O.T.~ Nasal Polyps- anybody suffer from these?

Been suspicious of my inability to breath thru my nose easily for a couple of years now. Nasal passages on the right side felt closed up, which in turns causes me to mostly breathe thru my mouth, which isn't good. I think it affects my sleep quality, too. Actually, most of the time I can inhale, but not exhale thru my right nostril. Left one not so bad. It is like a check valve....air in, but not out. It is solid blockage and no amount of internal pressure would let so much as a wisp of air out. None. Very discomforting. When I get a cold, it's horrible having a runny nose and not being able to blow it!!!

So, after much thought I finally made a doctor appointment with a E/N/T specialist. He sprays some sort of anesthetic (?) in my nostrils, let it soak in, then proceeds to snake some long slender inspection scope up into my skull!

A few "Aha"s and "hmmms" as he rattled off a string of ten dollar words to his assistant, who was attempting to keep up with his dictation on their laptop. I thought to myself that I couldn't have kept up with those words at that speed, either. He stopped and asked her if she got all that, and to her credit she said no and he then repeated it at a slower speed. At least I know my chart is accurate with the diagnosis.

He puts the scope down, turns to me and says "you are going to be spending some time with me, but you be sleeping thru most of it!" My bung hole puckers up hearing that!

Anyhow, deviated septum...blah blah blah.....and some sort of polyps. I told him I had done some research and had come to the conclusion that I thought it was polyps, too. Then I asked him how big they are, to which he made a circle with thumb and forefinger about the size of an quarter!!!

I was taken aback that they were so big, and can't remember if he said if there was more than one. Got an appointment for a cat scan of my skull so he can see the sinus cavity where these things are growing at.

I spoke to a close friend today who just happened to have had this same procedure done on his snout about a year ago. He said they fixed the deviated septum and removed 4 polyps on him.

Said the total cost was $30,000!!!!!

I replied "Holy Crap" and thought he was shitting me, but he said it was 15 grand per side. Was outpatient surgery. He had his done up in Kansas City at some hospital up there. Stayed overnight at a motel across from the hospital.

Said he had quite a bit of congestion after the surgery and he got kinda scared and was having trouble breathing, so they went and visit the ER for some attention to be sure it wasn't anything serious.... they said it's common and to just calm down and breathe thru his mouth and drink some fluids- which loosened things up and soothed his nerves and calmed him down. THey didn't have to do anything to him, and he went home the next morning and has been fine ever since.

Says he's never slept so good as he does now, food tastes better and he breathes lots easier. Has to spray some sort of "Flonase"- a corticosteroid- in the sinuses for some reason- like to keep them from reoccuring again. I hope that has no side effects

I have a chumm that had something like this done a few yrs ago.
Just shared a room with him last weekend, and he seemes fine.
Not sure what your question is really, but ...


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Think Snow Eh!
Ox

If you Google the nasal polyp issue and read extensively from comments you will find that the vast majority of nasal polyps will return after removal...sometimes in as little as 3 months ! The worst part is the surgery may damage your olfactory receptors to the point of permanent loss of smell sense. Much better to try a steroid regime first (typically involving 12 days of pills) which will shrink the polyps..... and then irrigate everyday with budesonide added to the water/salt mixture. And a spray or two of Fluticasone as well. Every four to six months, you may need the steroid pills again (for the rest of your life) but that's a safer way to go than surgery.

If that doesn't work, then perhaps the surgery might be indicated but should only be considered as a last resort due to both expense, posssible sense of smell damage and the possiblity it ends up being all for nothing anyway.

I had it in my left nostril about 2½ to 3 years ago.

Went to my doctor and his first remark was that he'd soon fix it. No such luck. Too far up so i was sent to a specialist. Again not good. The specialist said that it would require me going to hospital and being operated. From the X-rays he also said that if I didn't get it done I could risk going blind in my left eye.

Admitted to hospital after being told to take enough for an overnight stay. Woke up from the operation and felt fine. Was asked if I felt well enough to eat lunch. I guess so as much to the nurse's delight I ate two portions. The doctor came in to see how I was doing and told me he'd been surprised at how little I'd bled and if I felt as good as I looked there was no reason for me to stay. Before leaving I got a time for a check in 3 months time.
I also had to inhale a saline (salt water) mixture for 2 weeks. No problem.

Everything OK after the three months and a new date for 1 year for a last check. Seems I'm normal again and don't need to go back
My sense of smell is excellent

Now the interesting bit for my American friends. Cost! NOTHING as we have NHS paid for by taxes.
Where health is concerned - TAXES GOOD

Gordon

I had nasal polyps removed from both nostrils and nearby areas a year ago or so in the western Chicago suburbs. It was outpatient surgery so I was home the same day and told to take 3 days off work for recovery, which was mostly time required for the nosebleeds to stop. The 1st 24 hours in recovery were spent mostly on my back to minimise the bleeding which was probably aggravated by a blood thinner I take (but stopped for the week prior). The doc said most of my nasal cavities were plugged up with them so there must have been several. Insurance covered most of it; I don't remember the total cost, but suspect it was around $5k. The followup 30 days and 6 months later was good and I'm overdue for an annual checkup but suspect they might be reappearing. My breathing at night has been a lot better since, so I'd have it done again. There wasn't much pain following surgery (didn't need the pain meds) but the doc stuffed a wad of something up my nose to pack the area and it was a bit of a shock to see it come out a few days later. No significant pain, but a strange sense of pulling until it came free.

Mike

A fellow I work with is under going treatment for what seemed like a blocked sinus passage. For about six months he would try to breath through his nose and one side felt like it was blocked. That was his only symptom. He finally went to the doctor. After x-rays, cat scans and MRI's a blockage indeed exist way inside his sinuses. It was described as a ball about the size of a golf ball. A biopsy was performed. It came back as malignant cancer. Fibrous in nature and fast spreading/growing. A plan of attack was decided by a medical review board. Surgery is not an option at this time. Chem was started on March 4th. Prior to the start of treatment feeding tubes were installed so he could be fed if the chemo did not fare well with him. He has lost a vast amount of weight in a very short time. He is however able to eat baby food. His gums are turning black and teeth are loosing up. He drinks water to take perkaset for the pain.
If you have the sensation of anything growing anywhere in or on your body get it checked out. Don't wait. Your body will tell you when there is something wrong.
Denial is not an option.

tommy1010 said:

If you have the sensation of anything growing anywhere in or on your body get it checked out. Don't wait. Your body will tell you when there is something wrong.
Denial is not an option.

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In the case of a cancer in the sinuses by the time your body tells you anything it is probably too late.

But not to worry stuffy nose folks.... such cancers are extremely rare, around 2,000 cases per year in the USA. It's estimated that nasal polyps effect 1 to 4 percent of the population....but sinus cancer ?.. 2,000 out of 315 million is what, .0007% ?

Compare this to aprox 22,000 new cases of brain cancer per year and over 200,000 new cases of lung cancer per year in the USA. Even rare diseases such as ALS (Lou Gehrig's Disease) are more common at 5,600 new cases per year.

I admit the comparison is a little squishy in that the stats on those effected with nasal polyps is, once diagnosed, usually a lifelong issue.. whereas sinus cancer is rated in new cases per year, nonetheless I wanted to put some perspective on the situation.

Mike Henry said:

I had nasal polyps removed from both nostrils and nearby areas a year ago or so in the western Chicago suburbs. It was outpatient surgery so I was home the same day and told to take 3 days off work for recovery, which was mostly time required for the nosebleeds to stop. The 1st 24 hours in recovery were spent mostly on my back to minimise the bleeding which was probably aggravated by a blood thinner I take (but stopped for the week prior). The doc said most of my nasal cavities were plugged up with them so there must have been several. Insurance covered most of it; I don't remember the total cost, but suspect it was around $5k. The followup 30 days and 6 months later was good and I'm overdue for an annual checkup but suspect they might be reappearing. My breathing at night has been a lot better since, so I'd have it done again. There wasn't much pain following surgery (didn't need the pain meds) but the doc stuffed a wad of something up my nose to pack the area and it was a bit of a shock to see it come out a few days later. No significant pain, but a strange sense of pulling until it came free.

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For my curiosity, did you try the steroid regime, nasal irrigation and fluticasone spray first.. or go straight from polyp diagnosis to surgery ? Can you smell ok ? I think the changes of olfactory damage depends alot on exactly where the polyps are located in the sinus cavity.

against better judgment I will stir the pot

around 5% probability an individual will experience nasal polyps in a lifetime

surprisingly only 50% of individuals with polyps test positive for allergy

95+ % have chronic sinusitis--typically untreated/under-treated

when diagnosed--coronal ct scan is needed to understand anatomy and
relationship of any polyp like mass to the orbit and brain

about a one percent probability that polyp like tissue will have some
malignant change

if you are a woodworker/metal plater/ carbide grinder/ fume inhaler--cancer risk
is substantially greater

if ct scan does not demonstrate bony destruction a trial of antibiotic/oral and nasal steroid
is indicated --those of us doing this work witness near miraculous regression of polyps using this method
and thus avoiding surgery in about 15% of polyp patients

even if major resolution does not occur and if surgery is needed--bleeding reduction and recovery are
much improved from this medical management

if surgery is needed--do not submit to general anesthesia--this surgery should be performed
under local anesthesia with sedation-- if the surgeon's instruments stray toward brain--dura mater--
or contents of the orbit ---under local the patient will give signs of discomfort

most surgery of this type is performed using various endoscopes--rigid optical rods--
and since the advent of this method complications and malpractice claims have sky rocketed--
now the leading cause of ENT lawsuits

when complications occur--often catastrophic--blindness bleeding paralysis death

about me--
I performed over 6500 nasal/sinus surgeries over 35 years prior to retirement a few years ago

jh

I had the same surgery. Best thing I ever did. It is my understanding the results vary a bit. Couldn't breath thru my nose for about a week. Did the sinus irrigation thing and one day I sneezed. Out came the wad of packing from the operation. I told my daughters it was a mouse that crawled up there and died. Wish I'd had the operation 5 years ago, they'd a believed me then.

Gordon B. Clarke said:

Now the interesting bit for my American friends. Cost! NOTHING as we have NHS paid for by taxes.
Where health is concerned - TAXES GOOD

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Gordo, you're contradicting yourself. The operation and care obviously costed something: the doctors, nurses, and others that treated you were paid. The hospital costed money to build. Supplies, and even the extra portion of food you ate cost money. So the cost was substantial.

As you then point out (after saying the cost was nothing), your taxes paid for the costs. In fact, if your total costs for the year were higher than average, then not only did your taxes, but the taxes of your neighbors and friends, and even total stranger Danes, pay for the cost.

Not saying that your system is bad, its just that you are paying for your healthcare. It's not "the government provides it". You. Pay. For. It.

Our US system evolved because of government intervention (wage controls) that forced employers to offer perqs and benefits to attract the top workers. Our system is expensive, uneven, and choked with inefficiencies and arbitrary rules, limits, and cutoffs (both from private insurance and Medicaid, the later being worse).

Our "flawed" system also drives most of the healthcare innovation in the world. Even foreign companies have huge presence here in the US. Some of the least innovative (as judged by research efficiency, Astra Zeneca comes to mind, and Sanofi is another) have most of their research outside the US.

I'm not advocating that our system is perfect, or that the more socialized medicine approach in most of Europe is horrible. A big advantage of the latter is that folks don't make job choices based upon benefits packages. And a freer labor market is a more efficient one. My point is that there are trade-offs.

And I really don't think that higher taxes, OR large hospital bills are particularly good. But in either case you pay for it. They both suck.

It will be interesting to see how we ration healthcare with our new ACA. The Death Panels and all....

bosleyjr said:

Gordo, you're contradicting yourself. The operation and care obviously costed something: the doctors, nurses, and others that treated you were paid. The hospital costed money to build. Supplies, and even the extra portion of food you ate cost money. So the cost was substantial.

As you then point out (after saying the cost was nothing), your taxes paid for the costs. In fact, if your total costs for the year were higher than average, then not only did your taxes, but the taxes of your neighbors and friends, and even total stranger Danes, pay for the cost.

Not saying that your system is bad, its just that you are paying for your healthcare. It's not "the government provides it". You. Pay. For. It.

....

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boso I'm not contradicting myself

Do you really believe I don't realize that I don't know that I'm paying for my, and helping others that earn less than I do, medical treatment? Just as those that earn more help pay me.

The point of my post, and it could be I wasn't clear enough in it for you, was that when I read how much it woud cost in the USA I almost needed medical attention for a heart attack. Those in the USA that would do as I did and have it taken care of without thinking more about it probably pay a higher insurance policy that I pay for my share in NHS through taxes.

Therefore the "Where health is concerned - TAXES GOOD " statement.

The main point of my post was that what I thought was a minor problem (as did my doctor at first) turned out to be more serious than expected so I agree with all those that say "Don't hesitate, health isn't something you gamble with".
My advantage is that having paid through taxes (rather than to an insurance company) I'm not risking any money I perhaps don't have.

I have insurance for several things but medical treatment just isn't one of them. The problem with insurance is that I can never be 100% certain it'll give me full coverage if I ever need it. Assuming we are both healthy I have an advantage you don't - peace of mind for myself and family.

Bottom line is that if you're happy with the way your system works then I can live with that. Hopefully you can too. Live I mean

Gordon

Gordon, give up mate. They still can not understand the basic premise of making health care a society wide not for profit benefit. Instead they rather see so many get rich of the basic needs the people they live with - around have.

IMHO your akin to as bad as a non democratic dictatorship if you can not - will not support at least a half decent measure of health care for all. Yes, it has costs but in the terms of things it still really is not all that much.

JHOLLAND1 said:

even if major resolution does not occur and if surgery is needed--bleeding reduction and recovery are
much improved from this medical management

if surgery is needed--do not submit to general anesthesia--this surgery should be performed
under local anesthesia with sedation-- if the surgeon's instruments stray toward brain--dura mater--
or contents of the orbit ---under local the patient will give signs of discomfort

most surgery of this type is performed using various endoscopes--rigid optical rods--
and since the advent of this method complications and malpractice claims have sky rocketed--
now the leading cause of ENT lawsuits

when complications occur--often catastrophic--blindness bleeding paralysis death

Click to expand...

JH, do you not agree that most nasal polyps removed by surgery will return within two years, and often much sooner ? I hope you disagree, but if you do, it will be quite a revelation to me considering what I've been told by two ENT's that perform the operation, and what I have read extensively from real world experiences.

And what about the sense of smell issue ? Curious you don't mention that.

Also, correct me if I am wrong, but if 5% of population develops nasal polyps and 1% of those become malignant, that is 1% of 5% which works out to 157,500 cases out of 315,000,000 people. If correct we would then need to know what percentage of the population ultimately develops brain cancer and lung cancer rather than "new cases per year" in order to make a "rarity comparison" for perspective sake. Best I can tell, figures on brain cancer are that aprox 1% of population will develop same in lifetime, which would be 3,500,000. So compare 3,500,000 to 157,500 for perspective on rarity.

adama said:

Gordon, give up mate. They still can not understand the basic premise of making health care a society wide not for profit benefit. Instead they rather see so many get rich of the basic needs the people they live with - around have.

IMHO your akin to as bad as a non democratic dictatorship if you can not - will not support at least a half decent measure of health care for all. Yes, it has costs but in the terms of things it still really is not all that much.

Click to expand...

FWIW, "they" don't represent all Americans. Personally I can very much understand the basic premise. One of the most ridiculous aspects of the American health care system is how many of us are basically chained to the jobs we have based on worries about health care coverage diminishing or loosing it all together if we change jobs. To me, that is insane.

adama said:

Gordon, give up mate. They still can not understand the basic premise of making health care a society wide not for profit benefit. Instead they rather see so many get rich of the basic needs the people they live with - around have.

IMHO your akin to as bad as a non democratic dictatorship if you can not - will not support at least a half decent measure of health care for all. Yes, it has costs but in the terms of things it still really is not all that much.

Click to expand...

Me give up? LOL I don't suggest Americans change what they have but it would be a plus if "they" looked around and saw that there were other options. If what other comparable countries have doesn't look better than what they have then that is there choice.

Without knowing alternative options "free choice" isn't a free choice - it's sticking with what you have because you don't know what you could have.
US citizens need go no further than Canada for comparisons.

Gordon

Milacron said:

FWIW, "they" don't represent all Americans. Personally I can very much understand the basic premise. One of the most ridiculous aspects of the American health care system is how many of us are basically chained to the jobs we have based on worries about health care coverage diminishing or loosing it all together if we change jobs. To me, that is insane.

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As a non American I don't know if "insane" is the term I'd use but I think that so many reject the idea of NHS shows at best a closed mind attitude.

If the total amount Americans spend on insurance (private or through their job) was given directly to a form for national health care then the USA would probably have the best health care in the world. As it is at present the "best" is IMO only available to the wealthiest.

Here in little old Denmark we are probably the highest taxed country on earth and it isn't something we like being #1 at.
http://www.businessinsider.com/most-taxed-countries-in-the-world-2011-4?op=1
OTOH I've never heard any complain about the portion of our tax that goes to our NHS being too high or that it should be reduced. Everything else perhaps but just not that.

List of countries by total health expenditure (PPP) per capita - Wikipedia, the free encyclopedia

Gordon

P.S. If my polyp (polyps?) did return then I'd just have it taken care of again without losing sleep over whether I could afford it or not. I pay taxes so I have already paid for it

comment revision

polyp recurrence--

humans who form polyps will have a lifelong tendency to do so
in my practice, if a polyp former adhered to a regimen of routine care
the probability of repeat surgery was around 15% in a 10 year span

I developed a topical antibiotic spray -mupirocin cream- which proved very effective
in treating sinusitis/polyps and was widely adopted by family docs/pediatricians in
my practice region
this medication squirted in nose at bedtime reduces polyp recurrence

the statement that 1% of polyp tissue will have some form of malignant change is misleading--
I will explain

any pathologic process in mammals which is characterized by chronic inflammation elevates risk for malignant transformation
ie--non-healing skin ulcers, colon inflammation, or chronic crusting -bleeding within nasal cavity
and if diseased nasal/sinus tissue removed for biopsy is thoroughly examined under
microscope- tiny foci of dysplastic change is often seen-- but rarely is associated with clinical cancer

other examples might include 60% microscopic malignancy rate in random thyroid glands examined at
autopsy in the elderly
or 80% microscopic incidence of prostate malignancy at autopsy in 80 yr or greater men

perhaps you have heard the statement--all of us will develop cancer several times during a lifetime
but the immune system will seek and destroy

this is factual-- and if at death all individuals were micro-sectioned and examined at a
one cell level the incidence of undetected malignant transformation would be alarming

smell- olfactory neurofibrils--about 30,000 per side leave the brain cavity and do their
work high in the nasal cavity

if the mucous membranes containing these fibers are surgically removed smell sense is
greatly impaired----

if polyps obstruct inhaled air these fibrils cannot function
and any form of chronic inflammation further reduces function

successfully treated polyp patients in general have improved but rarely normal
smell function

jh

JHOLLAND1 said:

polyp recurrence--

humans who form polyps will have a lifelong tendency to do so
in my practice, if a polyp former adhered to a regimen of routine care
the probability of repeat surgery was around 15% in a 10 year span

Click to expand...

Well, that's good news if so.... but most I've read seems to indicate around 60% polyp reaccurance within 5 years...and sometimes in as little as 3 months. Perhaps long term success is technique related and you need to come out of retirement to teach ! It's my understanding the olfactory problem can be due to scar tissue after the surgery.

Personally, my problem is more smell related than breathing. With daily irrigation and fluticasone spray I can breath just fine but I find my sense of smell fading after 2 months from steriod pill regime, eventually to the point of no sense of smell at all. But then steriod pills and I can smell again for another 2 months. I find one easy test for normal smell is if I can smell cat food in the bag, and the test of any smell at all is to open a large Magic Marker...I figure if you can't smell a Magic Marker, you can't smell ! interestingly, the periods of lack of smell don't seem to effect appetite or desire for certain foods but do diminish the positive experience of certain foods a little.

Gordo,

Sorry, saying in one sentence a service you received didn't cost you anything, then in the next sentence that your taxes paid for it is, in my book, contradictory. The service did cost you the taxes you paid. Not shocking or anything.

I agree with Milacron that many of us in the US do see the flaws in our system. And the flaws in yours in Denmark and the UK - there are questions about whether, for example, the NHS is sustainable). And healthcare spending is rising much faster than econonomic growth in Europe (See Sustainability of Health Systems: Is Pay for Performance the Answer? Review of OECD experience, for example). That said, the US spends more of its GDP on healthcare than any country in Europe. And since we have a higher per capita GDP than anyone (except Canada), we spend more per person on healthcare than any European country. Some of the extra funds do finance innovation. We develop way more than our share of new drugs, and come up with more than our share of new medical devices. But there's a lot of waste and bureaucracy in both government and in big insurance companies. Still, Canadians who can't get in to see a specialist promptly under the rationing that their system imposes often end up here in the States.

As I said, unfortunate government meddling (wage controls) were what forced most employers in the US to offer health benefits as part of employment. And when our economy was in true juggernaut mode, most folks had jobs and so health insurance wasn't an issue. For the poor, we had Medicaid and for the elderly, Medicare. We got everyone covered pretty much, and coverage meant you got to see the doc you wanted, and that doc had excellent training, and our hospitals had the most innovative treatments for folks in a bad way. In fact, the health insurance premiums that pay much higher prices for my drugs in the US are paying for the innovation that delivers the drugs that the Danish system uses. That's probably going to change, so look for fewer new drugs being developed over the next few decades.

I'm not criticizing your health system, I'm criticizing the idea that it doesn't cost you anything. I think my note also took issue with the chauvanistic and gleefully unsophisticated tone of "our system is way better, yours sucks" that comes through in your note. The point about cost is that you pay up front, through taxes. If I may reinterpret your original note, you were not crowing about cost, but about the fact that it cost you nothing out of pocket, and that you didn't have to worry about whether you were covered. These are valid points. Another valid point that you didn't mention is that healthcare, as a percentage of GDP, in Europe is about half that of the US. A lower healthcare bill would be great.

That said, I think all government programs, in every country, are going to have a retrenchment and a lowering of benefits. Healthcare costs can't continue to rise faster than GDP growth indefinitely. There is going to be rationing, especially on the very expensive procedures and drugs. And with new government programs in the US there will be cost pressure on new drugs, and some new drugs won't get into the approved pharmacopeia. The "Death Panels" that are in place to limit costs will have the side effect of stifling innovation. There already has been a lowering of Medicare benefits for some procedures and therapies.

In short, there are valid pluses and minuses in every system, and I see changes coming on both sides of the pond. Stay tuned!