State of the Cassie Address: Many Months Later

Hi!

It's been a while.

You may have been assuming that I haven't updated this blog because everything has been going really well.  And you would be pretty much correct* in that assumption.

Since surgery, life has mostly gotten back to normal.  It's amazing how much of a difference having an open air-way makes.

I mean, it's seems obvious to say that breathing is important, but seriously. Breathing makes a huge difference!

A few months after my surgery, I was at an event at our big NBA stadium.  I was sitting with some friends near the floor,  so there were a couple stories worth of stair to go up to reach the level where concessions and restrooms are.  At one point, I ran up to the top and then realized that I had just run up several stairs and I wasn't winded.  I very nearly cried.

Since then, I've been taking full advantage of these newly available oxygen levels.   I was all set to run a 5K in October, but badly sprained my ankle two weeks before.

So, no 5K, but I've been doing other things.  Last week I went hiking for the first time in years. It was amazing.

I really didn't know how much I was limiting myself and what I was doing until all of a sudden I could do things again.

*But...

But...

Ok, so, it hasn't all been super great.

 My throat is in great shape.  And I am miles beyond where I was this time last year.

But my nose wasn't 100% fixed.  I mean, we didn't really expect it to be.

And the tearing in my eye came back.  So I went to my eye doctor and she was like "Go see your nose doctor because it might be nose stuff."

So I went and saw my nose doctor.  He stuck a scope up my nose and couldn't see the site of the eye surgery.  My middle turbinate was very inflamed and blocking off the opening to my tear duct.  He prescribed an anti-inflammatory nasal rinse with the hope that we could get the inflammation under control.  If that did work, he said, surgery.

So in the two months we gave that rinse to work, things have gotten worse.

It's always hard to tell with my nose if it's actually worse or not.  Changes in the weather, lots of dust, weird smells, all sorts of things make for bad nose days. But nose aside, the tearing is all back in my right eye and now I have some tearing in my left eye as well.

When things in that area are bad, it's probably an indication that things are bad.

So I'm seeing my rheumatologist tomorrow (lucky me got an appointment super fast). I might be ok, but I'm not optimistic.

Even if the Big Bad isn't doing its thing, my nose and possibly my eyes will need another surgery. It's just a question of whether that happens after a bout of GPA treatment or not.

Oops

Yesterday morning, right before I left for work, I blew my nose and the stent came out of my eye.

I felt a slight tug on my eyelid.  When I looked at the Kleenex (that is something I do because the color of the stuff that comes out of my nose tells me how healthy my nose is) I saw a few inches of silicon tubing.

It was supposed to stay in my eye for another 7 weeks.

So I called Eye Doctor, left a message, got a call back from her office saying “yeah, you definitely need to come in today.”

So I had a surprise appointment with my eye doctor yesterday. 

Everything’s ok. Mostly.

She did the needle-in-the-eye thing again to make sure that stuff could drain out of the new drainage opening – the one she created when she sliced up my face.  Some puss came out at first, but then it started draining really well.

Obviously, it would have been better if the stent had stayed in, and having it come out prematurely decreases the chances of the surgery failing.  I skimmed a couple medical articles on the subject though and according to those, premature stent removal decreased the success rate of the surgery from 93% to 90%, so it’s not really a big deal, probably.

Eye Doctor prescribed some anti-biotic/steroid eye drops which should help keep the new hole in my tear duct from scarring shut.  That was the stent’s job.  But now the stent is gone.

So that was fun.

The silver lining of that is that with the tube out of my eye, I am not tearing very much at all.  Today I’m even wearing eye shadow and it hasn’t washed away yet!

Also, she thinks the scar on my face is healing really well.  She was very happy about that.  

I can breathe!

Ok having the plastic bits out of my nose is amazing.

I can actually breathe. Through my nose. Easily. 

I feel like the inside of my nose is huge now; so much air can get through. It's really an incredible feeling. 

I keep expecting to not be able to take a breath through my nose, but then I can and it's weird and wonderful. 

It reminds me of the time I drove an ex boyfriend home after he had laser eye surgery. He kept saying things like "the trees have leaves! Obviously I knew they have leaves, but now I can actually see them!" And he was so excited and I was just like "um, yeah, that's pretty normal for those of us with eyes that work." I'm goin. Through that same thing but with my nose. 

And the plastic bits, by the way, were kind of huge. Picture a standard guitar pick. Now take the fat end and extend it about 1/2 inch. That's pretty much the shape of them. The plastic bits were probably thinner than a guitar pick, but still way bigger than you would expect to fit in a person's nose. 

But the point is, I can BREATHE!

Post-Op

Ok, so it's taken me a while to post about my surgery.  Two weeks. And then some.

Before surgery.  I thought it would be good to have a
pre-op picture for reference.

I think the reason I haven't posted is that I don't really have much to say about it.  I went over the procedures in ....  wait.... maybe I didn't go over everything all in one post.  Well.  I guess I'll do that now.

So, two ENTs and an Ophthamologist walk into a bar  an operating room.

The first ENT (Throat Doc) went and mucked about with my throat.  He used a laser to cut the scar tissue bridge that was going across part of my throat, and then cut into the band of scar tissue around the side of my throat.  Then he stuck a balloon down my throat, inflated it, and that was that. There are pictures if you click on the links.  I was really excited to have pictures, but not everybody likes to look at medical imagery.  Anyway, once Throat Doctor was done with all that, there was space in my throat to intubate so the other surgeons could surgerize.

The second ENT (Nose Doc) then roto-rooted my sinuses.  He went in and cut a band or two of scar tissue that was going from septum to turbinate (What's a turbinate? click to find out).  He also did a little digging around my sinuses - just under my eyes they were narrowed to about 1 mm.  The hope is that when the swelling is done, that opening will be around 3 mm.  He then sewed bits of plastic (or maybe they're sillocone) to my septum.  The purpose of those is to stop another band from connecting turbinate to septum.  Those are getting cut out later today - more on that later.

Finally, the ophthamologist took her turn. I pretty much went over her part in my eye post from a while back. Basically, she poked a hole in the side of my nose to create a new drainage path for my tears.  She also put stents in my eye, you can kind of see them even - I tried to take a picture but it didn't work, but if you see me in person, I'll be happy to point them out if you want.

So all that took about 4 hours.  I was feeling pretty good when I woke up.  I spent very little time in the recovery room before they moved me into the post-op room.  At that point, they finally let me eat (pudding) and drink (water... it was really good water... I was very thirsty).  Here's a picture of me there:

Immediately post-op.  There hadn't been enough time for things to start swelling.

Then it was time to go home.  I spent the next couple days kind of out of it and in pain.  Not a lot of pain though, really. My nose hurt more than anything else.  My throat was a little sore the day after, but then was fine.  I could already tell a difference in how much air I was able to get through my throat - very exciting.

My nose and eye got a little poofy.  I spent a lot of time with ice on my face.  I watched The Last Ship, Stranger Things, and a lot of Gilmore Girls.

Day after

Two days after. Eye was super swollen. Also, for some
reason my phone (with which I took all pictures) flipped
this one so it's all mirror-imagey.

By Sunday, the swelling had mostly gone down.  There was a little discoloration around my eye, as you can see in the picture if you look carefully, but that's it.  I fully expected to have a nice shiner, but all I got was some swelling and a yellowish tinge.  Good for me!

Sunday after (so 5 days)

I went back to work for half a day last Tuesday - a day sooner than my planned best-case.  Granted, I didn't work my full schedule last week, but neither would you if you had recently been punched in the face with a scalpel.  This week I've been pretty much back to business as usual.  I am taking it a little easy - and I'm still not supposed to lift anything heavier than 10 lbs.

Last Friday I had a follow up appointment with Eye Doctor.  She says the incision is looking really good and she thinks it will likely disappear as long as I make an effort to keep it from getting sun-bleached.  That means sunscreen, sunglasses, and fabulously large straw hats.  You have never seen such a glamorous recovery process.

As for everything concerning my eye that is not a scar - it all looks good.  I still have excellent vision, the pressure in my eye is good (having that tested in a weird experience btw), the eye tubes are positioned well.  My eye is actually a little dry, so I have eye drops for that.  I do still have a little bit of tearing, but that will probably go away when they take the stents out in 3 months.  It makes sense that having little tubes in my tear ducts is blocking some of the tears.  Also, the tearing is 300 times better than it was before the surgery, so I declare this one a success!

As I mentioned earlier, I am getting the stents cut out of my nose today.  I'm not really looking forward to the actual taking out part, but I'm definitely ready to get rid of the things.  I'm also glad to have a chance to check in with my doctor.  As of right now, I don't really feel like I'm any less congested than before.  I guess there's probably still some swelling going on in my nose, and the junk attached to my septum is maybe getting in the way of some normal nose clearing stuff.  I'd like to get a clear timeline of when I should expect to notice a difference, if I am going to notice a difference.

Now, 2 weeks post op.  In some lights the incision scar is barely
noticeable at all.

Also, the last couple days I've had a bit of a cough, and have even lost my voice a little.  Even though this is Nose Doctor I'm seeing, he is an ENT and the T is for throat.  Plus the cough could be just as much related to post-nasal drainage or something as it is to throat issues.  And I like Nose Doctor a lot more than Throat Doctor.

So, I guess that's about it.  The healing process is, well, proceeding.  It's all going about how I expected.  For the most part I'm feeling pretty good about it all.

Tomorrow is Surgery Day

In the morning I'm having my surgeries. 

I'm pretty excited. Not so much for the operation itself, but for the results. I'm excited for progress. 

I don't think it's realistic to expect the procedure to fix everything. I've pretty much made peace with the idea that my nose is always going to be messed up. But it should be better than it is now, after all I have a really good nose Doctor going in there. 

My eye is going to be better. I'm so excited to be able to wear eye makeup. It sounds a little silly, but I really do miss playing with makeup. 

My throat will definitely be better too. That whole breathing thing is going to be way easier. 

I'm so ready. 

That said, surgery is kind of a bit deal, so send me your good thoughts tomorrow. I'm not worried, but positive group vibes never hurt. 

I'll see you on the other side!

Things are Happening!

I’m taking prednisone again! Hooray! … wait… no, not hooray.

It’s only for the week prior to my surgery.  

My surgery is in a week.

I’m looking forward to it.  Well, it’s more accurate to say I’m looking forward to 3-6 weeks after it happens.  I can’t say which I’m more excited about - being able to breathe, or not having my eye water constantly.  Probably the breathing is more important, but I’m really excited about being able to wear eye makeup again.  Seriously.  I have some great eye make up, and I think it’s really fun.  I may go to Sephora or someplace like that and splurge on some really fancy eye shadow.

For the moment though, I’m going a little bit crazy.  We’re taking a little vacation* this week - we get back the day before the operation - and I’m a tiny bit stressed about getting everything done.

At this point, because I’ve been scrambling to do things, I actually have most of what I need to get done finished.  There are a few things left on my to-do list, but they are small, and can be done quickly in the next couple days.

Once we’re on the plane I will calm down.  That’s my deadline for everything.  Vacation time is time to relax before some very good doctors go to town on my face and throat.  Then I’ll have good drugs so I won’t worry about anything.

Actually, I’m getting lortab, which I’m not a super fan of.  I’ll take it to kill the pain, but hopefully I won’t have to take it much.  It pretty much just knocks me out and makes me woozy.  I don’t really like the feeling of drug induced sleep.

Here is a picture of my fierce face-eating cat.  This photo is serving as a transition instead of some kind of literary devise or something.  It's my blog I can be a lazy writer if I want to!  

Time is passing for me in a series of landmarks (except time related instead of land... timemarks?) or milestones on the way to surgery. They will continue after the surgery too. These are they - finished ones are crossed out - including parenthetical commentary (I enjoy parenthesis):

• Pre-Op Nose Doctor apt (Lots of post-op instructions. And my nose doctor is fantastic! At my request he walked me through exactly what he is going to do. He also gave me a couple precriptions (antibiotics and lortab) for post surgery)
• Anesthesia Pre-Op apt (This felt like a little bit of a waste of time. They didn't really do much. The nurse I met with was very surprised that they were planning on doing the whole surgical jam session as outpatient, so I guess there might be a good chance I'll be hanging out in the hospital over night. That will eat up my insurance deductible & probably my max out of pocket. yay? On the plus side, when I checked in for this appointment, they also early-checked me in for the surgery so day of I just have to pick up my ID bracelet)
• Rheumatologist apt (Actually not really directly related to the surgery. Just a regular every-three-months-appointment I get to do. Still, it's kind of nice to check in with him)
• No More Asprin or NSAIDs (This is hard. I think I may have come slightly dependent on my Excedrin and Naproxin to mitigate the aches and pains my sinuses and eye cause. But it is what it is)
• Start Prednisone (hooray?  The prednisone is the eye doctor's doing.  The reason I'm taking it is to reduce inflamation in my eye, both before and after surgery.  I only have to take it for a week. Still, not my favorite thing.  So that started today.  Surgery is a week from tomorrow)
• Last 3 days of work (this week I'm working a different schedule than normal so I can take less time for our vacation.  The good news is that we're going to be gone over a local holiday, so I am only missing one day of work - I'm planning to work extra so I only have to take 4 hrs of vacation for that day)
• Vacation! (woo!)
• Call Surgical Center for Surgery Time (I get to do this while we're out of town.  Hopefully, I'll get a time first thing in the a.m.)
• Come home
• Surgery
• 1 week: off work (hopefully not more)
• Nose apt to get stents removed (2 weeks post-op)
• 3 weeks: no heavy lifting
• 6 weeks: total healing process
• 12 weeks: Eye Stent removal

So that's what is happening.  I actually find it very relaxing to have it all laid out like that.  

Here is my other cat for balance.  She will not eat anyone's face.  She's very good at hiding.  In fact, she is so good at hiding, my dad doubts her existence.  She's actually very sweet though. And fluffy.

*I considered not mentioning our vacation because every now and then you hear about someone who’s house was broken into because they announced to the internet that they were going to be gone for several days.  But anyone who is thinking of robbing us while we’re gone - I have a fierce cat who will eat your face!  Also, I have people checking in on my house (well, checking in on my cats at least, but they are at my house) regularly.  Also also, I don’t really have anything worth stealing.