i am so upset about my broken nose. not likely to be fixed

[PavlovtheCat]

I broke nose at the weekend. Not too badly, fortunately, and although a little out of shape, and once the bruising has gone, it probably won't really noticeable other than to me/dh. My breathing is a little blocked on one side, but i appear to now have a bunged up nose anyway (can you damage sinus' when you break your nose? ).

On sunday night I went to A&E amd due to a minor head injury which they panicked about (junior Dr obviously using me as a practice case) they, and I, forgot about the referral to ENT for my nose. I was so pleased to be given the all clear that I forgot, that, along with a fuzzy head.

So, A&E told me on monday that I had to go back for the referral to be done, could not be done by gp or minor injuries unit as they had seen me. So off i went and spent anther 3 hours there.

Was confirmed (again) yes it was broken, and that the referral process involved them passing my paperwork to ENT under a fast track route and someone would call me to make an appt, to expect a call in 3-5 days.

No call, i called on thursday, was an answer machine, and yesterday. left an urgent message each time. no call back, no appointment, no time to fix my nose now.

So it might not be badly broken, but i know it isn't right. I am really really upset. They just don't take my bloody health or injuries seriously, this is not the only thing.

yes, the damned bloody shower screen was having an off day and took it out on my head. And the sink, aggressive little thing

oh dear pav. and the hospital parking charges will add insult to injury.

you need cake.

I don't pay them. I always 45 mins or less

its probably too late.

I was told that time is of the essence, and that we are at the cusp of being able to manipulate it back, which it needs. This op is mostly to give me some airways to breathe through, will attempt to straighten the exterior but unlikely to make much difference. Once this is done, it is likely it will only improve things a little breathing wise and I am likely to need a (septo)rhinoplasty op in 9 months once it has all healed, to address the proper straightening of the cartilage and the bone and to fix the breathing completely. Needs to be done tomorrow, or thursday, and even then the success of the op is unknown, as the longer it is since the break the less successful it is and it is now 10 days.

Then, after looking at the list and seeing it was full and not being able to re-jig it herself, the SHO then told me ithat it is now not going to be possible to do it til next week, monday at the earliest as the woman who sorts out the list and can authorise bumping people/fitting people in has left for the day and not in til tomorrow. Which is 16 days after the break at the earliest. I asked if this means it won't be successful and she sort of gave me this really shit confusing spin about me needing the full op in 9 months anyway and so they will do what they can but it won't really be fixed anyway, but it should help a bit, even at 16-18 days post break. Someone will call me at some point in the next day or so to discuss it.

I now have no idea if there is any point in this manual manipulation, if it aint going to work what it the point as I will need a GA and also one in 9 months. No point doing it now.

So basically I am unlikely to have a straightened breathable nose for at least 9 months, because there was no-one in the office doing their bloody job.

So sorry Pavolv.

I think it does warrant a formal complaint that proper referring processes were nto followed, resulting in greater expense to the NHS and greater distress and discomfort to you.

And I am not one who normally suggests complaining at the slightest thing - just that, having been a manaager in the health service, if this sort of thing is not brought to their attention, it'll not change or, more to the point, improve.

Tbh Pavlov, I found that manual manipulation f'ing painful and it did sweet fa and I had to have the op anyway. Afterwards they did admit that unless it was a v v simple break (and mine was v complex) it was never going to work grr.

I didn't have to wait 9 months for the op though. Perhaps ask if that can be speeded up. They just waited for the swelling to go down and my bone to fuse (as it had smashed) and then they did the op.

Good luck, sounds like you are trapped in hospital inefficiency grr!

yes, I will probably complain, just so they know its been shit all the way. If the referral was done when it should have been i would have had a earlier appt, either day earlier or earlier time and the woman responsible for the lists would have been in. Even an earlier appt today would have got me in for the op tomorrow/thursday. And if the woman was there, not gone home early i would have been on the list.

The whole dept was winding down by the time i was seen, the receptionist was telling everyone they would write with NAs instead of booking them on the system, and had her coat on by the time i came out.

Not even a x-ray to check exactly what is broken.

foxinsocks she told me it takes 9 months for the bone to fuse. perhaps she means, 9 months for the waiting list to go down...[cynical emoticon]

She did say I would be feeling rather sorry for myself for several days, black eyes, swollen eyes/nose etc. I might just tell them to hang on.

I am still breastfeeding and no point messing that all up if it won't do much good.

Yes I would ask them pavlov. If they are pretty sure you will need the op anyway and they aren't sure the manual manipulation will do much (and it does sound like they have waited a while to do it!) then I can't see why they should put you through it!

I suppose if they think it will work and you'll avoid the op then that's another matter.

Really feel for you Pavlov! That mouth breathing at night because your nose is blocked is horrid!

ok, so I have the op booked for monday to do the manual manipulation. I have to do some faffing, have pre-assessment, be tested for mrsa at gp's and the such first.

I spoke to the woman in admission as a duty dr was meant to be calling me about the op and how successful it might be by monday, no call back as yet. She said the consultant himself is doing it, and he is happy to proceed with it on monday, despite the time delay so must be ok, but he hasn't seen my nose so how would he know? .

I am now a bit confused as to what is going to happen. SHO told me firstly it would be to sort out breathing, rather than to straighten it, so not to expect it to be hugely different appearance wise, the 2nd op will fix that side of things, this would manipulate bone/septum back to open airways. Then she said to me that in this op they would not be going 'into' the nose itself, it would be done externally, so how can they sort out the septum internally? or should i not ask?

You must ask everything

My manual manipulation was literally that - someone grabbing my nose and manually trying to put it back into a position that meant I could breathe (didn't work as septum had rotated 90 degrees). That's why it was so painful I think. That manual manipulation wasn't done as an op iyswim. But this was a good 14 years ago so things might have changed.

Glad, at least, that the consultant is seeing you Monday!

fox i am having a ga, and then I expect manual manipulation is pretty much as you described! so, no not an op so to speak, but out of it so i don't punch them on their nose through pain eh?! I had read it can be done under local anaesthetic, if you were so desperate for it to be so. Yeah Right! . I am in two minds. I left another message for someone to call me back, preferably the consultant but not expecting the moon on a stick! some-one should call tomorrow. and I have a list of questions to ask:

*What exactly are you going to be doing to my nose, ie, straightening the septum or the bone? or both? Is it possible that if successful i could avoid the more major operation in 9 months?

*What if I do not have this manipulation done, if I chose to not have it done? will it make the operation in 9 months more complicated/hard to straighten my nose?

*What medical/health implications are there if I chose to leave it til the full op in 9 months? ie higher risk of sinus infections/colds/throat infections due to not being able to breathe so well through nose

*How long will i be unable to breastfeed for?

The thing is, I have almost convinced myself it looks ok, its not that bad. DH however has said it does look broken. And DH is not a man to be dramatic, (or maybe even too observant some of the time!) He is the soldier on as it all is type of man, and he hates hospitals, he will say anything to avoid me having this operation if it was not in his eyes necessary, such as 'oooooh its not that bad, you will be fine, you don't need it. So if he says it looks broken, it must look broken . And the SHO said immediately it needed straightening. I guess i was just kidding myself.

i had my septorhinoplasty 15 years ago. I guess in 9 months or however long, I shall see how much difference 15 years makes

Pavlov have been reading your thread, sorry about your nose. I have worked in ENT and when they manipulate your nose under anaesthetic they can use their hands to attempt to realign the structures of your nose or some blunt forceps to attempt the same thing, it's not an operation as such. Usually you will have a plaster of paris dressing taped over the nose to protect the realigned bone/cartilage after the procedure. You are quite right in thinking it probably won't correct a deviated septum.

geraldine i just spoke to the woman I saw on wednesday. Asked her what they will be aiming to do, and she said they will attempt to correct the blockage in the airways, and will not concentrate on the 'lumps and bumps' at this stage. Te purpose of this is to increase ability to be breathe more comfortably. But, if this is as a result of the septum being out of kilter now, will that help then? or is it that the bone inside is obstructing? She said to me they would not consider doing this if they did not think it carried some degree of success, but acknowledged the level of success cannot be determined, that it will improve me breathing to some extent but not necessarily correct it completely, hence the need for more surgery at a later stage. She also said that if I chose not have this procedure done, it may complicate the later procedure, that ultimately while it would be my decision, however she advised to proceed.

tuesday, the person i saw on tuesday. I have been somewhat out of sync with my timelines and thought processes recently!

If they can manipulate the outer structures successfully to improve your airways it is likely that it will help align all structures, including your septum, as it will be less pushed to one side iyswim. they are unlikely to focus on the cosmetic appearance of your nose. If the nose is pushed back into a more stable original position then the amount of work to do in the septo-rhinoplasty will be less, however, as you know its a much more invasive procedure. I feel very sorry for you as I have had an MUA myself and it was sore, make sure people are extra nice to you.

Can't we have a mumsnet whip round or something. FFS Pav, couldn't we get you a hollywood nose job? This NHS stuff is all sounding a bit primitive.
You deserve better.

Tell you what, you pick a hollywood nose and we'll see what we can do.

Jennifer A has quite a nice one. I will go for that one...or might that be a bit much?

on the side. I had to go onto the ward for a MRSA swab as it got messed up and a lovely nurse agreed to do it there where I will having the procedure. While there she checked the list. I am last. There is a 3 hour procedure first thing, then everyone else, then me. She reckons I won't be going down til 3pm so midnight til 3pm with no food , said i will either be out by 8pm, or else i might have to stay in on a ward as the ward I am on is outpatient ward and shuts at 8pm! So, talk about balls up my whole childcare, how the fuck are DH and I supposed to arrange childcare/who will come and get me if I have no idea when it will be, or if i come home at all, or, what?

Anyway, she said DS is allowed on the ward so at least DH can bring in him so i can feed him before i go down. Bloody hell, i could go to work, do my whole days hours at work and still be there in time! instead, I have had to take the day off just to wait all fucking day.

Apologies for the Bad Words. But fuck me i have ben dicked around all fucking week, more than a week already and it will continue.

geraldine i am not excited by this prospect let me tell you. I am wondering what the hell I am doing it for. Except even as I type this my nose feels painful, throbbing and blocked. I keep thinking 'can i live with this for 9 months' I know the next one will be more evasive, but I can prepare a bit better for it, and also it then only gets done once.

what amazes me is that I didn't realise people had anaesthetics for manual manipulation! Why did no-one tell me that lol!

Pavlov, I hope it works and gives you temporary relief.

It's funny what you are saying about your nose - I couldn't tell the difference with the shape of mine either but everyone else noticed (though I had stitches down the front so maybe that's why!).

Geraldine is right - all of this is very painful :( so make sure dh knows that in advance of your coming home.

I think he is aware of how painful it will be. I am a bit worried about the night time, in particular the first night as DS is teething badly, he has 4 teeth on the top cutting through, two through, two more literally bursting, so nighttimes he is up about 4 times only wanting me.

Do you think it is best if I don't sleep on my own the first night? As, there is a solution to being disturbed, which is to sleep upstairs in the loft room with DD, good sound proofing, but dh won't be there.

Had dinner with two of my closest friends this evening and they have said they will help with looking after both the children on monday, during the day, in the evening whenever they are needed, offered to pick dd up from school (they are named as an emergency contact so would be fine if needed), generally being great. logistically, its a bloody nightmare. I am half tempted to just say sod it and not bother. Apart from spending the last two days running around like a headless chicken sorting work cover and finishing off important work!

I really think you should have it done, If a consultant is doing it you have a much better chance of some success, at least to improve your breathing. it might feel worse before it feels better though, due to the new bruising and bleeding. Unfortunately it seems to be universal that MUA's are done on the end of ENT lists, but you never know, sometimes they shuffle the list round or patients get cancelled or don't arrive, so you never know it may be not as long as you think. Good Luck!

geraldine thank you! My friend made a good point today...when do i get the chance to put my feet up for hours and read my book/paper/listen to ipod?!!! Not much time for that with a job and two children, so as she rightly said, i shall make the most of the waiting . we now have childcare provisions for most eventualities covered too so feel happier that the logistical nightmare is sorted too. I have been told i can have baby ds on the ward to feed and for company so DH will bring him in after nap time for a feed if i am not about to go in for the procedure. tbh, these things were bothering more much more than the op themselves, and actually going in later on the list might be better as the children will be asleep when i get home so DD (4) in particular won't see me in a right ol state!

Went to a afternoon tea party today and several people who know me well were at how broken the nose looks, and how crap my speech is (i also have this occasional lisp behind my front teeth, don't know where that has come from, no broken teeth). Now the swelling has pretty much gone you can actually see the shape of a bit of bone sticking out to one side , not a crooked nose, but a lump of bone!

Thanks for all the support, reassurances and handholding ladies.

(geraldine - do we get wi fi in the planned treatment wards?

All done! and i am not a gibbering wreck either! waited ALL DAY with nothing to eat, but had some nice painkillers for a bad back . Was starving when i woke, and desperate for a coffee!

Doc said it was a 'success' as far as he could tell, and he said before we went down that he would be attempting to improve it cosmetically as well as the breathing (yey!). He said that he would sort out the cosmetic side which should in turn sort out the airways. He said that possibility stil of further op, but see how it goes in a month or so when it has all settled down. He also said it was rather complicated manipulation as it would difficult to distinguish between old break and new, so he would 'go gentle' on me .

still bleeding so have a pack thingy under the nose to stop it going everywhere!

thanks for the handholding ladies

you look gorgeous pav (even with the blood soaked packing)