermath of all this will be for a future post, but I hope this is helpful. I wanted to arm myself with as much information as I could before I decided to do this, so I hope this can scratch some of that itch for you. If you get the surgery, let me know how it goes! What was similar and different for you?

For the next in my series, here is the post covering the post-op appointment, all the way to a full month out from surgery.

This is a series. For the days leading up to surgery and the first week after, click here; for the post-op appointment and subsequent weeks of recovery, click here.

I haven’t been able to breathe well, with my nose, in years. Maybe even in a decade. For example, when I think of a yoga class, my very first thought is, but will I be able to breathe? The answer was usually “no”. I came to associate yoga classes with a slight anxiety–what’s the point of going if I can’t experience the benefits, simply because I can’t breathe through my nose!

As I’ve worked on my singing skills on my own, I’ve spent a lot of time on mixed voice, which requires some air to go out through the nose. Once I got up past certain notes, I would feel resistance in my nose, restricting the airflow and making the notes unsteady and strained. With even higher notes, I would feel my soft palate trying to flip around to compensate.

I work in voice-over, and it’s been difficult because I’m always congested. Not only that, but my sinuses audibly click. I’d have to do multiple takes sometimes and really modify how I formed words in order to work around it.

It took me years to start looking into all this in earnest. Medical expenses being what they are, and work schedules clashing with doctors’ office hours the way they do, it took a while (years). Eventually, I got to an allergist. I figured I’d start there. I must be allergic to something, so if I could just eliminate that, then I could at least start finding the Big Problem by process of elimination. I got shots, took allergy medicine, used a nasal rinse, and used a prescription-strength nasal spray, and I still couldn’t breathe.

I finally saw an ENT, and in fact, by some miracle of my HMO, a board-certified laryngologist (this is the classification vocal performers should look for, as they specialize in our area and are certified by an overseeing panel of experts), and it didn’t take them long to perceive that I had a deviated septum (the septum is the wall separating the two nostrils on the inside, and deviated means it’s bowed to one side). Not only that, but I also had enlarged turbinates and a nasal obstruction. Turbinates are bulbous things in your nose that direct airflow, and some people just have them too big–either genetically and/or due to inflammation from allergies or another condition. A nasal obstruction refers to a nostril that collapses when inhaled through. The doctor had tears spilling out of my right eye from getting the camera up my right nostril to take a look around–it was quite tight.

I did a lot of research. I asked people I know personally, I asked a Los Angeles singers group I’m in, I looked on Reddit. I spoke to an ENT I know personally who’s in the final years of their residency. Across the board, with few exceptions, the feedback I got was that the procedure is very helpful, and usually people end up regretting not doing it sooner. My doctor also told me what every doctor in their practice does one to two of these a week. It is incredibly common, and a straightforward procedure. I signed up. And that’s that!

If you came to the same decision I did, make sure to check out my Tips if you’re getting a deviated septum corrected post! This covers pre-surgery, the surgery itself, and the following week of recovery leading up to the post-op appointment.