Monday, January 29, 2018

SINUSES AND CF


Last week I underwent my second debridement from my sinus surgery from December 2017. I talked about some of the 'crusties' they removed and quite a few weirdos messaged they wanted to see pics...welcome weirdos, you are home! 
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Wait, wait wait. I can't put 'the goods' at the beginning! They've got to be at the end, make you read all the word vomit before, build up the hype and not make any sensitive stomachs ill. I want ya'll to come back!
Don't worry - I'll put a discretion warning before you scroll to them.

Why are sinuses an issue with someone who has Cystic Fibrosis? With CF, the sodium chloride channels in each cell are defected; causing the mucus in our body to be real thick and sticky. You can imagine how this affects the sinuses. Our mucus has sometimes been referred to as 'peanut butter' or that of a strong 'rubber band'.

Many patients with CF develop with is called "Sinusitis." Basically a chronic sinus infection.  Have you ever had a sinus infection? Literally a daily reality for many of us. With sinusitis, polyps develop in our nares and nasal passages. As they obstruct the nares it's not only harder to breathe but difficult for anything to drain out....combine that with the thick consistency already and lets just plug it up like a dam, already.

Those headaches on your forehead and behind your eyes? ... Can't remember the last time I didn't have one (pre surgery). It truly is a daily, pain in the butt head. Not only can I buy out an entire grocery stores stock of tissues, from nose blowing but we also flush our sinuses with the Neil Med, a minimum twice daily. But seriously, this Neil Med has been life changing. It is one of my favorite gadgets and the best 'treatment' I have to do to keep my disease in check. After a flush I feel soooo good! It is absolutely refreshing and gets way more out than a basic nose blow. This regimen was really life changing for managing CF.


Sinusitis emerges at different stages in each individual. I've know it as early as infancy and some not settling in until late teen or early adulthood.

How is it determined when sinus surgery is needed? When the headaches (plural) turns into one headache that never alleviates. When the nose blowing and clearance from flushes increases. And when a CT scan indicates it. On a CT Scan of the sinus (or the lung of an X-ray), black indicates air, white indicates bone. When the 'blackness' of your sinus pockets start decreasing, it indicates, inflammation, infection, or blockage. *My last CT scan, I had zero black in my sinuses, except for one teeny-tiny spot. Every cavity and passage was grey. It was a unanimous vote; time for surgery.

Often times the first sinus surgery we undergo will be pretty extensive. In patients with CF, they want to 'open up' (aka drill) all sinus pockets to make them larger. As well as widen the drainage canal, hoping to make draining easier with that thick mucus.

In that surgery, as well as surgeries post 'initial surgery',  polyps will also be scraped out -- literally scraped. Sinus cavities suctioned. Scar tissue lysed and if there is any bone overgrowth or extended bone calcification that will be drilled away. The most common site this occurs is in your upper cavities, completely blocking draining and allowing the headaches to grow in strength. *My sister, Natalie has had this bone calcification occur 15+ times, she has undergone sinus surgery 25+ times. (This was only my second surgery). She is Wonder Woman Super Human.


 Anytime your body heals an incision or cut, it develops a scar to close. Same thing occurs within the sinuses. However we have just worked so hard to open and enlarge all pockets and canals, we want to avoid any scaring from occurring and backtracking the improvements just made. This is where debridement's come in and are so crucial to proper healing.

The debridement's go in and remove any crusting, lyse any scar tissue that seems to be forming and suction out your passages so your sinuses may remain as open as possible. A debridement will occur every 1-3 weeks following surgery. How many debridement's are needed? It will be determined with your ENT at each appointment if they think you need to come back for another.
   



lysing the scar band

Last week I underwent my second debridement post surgery and have a third appointment in two more weeks to see how things are looking. Though a debridement seems real intimidating, it is rather refreshing. I'm a 'nervous nelly' beforehand, but look what was in our waiting room last time! This therapy dog not only served as a distraction, but brought happiness and comfort to many! Don't worry, I didn't pet it 😉 too many other peoples germs on his coat.




 Immediately following a debridement you can expect a throbbing head ache and my eyes have a hard time focusing. Always bring someone to drive you home. But the relief and increase in air movement you instantly feel is sooooo relieving and worth every sweaty palm. I highly recommend sinus surgery to anyone who might need one. It's absolutely worth it.

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*viewer discretion is advised*
If you have a queasy stomach these photos are probably not for you.
Go ahead, go grab a dime, penny and nickel for size reference...
 I present to you my Crusty Creatchers!




                                                                                    thumb for size reference





Unfortunately, the biggest, nastiest, most fascinating green crusty did not make it into the photos. It was the size of a nickel, or larger, and the ENT immediately wadded it up in a piece of gauze. Quite disappointed he kept that one for himself and didn't share - my response was a slow motion, 'NOoooo' he didn't understand how important that photo would be to me lol. Maybe next time we'll get another one. 

Can you imagine picking something like this out of your nose? Some of them felt like my brain was being pulled out!  
Hope these were as fun for you as they were for me!


Xx, M



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