Thursday, September 22, 2011

6 Week Follow Up Appointment

My six week follow up appointment was pretty uneventful, which is good!  Dr. Haas felt the bone in my nose, asked if the odor went away (it did, thank God!), and told me everything looked good.  He asked if I liked the way it looks (I do!), the nurse took my picture again, and they told me to call for one more appointment at the 1-year mark.  Before I left though, we went through some of the pictures on his laptop... I swear it's like the paparazzi every time I go there.  First was my before picture, then there was a picture of the day I got the splint off, and then there was the picture they took of me when I went in to get the odor checked out.  And then... OMG.  A picture I hadn't seen before and didn't even know was taken.  It was a picture of the bone and cartilage that was removed from my nose, held up to a ruler.  It was slightly horrifying, yet interesting.  I can't remember the exact measurement, but I remember Dr. Haas saying, "You had a pretty big hump on your nose" as he scrolled to the next picture.

Should I call and ask them to email it to me?  Would that be a gross thing to post on my blog, or does it go with the territory?

Monday, August 22, 2011

Day 24 Update

Well, today is three weeks and three days post-op.  I haven't updated lately because I haven't really had anything new to say.  The biggest difference since my last entry is that it no longer smells like I am sitting inside a glass dumpster on a hot day.  I've been using my Neti pot almost everyday, and that foul smell is completely gone now.  That alone makes me more excited than Jessie Spano on pills.

I do still have some lingering tenderness on the bridge of my nose, but I only notice it when I put pressure on it.  I can't wait to be able to really wash my face good and hard, and then rub it dry with a towel.  I am sick of having to be so gentle.  I also am sick of not being able to wear sunglasses.  I have to drive 25 minutes to work at 2pm every day, and it almost kills me, but I am being very careful about the post-op instructions, which say no glasses for 4 weeks.

I had an altercation with my refrigerator door the other day, too.  I'm not sure who started it, but I lost.  Somehow it rammed me right in the nose while I was opening it, and I ended up in a ball on the floor with my eyes watering.  Even though it hurt a lot, I could tell my nose was probably fine.  It didn't bleed, the pain subsided, and it didn't look or feel broken, so I didn't call my surgeon or anything.

Hmm... what else.  Oh.  I have a couple wads of scar tissue or something inside my nose.  I'm not sure what they are actually, but it's basically a hard knot on my septum inside each nostril.  They've been there since the very first day, but have gotten a lot smaller over time.  I'm sure they will probably go away altogether at some point, but if not, whatever.  They're not bothersome or noticeable from the outside or anything.

I'm planning on taking another batch of pictures this weekend for my one month update, and then I'll continue to take pictures every month or two, since Dr. Haas said my nose will change slightly over the next year.  So far, I can tell it's changed a little bit since the Day 5 pictures I've posted.  Mainly, my nostrils have evened out and I think my nose looks the same from both sides now.  Notice in the Day 5 pictures it looks a little different from the facing left view and the facing right view, but now I can't see a difference.  Also, the tip has dropped a little.  When my splint first came off, I was afraid it looked too upturned, but now I like it.

The crazy thing is, my nose job isn't very noticeable to people.  I know that's hard to believe, because the people reading this blog are looking at the before and after pictures side-by-side, but not one person has asked me anything about it.  No one at work has said anything to me, and I was around my whole extended family and I had to tell the ones who didn't already know.  They were all supportive of my decision said it looked great, but the general consensus was they could see the difference now that I mentioned it, but wouldn't have noticed on their own.  Even my husband says he doesn't notice it when he looks at me.  This is exactly what I was going for, so I am very pleased!

Thursday, August 11, 2011

Day 14: Flushing it out!

Anyone want to guess why my bathroom looks like this?

Things that don't belong on the counter include:  Saline spray, two disposable tupperware containers, measuring spoons, a measuring cup, table salt, a funnel, a digital meat thermometer, a spoon, and a towel.  Any guesses on what I was trying to accomplish?  Ok, two nights ago, I was trying to recreate a Neti pot.

I don't have one because they look scary, even though Dr. Haas has now advised me twice to use one.  And plus, the first time I ever heard of a Neti pot was back when Dr. Oz demonstrated it on Oprah.  First of all, I think Dr. Oz is a crazy man, because the first time I saw him, he said he doesn't use deodorant because it blocks his natural pheromones, and he hadn't used toilet paper in like 20 years (he prefers to spray off with water, in case you were wondering).  Anyway, he just seemed way too crunchy and weirded me out.  So the next time I see Dr. Oz, he had this thing he called the "nose bidet" and said he uses it every day to clean his sinuses.  I was immediately turned off by it because it looked awful, and based on my limited knowledge of Dr. Oz, if he used it and loved it, it was extreme and unnecessary.

Ok, so it's gotten a little better, but the stench is still there.  And I'm getting desperate.  So I looked up Neti pots online, and educated myself.  What I learned is that as long as your saline solution is the same salinity (0.9%) and the same temperature as your own body, it won't burn and it won't feel like there's water in your nose.  Then I turned to YouTube and watched a few demonstrations of it, and what sold me was a video of a two year old using one.  I decided I could totally do it and resigned to buy one, but it was 2:00 AM, so I couldn't run up to CVS right then.  So instead of going to bed like a normal human, I decided to get to work and rig up my own nasal irrigation system.

I looked up the recipe and it called for 3/4 teaspoons of non-iodized pure salt and 16 ounces of distilled water.  My recipe: 3/4 tsp Morton's table salt and 16 oz warm water from the bathroom sink.  Whatever.  Anyway, I measured it and tested the temperature with that meat fork thing, because I can't find my regular thermometer.  Then I stuck the funnel in my nose, tilted my head, and poured it in with the measuring cup.  It worked!  The saline solution went in one nostril, filled up my sinus cavities, and then was forced by gravity out my other nostril, and I swear, it never felt like there was water in my nose.  It felt the same as pouring water over your arm or something.  The only difference was, because of my method, I didn't look like this girl. 

I did, however, look like this cat.

The funnel thing worked enough to show me that irrigating my sinuses with a Neti pot isn't scary, but not enough to make a seal in my nostril and not get homemade saline solution all over me.  Nevertheless, when I saw mucus come out with the water, I was sold on the concept.  So yesterday I went to the drugstore and bought my very own little Neti pot.  This is the model I bought for $14.99 at Rite Aid.

Yes, it looks like a little blue phallus, but that thing is microwavable and dishwasher safe, plus it comes with 50 packets of saline rinse stuff, so I don't have to measure anything.  I've already used it twice and guess what?  The smell has diminished drastically.  I am kicking myself for not getting one of these things sooner, and I love that I'm flushing and cleaning out all that stuff in a completely safe and effective way.  And to be honest, I kind of like the way it feels.  It's soothing and relaxing.  I can see myself having a lifelong relationship with this thing, especially because I have a ton of seasonal allergies and Neti pots are supposed to really help with that.  I know this is going to do the trick for me and get rid of that smell once and for all.  I should have just listened to Dr. Haas, because once again, he proved he knew what he was talking about.

I still think Dr. Oz is a crazypants though.

Tuesday, August 9, 2011

Day 12: Surgery Stinks.

No, really.  That's the official diagnosis.

Two days ago I was cool as a cucumber when I wrote that post, because I saw one doctor somewhere on the internet say that the odor was normal.  But clearly, I spend too much time online, because I wouldn't give it a rest and yesterday, I found THIS.  That there is a link to a forum where someone with my same problem (very inarticulately) asked a panel of plastic surgeons about it, and all of them recommended that the person with the post-rhinoplasty stanknose see their surgeon ASAP, because it could be normal, or it could be an infection or some other things that sounded really gross.

So I went in yesterday.  And Dr. Haas took a peek and tapped around and then told me, "You had an operation.  You're smelling blood and boogers."

Well, color me an embarrassed hypochondriac.  But he was nice about it, and told me to keep on with the saline spray, possibly look into getting a water pick or Neti pot, and it will go away.  And then he called me today to check on me and said to let him know if it's still there in a week or so, which was also very nice.  But OMG, y'all.  It smells like a dead animal crawled up there and then died again, and if I want to breathe, I have to either smell it or taste it.

My best friend at the moment is a Bath and Body Works Japanese Cherry Blossom fragrance roll-on, which I'm rolling on my upper lip in between saline flushes.  Luckily, it has gotten a little better in the last couple days, although it does tend to come in waves.  Also, since the smell is coming from within my own nasal cavities, other people around me can't smell it.  I just hope I get past this soon, because this BY FAR has been the worst part of my recovery.

Sunday, August 7, 2011

Day 10: Something I wish I had known.

I haven't updated recently, mainly because Thursday morning I woke up sick.  Very sick.  It had nothing to do with my recovery; it was just a bug.  But I camped out on the bathroom floor and threw up for 12 hours straight, and ended up losing 7 pounds of fluid that day.  Friday, I stayed in bed all day trying to drink ginger ale and recuperate, and I only got up twice to eat some chicken soup and saltine crackers.  Thursday hit me so hard that all day on Friday I could still taste and smell bile, no matter how many times I brushed my teeth and mouthwashed, but I was relieved that throwing up didn't seem to do anything to hurt my nose.

Then yesterday, Saturday, when I was finally up and about and feeling OK, I noticed I have um... an odor... coming from my nose.  And it's foul.  At first I thought it was still residual something-or-other from being sick, so I went to CVS and bought some new saline nasal spray and flushed out my nose several times.  Well, the smell never went away and I was convinced I had an infection, so of course I turned to Dr. Google.

Turns out, it's completely normal, and there are about a jillion people all over the internet looking for answers about the unpleasant odor in their nose after rhinoplasty.  Here's a good explanation I found on the website of CA rhinoplasty surgeon Rollin K. Daniel:

It is caused by the accumulation of mucus in the nose due to a reduced mobility of the “mucus blanket” within the nose. A healthy nose secretes around a cup of mucus a day, which is propelled into the back of the throat by the nasal lining cells. After surgery, the physiology of the nose takes four to six weeks to come back to normal, but in the interim you can clear the mucosal blanket with intranasal saline sprays. 

That's gross, but also a relief.  Although now that I think about it, I would be surprised if I had an infection because my stubborn self finished the whole course of antibiotics even though they gave me hives.  But the bad news is, according to all these people online, this gross mucusy smell lasts for a really long time.  Do you know how awful it is to have a bad smell in your nose?  You can't get away from it!  You smell it with every breath you take and you can taste it.  And apparently, I'll have to live with it for at least another month, and some (hopefully melodramatic) people claim they had it last for years!

It's not like I wouldn't have gotten a nose job if I had known about this unpleasant side effect.  I just wish I had known in advance that it was normal because it did alarm me.  It's a good thing that there's no such thing as too much saline spray, because I am pretty much dumping the stuff in my nose right now.  It gives me a temporary relief from the odor, and hopefully, it will help move this healing process and mucus blanket along.

Tuesday, August 2, 2011

Before and After Pictures: Day 5

Here are some side-by-side before and after pictures that I finally was able to make using the collage feature on Sorry the zooms aren't equal, but you get the gist. I have both smiling and non-smiling pictures from all three angles.

Head On

Facing Left

Facing Right

Dr. Haas is clearly an artist.  I am just in awe that he was able to turn my old nose into my new nose at all, especially without me having incredible amounts of pain, swelling, and bruising afterward.  And the whole surgery only took him 45 minutes. Also, remember how I was obsessing over whether or not to tell him I wanted more done than just removing the hump?  No need... the man knows what he is doing.  Needless to say, I'm pleased!

The splint is gone!

Ok, I'm redoing this blog entry now that I have time to say more.  I put those fancy collages I worked so hard on in my most recent entry, so I'm replacing the pictures I put here before with pictures of me without makeup after the splint came off today.

As you can see, I still have those darn-resilient yellow bruises under my eyes, but they are a little lighter today.  The purple bruises on my eyelids have gotten slightly lighter as well, but they're still there.  One nostril is bigger than the other at the moment because of how the splint was stuck on there crooked and caused uneven swelling.

But anyway, about my appointment today.  When I got there, I was bouncing off the walls internally, but trying to remain all cool and collected on the outside.  I just couldn't wait to get that splint off and see my nose.  When he took it off, I really didn't expect the dramatic difference and I was kind of stunned for a minute.  With the splint on, I couldn't see the beautiful curvature Dr. Haas created.  I have always loved those little ski slope noses, but I seriously never thought my nose could look like that even with a nose job.  I couldn't be happier with the results and with my entire experience.

That said, I'm not done yet.  Dr. Haas told me to expect more swelling and bruising now that the splint is removed.  Something about compression from the splint and water in my face or something.  I was too busy staring in the mirror to listen to him.  Well, that's already happening.  The swelling at the bridge of my nose especially has increased all day, and I have had more pain tonight than I've had in a couple of days.  The area around my nose feels bruised, and it is tender when I raise my eyebrows or smile.  My nose is also too sensitive to exfoliate away all of the lovely tiny whiteheads that were waiting for me under the splint- I guess from the adhesive.  And I really wish I hadn't gotten all excited and put on makeup this afternoon, because it is not going to be fun to wash it off tonight.  But I felt like the anklet had been removed, and I couldn't wait to just go somewhere.  (My big outing celebrating my release from my 5 day home incarceration consisted going to HoneyBaked Ham, Borders, and the airport to pick up my dad's truck.  Such an exciting life I have!)

Dr. Haas also told me that the residual swelling can take up to a year to go away completely and to see the final results, which I had read online already, but it seems so hard to believe considering what little swelling I have now.  We made a follow-up appointment in six weeks for him to take another look at me.  Before I left today, I asked him when I can go back to work and back to the gym.  I was surprised yet happy when he said it would be hard to injure my nose at this point so I can do both, as long as I don't get hit in the face.  His exact words were, "No kickboxing, no rugby," so I should be safe.  Fitness 19 doesn't have either, and I've gotten good at dodging my dementia patients' swings at work!  (Just kidding, they don't hit me.  They usually stick with hair-pulling.)

Monday, August 1, 2011

Recovery: Day 4

Today I had a little more pain than yesterday.  I'm pretty sure it's a combination of sleeping in bed and not the recliner for the first time, and being the worst recovery patient ever.  I've been running around all day, doing stuff in the yard, etc, and haven't taken any pain pills.  Not to mention I can't keep my hands away from my nose, and I might as well give up on the "no sniffing" thing, because as much as I try not to, it happens completely involuntarily.

Tomorrow at my appointment to get the splint taken off (yayy!!) I'm going to ask Dr. Haas if I really have to wait another 9 days to return to work.  I feel like I'd be just fine to return to work as soon as this splint is off, tomorrow afternoon even, but then again, my job requires me physically lifting and rolling patients, so I don't want to cause any setbacks to my healing.  I'm just so BORED.  I feel like I'm serving a home incarceration sentence.  I haven't been anywhere besides my parents' house and my own house since Wednesday, and I'm usually such a busy person.  I'm accustomed to working full time and going to school full time, and now I'm watching movies, reading, and sleeping full time.

It's my blog and I can give TMI if I want to.  Let's just say that my one problem has "regulated" but I'm going to continue with the stool softeners for now.  Also, I'm sorry if anyone is uncomfortable or grossed out by me talking about this on my blog.   At work I have to chart all of my patients' voids right down to descriptions and size.  Not only am I totally desensitized to the ick factor of it, but I'm also very conscious of how important regularity is to your health, and 4 days without a BM was worrisome.

Aaaaaaaannnddd, here is a picture.  Not much change from yesterday.  I still have the tiniest bit of swelling, and yellow fading bruises under my eyes.  And now my face is red and officially broken out in tiny rashlike bumps, due to what I suspect are hormones, the fact that I can't thoroughly wash my face, and possibly one of my medications.  So as I'm sure you can tell from the tone of this entire blog entry and the look on my face below, today was not the greatest day for me.

Sunday, July 31, 2011

Recovery: Day 3

Today I woke up with itchy hives on the back of my knees.  I wasn't sure if it was from my parents' dog, which I'm allergic to, or if I was having a small allergic reaction to my antibiotic or one of my other medications.  I called Dr. Haas' cell phone and left a message telling him I have no known allergies to medicines, but I have hives on my legs, and asked him whether or not I should continue the antibiotic. He called me right back and told me I could stop taking all medications, and said I no longer needed any of them.  Shortly after that conversation, the hives disappeared, so I kind of think it was just from dry skin or my allergy to the dog, so I've taken my pills today.  Since Phillip comes home tonight, I'll be going home.  If I get hives again, I'll stop with the medication.  If I don't, I'll just chalk it up to my dog allergy.  But I figured I only have two more days on the antibiotic anyway, and I'd like to finish the course if possible.

While I had Dr. Haas on the phone, I asked him how to irrigate my nose.  He told me to go get the Ocean brand saline drops, and that it was perfectly fine to put the nozzle in my nose.  So I've done that several times today, which has softened the dried blood enough where I could suck it out with one of my baby nephew's nasal aspirators (we put it in the dishwasher afterward).  Since I've done that, I'm breathing through my nose and I am much more comfortable.  There are still bumps of swollen tissue in the inside corners of my nostrils that are a little painful, but I should also probably quit touching and picking at them.

The other little aggravation I blogged about yesterday has been slightly resolved, but not by much, if you catch my drift. Nuff said about that.

One thing I haven't mentioned much but probably should, is my diet. Before the surgery, I stocked up with soup and yogurt and soft stuff, because that's what the pre-op instructions said to do.  Thursday, the day of my surgery, I ate soup for lunch and dinner.  Since I take the Lyrica at night and I need to eat food with it, I had a piece of bread with peanut butter on it.  I got it down, but it was a little bit difficult.  I had to tear it into little pieces so I didn't have to take bites off it, just put them in my mouth and chew a little bit.  The next day I had a BLT for lunch, and it was just a little bit more difficult than normal to open my mouth wide enough to take large bites.  It wasn't painful, though.  Friday night I had more soup for dinner again, and then yesterday, Saturday, I was eating solid foods with no problem whatsoever.  This is another thing that has pleasantly surprised me about this whole experience.  I thought it would take a little bit to get back into the swing of a regular diet, but it only took two days post-op.

OK, without further adieu, pictures from today:

My black eyes are now yellow eyes, but I still have purple bruising on my eyelids.  My swelling has gone down considerably, and even though I can still see it and my mom can too, I doubt many other people would notice it.  I think if I didn't have the splint on my nose, I could put on a little makeup and no one would know I had surgery 3 days ago.  And speaking of that splint, it comes off in two days!

Saturday, July 30, 2011

Recovery: Day 2

Before I show you pictures of myself, I must say, I feel SO good today.  I took another bath, shaved my legs and had my mom wash my hair for me.  I put some apricot scrub on a washcloth and carefully washed my face.  I brushed my teeth, put on deodorant, lotion, and clean clothes, and I just feel the best (and cleanest!) I've felt since before Thursday.  I also used some astringent on my face and put some peroxide on a Q-tip and carefully cleaned the dried blood from around my nostrils.  I have only had one pain pill today, and I no longer need gauze taped under my nose because the drainage has mostly stopped.  I had an awesome smoothie for breakfast and had a huge brunch a little later with homemade biscuits and gravy, bacon and scrambled eggs, and I ate and drank every bite.  I've been up and about all day.  My dad dropped me off at home, and I drove my own car back over to their house (I still am staying over here for the awesome recliner.  I'm afraid I'll roll off my pillows and squish my nose if I sleep in my bed.  And let's be honest, my husband's out of town and I'm getting good service over here!).

That being said...  This is what I look like today...

As you can see, my face is swollen in weird spots and looks lumpy, and the bruises around my eyes are much darker.

And here is a close up, so you can see the nice eyeliner bruising I have going on today.

My mom said the second picture looks like a photograph of a crime scene corpse.  But there's a reason my post-op instructions said to take 2 weeks off of work.  My surgery was only two days ago, so I don't expect to look beautiful just yet.  I'm just happy I feel well and am not in pain.

Here's something a little TMI, but this blog is all about nose job full disclosure...  I was warned at my pre-op appointment that the pain medication and the antibiotics will cause constipation, and I should take stool softeners to help with that.  My surgery was Thursday, and I started on the stool softeners on Wednesday- one in the morning and one at night.  Today is Saturday and I still have not had a bowel movement.  I am not uncomfortable and I don't feel constipated, but I haven't had a BM since Tuesday or Wednesday (I can't remember), and I've been on stool softeners the whole time, so I don't think that's good.  Tonight I'm eating red beans, lentils, and brown rice for dinner (i.e. fiber, fiber, and more fiber) to see if that situation resolves itself.  Otherwise, I may get off the pain medication completely and just take extra-strength Tylenol if and when I need it.

Another nuisance is the accumulation of dried blood inside my nose.  It is almost completely full of rock hard solid blood inside, and while the nurse said I can irrigate with saline drops, I am afraid to because I don't want to stick anything up there.  I know my incisions are somewhere inside my nose, but I honestly don't know where, and I don't want to get anywhere close to them. Same goes for my Q-tip with peroxide I was using earlier around the outside of my nostrils.  It just makes me nervous to put anything inside my nose right now.

But like I said, I'm still doing great and feeling great, as unattractive as I may be right now, and hopefully soon I'll look as good as I feel.  Lastly, Dr. Haas and the surgical nurse have both called to check on me, which I thought was nice, and the unveiling is scheduled!  The splint comes off at 10:30 Tuesday morning, and I can't wait to see how it looks under there!

Friday, July 29, 2011

Recovery: Day 1

I woke up expecting a little more bruising and swelling today, and I was correct.  The skin around my eyes is so swollen and puffy I can actually see it.  The black eye has gotten worse and has spread to the left eye a little.  But on the plus side, I still have not been in any pain!  Here are pictures from this morning, after removing the gauze from under my nose.  Those are the strings from the packing hanging out.

****BEWARE!  These pictures are gross looking.  They look like the mugshots of someone who was in a bar fight and there are bloody strings hanging out of my nose.  Proceed at your own risk!****

Note:  My nose is not crooked, but they stuck the splint on there a little crooked.  Also, it's hard to tell in the pictures, but in real life one nostril looks bigger than the other.  That is just from swelling though, since Dr. Haas did not cut or do anything to my nostrils.

After taking these pictures, my mom pulled those strings and removed the packing for me.  I waited for my pain pill to kick in before removing the packing, but still, it hurt!  The inside of my nose was on fire for about 5-10 minutes afterward, but it's fine now.  With the packing gone, I can breathe through my nose, but it feels weird so I don't.  The hard thing about having the packing out is that I still have the drainage going on, and my natural response is to sniff, instead of just letting it drain out into the gauze I have taped under my nose.  My post-op instructions say "no sniffing" so I'm trying to not do it, but it's automatic sometimes.

I am still at my parents' house, so I took a whirlpool bath today in their newly renovated bathroom, and it felt heavenly.  I did have a wave of nausea hit me as I was getting out of the tub, and I had to lay on the bathroom floor for a few minutes before I could get up and go down the hall to my old room.  I sat in a chair in my old room for few minutes and talked to Phillip on the phone, and then I felt better.  Thank God.  I am still terrified I'm going to have to use one of those Phenergan suppositories.

I also carefully brushed my teeth today and used one of those Neutrogena facial wipes on my face.  I can't get my splint wet so I am going to wait until I go home to wash my hair because I have a hand-held shower head there.  Overall, I'm feeling great, and I still give my pain level a 1 out of 10.  I hope everything continues this smoothly!

Thursday, July 28, 2011

The Surgery Story

Ok, I'm back.  Here's a rundown of my day...

I woke up at 6:15 this morning to take a Zofran (anti-nausea) and a Lyrica (for nerve pain).  I then sat around for a while hating life and thinking I was going to die because I couldn't have coffee.  I got in the shower around 7:30 and washed with another one of those fire sponges, and my mom picked me up at 8:00, because Phillip had to leave for Indianapolis today.

Once I got to Imaage, I changed into a gown and they covered me with warm blankets that came out of an 160 degree oven.  I chatted it up with the recovery nurse and the nurse anesthetist and warned them both that the last time I had anesthesia, when I had my wisdom teeth taken out, I woke up CRAZY.  Crazy as in I tried to kick in the windshield, take my shirt off in front of my dad, sing Tim McGraw, and then burst into tears all within a 5 minute car ride.  So it was just an FYI to the Imaage staff, don't wake me up too early or piss me off.  I think they heeded my warning, because after that conversation the nurse anesthetist refreshed my blankets with new ones from the oven and fluffed my pillow, and assured me he would not let me act on any of my aggressive or stripper tendencies while I was under his watch.

I then went into the operating room, and talked to Dr. Haas.  I told him I had misgivings and tried to explain to him that even after removing the hump, I think my nose will still be too long.  The next thing I know I was awake in the recovery room.  The recovery nurse, the nurse anesthetist, and Dr. Haas were all there telling me it looks great and I did great.  Dr. Haas told me it wouldn't look too long and I should be happy with the results, so I hope he is right.

My mom had to go to Cincinnati, so my cousin Elizabeth came to pick me up, so at that point the recovery nurse brought her in and gave her all of my post-op instructions.  That's also when Elizabeth took this picture for me.  That is my attempt to smile right after waking up from anesthesia.

When I got home (to my parents' house), my sister-in-law, Sawsan, and baby nephew, Adam, were there waiting.  Elizabeth and Sawsan did a great job taking care of me until my mom came home at 3:45.  Elizabeth gave me my meds and started a chart on them to give to my mom, and Sawsan fed me soup and fluffed me up in the recliner with pillows and a comforter.  They both kept me in steady supply of water and ginger ale, because so far, the worst part of my Day 1 recovery is the cotton mouth.

On a scale of 1-10, I would say my pain level is a 1.  And that 1 really isn't even pain, it's more just discomfort.  I have things that resemble tampons in my nose, with strings hanging out and everything.  I have gauze squished under my nose and taped to my face, which needs to be changed every couple of hours.  I have a splint on top of my nose.  I have to mouth breathe.  When I stand up, I feel a little wobbly.  But I'm not in pain.

As far as swelling and bruising goes, I have just a little puffiness around both eyes, but a big black eye has formed under the right one.  The nurse said the swelling peaks at 24-48 hours though, so I have that to look forward to I guess.  Which reminds me, I'm supposed to be doing 20 minutes on and 20 minutes off with an ice filled eye mask, and I need to get back on it.

Here's a picture taken just before writing this blog entry, so about 9 hours after surgery.

Please ignore the white collared shirt.  I had to wear a button-up, and it was the only one I didn't care about getting stained by any drainage.  It's actually an old uniform shirt from my Catholic school days.

Lastly, as you can see, I'm totally alert and oriented.  I've taken a few catnaps, but I haven't been completely zonked out like I thought I'd be.  After my wisdom teeth surgery, I think I slept for 3 days straight with those Percocets they gave me, but these pain meds Dr. Haas prescribed don't seem to have that effect on me.  I am able to walk around and take myself to the bathroom, which I'm glad for.  I also haven't had any nausea at all today.

Overall, Day 1 was easy peasy.  I hope I'm not in for an ugly surprise tomorrow morning when there's no residual anesthesia and my face is swollen and bruised like a street fighter...

It's done!

I'm home, alert, and oriented. More to come. Oxycodone kicking in... But Dr. Haas assured me that my nose will not look long, then I fell asleep and then it was over. I took a picture but I can't figure out how to get it on here with this iPhone. It's new and I suck at it. Help? I'll get on a real computer after I take a nap.

Today's the Day

Good morning.  I'm awake but I might not live until my 8:30 surgery because I'm not allowed to have my morning coffee.  I was a nervous ball of energy last night.  I stayed up until 2:00am, and then had to wake up this morning at 6:15 to take my first doses of Lyrica (for nerve pain) and Zofran (for nausea).  I don't mind being tired right now, because I'm pretty sure I'm going to sleep all day for the first couple of days.  I get hangovers from Benedryl these days, so I can only imagine what all these meds are going to do to me.

Last night I was running around trying to do laundry and dishes so I won't have to deal with it during my recovery, and that's when Phillip had to talk me down from my ledge.  He said if I didn't want to go through with it, I don't have to, $900 be damned, but he reminded me that this is something I've wanted for a long time.  He also helped me to realize that the chances are slim to none that I'll like my nose less after surgery than I do now.  Basically he said exactly the right things, and somehow this morning I am not nervous.  Maybe I got it all worked out in my head last night, or maybe I'm just too tired to care or something, but I kind of feel like today is just a regular day and it's just a dentist appointment in an hour and a half, not a surgery with a long and painful recovery that is going to change the face I've had for 27 years.

I'm about to go shower with my microorganism-killing scrubby thing.  I had to wash my face with the first one last night, and I felt like my flesh was being seared off, so this should feel great all over my body at 7 am.  Wish me luck today and please keep me in your prayers!

Wednesday, July 27, 2011

Prescription Costs

This was a pretty big concern, since we do not have prescription coverage, but they were not nearly as bad as I thought they would be.  I read online that as an added benefit of having a Costco membership, you can enroll in their discount prescription plan if you don't have prescription coverage on your insurance or if you have no insurance at all.  I had never used Costco's pharmacy before, but we are members and I figured it would save a bit of money, so that's where I filled them.

I already took all of the prescriptions to my parents' house, since that's where I'll be staying after surgery tomorrow, so I'm not sure of the breakdown, but the total cost was $92 and some change.  The most expensive one was the Lyrica at $39, and the other five were all between $5-17.  The Lyrica was the only prescription that was not generic.

I don't know a darn thing about how pharmacies work, but if I got five generic drugs, did I actually save money with Costco's plan?  I think Walmart has $4 generics now... Does that apply to all generics, even narcotics?  Could I have saved $33 if I had gone there? (Assuming the Lyrica was still $39 and the generics were $4 a piece.) I'd rather not know now.  I hate throwing money away, and there's nothing I can do about it now.  Next time I'm written a prescription though, I'll call and ask prices at Costco and then at Walmart, just to see.

Tuesday, July 26, 2011

Before Pictures

I finally got someone to take my "Before" pictures last night.  I took one smiling and one not smiling from head on and both profile views.  As a reminder of what I'm doing, I'm getting my nose straightened (you can tell it leans in the head on view), and the hump removed (profile views) and the tip brought up just a little (not turned up like a pig, but just so it doesn't hang down anymore).  When I talk to the doctor before surgery on Thursday, I'm going to ask him about reducing the tip a little bit too, because I think it needs it.

Monday, July 25, 2011

This is how much

Since I've already gotten emails asking about this, and since I intended for this blog to be a resource, this is the financial breakdown of my nose job.

Cost if I had paid cash: $4950
Cost if using a surgery loan company: $5099 (<--- my price)
Cost to book surgery: 10%

I knew I'd be financing my surgery, so I paid $510 to get me on the books the day of my consultation.  When I got home, I applied for financing through Care Credit, which is "a healthcare credit card that can be used as a payment option for certain expenses not covered by insurance or to bridge situations when desired care exceeds insurance coverage." (description from their website.)

Care Credit qualified me for $4200, so the next day at my pre-op appointment, I went in with the credit documentation and paid the remaining $390 in cash.  I chose a 24 month payment plan, so my monthly payment including 14.9% interest will be $203.  The total cost over the life of the loan will be $4872.

Including the $900 I put down already and assuming I only make the minimum payment each month, the total cost of my surgery will be $5772.

When you Google, the average price of rhinoplasty is $3000-8000, so I think mine is reasonably priced for an experienced surgeon in Louisville, KY.

Sunday, July 24, 2011

This is where

Imaage Cosmetic Surgery Center.  It's a brand new, state of the art facility and I feel like I stepped out of the east end of Louisville and right into Beverly Hills when I go there.  The nurses and aestheticians are all beautiful people, too.

Here are more pictures:



Surgical Suite

Isn't it grand?  Part of me is aware that with a center this ritzy that I'm likely paying more for my surgery.  But the other part of me is aware that Dr. Haas wasn't able to get this great big opulent building if he wasn't really good at what he does.  He has this amazing center because a lot of people have been coming to him for a long time.  In addition, the surgery is done in an O.R. right there in that building, so I don't have to go to a hospital.  From what I've read, plastic surgery is one of those "You get what you pay for" type things, and the most prominent feature of my face is not something I'm willing to go the budget route on.

Saturday, July 23, 2011

This is who

Dr. Tom Haas will be my surgeon.  I did not surgeon shop, or even consider any other surgeon, for a couple of reasons.

1.  I know him.  Not well, anymore, but he is my parents' neighbor and I used to babysit his kids all the time. Of course, that was 12 years ago and he didn't even recognize me now, but once I reminded him who I was he was warm and relaxing. I really feel more comfortable in his hands just because of that small personal connection.

2.  He's good.  I googled him.

In 2009 and 2010 he was voted:
  • Best Louisville Plastic Surgeon: Breasts
  • Best Louisville Plastic Surgeon: Liposuction
  • Best Louisville Plastic Surgeon: Face
For 2011-2012, he was selected among the elite Best Doctors in America

3.  And this is superficial but whatever, this is a plastic surgery blog.  Doesn't he just look capable?  Even if he wasn't standing in front of his diplomas and certifications.  Maybe because I already knew him, but there's something about this picture that just exudes confidence and competence, but also kindness.  That's how he seems in person, too.  There are testimonials from past patients on his website who have said how comfortable they felt with both Dr. Haas and the staff, so I know it's not just me.  I just get good vibes from this guy.

Photo taken from Imaage's Facebook page.

Friday, July 22, 2011

This is why

Why are people so weird about nose jobs?  I can't tell you how many people are telling me I shouldn't do it.  My favorite is "Don't change the way God made you!!!!"  Ugh.  If that's your reasoning, does getting a nose job make me any worse than people who get braces or wax their lip hair?  What about how 95% of baby boys get circumcized? (This was the percentage they gave us at the hospital my nephew was born at in May.)

But just to address this once and for all on this blog, I'm not changing my mind.  I'm not still dwelling on every little mean comment that was thrown my way in middle school, but this is just to illustrate that I have been living with something on my face that I not only hate, but has caused me enormous grief since I was ten years old.  I'm sure I would hate my nose regardless, but bullying does have lasting psychological effects.  It's possible that the bullying I endured because of my nose is actually the cause of some of my insecurities as an adult.

It was first brought to my attention in fifth grade.  A friend of mine came up to me after a school program and said, "My grandpa said you're pretty except you have a long nose."  Parents?  Don't tell your kids stuff like that.  This friend was not trying to hurt me, but children that young do not have a concept of tact.

In sixth grade, the 8th grade boys decided to nickname me "Nose."  Nice right?  They didn't know me and I didn't know them, but when I passed these boys in the hall they would loudly say, "Hey NOOOOSE!"  Soon, the sixth grade boys (trying to act like the 8th grade boys) caught on, and I was teased every day.

Seventh grade.  The French teacher picks me for the subject of this activity, even though I begged him not to because I could see where it would lead.  He would say the French word for a facial feature and call on someone, who would have to go up and draw that feature.  So he calls on this girl to draw my nose, and she drew the nose bigger than the entire head.  Then he called someone else up to the board to draw the eyes, and that person got confused and drew them on my nose.  So then the French teacher had to explain that that was my nose, not my face, and then the whole class laughed while I tried not to cry.

From high school on, people were less cruel, but it was still an issue.  There was one incident when I was at a red light with my windows down, and a person in a Jeep at the light next to me said, "Look at her nose!"  to his passenger, but the bullying at school had stopped.  In my adult life, people just say things like "aristocratic" and "Roman" when describing my nose, or that it "has character."  To me, I just hear "BIG." 

Contrary to how this post seems, hating my nose doesn't consume me.  I have a very rich, fulfilling life.  I am happily married, employed, and currently going to school for my second Bachelor's degree.  But although it is less of an issue now, it is still an issue.  I still feel like my nose walks into a room first, with the rest of me following. I still imagine that every time I meet someone new, they think, "She would be pretty, except for that nose."  I still feel like every time I'm at a red light, the people in the car next to me are staring at it and thinking about how big it is.  I still almost always delete, untag, or throw away pictures of me that show my profile.  I am tired of feeling like this, and have finally decided to do something about it so I won't have to feel like this for the next 60 or so years of my life.

My closest friends and family are supportive, because they know me and how I feel.  Other people I'm not as close with just cannot empathize, because I haven't shared with them all of the feelings I've had for the past 16 years.  I'm doing this for me, and I'm happy about my decision.  Hopefully this post gives everyone else a little insight.

One week to go

I'm starting to get a little nervous now.  Phillip and I went grocery shopping today, and while we were there, I picked up several types of soup for me to eat after the surgery.  It hit me right there in the soup aisle that it was just a week away, and I got butterflies in my stomach.

Again today, I have used my hand mirror to stare at my profile in the bathroom mirror three or four times.  I am still sure I want to have the tip of my nose reduced a little, as well as removing the hump, but then that also started to scare me a little.  It seems like the tip of my nose could be more easily messed up, so maybe he should just shave the bump down and leave my cartilage alone.  But then I think about how disappointed I'll be if I'm still self-conscious about the length of my nose after the surgery.  I also have fears that I will just hate the final product completely, and I won't be able to get my old nose back.  The rational part of me knows that is extremely unlikely, considering I chose a good surgeon with plenty of experience.

What I am trying to convince myself is that it's not going to be perfect, nor do I want it to be.  A perfect nose would look silly on my imperfect face.  A tiny, button nose would not go with my strong jaw.  I will still be me, and I will still find flaws. But an improvement sure will be nice.

Wednesday, July 20, 2011

The Pre-Op Appointment

Today I went back to the surgeon's office for my pre-operative appointment.  They told me yesterday as soon as I decided how I wanted to pay for my surgery to come back in and we'd take care of the rest of the pre-op stuff.  I went home and secured financing right away for about 82% of the total cost, so I went in today and paid the remaining 18% in cash.  I also signed the consent forms, and got pre- and post-surgery instructions, along with my prescriptions that I am supposed to fill before surgery.  You know how many prescriptions are involved in getting a nose job?  Six.  I assumed I would just be getting some pain pills!  Here are the drugs, in case you were wondering, and the directions for each.

Lyrica: This is an anticonvulsant indicated for the management of neuropathic pain. I will take one pill the morning of my surgery and one pill two times a day for 7 days after my surgery.

Tylox: This is the pain medication.  I will take one or two tablets every 3-4 hours as needed.

Phenergan:  This is a rectal suppository for nausea as needed, but I hope it won't be needed!  The prescription is for 10 though, so that makes me a little nervous.

Keflex: An antibiotic to fight infection.  I will take one pill 4 times a day for 5 days.

Robaxin: A muscle relaxer.  One tablet 4 times a day for 5 days as needed.

Zofran: An oral dissolving tablet for nausea.  I place it on my tongue and it dissolves.  I will take one before surgery and the other after surgery if I feel nauseous.

I also got two antimicrobial scrubby things that I'm supposed to use on my face the night before and the morning of surgery, and a list of things to have on hand after my procedure, which includes things like gauze, ginger ale, and light foods like soups, crackers, and yogurt.  I didn't speak to the doctor again today, so I haven't been able to tell him about my slight misgivings.  I have decided though, that I definitely want for him to reduce the tip of my nose just a little, as well as removing the bump.  I decided after very thoroughly examining my nose and poking, prodding, pushing, and bending it with my fingers, that even with the bump smoothed out, my nose would still be long, and if I'm going through with this, I want to be happy with the results.  I am planning on calling the doctor tomorrow and running this by him.

8 days to go!

The Consultation

Today I met with the plastic surgeon for my nose job, paid the deposit, and scheduled the surgery.  After I got home, I secured the financing, so now I'm all set to have the rhinoplasty operation on July 28th.

I am both nervous and excited about the surgery.  I am not nervous about the actual surgery (the going under the knife part), but I am nervous about not being happy with my results.  I wish I spoke up more at my consultation after the doctor told me what I should do.  Luckily, my husband had my back.  While I went in there today with high hopes for a major change, the surgeon immediately said all he needed to do was file down the bump (or "dorsal hump" as he called it).  Phillip interjected and said, "Is that all you want done?  I want you to get what you want," which I appreciated because I was just blindly agreeing with the surgeon, assuming he knew best.  That encouraged me to speak up and tell the surgeon about my dislike of my nostrils and the crooked way my nose leans from a head-on view.

We ended up settling on just shaving down the bump and straightening the nose, but leaving the nostrils.  He also said the tip of the nose would come up just a little bit.  Not like a pig nose, but just so it's not down-turned anymore.  I think I made a good decision there.  I will still look and feel like myself, and it will still be the nose characteristic of my mother's family.  The surgeon said most people won't even notice I had anything done, because the general look of my nose will be the same.

That sounded good at the time, but tonight it led me to wonder why I agreed to pay this much money if you can't even tell I had anything done.  Then I looked up before and after pictures, and I could see what he meant.  When you look at a person, you see their face as a whole, not their nose or any individual feature.  If you didn't know someone got a nose job, you might think that he or she looks different, but not know what has changed.  You only notice the difference if you know to look specifically at their nose, if that makes sense.  But now I am having second thoughts about only removing the bump, and not reducing the size and/or length of my nose.  I'm going to mention it to him when I go back in there to sign the consent forms if I see him, or when I talk to him pre-op if I don't see him this week.  Like I said, I'm just really nervous I'm going to be paying all this money and going through this brutal recovery and I won't be satisfied with the results.

I called work today and told them I need two weeks off because I'm having sinus surgery.  If anyone notices any differences and asks, I'll say I had my deviated septum straightened.  I just think this decision is a personal one, and I do not have to justify it to my work.  Plus, so far the few people I've told have all tried to convince me not to do it.  I really hate that.  People?  Just because you would never do it, doesn't mean I shouldn't.  Which is a good place to leave off for the night, I'll get into what led to this decision and the reasons why I am doing this soon.