nasal polyp removal 
Author Message
 nasal polyp removal

After years of allergies and nasal blockages that often make
nose breathing difficult or impossible, I asked my doctor if
I might have a nasal polyp.  "And how!" was the answer after a
peek in my nostrils, and I made an appointment with an ENT doc
for an exam pre surgury to have it removed.

Now I have a few weeks before that exam, and I can't wait to
get rid of the monsters.

Some questions while I wait:

        I read up on it in some ENT texts, and the procedure doesn't
look so bad.  For the most part they said the procedure was done under
local only, and involved going in through the nostril and avulsing the
offenders with a wire noose.

        I almost lost my lunch when I saw the diagram for lateral
rhinotomy.  If the tumors are too large (or deep?)  to get at through
the nostril,
the surgeon must cut open the nose from the side.  Pure horror show.
I got the impression that that was for more extreme cases, and that
the wire noose procedure was the norm for polyps.

        For those of you who have had this or know of it, is the
wire snare procedure under local the way you heard about as being
the norm?  That sounds like not such a big deal.

(If relevent, they seem to be on one side only, and act as a valve
which seal and prevent exhalation while allowing some inhalation.
Grape size for one, plus two tiny ones [perhaps some more are not
visible, but
I hope these are it].  I can't wait for these to go, because it's
been a long time since I've gotten a decent sniff of air. 8^)

        My doctor (not ENT) thought removal required an unconcious
patient, contrary to the ENT book which specified local numbing
only for the simpler procedure.  What is the norm?  I have two
concerns with this:

        1)      I don't want to be knocked out.
I don't want to be unconscious, with nothing but
an anesthesiologist's competence between me and death. 8^(.

        2)      I don't want to remember it either.

This may seem like a contradiction, but it isn't.  When my wisdom teeth
were removed, I was sedated (but conscious) with Versed, (a benzo*?),
which erased all memory of the procedure.  This is ideal for me, because
I suffer severe anxiety about surgery, needles, cutting, {*filter*}, etc.

My last operation, which was a novacaine-only minor finger surgury, I
jumped off the table at the first poke.  It sounds silly, but at the time
my heart was going a mile a minute and a fast exit from the knife was like
an involuntary reaction (like a fight/flight override of reason).

I was given an {*filter*}benzo-something, and I came back in a few hours
calm and there were no problems.

Thanks,
Jim Del Vecchio



Mon, 25 Sep 1995 23:11:35 GMT
 nasal polyp removal

Quote:

>    I read up on it in some ENT texts, and the procedure doesn't
>look so bad.  

Well, "bad" is a relative term.  This isn't like open-heart
surgery (not that I've had that), but you can still feel pretty
wiped out afterwards.

I think it depends on how extensive the surgery is.  I've had
sinus surgery (endoscopy) done twice, under general anesthetic.
For the first one I was out of work for 1.5 weeks and could have
used 2 weeks but there was a big project going ont.  I felt like
{*filter*}the entire time.  For the 2nd surgery I was out for 1 week
and was starting to feel OK by the middle of the week, though
couldn't go out due to nose-tampons with the black string{*filter*}
out and taped to my cheeks.

Quote:
>For the most part they said the procedure was done under
>local only, and involved going in through the nostril and avulsing the
>offenders with a wire noose.

>    I almost lost my lunch when I saw the diagram for lateral
>rhinotomy.  If the tumors are too large (or deep?)  to get at through
>the nostril,
>the surgeon must cut open the nose from the side.  Pure horror show.
>I got the impression that that was for more extreme cases, and that
>the wire noose procedure was the norm for polyps.

Hmmmm.... I don't know about that.  I had lots of polyps between
the eyes which sealed my forehead cavities and my right behind
the cheekbone cavity.  My left cavity is underdeveloped and
sealed itself shut.  They also fixed a deviated septum and shaved
the turbinates.  All this was done with endoscopy.  But I really
don't know what they can and cannot reach.

 >   For those of you who have had this or know of it, is the

Quote:
>wire snare procedure under local the way you heard about as being
>the norm?  That sounds like not such a big deal.

Your current doctor is not a specialist.  Get an OTO.  Then get a
2nd opinion.  Ask around and get referrals to good ones.  Get
someone who has done lots of endoscopys.

Quote:
>    My doctor (not ENT) thought removal required an unconcious
>patient, contrary to the ENT book which specified local numbing
>only for the simpler procedure.  What is the norm?  I have two
>concerns with this:

Its a waste of time to expect an answer from anyone other than
the specialist.

My OTO said that he did small procedures in his office.  Other
relatively small procedures he does under a local in a hospital.
Big procedures he does under a general.  He wanted me under a
general.  

Sorry I can't be more specific about what "big" and
"small" are.  Get a 2nd opinion.  Get a doctor with an excellent
reputation and much experience with the procedure being done on
you.  Ask lots of questions of course, but know when to shut up
and let him do his job.  In other words, at some point you have
to give up control and trust him.  If you can't do that, keep
looking for another doctor.

Quote:
>    1)      I don't want to be knocked out.
>I don't want to be unconscious, with nothing but
>an anesthesiologist's competence between me and death. 8^(.

Its not that bad.  Just follow the directions regarding no cooking.net">food
and water.  Waking up sucks, especially if you're inclined to
puke.  But by then you know you're still alive, so its not that
bad.:)  What gets me is the "racing" feeling I always get at the
same time I really want to sleep but can't.

Quote:
>    2)      I don't want to remember it either.

What's worse than remembering it is going through it.  I've had
approx. 2 dozen "small" procedures done in my doctor's office.
They all involve numbing with lidocaine (which is another story)
sticking the endoscopic instrument up there to look around.  Then
going at it with the "snot sucker" machine.  Usually this is
accompanied by scraping off scabs.  Something about the sinuses,
they don't clean themselves out well, so each surgery is followed
by 4 "scraping and sucking out scabs sessions."  

Note, this is just for the routine office procedure.  Generally
it causes more anxiety than actual pain, but a few times it has
been quite ouchy (especially after I was dumb enough to complain
about too much lidocaine making it harder to breathe when it ran
down my throat).  The point is, have you ever had a minor
procedure done with the "snot sucker" and pointy metal things?  
If you don't know how you'd handle that, how can you say you want
to be awake during a surgery?  I can't imagine wanting to be awake
during an actual surgery.

Quote:
>This may seem like a contradiction, but it isn't.  When my wisdom teeth
>were removed, I was sedated (but conscious) with Versed, (a benzo*?),
>which erased all memory of the procedure.  This is ideal for me, because
>I suffer severe anxiety about surgery, needles, cutting, {*filter*}, etc.

I just had my sideways and deeply impacted wisdom teeth removed
with just novacaine.  It took years to find a doctor I liked well
enough to do it.  Something about dentists running an IV in their
office and strapping you to the chair really turned me off.  I
found an {*filter*}surgeon who had done zillions and explained
everything.  He preferred the novocaine and said patients got
less "beat up" than with a general, because they were able to
cooperate by holding their mouths open.  It wasn't all that much
worse than the procedures I had in my OTO's office, except for
the part where the red blob flew across the room and landed on my
sneaker.  I remember everything perfectly well.  It did
not actually hurt, until the novocaine wore off.  Just gave me a lot
of anxiety.  The surgery wasn't that big of a deal and I was glad
I had it under just novacaine.  (I swelled up like a watermelon and
it hurt a lot after.)

Quote:
>My last operation, which was a novacaine-only minor finger surgury, I
>jumped off the table at the first poke.  It sounds silly, but at the time
>my heart was going a mile a minute and a fast exit from the knife was like
>an involuntary reaction (like a fight/flight override of reason).

When someone has an endoscopy instrument between your eyes this
is something you must avoid.

Thoughts that come to mind are:

  o See a specialist then get a 2nd opinion.  

  o Where are the polyps located?  I mean, if they're
    easy to reach it might not be a big deal for someone
    experienced.  In that case, if you can hold still, a
    local might be easier on you in the long run.  Waking
    up from a general is the pits.

  o The closer to the brain the more I'd be inclined to get the general.

  o Are you just having a few polyps removed, or a deviated
    septum, or enlarging passage, shaving the turbinates?

  o Finally, keep looking until you find a doctor you trust and
    then follow their recommendation.

Quote:
>Jim Del Vecchio

- Peggy -


Sat, 30 Sep 1995 05:38:00 GMT
 
 [ 2 post ] 

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