The Nose Knows: Enlarged Turbinate Surgery
Since getting my new Humana Medicare Advantage Plan back in November, I’ve been on a hot streak of getting medical attention. I got my eyes examined, and two new pairs of glasses. I’ve been to the dentist and had three teeth crowned. Been to a cardiologist—just to get a baseline for my heart health. I also found a fantastic Otolaryngologist (ENT)—Douglas Cowan MD of Ascentist Health. As a person with Sarcoid, I must keep tabs on any new gifts “the disease that keeps on giving” has sent my way.
It all started with the first crown. Because my Humana plan started in November of 2023 I had ALL that years benefits to use up before January 1, 2024. So my dentist booked my 3 crowns in my first visits, and the plan was to finish the first and at least start the other two before December ended. One of the side effects the first and the following two crowns bestowed upon me was jaw and ear canal pain, plus headaches. My dentist over the next few months had put me on two doses of antibiotics trying to make sure it was not an infection. Sadly they didn’t do enough. The pain continued.
In the interim, I went to see my new cardiologist (Jean-Alfred Thomas, MD)—whom I absolutely love! He is one of those doctors who listens, and takes note of, and embraces your input. I had mentioned that I thought I saw or had inflamed lymph nodes around my mouth and my neck—he noticed them too. At that point I already had an appointment lined up with my new ENT.
The first visit to Dr Cowan’s office was incredibly thorough and quite enlightening. The first step was to get an in-office MRI of my melon. Um … how many doctors have an MRI machine built for only head MRIs & in their office? Definitely my first! Then it was time to see Dr Cowan. In walks the doc & a few assistants (nurses?) all carrying MacBook Airs. Okay. Color this Mac fanboy already impressed! Not afraid of technology & a Mac fan! Awesome!
He opens his Air and brings up my scan. He walks through what he sees in the scan and explains it to me. We talk about my Sarcoid and he then scopes my nose and sinuses. He makes notes & talks to me about how my Sarcoid has not only formed non-caseating granulomas in my sinuses, but has also enlarged my turbinates on both sides. He talks about surgery. But before surgery he wants me to do a Z-pac to try to cure the infection he sees deep in my sinuses and also wants to see if it reduces my jaw and ear pain. We make an appointment for 2 weeks out to see what’s what. He also wants to do a second MRI to see if he sees enlarged lymph nodes in my neck, but to also see if the Z-pack has changed anything.
Two weeks later … still had ear and, jaw pain and more headaches. He checks the new MRI and sees no change in my nose or sinuses. He also doesn’t detect any lymph node enlargement. Nice! We then schedule my turbinate surgery. He also tells me that he will also be opening up my nasal passages beyond the enlarged turbinate reduction(s). I am scheduled for my surgery—Thursday March 21, 2024 @ 8:30 AM—right in his office.
I arrived a little early for my appointment. My Air Pods Pro and iPhone in hand—wanted a little music to distract me from “the procedure.” Intake was quick. I was given a “goodie bag” containing all the instructions and other items I’d need post-op. The nurse put two numbing strips up each nostril—”this may feel a little strange”—understatement. Within 15 minutes I was brought to the room where my surgery would take place. I was offered “laughing gas.” I did partake. After a few minutes though,  I stopped. I didn’t like the “rubbery” feeling I was getting from it. Made me feel too “swirly” and out of control. But then again—control is an illusion.
Dr Cowan came in gave me a big smile and a reassuring “squeeze” of my arm and we were ready to go. He tells me it shouldn’t be more than 15 minutes and starts by removing those strips in my nose & injecting my nostrils with more numbing agent. From there … lots of tools going up my nose. Almost felt like a dentist drill at times—very odd feeling. “You’ll now hear and feel a little crunching”: not words or sounds you want to hear or feel. But it’s all in the name of breathing better.
The left nostril & sinus seemed rather easy and uneventful. The right side—a little more problematic. But all in all it did all go by rather quickly. I liked that the doctor talked to me during the procedure, telling me if something might “feel strange” or “you’ll feel a little pressure and some crunching” etc. Once done they put gauze under my nostrils, held tight by what seemed like a repurposed face mask with its elastics looped around my ears.
And that was it.
I felt a little woozy when I first stood up. And I took my time getting back to my car. Once there I sat 10 minutes or so until I felt clear headed enough to drive back home. While I was waiting another gentleman was walking to his car with the telltale gauze and makeshift mask under his nose. Our eyes met. There was a moment of acknowledgment and understanding of what we both just “survived”. He got in his truck & drove off immediately. I sat there still collecting my wits & processing what had just happened. And of course—the obligatory in-car selfie to document the occasion.
And with that … it was time to go home to rest, recover, and recuperate. I will be in “take it easy” mode for the next two weeks. No heavy lifting. No bending over. Lots of neti pot use, antibiotics, and nasal antibiotic ointment. Fun fun fun! Lots of kitty cat kissing & snuggling too. All in all … I’m glad it’s done! And hears to breating better!
