The Doctor as the Patient: My Septoplasty for Nasal Airwary Obstruction Procedure

You know how they say doctors never take care of themselves?  Well…. I am guilty as charged.  Although I exercise almost everyday, recently ran a half marathon with my fiancee, eat well, and try to get plenty of rest, I have never been able to breathe out of my nose properly, which I have ignored for quite some time. Eventually, I started to convince myself that there was a slowly growing tumor in my nose.  Physicians are also slight hypochondriacs, of which I am obviously also guilty, due to the fact that I started to truly believe I had a tumor in my nose.  A tumor would have been an extremely rare cause of nasal obstruction, but it is the most serious type.  I happened to be in the CT scanner room one day at my office, and I thought it would be good time to identify the cause of my deviated septum.

Dr. Jonathan Kulbersh’s CT scan:

On a CT scan, the left and right side are switched.  The green diamonds represent the eyes and the yellow diamond is over the brain.  The blue arrow shows the open nasal passageway on the left side and the red arrow shows the deviated septum causing complete nasal obstruction (on CT scans black is air, grey is tissue, and white is bone).

A CT scan is an unnecessary test to diagnose a deviated septum.  A deviated septum is easily diagnosed by a qualified facial plastic surgeon.  I was relieved to know my deviated septum was the cause of my nasal airway blockage, and it was not blocked by a tumor. I was also relived to find out that my breathing could be fixed from a safe surgical procedure, septoplasty.  My first step to fix my deviated septum was to find a qualified cosmetic surgeon, Dr. Babak Azizzadeh. Even though I am a facial plastic surgeon specialist myself, I still had a consultation with my doctor.  We went over the risks, benefits, alternatives, and location of the septoplasty.  After gaining complete trust from a great first consultation with Dr. Babak Azizzadeh, I moved forward with the septoplasty surgery.

The septoplasty surgery was yesterday, and was my first time being on the “other side of the table”.  Even though I am a facial plastic surgeon and have done this procedure many times, I was still nervous before the surgery.  When I showed up at the outpatient surgery center, I was greeted with a very warm welcome, which eased my anxiety. I was taken into the bathroom, where I changed into a gown, socks, and put on a hat.  I was then placed in a patient room and welcomed by a very friendly nurse.  She asked me a variety of medical questions, and then placed an IV into my arm.  Unfortunately the first IV was not placed in the vein properly, and the anesthesiologist had to administer the IV in my other arm.  When the anesthesiologist placed the IV, he first numbed the area with lidocaine and this technique was much more comfortable.  After the painful experience with the first IV, I will now insist that all my patients receive lidocaine before their IV’s.  After the placement of the IV, my doctor came into the room to answer any of my last minute questions and concerns.  The anesthesiologist then gave me a medication, Versed, to relax my nerves, and I was taken into the operating room.  All I can remember is the anesthesiologist placing oxygen on my face, and then the surgery was over.  (I was told later that I was feisty waking up from surgery!)

Immediately after waking up, I could feel slight pain in my nose.  I told the nurse about the pain, and she immediately gave my an IV pain medication that resolved the pain. Within one hour, I was feeling better and ready to go home.

I am always honest with my patients, and I would say last night was uncomfortable.  I was not in pain, but I could not breath out of my nose because I have silicone nasal splints in my nose.  Therefore, I was breathing through my mouth, which became very unpleasant.  My nose slowly dripped small amounts of blood throughout the entire night.  If it says anything about the experience, I am writing a blog post about it the next morning!

Being the patient for a facial cosmetic plastic surgery procedure was a valuable experience.  As physicians, we are striving to understand our patient’s needs and concerns.  There were many little events yesterday that created a trusting environment that improved my surgical experience. The quality of the nurses, the doctor’s extra few minutes he took to answer my questions and the staff’s initial warm welcome got the day off to the right start.  For me, most importantly, I also now know the importance of the doctor spending a few moments with the patient before surgery for reassurance.  Additionally, my cosmetic surgeon called me the evening after the surgery to ensure I was doing well.  I learned many valuable lessons over my surgical experience that I hope to use to improve the experience for my patients in the Carolinas.

I am a facial plastic surgeon that trained in Beverly Hills.  I have two offices in the Carolinas, Charlotte and Columbia, serving the Dillworth, Ballentyne, Southpark, Meyers Park, Eastover, Lake Norman, Huntersville, Irmo, and Lexington.