Episode Transcript
Interviewer: You had your sinus surgery and now it's afterwards and you've probably got a lot of questions. What's going to happen during your recovery, what do you need to do or avoid, and what are some common questions and issues that generally arise? That's what this podcast is going to talk about, after your sinus surgery.
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Interviewer: We're with Dr. Richard Orlandi. He's one of the experts here at University of Utah Healthcare and Sinus Surgery, and I think the first concern people would have after surgery is what am I going to look like? Am I going to be bandaged up? Am I going to have bruises? Is it going to look like I went through something major?'
Dr. Orlandi: That's a really important point. The thing to remember with any surgery that's happening just inside the nose, is no, you are not going to have bruises and you're not going to have a cast on your nose. If work is being done to change the outside appearance of your nose or a much more extensive procedure is being done to straighten out the inside of your nose, what we call the septum, the wall between the left and right side, then yes, that might happen. Hopefully, your surgeon is going to discuss that with you ahead of time. But for the vast majority of sinus surgeries, no, you're not going to be able to look at someone and tell that they had it done even hours or days later.
Interviewer: Did that not used to be the case?
Dr. Orlandi: That definitely did not used to be the case. When we were making incisions under the lip or between the eyes and the nose, quite a bit of bruising was going on. Now with everything being done with fiber optic scopes through the nostril, that's the endoscopic part of endoscopic sinus surgery, we're not seeing that happen.
Interviewer: A next question a patient probably is going to have is how long until I can . . . fill in the blank. Go back to work, exercise, smell the roses . . .
Dr. Orlandi: Let's go in the order of when these things are going to happen. Right after sinus surgery, because the nose has such a rich blood supply, we don't really want to get the heart pumping and the blood pressure up because it's going to cause the nose to bleed a little bit more. So we're going to hold off on vigorous exercise for three to five days. What I tell patients is, "Go ahead and go out for a jog when you feel up to and if your nose starts bleeding, stop and try again a day or two later." It's a little bit of trial and error but we typically want to hold off on that.
Going back to work, I think about a week is pretty standard. If we're doing work on the septum to straighten out the inside of the nose then we're going to wait about 10 days on average. Stopping and smelling the roses, a lot of times sinus problems can cause a reduction in the sense of smell. That can take a little while to come back, more on the order of two to three weeks or even longer for that to come back. Sometimes it doesn't come back all the way and that's really frustrating. That's a big quality of life issue. If you can't smell your food, much of what we perceive as taste is actually smell. Our patients are really concerned when they can't smell and taste very well because it does impact their enjoyment of food.
Interviewer: You've given us an indication of how long you should wait until you can do some common things. You said about a week off of work to recover. What am I doing in that week? Why can't I go back right away?
Dr. Orlandi: Most of the time patients are still having a little bit of discomfort or pain. They may still feel a little bit out of it just from having the surgery. It's right in between your eyes and so it's hard to ignore. Concentration can be an issue.
I've seen patients go back to work two days after surgery. I've seen patients go back to work two weeks after surgery. Everyone is different, but on average you're feeling just a little bit out of it and maybe sitting on the couch and watching ESPN is the better thing to do for a few days.
Interviewer: What does recovery look like? We already talked that we're not going to look like that preconceived notion that somebody punched me or beat me up with the bandages and the [inaudible 00:03:48], but what about bleeding and changing bandages and that sort of thing?
Dr. Orlandi: The inside of the nose doesn't look as good as the outside. There are a lot of raw surfaces. There is a little bit of oozing, and patients, especially for the first day, may wear a bandage or a piece of gauze underneath their nose with some tape going up to the face to try to catch that blood as it comes out. That'll diminish usually in 24 hours after the surgery and that won't be necessary.
One of the critical things that we encourage our patients to do is to rinse their nose out with salt water after surgery. I'm not talking a little misting spray. We're talking a quarter cup or a half of cup of saltwater in the nostril where the surgery was done, and on both sides, obviously, if the surgery was on both sides. That's going to rinse out a lot of that blood and secretions that can accumulate during the surgery.
That blood and secretions need to come out one way or the other, so I'd rather have the patients remove it day-to-day at home rather than have it have to be removed in the office. That is not comfortable at all.
Interviewer: And pretty crucial to the healing process that that gets out of there?
Dr. Orlandi: It is, because that accumulated blood can lead to scar tissue if it's not removed, and then that can block off the sinuses and then we're back to square one.
Interviewer: Gotcha. Are there any other really important parts of recovery that you should take seriously? Rinsing the nose sounds pretty important.
Dr. Orlandi: That's really the big one, frankly. We do put patients on antibiotics sometimes after surgery and we want patients to continue those. Obviously, patients will take their pain medicine as they need to. Those are really the big things. And then as we talked about, some exercise restrictions to not make things worse.
Interviewer: What does a timeline look like as far as getting back to normal? I'd imagine things are worse before they get better.
Dr. Orlandi: There is one other thing and it sounds so weird, but we ask patients not to swim for four weeks after surgery because chlorinated water can irritate the sinuses. Other than that, no. I think patients can expect to feel worse than they did before surgery for about three weeks. At about three weeks they can often feel about the way they did before surgery, and then we hope that that improvement continues and they steadily feel better afterwards.
The healing from sinus surgery, meaning the recovery back to normal, can take weeks to months. Now you may feel largely back to normal after three weeks to month, but that healing actually takes up to a year so there's going to be quite intensive care afterwards until we get to a point about a year after surgery where we're into the smooth sailing area.
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updated: November 9, 2018
originally published: February 5, 2015