Sinus and Larynx Surgeries: The Next Day

Well, for those of you who read my last few posts, I would like to say: I have survived my surgery. We arrived at the hospital at 8:00 am. The nurse at the admittance desk told me that my surgery would be at 11:30. Too bad no one called me the night before to let me know that. Then, we could have gotten up at a reasonable time. Oh well. They took me back to the pre-operative area about 11:15. I did not go back to surgery until almost 12:45. The surgery was done by about 2:00, and I was out of recovery by 3:00.

I'm none the worse for the wear, I suppose. My nose is a little bloody, and my throat is pretty sore. Based on how it feels, my nose should be better in a few days, and I'm hoping my throat will start feeling better by Thursday. The bleeding in my nose should clear up with saline and time. Hopefully, I won't have to worry about my sinuses for a while (since they got cleared out).

I go back to see the doctor next Tuesday, the 21st. He should be able to tell me how the sinus clearing went, and he should give me the results of the biopsy from the neoplasm on my vocal fold. He said that it did not look malignant, but they would not know for sure until they run a biopsy. I should know more next week.

I'm glad that the surgery was pretty easy. I haven't had to take too much medication for pain management, yet. I went ahead and had a full day back at work today, if that lets you know how I am feeling.

I'll post my biopsy results once I find out what they know. See you next time!

Sunday, June 12, 2011

It is one day before my surgery. Tomorrow I get to go in and have some procedures done. Here is what my doctor's orders say:

I have been informed of the risks, possible alternative methods of treatment, and possible consequences involved in the treatment by means of:

• Functional endoscopic sinus surgery
• Laryngoscopy with biopsy

under the general anesthesia for the relief of:

• Chronic sinusitis
• Neoplasm Larynx

That's just the fancy way to say that they found a growth on one of my vocal folds (observed through visual means) and that my CT revealed that my sinus cavities were full of junk (thanks to the CT scan). The doctor will be removing the growth from the vocal fold, and he will have it sent off for biopsy to make sure it is benign. He will also go in and vacuum out (or flush out) my sinus cavities and give me a fighting chance against my allergies (at least for a little while).

As of this morning, I do not have a time for my surgery, yet. They hospital is supposed to call me this evening and give me instructions. We will drop off Hannah with Jenny's mom, and then we will head to the hospital to be bored for a while, then surgery, then back home (yippie).

My only real questions for the doctor will be to ask him if he recommends any antibiotics to fight off lingering infection (now that the growth will be gone). I'm also going to try to ask about post-operative care (what to do and not to do) and if I will need any pain medication. The surgery itself sounds pretty simple, so that should not be an issue.

The last time this doctor operated on me, for my deviated nasal septum, I remember more of the overall day than any other previous surgery. It was interesting to have to get on the surgical table myself, and then to be awake for almost the whole hour of "post-operative observation". (And yes, grammar nerds, I have chosen to go with the more British use of the period outside of the quotation marks. I believe that everyone in America will start doing this, eventually.)

So, that's all that I have for today. If you remember me tomorrow, I could use your prayers. I would ask that the doctor would do his job well, and that my recovery would be quick and easy. See you all next time!

ENT Visit (Forever-Cough)

OK. Here's the story so far. I had some allergy-related coughing and sneezing back at the end of March. At my nephrologist appointment, the doctor prescribed me a Z-Pak (this was early April). I took that for five days, but it did not really help. Then, I called them a few weeks later, and they prescribed me some Avelox (for ten days). That helped, some, but I still did not stop coughing. So, I called the kidney doctor a third time, and they advised that I go and visit my ENT.

I saw the ENT on Wednesday morning. He took a look down my throat, and he saw that I have a growth on my vocal folds (also called vocal cords). He said that it is probably benign, but that it is causing my vocal cords to not be able to fully come together, which allows air to aspirate and can be a big problem with my cough and allergies. He wants me to come back in the middle of June for surgery to have the growth removed.

This Friday (tomorrow), I will have a CT done on my head to check my sinus cavities. The doctor thinks that I probably have a lot of blockage up there, again. If I do, he wants to go and flush them out, again, like we did back in 2008.

So, I am going to have a head CT on Friday, and then I will check with the doctor next week to find out what they see. I'll let you guys know what I find out later. I'm guessing that I will have to have my sinus cavity washed out again.

So, the doctor said it is probably a benign growth. I have a head CT on Friday. I will have surgery in the middle of June.

Enjoy your weeks!

Nephrologist Update: April 7, 2011

OK - so I'm back again, this weekend, trying to catch up on my blog posting. As you can see, I'm still posting one month in arrears. (I admit, I phrased that last sentence just to use the word "arrears").

I went to see my nephrologist back on April 7 for my normal quarterly appointment. They confirmed that my work-up from January all looked fine. For those who do not remember, I had my annual Glofil appointment back in January. The doctor was concerned that the test results were much lower than they should have been. They had me turn in a 24-hour urine collection just to double-check the results. As it turns out, I am in the upper 70's (I don't recall the exact number). This is a little lower than the 80.2 that I got last year. They did not seem concerned about the lower number. Being in the 70's is probably still pretty good for a post-transplant patient. And, we will see how well I do next January.

Unfortunately, the clinic was having their computer system updated the week that I was there. That means, they were not able to get me my blood work results for that session. I have been feeling pretty good, so I am not concerned about not having results.

My only negative this appointment was a persistent cough. I started coughing about a week before my appointment. The doctor gave me a Z-Pack. I took it for five days, but it didn't seem to do much for me.

If we fast-forward to the present, I am still coughing (May 8). I called the doctor again this week, and I got a 10-day prescription for Avelox. I am also scheduled to see an ENT on May 18. I'm hooping that he will have some kind of suggestion to help. That, or maybe the Avelox will be working by then and I won't need anything. We shall see!

That's all for this week. If I do my job right, then I should post again after the May 18 appointment. That will get me completely up to date. And, I should be better by then (if everything works right).

See you later!

Nasal Surgery - No More Nose Splints

Good evening everyone (and, if I didn't see you, good morning and good afternoon).

I had my first post-operative appointment from my Nasal Septal Reconstruction. I arrived at 3:40 for my 3:45 appointment, and was sent back to the room at 4:45. The doctor came in shortly thereafter and said that it would be a quick procedure.

He gave me some tissues to use to blow my nose when he finished. He said that the splints were being held in place my a stitch. He said he had to cut the stitch (not me) and then pull out each of the splints. Cutting out the stitch was not all that enjoyable, but I did like him removing the splint. It made my sneeze and my eyes watered, but I was able to breathe much easier. Then, he quickly removed the splint on the right-hand side. There was a lot of coughing, then I got to blow my nose.

Blowing your nose may not seem like a big deal, but you have to think about what I've been doing all week. I'm allergic to just about anything in the air, so my nose has been running (a lot) since last Monday. And, I wasn't allowed to blow it (shucks). So, getting to get some of that built up mucus (and dried blood) out of my nose was very nice.

It feels cold inside my nose when I breathe, at the moment. Also, if I blow too hard or inhale to sharply, then my septum feels as if it is flapping all over the place. Imagine holding a sheet of paper between your thumb and finger, one hand at the top of the page and one at the bottom. Then, turn the paper so that you are facing the edge that you are not holding. Blow sharply across it, and that's the the way my septum feels (or, that's the way I would describe it).

I don't have any worries. The doctor said that I am healing very well and he will see me in two weeks. He also said the slight numbness behind my two front teeth will get start to get better now. All I have to do is use some saline solution a couple of times a day for a while as my septum heals. They don't want my nose to get dried out.

Thank you all for your prayers for a quick recovery.

For those of you wondering: my next appointment with the nephrologist is September 11. So, you can expect an update on the kidney front after that time.

Many Tests Later ...

Welcome back everyone! I know that it has been more than a month since I last posted, and many of you are wondering about how I am doing with my cough. Well, I still have it. It's been about six weeks now, and I've taken two different antibiotics as well as a cough suppressant and something to get the mucus out of my chest. None of the medications have done anything to help.

I visited the doctor last Thursday, and they told me to go and have a CT scan done of my sinus cavity and of my chest. Here are the results:

STUDY: CT CHEST/THORAX W/CONTRAST
Findings:
The heart and great vessels opacify with contrast normally. An aberrant origin of the left vertebral artery from the aortic arch is demonstrated.

Evaluation of the lung windows demonstrates no air space opacity, pleural effusion, or pulmonary nodule.

Polycystic kidney disease involving the right kidney is demonstrated. A left nephrectomy has been performed. Multifocal low-density lesions are present throughout the liver, compatible with hepatic cysts. Spleen is mildly enlarged, measuring approximately 14 cm in craniocaudal dimension. The osseous structures demonstrate no abnormality. No mediastinal, hilar or axillary adenopathy is seen.

Impression:
1) No acute abnormality is visualized on the CT chest.
2) Polycystic kidney disease involving the right kidney and liver. A left nephrectomy has been performed.
3) Mild splenomegaly.


STUDY: Paranasal sinus CT
Findings:
Bilateral frontal, ethmoid, and sphenoid sinuses are well aerated with no air-fluid levels or mucosal thickening.

Mild mucosal thickening along the medial walls of bilateral maxillary sinuses. Multiple mucosal retention cysts and/or polyps in the bilateral maxillary sinuses with the largest measuring 2 cm in diameter located along the left anterior maxillary sinus wall. Bilateral osteomeatal units are patent.

The cartilaginous nasal septum is midline. Concha bullosa of the left middle turbinate. There is mild right osseous nasal septal deviation with a 3 mm nasal spur with mucosal contact point with the inferior nasal turbinate.

Orbits and visualized intracranial contents are unremarkable.

Impression:
1) Mild mucuosal thickening of the bilateral maxillary sinuses with multiple mucosal retention cysts and/or polyps. Bilateral osteomeatal units are patent.
2) Otherwise, ethmoid, sphenoid and frontal sinuses are unremarkable.
3) Right osseous nasal septal deviation with septal spur.

And, after all of that, you'd probably like me to explain what I learned. Too bad. I learned almost exactly what you did. There's nothing wrong with my chest, and my sinuses might have a problem, but a "specialist" will have to look to confirm.

So, next up is a trip to visit an Ear, Nose and Throat (ENT) specialist. I've got to make some calls to the hospital tomorrow and see who they have on staff that can poke around inside my head. Hopefully, they won't leave anything up there. I know there's lots of room, but I don't want any rattling.

I've seen the doctor twice in the past two weeks (one for my regular check-up and one for this post-CT checkup). My creatinine was 1.0 and then 1.1 -- both are good numbers. Everything else looks pretty good on my labs, as well.

I think I'll have more to post in a later edition, but for now, I need to cut this one off. Don't want any of my readers falling asleep while they are here.

Tune in next time to find out more about what post-transplant patients are able to do with their vacation time!

Allergy Test Results

I had my allergy test on Tuesday. It was not too bad, though I was very allergic to dust mites. I reacted to them as soon as she put that swab on my back. The allergy test involved me taking off my shirt, and laying on my stomach for 15 minutes. The nurse put a LOT of swabs (86, I think) on my back, and then did a small scratch on them, to expose me to the allergen. After about five minutes, she came in and wiped off the ones I had the greatest reaction to, and then was back about 10 minutes after that to clean me off, write down results, and give me an anti-itch spray.

Here are the results:

• GRASS POLLEN: (see types)
  
• Bermuda - yes
• Fescue - yes
• Brome - yes
• Orchard - yes
• Red Top - yes
• Rye - yes
• June/Blue Grass - yes
• Johnson - yes
• Timothy - yes
• Bahia (Dallis) - yes
• Wheatgrass - yes
• RAGWEED POLLEN: Yes
• POLLEN OF OTHER WEEDS: (see types)
• Careless Weed - yes
• Dock - yes
• Pigweed - yes
• Western Water Hemp - no
• English Plantain - yes
• Firebush (Kochia) - yes
• Sage - yes
• Cocklebur - yes
• Lambs Quarter - yes
• Marsh Elder - yes
• Russian Thistle - yes
• Sorrel - yes
• SPRING TREE POLLEN: (see types)
• Cottonwood - yes
• Ash - yes
• Box Elder/Maple - no
• Hackberry - yes
• Willow - yes
• Mulberry - yes
• Walnut - yes
• Pecan - yes
• Oak - yes
• American Elm - yes
• Sycamore - yes
• Privet (Ligstrum) - yes
• Pine - yes
• Mesquite - yes
• MT. CEDAR POLLEN - yes
• CEDAR ELM POLLEN - yes
• MOLDS - FUNGUS - yes
• HOUSE DUST - yes
• DUST MITES - yes
• FEATHERS-DOWN - yes
• COCKROACH - yes
• CAT DANDER - no
• DOG DANGER - yes
• HAMSTER - yes
• HORSE DANDER - no
• CATTLE - yes
• Other:
• Peanut - yes

So, I disagreed with the doctor about Cats and Peanuts. I told him that cats make me sneeze, just to see them. And, I've never reacted to a peanut. But, that's the way the tests came back.

They suggested reducing my exposure to being outside to help with outdoor allergies. They said to not open doors/windows at home to get "fresh air" as that will let in more allergies.

They told me to continue on the Nasonex and to go back on my Zyrtec (or generic stuff). They also added Astelin nasal spray to my regimen. I'm supposed to mix and match until I find the minimum number of medications that work for me.

So, I expect to hear lots more requests from Jenny to get a cat (which I will continue to deny). I also went to the local health foods store (Sprouts) and bought a new deodorant. It's called "Crystal Stick Deodorant" and contains only "natural mineral salts". You are supposed to get it wet, rub it on, and then dry off the stick. So far, it's working pretty well. I think my arms have healed quite a bit since I started using it. I'll see how I like it after a month or so.

That's about it for today. Good night everyone!