Under The Knife!
Feb 20, 2013
Under the Knife!
When I started thinking about my next blog, I decided to share my personal experiences with having a chronic ailment and what I went through making the decision for surgery. For the last 6-7 years I have had ridiculously large tonsils that that were bad enough that they bothered me almost on a daily basis.
For the better part of my adult life, every time I went to the doctor for my yearly exam, the doctor would have me open my mouth and say ahhhh! The response was always the same. "Wow, those are really large tonsils" or "Wow, those are the biggest tonsils I have ever seen." But not once did they say, those look abnormal, you should consider getting them removed. I had always had big tonsils, but never really had chronic sore throats or strep throat. Once or twice a year, I would have a bought of strep throat, but not once did someone say, you should have those removed. Six or seven years ago, I went to my general practitioner and asked for a referral to an ear, nose, and throat specialist because I had had enough, with the comments and the fact that I had extremely large bothersome tonsils. He refused a referral because he had concerns about adults having life-threatening complications and he personally had lost two adult patients that he had referred. So after grumbling for a little while I trusted his professional opinion and decided that I would live with the abnormal tonsils for a while longer.
I never really had chronic strep throat or even sore throats growing up as a child. The occasional case of a sore throat, but by no means chronic. But these babies had grown to sizes that would compete with average kiwis as an adult. They had extremely large crypts that harbored food and bacteria and made things called tonsiliths. For those who don't know what those are, they are concretions of debris and saliva that form in the crypts. They can grow in size and become painful. Over the summer of 2012 I started having more and more problems with my throat. Swallowing became a chore. I ran out of patience. I spent many days looking at Google, Webmd, and various other internet sources to decide what I should do. I would run across forums, where people had documented their horror stories with tonsils and some without. I had conversations with my wife, who would always give a "No" to the idea of surgery. She would always remind me that our old general practitioner had refused referral because it was too risky. I would shut up and ignore it for just a while longer.
This past August I could not stand it anymore; I called my general practitioner and said I needed a referral. A few weeks went by, but I eventually got in to see an ear, nose, and throat specialist. I had reservations just going to the appointment. I wanted the tonsils out, but at the same time I wanted to please my wife and just deal with them a little longer. I was taken to the exam room. The doctor walked in, got my history, and then shined a light into my throat and nose. It took her a maximum of 30 seconds to complete her exam and proclaim that I had to have my tonsils removed. While removing my tonsils she also would perform a turbinate reduction to allow me to breathe through my nose which had become 90% occluded due to chronic allergies. I immediately got a little defensive. What about the complications? What about the down time? It was different than what everyone had told me about adult tonsillectomies. She responded with some quick answers that put me at ease. It was obviously not going to be as easy as a child going through the same surgery; and unlike a child who only misses two days of school, I was going to miss two weeks of work. My fear of hemorrhage and bleeding out was removed when she said that <3% of all tonsillectomies bleed postoperatively and far less than that have to go back to surgery. Without much thought I said "let's go for it".
Due to the doctors and my schedule I wasn't going to be able to have the surgery until the second week of December. That worked for me because I could capitalize on my slow work schedule and the Christmas holiday to rest and be ready to get back to work. My wife wasn't so sure, but she decided to go along with it.
The next couple of months, I would wax and wane. One day I couldn't wait any longer and some days I did not want the surgery at all. My wife was still pretty apprehensive, but also supportive of my decision for surgery.
December came and it was time for surgery. Again, I asked the doctor one last time if she thought I needed the surgery and if I was going to be ok. She proclaimed that I was and that I needed them removed. Here was the hard part, I had given the speech so many times to horse owners with regard to the need for surgery outweighing the complications and how we cannot worry excessively about complications. I had to trust the doctor and the anesthesiologist with their decisions. For the first time in my professional career I was the owner taking their horse to surgery, but I was also the horse.
The surgery went well and I recovered shortly after. The doctors stopped in one by one to visit and clear me for discharge. Before I could go, I had to get up, walk to the bathroom and drink a cup of water to prove that I was able to be discharged. I jumped up drank a cup of water and walked to the bathroom. Shortly after that I was ready to go home. The first couple of days are a little fuzzy between the narcotics and sleeping, but I did not feel too bad. I couldn't talk so I would write on a piece of paper to get what I needed. I didn't eat much, but I continued to drink water. The doctor's orders were to drink 4-5 bottles of water a day to prevent the scabs from drying out and falling off. I did not want to hemorrhage and have to go back to surgery. I followed those instructions perfectly. The first few days it was not hard to drink water. I actually felt like I could eat, but I had heard to not rush the eating that I should just focus on drinking. Everyone was right; the first few days were not too bad other than the swelling. It was not that painful. However, days 3-7 were miserable and by far the worst. I ate 5 easy mac bowls and 2 cans of soup the entire first week. If you want to lose weight and not do it by exercising and dieting, get a tonsillectomy.
On day 12, I ventured out of the house and my wife drove us to Indy for the family Christmas party. While standing wrapping presents I got a blood taste in my mouth. I immediately walked over to the trash can and spit and my worst fear had come true, I was bleeding. Of course my wife got panicky immediately. It had been 12 days since surgery, I was surely out of harm's way and this was just something minor. I called the emergency on call doctor and he said that it couldn't possibly be a big bleed because I was 12 days postoperative. The bleeding stopped after drinking ice water and resting like the doctor said it would. Later that night it happened again. I called the doctor and once again, he instructed me to drink ice water and rest and that it should stop. So I went to bed and rested like instructed. Around 3:00 in the morning I woke up with a stomach ache. Without turning the light on I went to the bathroom and switched on the light. To my disbelief, I had a big time problem. I looked like a vampire who had just had his first feeding. I know it sounds disgusting, but I had blood all over my hands, arms, and face. I immediately ran into my bedroom and yelled at Cathy that we needed to get to the hospital that I was bleeding and it wasn't stopping. She stirred, sat up, and said call the doctor. This time, the doctor was not going to tell me to drink ice water and rest. He immediately told me to go straight to the hospital and get evaluated.
To make a long story short, I arrived at the hospital at 4:20am and by 5:45am I was on a gurney and headed to surgery. As I was wheeling into surgery, the doctor who was going to perform my second operation lifted his Iphone flashlight and peaked in my mouth to proclaim I needed surgery and there were no questions. I awoke shortly thereafter in recovery to find out that they had in fact re-cauterized my surgery site and had pumped my stomach to remove the blood that I had swallowed. I was discharged and home in bed within 3 hours of my second surgery.
It took nearly another 2 weeks for me to get back to feeling good enough to go to work regularly, but I did eventually get back to feeling good. It has been a couple months since my surgery and people ask me two questions. How do I feel and would I ever do it again. I still have some occasional sore throats but overall I feel good. I don't have the golf ball to kiwi masses in my throat that seemed to obstruct breathing and eating. I currently make a noise that my wife wants to name. Maybe I should have a name the noise contest. My soft palate makes a noise when I swallow that sounds like I am grunting. The doctor assures me that it will not last forever and will eventually go away. She tells me that it will be 6-8 months before I feel completely back to normal. The hard question is whether I would do it again. And this is why I wrote this long blog. I tell owners all the time that they need to take their horse to surgery and trust me. The same way I had to let myself go to surgery and trust my doctor. I have put peoples horses through surgery and some have had complications that are life threatening. Some even had to be euthanized due to the complications. Owners will respond that they would not do it again because of the risk of complication.
Most complications that we describe to horse owners are realistically never going to happen, but we spend 5-10 minutes before surgery making sure that we tell them, so that just in case it does happen, they were prepared for it. We don't inform the owners of complications to prevent them from surgery, just to prepare them for the worst. It probably won't happen, but at least they are prepared. Well this is exactly what happened to me. I was informed of a complication that less than three percent of all patients undergoing a tonsillectomy have. And on top of that less than one percent has it as far out as I did. Yet it did not discourage me from surgery. I signed on the dotted line and off to surgery I went. Horse owners have to make those same decisions all the time putting their horse through surgery. A lot of people will say that it is not the same, but for a lot of our owners it is the same. These animals are their kids and family members and we have to make the decision to put them through a surgery to help them.
To answer the second question, YES! I would do it again. I have suffered some ridiculous pain in my postoperative period, but overall I no longer have the bad breath causing, difficult breathing, and difficulty swallowing kiwis in the back of my throat and it is sure a whole lot better now.