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All The Good Details

Posted Oct 06 2009 10:00pm
I've had many people ask me specifics about my recent uvulo-palato-pharyngoplasty (removal of the tonsils + removal of uvula and shortening of the palate in the back of the throat), so I thought I'd share as much info as possible about the surgery and recovery in one post. If medical terms and details make you squeamish, you may not want to read this one...

As I mentioned in This Post, I've known for several years that my tonsils were abnormally ginormous, and have also suspected for a few years that I may have sleep apnea. After years of talking with different doctors, I finally found a surgeon who recommended surgery, and with the help of some very severe sleep apnea scores, the decision for me was an easy one.

I had surgery on Monday, September 14 around 11am at Duke. The surgery lasted about 45 minutes...I was asleep and intubated. Because there are greater risks involving this surgery in adults than children, including a much longer recovery time, they kept me overnight for observation. I was given and IV for fluids, as well as morphine and oxycodone that first day, and sent home with a prescription for oxycodone.

Other than some moderate pain in my throat, which did not keep me from drinking lots of ice water, my only immediate issue was some moderate pain, swelling and numbness in my tongue. I was told that this is common, because of the tools used to keep the mouth open for surgery, and that my tongue should return to normal after a few days...I was given some steroids to help ease the swelling. My throat did not hurt at all at any time to talk, although I could not raise my voice or sing without experiencing pain until about day 10. However, even now, three weeks post-surgery, and after 5 days of steroids and antibiotics last week, my tongue is still a little swollen and numb, although not nearly as bad as it was. I'm hoping it returns to normal soon, because I'm still speaking with the tiniest slur...

I was very determined to take my pain meds every three hours, which I did for about 10 days, even waking myself up during the night to take them. This, along with drinking tons of ice water really kept the pain and swelling down and allowed me to swallow that first week with minimal to moderate pain. I did have an allergic reaction to the oxycodone, which meant that I also took benadryl with it every three hours, which meant that I was especially tired and groggy all the time, which was totally fine with me.

I spent most of my time that first week sitting on the couch updating facebook, watching DVDs (thanks to my awesome friends), playing my brother-in-law's Wii, and drinking lots of ice water and slushies. Other than the constant grogginess, I was still able to spend a lot of time with Tricia and able to play and care for Gwyneth. Other than church the first Sunday and a trip or two out in the car, I didn't venture out of the house much until about day 8.

You can read more about some of the foods and stuff I ate the first few days after surgery in the post I linked above. I began to eat lots of soup around day 5, and I ate my first real meal (spaghetti and meatballs) on day 11 and had my first bowl of crunchy cereal (and my first milk) on day 12. By day 13 I was eating just about whatever I wanted to.

Although I'd lost about 10-15 lbs in the 6 weeks before the surgery on my own, I lost an additional 15-20 pounds in the first two weeks after the surgery, which is cool with me. It took me a good four days after I stopped taking the pain meds and started to eat regular food before the grogginess began to dissipate and my energy returned. Although I worked at home a bit that second week, my first full day back at work was on day 16, and I was back on stage singing by the third Sunday.

By day 17, all of the soft scabs were gone and most, if not all of the swelling in my throat seemed to have resolved. I do have several sutures that are still dissolving...I've actually had to reach back there with some scissors and trim a few of them because they were sitting on the back of my tongue and making me gag. I never did experience the scabs falling off and gagging me the way many people told me they would...from what I could tell, they kind of just faded away slowly without much problem, for which I am very thankful...I'm thinking the fact that I was constantly drinking water may have helped with this.

Other than the issue with my tongue, the only other problem I've experienced has involved my shortened palate. Although swallowing is also much, much easier...I knew before the surgery that my tonsils were affecting my ability to swallow...I am having to "relearn" how to swallow because some food and drink is actually getting stuck up on top of the very back of the pallate (in my nasal cavity), which is more uncomfortable and frustrating than anything...but, it is getting better. I still have the slightest bit of pain and discomfort in the back of my throat when swallowing or yawning, and I can still see a few places back there that are a little red and irritated.

From what I can tell so far, I am sleeping much better and am feeling much more well-rested in the morning and throughout the day. Tricia reports that I've yet to snore, which means she's probably sleeping better as well. I am unable to do some of the things I could do before the surgery, like "scratching" the back of my throat by sucking air between my tonsils and tongue (anyone know an alternate way to scratch this area?). I am also having to relearn how to clear my throat of flem and how to do that loud, disgusting, reverse-nose-blow thing that most of us do to clear our sinuses when we think nobody's looking/listening.

I can also tell that my breathing while I'm awake is much easier. So much so that I've noticed my nose "runs" just a little bit sometimes because I'm breathing a greater volume of saturated carbon dioxide out of my nose (at least, that's my assumption?). Although I don't think my speaking voice has changed, I certainly have much more space for my singing voice, especially my classical voice, which is great. If I could compare, in numbers, how much open space I have in my throat now to before, I'd guess that, if I now have %100 of the space I should have, I only had about %35 of that open space before.

From what I can tell from my own experience and from reading/hearing the experiences of other adults who had the same or similar surgeries, my pain and discomfort was definitely not nearly as severe as many others. I was told about possible bleeding, which I didn't see an ounce of, about the scabs falling off, which didn't happen, about days 1-2 being easier than 3-7, which wasn't the case (my pain and discomfort seemed to diminish a bit every day), about possible ear pain, which I did not experience, etc. All of that seems pretty significant considering I'm typically not very pain tolerant. As I've mentioned already, I'd attribute my relative "easy" recovery to sticking with my pain meds and drinking tons of liquids.

I'm certainly thankful to finally be rid of those horrid I mentioned, I can already tell a difference in my quality of life, and I'm looking forward to seeing what the next few weeks bring as everything completely heals and the sutures dissolve. I'm also hoping to have another sleep study in a few months to truly discover if this has helped alleviate or even completely eliminate my sleep apnea issues.

Let me know if you have any questions about my surgery and recovery, and I'll try to answer them in the comments section.

Thanks for your prayer and encouragement (and patience) over the past few weeks!

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