Sinus Surgery

[sugarhead]

Just came back from the EENT clinic at BNH.

After 6 weeks of antibiotic medication for treating chronic infection of my sinuses and an additional CT Scan, doctor tells me he'll need to proceed with surgery to get rid of some polyps and remaining mucus.

He explained that it will take a 3 hour operation and that I'll have to stay 2 nights/3 days in the hospital under observation.

I thought sinus cleaning was minor surgery that didn't even involve staying overnight....

Any thoughts, experiences ??

Thanks

[mauiguy90]

Just came back from the EENT clinic at BNH.

After 6 weeks of antibiotic medication for treating chronic infection of my sinuses and an additional CT Scan, doctor tells me he'll need to proceed with surgery to get rid of some polyps and remaining mucus.

He explained that it will take a 3 hour operation and that I'll have to stay 2 nights/3 days in the hospital under observation.

I thought sinus cleaning was minor surgery that didn't even involve staying overnight....

Any thoughts, experiences ??

Thanks

Recommend that you do a search on thaivisa.com regarding sinus infections (sinusitis) before doing an operation. There are at least two different and extensive threads on this subject. Also recommend that you look into using a neti pot or sinus rinse kit to alleviate sinus congestion.

http://www.thaivisa.com/forum/index.php?sh...140066&st=0

Edited May 6, 2008 by mauiguy90

[moldy]

The procedure seems to vary from country to country. Certainly in US, and UK it's more in and out. It sounds about right for your condition, but I would see one or 2 consultants. Let's assume that in Thailand, they like to keep you in as their wages depend on it, whereas in the UK (which is free) there is the opposite incentive.

I can recommend St Louis and Rama 9 hospitals, the former in particular has a good reputation on these boards.

It's a miserable affliction, that needs to be sorted.

[moldy]

The procedure seems to vary from country to country. Certainly in US, and UK it's more in and out. It sounds about right for your condition, but I would see one or 2 consultants. Let's assume that in Thailand, they like to keep you in as their wages depend on it, whereas in the UK (which is free) there is the opposite incentive.

I can recommend St Louis and Rama 9 hospitals, the former in particular has a good reputation on these boards.

It's a miserable affliction, that needs to be sorted.

What I forgot to point out is that general advice, eg, neti pots, decongestants, etc whilst useful for minor conditions, probably isn't much use for your chronic condition. Initially, it would just have been about infection, but latterly it's about polyps, how thery obstruct and promote infection.

Ask a doctor about using cortico steroids to keep your nose as free as possible and a different antibiotic (one of the cyprofloxins I think), and of course explore the possibility of medicinal rather than surgical treatment, but no, don't rely on this message board for advice, as I'm afraid hanging garlic over the bed, or rinsing with Doctor Visas special sinus recipe won't do the trick.

If you live in a big city like Bangkok, then a partial cure would be leaving it in all honesty.

I understand surgery is very successful although I have no first hand experience, I maintain you should obtain a few quotes, as I believe this is routine rather than specialised surgery.

[mauiguy90]

The procedure seems to vary from country to country. Certainly in US, and UK it's more in and out. It sounds about right for your condition, but I would see one or 2 consultants. Let's assume that in Thailand, they like to keep you in as their wages depend on it, whereas in the UK (which is free) there is the opposite incentive.

I can recommend St Louis and Rama 9 hospitals, the former in particular has a good reputation on these boards.

It's a miserable affliction, that needs to be sorted.

What I forgot to point out is that general advice, eg, neti pots, decongestants, etc whilst useful for minor conditions, probably isn't much use for your chronic condition. Initially, it would just have been about infection, but latterly it's about polyps, how thery obstruct and promote infection.

Ask a doctor about using cortico steroids to keep your nose as free as possible and a different antibiotic (one of the cyprofloxins I think), and of course explore the possibility of medicinal rather than surgical treatment, but no, don't rely on this message board for advice, as I'm afraid hanging garlic over the bed, or rinsing with Doctor Visas special sinus recipe won't do the trick.

If you live in a big city like Bangkok, then a partial cure would be leaving it in all honesty.

I understand surgery is very successful although I have no first hand experience, I maintain you should obtain a few quotes, as I believe this is routine rather than specialised surgery.

Moldy,

Funny how you advise others but as you say, there are no experts here. That includes you even tho' you make yourself sound like one! Strangely, after all your advice, you point out you have "no first hand experience". Of course, I think its good advice to get a 2nd and even 3rd opinion before any kind of surgery. Its also a good idea to get all the information you can on your ailment, which includes neti pots and alternative medical treatments before surgery.

Edited May 10, 2008 by mauiguy90

[moldy]

The procedure seems to vary from country to country. Certainly in US, and UK it's more in and out. It sounds about right for your condition, but I would see one or 2 consultants. Let's assume that in Thailand, they like to keep you in as their wages depend on it, whereas in the UK (which is free) there is the opposite incentive.

I can recommend St Louis and Rama 9 hospitals, the former in particular has a good reputation on these boards.

It's a miserable affliction, that needs to be sorted.

What I forgot to point out is that general advice, eg, neti pots, decongestants, etc whilst useful for minor conditions, probably isn't much use for your chronic condition. Initially, it would just have been about infection, but latterly it's about polyps, how thery obstruct and promote infection.

Ask a doctor about using cortico steroids to keep your nose as free as possible and a different antibiotic (one of the cyprofloxins I think), and of course explore the possibility of medicinal rather than surgical treatment, but no, don't rely on this message board for advice, as I'm afraid hanging garlic over the bed, or rinsing with Doctor Visas special sinus recipe won't do the trick.

If you live in a big city like Bangkok, then a partial cure would be leaving it in all honesty.

I understand surgery is very successful although I have no first hand experience, I maintain you should obtain a few quotes, as I believe this is routine rather than specialised surgery.

Moldy,

Funny how you advise others but as you say, there are no experts here. That includes you even tho' you make yourself sound like one! Strangely, after all your advice, you point out you have "no first hand experience". Of course, I think its good advice to get a 2nd and even 3rd opinion before any kind of surgery. Its also a good idea to get all the information you can on your ailment, which includes neti pots and alternative medical treatments before surgery.

Well you can infer what you like pal!!!! I think your posting is just wrong.

How is this not a balanced posting in which I make sensible points, emphasise the need for a genuine medical opinion (or 3).

Which bit was inaccurate or negligent exactly ?.

Twit.

[Sheryl]

The health forum is a place or people to seek help or constructively offer it.

Mauiguy, your tone was uncalled for and unnecessarily offensive to the poster you were addressing. Also if you read the post again you'll note that the part he had no experience with was surgery, he does have some experience to share with respiratory/sinus problems.

Moldy, you were understandably provoked, but tit for tat name calling isn't exactly taking the high road.

The last 2 posts haven't added anything to this thread. Take it outside, guys, or to the neighborhood bar.

[jfchandler]

I had three sinus surgeries (all FESS - Functional Endoscopic Sinus Surgery) in the U.S. (Los Angeles) over a period of about 5 years, each at a different hospital and doctor. In each case, it was outpatient surgery, go in in the morning, and go home at the end of the day...after some hours in recovery, with the staff checking to make sure everything was OK... In one case, the doctor said he'd like me to stay overnight for free if I wanted... But I felt fine...and preferred to rest at home instead. In all of the cases, I felt fine after to go home by the day's end.

Side note: there is an older form of sinus surgery where instead of FESS, which involves going in thru the nasal openings, they used to do a surgical incision inside the mouth/gum to get at the sinuses... I think that's pretty out of date now..but.. I could certainly imagine someone undergoing that procedure needing a longer post-op stay in the hospital.

Since relocating to BKK, I also went to the Bumrungrad Hospital ENT location for consultation, but just for treatment not surgery. I wasn't overly impressed with the doctor I saw or treatment I received... although...they have quite a few ENT docs on staff there. Subsequently, a nurse friend suggested I see a doctor (Dr. Thavornant) at the smaller ENT unit at BNH Hospital near Saladaeng BTS on Soi Convent... I've subsequently seen him a couple of times, and been very impressed with his knowledge and treatment methodology...and willingness to do a full endoscopic exam (something Bumrungrad never did) and tests as required...and not just automatically prescribe antibiotics...

In my case, even after the U.S. surgeries...I kept having problems and symptoms... And all the docs in the U.S. and Bumrumgrad would do was prescribe antibiotics. At BNH, based on my talking with the doctor, they also ran a different test (one I'd been asking the other doctors to do for a long time, but they never would) for a fungal infection. That test at BNH turned up positive, even to the doctor's surprise. He subsequently put me on an anti-fungal medication (and off antibiotics), and my sinuses feel so much better just in the past week. I tell that account not because you may have the same thing, but rather, to illustrate the quality of care and diagnosis I got at BNH....

I'd certainly suggest you get a second opinion...and think Dr. Thavornant would be a good one to consult.

More broadly, there are some physical conditions with sinuses that no medication will solve... deviated septums, polyps... etc etc... Those have to be dealt with via surgery. But there's a whole range of other issues...infections...swelling... allergic reactions, etc etc... that are amenable to non-surgical treatment.

With or without surgery, one of the most universal recommendations is regular rinsing with saline solution, if your sinuses are bad, then up to 3 or 4 times a day. There are several different ways to do sinus rinses, if you don't have experience with that. You also can enhance the benefit of those by steaming your nose/sinuses for about 10 minutes prior to rinsing... I use a ConAir personal steamer, which comes with a kind of adapter that channels the steam to your nose. Adding a couple drops of pure eucalyptus or tea tree oil to the steam reservoir also helps.

Beyond those suggestions, the field of treatment for sinus problems is a minefield of different and sometimes conflicting recommendations about treatments and medications -- other than doctors who consistently will prescribe antibiotics and, when those don't work, will recommend sinus surgery... Sometimes, though, surgery alone isn't going to solve the problems.

Good Luck...

[Jockstar]

I am currently on the waiting list here in Sydney for an operation to remove a polyp. I was told i would have to stay in over night. But when i get out was advised to have a week off work. Reason being that if you lift things you could have a bad nose bleed.

[jfchandler]

Yes...I agree...about rest after sinus surgery... They always advise that...also because it helps with the healing process...and..you need time to recover from the effect of the anesthesia...and...because...they don't want you doing anything to cause blleding..

[sugarhead]

Thanks for the details jfchandler. I'm in tomorrow at 06.00am at BNH, surgery at 08.00am. Will post a note in a couple of days.

sugarhead

[moldy]

The health forum is a place or people to seek help or constructively offer it.

Mauiguy, your tone was uncalled for and unnecessarily offensive to the poster you were addressing. Also if you read the post again you'll note that the part he had no experience with was surgery, he does have some experience to share with respiratory/sinus problems.

Moldy, you were understandably provoked, but tit for tat name calling isn't exactly taking the high road.

The last 2 posts haven't added anything to this thread. Take it outside, guys, or to the neighborhood bar.

Ok Sorry, but he got less than he deserved and I'm under not obligation to rise above it.

Great testimony since then, and I certainly agree that some conditions are beyond medicine and need surgery. In stressing this I was perhaps a little unkind to the bats wing brigade but surely correct!?

I also concur that saline rinsing is very good overall. For me the effects seem to be cumulative and have taken 4 months to really help. As of this moment I am sinus pain free. But as everybody knows with these conditions, the same may not apply tomorrow.

I also think the steroid spray I am using has been of great assistance in opening airways that might otherwise get blocked and be a source of infection otherwise. I use nasocort under medical supervision. Part of that supervision is to check there are no ill effects on my nasal linings. The importance of medical supervision cannot be stressed too much as I'm told damage from misuse can be permanent.

A good doctor in Bangkok also knows what's up! I go to Rama 9 and am very impressed, but like OP was surprised and both the price and procedure of the operation I was recommended (septoplasty in my case), and I rather think that although the doctors are good they rely on more old fashioned techniques.