Surgery - 3 month update
Disclaimer: This is my experience and it is not advice to get any procedures done, they come with risks so please do proper research into them.
I have had chronic rhinitis for 5 years. It gradually worsened over that course and eventually consumed a lot of my life. I had negative allergy tests and minimal benefit from Dymista. Ultimately I fell into a decongestant dependency cycle of fluctuating use.
My symptoms:
Nasal blockage: Could be dry or wet, always worse in the evenings.
Rhinorrhea: Runny nose, triggered by eating, outdoors, cold, exercise.
Sleep disturbance: Minor for most of my years of symptoms but got worse towards the pre surgery period.
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What did I try?
Nasal steroids, azelastine and Dymista: Helped to dry out the nose but rarely helped with blockage.
Nasal saline irrigation: Twice a day, moderate benefit for a few hours to rhinorrhea and blockage but again not significant relief.
Capsinol: Nasal capsaicin spray -do not try to make your own - this was medical grade from a company in Europe. No benefit here, very painful.
Breathe right nose strips extra strength: Significant benefit to the point I was wearing them 24/7.
Oral pseudoephedrine: Minor benefit and concerning systemic side effects, meant to be harmful for blood pressure. A few times a week these gave me moderate relief for a few hours but quickly build a tolerance with overuse and officially not meant for long term use.
Nasal decongestants - Instant relief but the long term dependency and potential turbinate hypertrophy means avoid where possible. I had a dependency that I tried to keep minimal but was probably 1-2 sprays per night for a few years and then escalated towards my surgery decision.
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Surgeries: Technically 3 procedures in one operation.
Turbinoplasty : Partial reduction to the inferior turbinates.
Posterior nasal nerve neuronectomy: The posterior nasal nerve drives some of the rhinorrhea so cutting it should theoretically stop this, a mesh is then placed to stop the nerve regrowing. This is like the cryofreezing procedures that are available but supposedly with more sustained benefits.
Septoplasty: My septum had only a minor deviation and this was corrected.
I paid £10,000 for this at a hospital in the UK. Feel free to message me for details of the hospital.
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After the operation I had to have stents in my nose for 1 week.
Post op recovery:
Pain was minimal, a little sore over first week but completely manageable without pain relief.
Dripping nose bleed (minor bleeding) for first few days required the nose to be covered with tissue.
Sleep: Horrible for the first week due to the stents, absolutely no airflow through the nose.
Once stents were out:
Resumed saline nasal irrigation twice a day.
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Week 1-4: These were terrible for me with near complete congestion. A very difficult month. No bleeding or pain.
Week 4-6: Finally light at the end of the tunnel. I reached the point I was at pre-surgery with occasional patency, able to eat food without gasping for breath.
Week 6-8: Significant improvements, I began sleeping with no congestion and going all morning without congestion. The evenings were still a bit blocked.
Week 8-12: Reaching a new baseline. I continued nasal irrigation (maybe a bit out of habit). I had no congestion for most of the day and maybe one episode of congestion each day in the evening and that was it.
Week 12 onwards: Stopped the nasal irrigation and no extra congestion, really happy about this.
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So what’s my new baseline?
No congestion is my new normal but I do get maybe one episode in the afternoon or evening where I get congested, blow my nose a bit and after 20 mins I’m back to clear. Occasionally I’ll be breathing through my nose and can feel it’s a little bit clogged but I can still breathe through it. Ultimately my nose does not bother me for most of the day.
The rhinorrhea has cleared up moderately, now when I’m going on runs, cycling, walks, I will still blow my nose a bit but only a small amount of mucous comes out and it quickly goes back to being clear. This might worsen in winter with colder air so we shall see.
So new baseline:
Occasional minor congestion, occasional minor rhinorrhea.
Not as good as someone with no nose problems, I still carry tissues everywhere and blow my nose multiple times a day but it is a sure lot better than it was!
I now live without thinking about my nose at all in the day, no more nose strips.
I still keep azelastine to use occasionally but it’s probably psychological and I might lock it away and see how I do.
There is lots of talk about empty nose syndrome on the sub and my ENT was aware of it, it’s worth discussing this with your own ENT as it’s complicated. I can’t remember the exact conversation we had but I came away happy on the risk/benefit balance for the procedures given how life limiting my symptoms were. I’ve not had any problems with nasal airflow/ ENS-type symptoms at all post-op but again this is not medical advice and please have your own discussions with an ENT.
TLDR:
Partial inferior turbinate reduction, posterior nasal nerve neuronectomy, minor septoplasty.
Tough recovery period but ultimately successful surgeries with a significant reduction in symptom burden.
I still have rhinitis symptoms but they are much improved.