I wasn't living life properly until I fixed this - a guide to the Deviated Septum
July 05, 2019
For about the last 10 years I've suffered from chronic fatigue, lack of sleep, a negative mood and generally not having a good time
I attributed this all to my personality, a lack of motivation that I perhaps picked up through my choices throughout childhood and my use of digital media, the "maybe I just don't try as hard as everyone else" argument to myself. On top of that I would exhibit a few other strange symptoms during the day: I would completely zone out of conversations at times, have a hard time communicating, yawn heavily when exercising, randomly become overwhelmed and anxious. This general comprehensive state of discomfort followed me wherever I went and due to it's persistence dominated my train of thought.
To deal with this state of permanently lowered quality of life I changed my habits, moved out, travelled abroad, bought multiple mattresses, read countless self help books and spent hundreds of hours at the gym and at various physical activity programs - all to no avail and without ever connecting the dots. Then one day suddenly and serendipitously a thought popped into my mind that has redefined the last 10 years of my life and answered all of my questions. I was making fun of a friend of mine from Britain, explaining how long term mouth breathing may affect development of bone structure and how this may be caused by a deviated septum. Once I said this I immediately slapped myself and ran off to do research. (I have had a severely deviated septum since early high-school)
As it happens, a deviated septum is a common issue many people unknowingly suffer from, somewhere from 70 to 80% of the total population has some form of septal deviation, the effects of which vary from person to person. The range of total symptoms something like a septal deviation causes and the amount of people it affects is absolutely absurd for how little the general public actually knows about it.
There are hundreds of studies on the effects of septal deviation but one really highlights the general areas where it affects a persons quality of life: Outcomes of Septoplasty
In this study a questionnaire was given to three groups of people pre-and post op for correcting breathing issues caused by a deviated septum. The results of which are fantastic - I mean literally magical. All three groups reported significant psychological, sleep, social, physical, general health, emotional, nasal and even hearing improvement. Every single conceivable area of discomfort affected by poor nasal function was improved. Considering that this study averaged each individual report and that the surgical procedure in general (Radiofrequency turbinate reduction) has been considered lacklustre compared to the alternatives for outcomes you could imagine that the procedures effects may be even more astronomical in some cases.
Upon learning all this I immediately rushed to action. I booked an appointment to see a prominent ENT (Ear Nose & Throat) doctor through my General Practitioner. The ENT in question is Doctor Solomon, a Plastic Surgeon known for Rhinoplasty - unfortunately, unbenounced to me the Doctors office no longer took in non-cosmetic cases of surgery (something caused by the Canadian healthcare system) so I was transferred to another lesser known ENT operating from the same building. The wait time for this ENT was 3+ plus months and another 3+ months for operation. I was extremely disappointed to figure this out three months into my wait so I went to a different ENT who referred me to yet another ENT operating out of a major Toronto hospital who would see me in two weeks and operate in two months.
The operation happened on the first of February
(pictured: my ass with some random nurse five minutes after waking up)
The surgery was a Septoplasty and Electrocautery Turbinate reduction. It was really very scary to get operated on and I almost fainted when I got an IV drip since the nurse kept missing the needle BUT luckily in that situation the anaesthesiologist can give you laughing gas which after a few inhalations renders the body completely relaxed and the nerves completely at peace - at which point almost instantaneously I woke up three hours later.
It felt kinda like this:
The surgery itself helped immensely and was also a tremendous disappointment.
A week of total misery followed, the worst part of nose surgery is the recovery. My nose being very inflamed and stuffed with plastic to hold it all together made it completely impossible to breathe normally - but everything is bearable after your bear it so it wasn't too bad. The actual worst part was discovering that only half the job was done.
The doctor only fixed a spur in my septum in the back of my nasal cavity, which immensely improved breathing on only one side of my nose and the turbinate reduction also helped a little. When I questioned the doctor on why the other side of my nose wasn't touched I was given possibly the dumbest answer I could expect: "that would be a Rhinoplasty". So according to this ENT, fixing a deflection of the caudal septum was to him a "Rhinoplasty" procedure...
"This won't do" I thought and booked an appointment for Rhinoplasty with the first ENT I was referred to, Dr.Solomon. Dr.Solomon saw me within two weeks of scheduling the appointment and he said what I was looking for was a Septoplasty but agreed to do a revision Septo-Rhinoplasty in order to correct everything missed in the last operation and make my nose point forward (it has always pointed slightly to the left). I had this surgery on the first week of June.
So again I went under...
This time it nearly worked
But not quite...
For the first time ever I can breathe properly through both nostril's. However I can only do this one at a time... and it seems like the right side is slightly worse off. So what is the problem? Potentially the Nasal Turbinates, which swell over time due to septal deviation may not have been shrunk enough in the first procedure and were not addressed at all in the second one.
So I have now scheduled a second opinion from an ENT focusing on Endoscopic Sinus Surgery and Rhinology (nasal surgery) to hopefully solve whats left of this problem.
This is the before and after from right after the first surgery to just after the second one:
As you can see, not perfect but a huge improvement!
Figuring all of this out and acting upon it is a difficult and confusing process. In Canada the the public healthcare system is slow, inefficient, indifferent and behind. It's very difficult to find a good doctor that knows what he's doing. Most ENT's here prefer to do the electrocautery turbinate reduction method, which is okay and safe but it is literally electrocuting your turbinates to get them to shrink, a method which can damage the turbinate and also has a high regression rate in one year follow up studies.
In my opinion, a microdebrider turbinate reduction in the right hands is a superior method to this surgery - the device physically removes the tissue and vacuums it way leaving unburned and lasting volume reduced turbinates. And all of this will only give lasting results if it's done in conjunction with an effective septoplasty procedure covering all area's of the septum.
So my advice is, get a US doctor they have generally more experience, know-how and tools when dealing with this issue - but if you can't and you're in Canada, go to a reputable and experienced facial plastic surgeon because more likely than not they will end up having leagues more experience in nasal surgery than a regular ENT. and finally, try to look for an ENT with clinical interests in nasal airway function, endoscopic surgery and Rhinology - this is crucial to not having to do multiple surgeries like me.
Finally all I can say is don't listen to anyone, most people don't understand the issue this can be and will never understand even if you explain it. If you see someone with a deviated septum though, tell them about it, you may just be giving someone the best information they could ever possibly get.