nasal-Care

Just Swell...

For first couple of days post-op, Dr. Romano recommended using iced gauze pads on the eyes (not the nose) to bring down the immediate swelling. I had limited success with gauze pads, but was very happy with Tracy's tip of freezing 1 part rubbing alcohol, and 2 parts water in small ziplocks. The alcohol keeps the solution in a slushy state. The smallest "snack" size (3.25" by 7") zip-lock with a half cup to three-quarter cup of solution was light weight and worked very well for me. Lay the bags flat when in the freezer to keep the slush evenly distributed.

The snack ziplocks make it possible to put an end on each eye, and make a little tent over the nasal bridge to avoid contact with the nose and splint. I cooled my eye area on the day of surgery and the first day afterward. On the second day, I cooled my eyes a few times just because it felt good.

Going up to keep it down

Although some post-ops only sleep in an elevated position for a matter of days after surgery, I slept in an elevated position for several weeks afterward. It turned out that sleeping in an elevated position on a waterbed was just about as comfortable as in the normal position for me. Between the elevation and nasal taping, I didn't wake up in the morning with a nose more swollen than the night before. When something works, you stick with it.

Initially, I started out with five pillows that were stacked more or less stacked on edge in a two-tier effect. Later, I tried the inverted-V configuration suggested by Tracy, and that worked better. The inverted-V arrangement starts with 2 pillow arranged such that bottom of the V is at the head of the bed. Lay one or two pillows horizontally across the inverted-V such that there is an incline toward the head of the bed.an infrequent

Swabbing It Up

To keep the external sutures on my columella clean, I used a Q-tip dipped in 3% hydrogen peroxide, and gently dabbed the area twice a day. Hydrogen peroxide may also be used to loosen the outer red crusties around the nostrils. Fortunately, I didn't have much of a problem with the red crusties.

Spray, Spray, Spray, Enough to Fill an Ocean

...more appropriately, the Ocean filled me. I use the "Ocean" brand nasal spray recommended by Dr. Romano.

After the packing had been removed, the tip and nostrils seemed to get tight a few times a day. This tightness sometimes reduces airflow a little bit. Using the saline spray immediately relaxes the tightness.

Often, mucus build-up decreased the airflow. To remove some of the mucus, I'd use the saline spray for several rounds over a 15 minute to half hour period. With my well wetted nose, most of the time I could breathe heavily (not really blow) to get the mucus out.

Sometimes, even doing a lot of saline spraying didn't do a good job clearing out the mucus. After all of the internal stitches had finished dissolving (3-4 weeks post-op), I would tip my head back in the shower and let the fine stream of water hit my upper lip. Some of warm water would work its way up the nostrils, and eventually drip down the back of my throat. The water entering the nostrils was not so strong as to cause a headache effect, and was very effective at really loosening the mucus. Perhaps, it was the intense humidity and the warmth of the water as opposed to volume of the water that made this effective for me.

Scarred for life... NOT!

A side-effect of having an open rhinoplasty is that there is a tiny scar on the underside of my columella. At two months post-op, the scar wasn't very noticeable. At three months post-op, there was just a slight pinkish color, and you have to go looking for it. Although the scar was not prominent at 3 months post-op, when I traced my finger along the length columella underside, there is a distinct bump. In time the bump will diminish, and I believe that the scar will become undetectable.

One of the unsung benefits of being a full five and a half feet tall is that few people will ever be in the position to look up my nose. Unless I'm standing right over someone, no one is going to even get a chance to get a good gander at the underside of my columella. My columella scar is almost a secret, and rhinoplasty spotters are not going to have a tough time spotting this one.

To help my columella scar heal, Dr. Romano recommended that I massage some Aloe vera cream into it. I've been using Aloe vera cream (72% pure), so that might be why my scar is healing faster than I expected. There are Aloe vera gels available (99% pure), but I'm not sure if a more pure gel would be any more effective.

Nasal Arousal

In the first month post-op, I had congestion that would come and go during the day. Some weeks were better than others. The congestion became less frequent in the second month, and was less of an annoyance. In the third month, the brief periods of congestion became even less frequent, and less severe. In the third month the situation never warranted an all-out attack with saline spray and Q-tips. However, I always became congested within 5-10 minutes of doing aerobic exercise. Once congested, I'd have to mostly breathe through my mouth until the end of aerobic exercising. A few minutes after aerobic exercise was done, the congestion magically lifted, and didn't required me to so much as blow my nose.

Dr. Romano informed me that the nasal area is one of the two places in the body where erectile tissue occurs. You can can probably guess the other place that's home to erectile tissue. When I was doing aerobic exercise the nasal erectile tissue would swell and block the airway. That's why I'd have to resort to breathing through my mouth. When the aerobic exercise stopped, the erectile tissue reverted to its former state. This is just one more thing that's part of the healing process and will eventually go away. On the bright side, there isn't any mucus secreted or any kind of dripping that gets in the way of a work-out.

Splint Saver Shower Shield

Sure, a shower shield looks silly, but it took all of the worry out of getting my splint wet while showering. All it took was a a piece of Saran Wrap, folded in half, three strips of 3M Micropore 1" tape (which is also used for nasal taping), and there you have it – Steve's Shower Shield! You need to fold the Saran wrap in half to give it a little structural stiffness. Make sure that the lower edge of the plastic is above your mouth, just in case it folds in around your nose.


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Updated Sun Jun 22, 2003