Tuesday, October 6, 2009

All The Good Details

I've had many people ask me specifics about my recent uvulo-palato-pharyngoplasty (removal of the tonsils + removal of uvula and shortening of the palate in the back of the throat), so I thought I'd share as much info as possible about the surgery and recovery in one post. If medical terms and details make you squeamish, you may not want to read this one...

As I mentioned in This Post, I've known for several years that my tonsils were abnormally ginormous, and have also suspected for a few years that I may have sleep apnea. After years of talking with different doctors, I finally found a surgeon who recommended surgery, and with the help of some very severe sleep apnea scores, the decision for me was an easy one.

I had surgery on Monday, September 14 around 11am at Duke. The surgery lasted about 45 minutes...I was asleep and intubated. Because there are greater risks involving this surgery in adults than children, including a much longer recovery time, they kept me overnight for observation. I was given and IV for fluids, as well as morphine and oxycodone that first day, and sent home with a prescription for oxycodone.

Other than some moderate pain in my throat, which did not keep me from drinking lots of ice water, my only immediate issue was some moderate pain, swelling and numbness in my tongue. I was told that this is common, because of the tools used to keep the mouth open for surgery, and that my tongue should return to normal after a few days...I was given some steroids to help ease the swelling. My throat did not hurt at all at any time to talk, although I could not raise my voice or sing without experiencing pain until about day 10. However, even now, three weeks post-surgery, and after 5 days of steroids and antibiotics last week, my tongue is still a little swollen and numb, although not nearly as bad as it was. I'm hoping it returns to normal soon, because I'm still speaking with the tiniest slur...

I was very determined to take my pain meds every three hours, which I did for about 10 days, even waking myself up during the night to take them. This, along with drinking tons of ice water really kept the pain and swelling down and allowed me to swallow that first week with minimal to moderate pain. I did have an allergic reaction to the oxycodone, which meant that I also took benadryl with it every three hours, which meant that I was especially tired and groggy all the time, which was totally fine with me.

I spent most of my time that first week sitting on the couch updating facebook, watching DVDs (thanks to my awesome friends), playing my brother-in-law's Wii, and drinking lots of ice water and slushies. Other than the constant grogginess, I was still able to spend a lot of time with Tricia and able to play and care for Gwyneth. Other than church the first Sunday and a trip or two out in the car, I didn't venture out of the house much until about day 8.

You can read more about some of the foods and stuff I ate the first few days after surgery in the post I linked above. I began to eat lots of soup around day 5, and I ate my first real meal (spaghetti and meatballs) on day 11 and had my first bowl of crunchy cereal (and my first milk) on day 12. By day 13 I was eating just about whatever I wanted to.

Although I'd lost about 10-15 lbs in the 6 weeks before the surgery on my own, I lost an additional 15-20 pounds in the first two weeks after the surgery, which is cool with me. It took me a good four days after I stopped taking the pain meds and started to eat regular food before the grogginess began to dissipate and my energy returned. Although I worked at home a bit that second week, my first full day back at work was on day 16, and I was back on stage singing by the third Sunday.

By day 17, all of the soft scabs were gone and most, if not all of the swelling in my throat seemed to have resolved. I do have several sutures that are still dissolving...I've actually had to reach back there with some scissors and trim a few of them because they were sitting on the back of my tongue and making me gag. I never did experience the scabs falling off and gagging me the way many people told me they would...from what I could tell, they kind of just faded away slowly without much problem, for which I am very thankful...I'm thinking the fact that I was constantly drinking water may have helped with this.

Other than the issue with my tongue, the only other problem I've experienced has involved my shortened palate. Although swallowing is also much, much easier...I knew before the surgery that my tonsils were affecting my ability to swallow...I am having to "relearn" how to swallow because some food and drink is actually getting stuck up on top of the very back of the pallate (in my nasal cavity), which is more uncomfortable and frustrating than anything...but, it is getting better. I still have the slightest bit of pain and discomfort in the back of my throat when swallowing or yawning, and I can still see a few places back there that are a little red and irritated.

From what I can tell so far, I am sleeping much better and am feeling much more well-rested in the morning and throughout the day. Tricia reports that I've yet to snore, which means she's probably sleeping better as well. I am unable to do some of the things I could do before the surgery, like "scratching" the back of my throat by sucking air between my tonsils and tongue (anyone know an alternate way to scratch this area?). I am also having to relearn how to clear my throat of flem and how to do that loud, disgusting, reverse-nose-blow thing that most of us do to clear our sinuses when we think nobody's looking/listening.

I can also tell that my breathing while I'm awake is much easier. So much so that I've noticed my nose "runs" just a little bit sometimes because I'm breathing a greater volume of saturated carbon dioxide out of my nose (at least, that's my assumption?). Although I don't think my speaking voice has changed, I certainly have much more space for my singing voice, especially my classical voice, which is great. If I could compare, in numbers, how much open space I have in my throat now to before, I'd guess that, if I now have %100 of the space I should have, I only had about %35 of that open space before.

From what I can tell from my own experience and from reading/hearing the experiences of other adults who had the same or similar surgeries, my pain and discomfort was definitely not nearly as severe as many others. I was told about possible bleeding, which I didn't see an ounce of, about the scabs falling off, which didn't happen, about days 1-2 being easier than 3-7, which wasn't the case (my pain and discomfort seemed to diminish a bit every day), about possible ear pain, which I did not experience, etc. All of that seems pretty significant considering I'm typically not very pain tolerant. As I've mentioned already, I'd attribute my relative "easy" recovery to sticking with my pain meds and drinking tons of liquids.

I'm certainly thankful to finally be rid of those horrid tonsils...as I mentioned, I can already tell a difference in my quality of life, and I'm looking forward to seeing what the next few weeks bring as everything completely heals and the sutures dissolve. I'm also hoping to have another sleep study in a few months to truly discover if this has helped alleviate or even completely eliminate my sleep apnea issues.

Let me know if you have any questions about my surgery and recovery, and I'll try to answer them in the comments section.

Thanks for your prayer and encouragement (and patience) over the past few weeks!

Nate

19 comments:

Julie said...

I didn't realize you had anything but have your tonsils removed. I've never heard of the removal of the uvula. Then again I've never heard of LOTS of stuff, so... Talking about the uvula always reminds me of one of my fave "Far Side" cartoons though - "Final page of the medical boards" where a person is depicted holding a question paper that reads "BONUS QUESTION: (50 points) What's the name of that thing that hangs down in the back of our throats?". LOL

Glad your recovery went well, and I'm sure much of the "ease" you had in recovery had lots to do with your diligence in taking your pain meds and drinking lots of water. Many people don't force themselves to do that stuff, which just makes their recovery longer.

Our life is a bowl of Barry's said...

While I'm not going to have that suregery..tonsils out when I was 6...I found that post really interesting and informative...thanks for sharing and I'm so glad your recovery has been so great. Also glad you are sleeping better!!

Rick Lawrenson said...

The weight loss has likely had an impact on the snoring as well.

Deb said...

So glad you are feeling better! I was praying for you. I dont think I'll have to worry about it for myself, but ya just never know with little ones. And I'm glad for Tricia that you are not snoring! I do know about that! haha.
Hope you continue to feel better and not have any complications. And that you can figure out how to do your nasty reverse nose-blowing thing ;)

Candy said...

I'm so glad that you are feeling well and on the road to complete recovery! Thank you for sharing so many details with us and opening up about what you've been through. I pray that this is the end of your apnea issues!

I'm home now what? said...

Thank you so much for posting the details. My husband has severe apnea. He stops breathing 73 times an hour when tested. I'm terrified he's going to die in his sleep and he's only 39 and maybe 30lbs overweight. While he does not have his tonsils the other part of the surgery was suggested or breaking his jaw. He refused it but I'm going to show him your reaction to it hoping he might revisit the option.

The Smith's said...

i didnt know they would take the uvula out! my 15 year old had her tonsils and adenoids out and had to relearn out to swollow again- all liquid came right out her nose and stll does time to time- her nose runs alot still but she says she happier this way than sick all the time like before.

agmwilliams said...

Thanks so much for all the details on your surgery and recovery...I'm scheduled to have mine out the 21st of this month and am pretty apprehensive even though I've already given birth to 3 children...from what i've heard this is just really bad. My main concern is the pain, obviously, and being able to take care of my family, a 6 year old, 3 year old, and 1 year old, as quickly as possible. Glad things have gone so well for you!

Debi said...

I am convinced. I have severe sleep apnea and hate wearing the whole mask and tubing with the CPAP machine. As soon as our insurance kicks in I am going to see about this surgery. Thanks so much

Queen Mommy said...

I'm so glad everything went well for you, and you're feeling so much better! BTW, I've never been able to do that "reverse nose blowing" thing, which is, quite possibly, because I had my tonsils removed when I was 3.

Sarah said...

My cousin had her tonsils out about a year ago and there's been talk about getting mine removed. But she says it's the worst thing you can ever have done in your life and she wouldn't reccomend it to ANYONE over the age of 5. I'm so glad you had a better experience than she did.

marlene7038 said...

I was also "older" when I had my tonsils removed and similar "side jobs" as you did. I was not able to be under general anesthesia due to other health issues, and I remember the scabs loosening, etc... The entire ordeal was a nightmare but... I'm all better now!!! It takes longer to recover when you are older but it does get completely better! Hang in there, you are over the worst!

My2Girls said...

Nate - I had my tonsils and adenoids removed as an adult. I was a very loud snorer and always had a rather "nasal" tone to my voice. Post-surgery .... rarely snore now unless I'm absolutely exhausted AND the tone of my voice actually changed. Not so nasal sounding anymore. MY tonsils were HUGE!! The doctor used to look down my throat and say, "Wow, those things are kissing back there" because they normally were so BIG that they actually touched each other ..... even when I was healthy. Let me just say this .... I am so glad that you had a "positive" recovery. I remember eating nothing buy ice chips for days. Seriously! I also remember having an allergic reaction to one of the pain meds, which in turn caused vomitting! Quite lovely when you have stitches in the back of your throat. OUCH! Anyway, I'm not gonna lie to you. I'd rather give birth ANY DAY of the week than have my tonsils removed again. YIKES! In contrast to your experience, I very vividly remember the stitches coming "loose" ..... YUCK! It was terrible. Okay, so my husband suffers from really bad seasonal allergies and often has an "itchy" throat. Here's his "trick" to "scratch" the back of his throat. He swears by coarsely chewing up some hard chips (Doritos or Ruffles) and then swallowing them to help "itch" the back of his throat. I think it sounds rather bizarre, but hey ... just thought I would mention it. I guess it doesn't sound too appealing since your throat is still healing from surgery though. I think I would just stick to an over-the-counter antihistamine. :) Your loyal reader in Va Beach, Amy

Anonymous said...

Yeah! I am so happy for you!!! Thanks for the update.

Amanda said...

I sometimes "suck" food up into my nasal cavity. Corn and ground meat are not supposed to be up there. It burns.
Glad you are feeling better.

Tracy P. said...

"...when we think nobody's listening." :-) Oh THAT one!

Yea for you!

Amy said...

Glad to hear your recovery wasn't too bad. Glad to have you back to blogging too!

Nikki said...

Hi Nate . My daughter had her tonsils and adenoids removed in July of this year . She has Cf but also is a severe asthmatic. They removed the tonsils and adenoids in the hope that it would lessen the amount of asthma attacks and hospital related stays to a minimum. At this moment in time we are still experiencing daily attacks needind nebulised salbutamol as well as all the other Cf medication. I can't believe you were able to have ice and water etcc. Chloe come out of theatre after having a big allergic reaction to the anasethetic and within an hour they were making her try some toast . For supper they tried to make her eat chips. We had to stay over night and in the morning it was dry cornflakes for breakfast. The surgeons said here the harder the better . It makes the scabs fall off and the throat heals quicker. I hope you continue to recover well. Take Care Nikki x

Katie said...

I have to tell you that I STLL have an issue with food and stuff getting caught in that sinus cavity that is exposed. I especially notice that if I don't blow my nose after crying, the hardened mucous seems to get caught there and I get a flamming sinus infection ;( I had my tonsils out thirteen years ago and its still there so I feel your pain! The moral of the story; blow your nose ALOT!