Friday, September 17, 2010

Uvulectomy update

A number of folks have been asking how I'm doing after my uvulectomy, so here's an update. Basically, I'm doing pretty well -- better than I expected, for sure. I'm going to go into some detail on this for the benefit of others who may be looking forward to a similar procedure (having searched online myself beforehand).

A little background: The uvula is that little thing that hangs down in the back of your throat (you see it all the time in cartoons during extreme close-ups of a character yelling). What is a uvula for? Turns out, not much. It helps to close the nasal passages when you swallow so that milk and water don't go up your nose. It also apparently helps you pronounce uvular sounds in certain languages. And in my case -- prior to Wednesday -- it also did a fine job of blowing up to ten times its size as part of an allergic reaction once every few months. Usually this would happen in the middle of the night, with the result that I could not eat, talk, or lie down without gagging for a couple days. After seeing no fewer than three different specialists about this problem (an otolaryngologist, an allergist, and an infectious disease expert), not to mention five different primary care physicians (I'm counting the emergency room doctors), I was finally diagnosed as having "idiopathic angioedema." That translates as "swelling of the throat for no good reason." We thought it was going to go away -- the episodes were becoming less frequent and less severe -- but then I had a doozy of a uvulitis attack in May, which is when I decided it had to go.

So on Wednesday, after a very restless night of mostly not sleeping, I got up at 6 and popped over to our local hospital for a "primary uvulectomy." That is to say, the uvula was the only thing removed. Usually, the uvula is removed to solve a sleep apnea problem, and in those cases, it's not just the uvula, but also the tonsils and a portion of the soft palate that is removed. Those operations are more involved, with a longer and more painful recovery. (I waited to do this in part because no fewer than three different doctors told me, "That's going to hurt. A lot" when I brought up the possibility of removing the uvula.) Primary uvulectomies are apparently fairly rare; my otolaryngologist says he's only done one or two others.

In any case, the procedure only takes fifteen minutes, but they still have to knock you out -- it does involve reaching into the back of your throat with sharp objects, after all. The anesthesia turned out to be the most complicated part of the procedure -- and also the part I was dreading the most. The last time I had anesthesia for a surgical procedure, it was like all that time went completely missing -- not like you're sleeping, but like it's just gone. It's a very weird sensation. This time, that didn't happen. The last thing I remember was the anesthesiologist telling me to breathe deeply. Then I was waking up -- an hour later, according to the clock. This time, though, I had the sensation of waking from a dream, so it wasn't so existentially bizarre.

As I woke up, I noticed that my throat hurt a little -- but that I could talk without too much pain (good!), even though my voice was raspy from the intubation they do while you're out. They propped me up a little -- and that's when things started to go south. I had a vagal reaction -- basically lightheadedness combined with nausea and a falling heartrate. If you want to get a bunch of medical people moving, having one of these episodes is very effective. I had one the last time I had surgery (for a hernia) and basically passed out from it; when I woke up, they'd coded me and brought in a crash cart and the whole works. This time, they were on top of it very quickly and I never passed out.

That little episode meant that instead of getting out in half an hour, I ended up staying more like an hour and a half to make sure it wasn't going to happen again.

By 11, I was on my way home with a milkshake and a fruit smoothie from McDonald's. I spent the rest of the day sleeping and being waited on by my faithful and loving wife. They gave me some heavy-duty painkillers, but I have been avoiding those in favor of plain old Tylenol, which has been working fine. The pain has not been as bad as I expected, based on the doctors' warnings and what I had read online. I've had viral sore throats that were much worse than this. It is a little uncomfortable back there from the stitches, and I have some referred pain to the ears (like having a mild earache), but so far, on day two post-operation, I'm eating and drinking and talking just fine. Oh, and I also have some kind of upper respiratory infection that has left me pretty worn out, but that might be due to the cold I had before surgery. With the full uvulectomy-tonsilectomy procedure, the soreness apparently gets worse over time, but so far mine has actually been getting better.