OpenHealth Q&A

Get answered by medical professionals

Seeking Guidance for a Perforated Septum

8/14/2025, 9:10:52 PMMale25-34

I am a 29-year-old female, 5'9'' tall, weighing 145 pounds. My medication regimen includes 123 mg of methadone and 40 mg of Prozac, and I occasionally use a vape. I have no significant medical history apart from sinus surgery I underwent around the age of 18 to alleviate persistent sinus and ear infections. Thankfully, that procedure completely resolved my issues for many years, until now. I'm reaching out to multiple forums for suggestions, especially regarding any relevant communities to discuss this. Over the years, I've developed a perforated septum due to extended usage of fentanyl. It seems that many others who have used the drug in a similar manner have faced similar problems. I've been sober for some time and am eager to address this condition, as it leads to a continuous runny nose and recurring ear infections that refuse to heal. Although my nostrils have not collapsed yet, I can sense a slight change, likely due to my obsessive self-monitoring (which I know others wouldn’t notice). I’ve been informed that insurance might cover the necessary treatment, but I need direction on which specialist to consult. I recently had an appointment with an ENT specialist who examined my case and informed me that the perforation is extensive, making it beyond his ability to repair. He recommended a reconstructive surgeon, mentioning institutions like Johns Hopkins and another highly regarded medical center known for their expertise in such surgeries. Unfortunately, he couldn’t refer me to a specific surgeon, stating he’s not familiar with any. The possibility of needing a tissue graft was raised, yet the doctor expressed concerns about the high likelihood of failure due to the size of the perforation. This news was incredibly disheartening and has left me in tears while writing this. His uncertainty has left me wondering about other options and professionals out there, as it feels crushing to think there's no solution available. I fear that without treatment, my septum will inevitably collapse. I’m determined to find a way forward, but I’m lost and need support on how to begin this process. If anyone has insights or recommendations, I would be grateful.

AsthmaMultiple SclerosisInternal Medicine

Answers (1)

Cony

8/14/2025, 9:11:19 PM

OpenHealth AI

I understand that you're feeling overwhelmed and disheartened by your situation with the perforated septum, especially after receiving challenging news about its repair options. It's completely normal to seek support and clarity in your journey toward healing.

Main Points:

  1. Next Steps for Treatment: It’s essential to find a reconstructive surgeon with expertise in septal repair.
  2. Consider Additional Opinions: Seeking a second opinion can provide you with different perspectives and options.
  3. Support and Resources: Connect with support groups for individuals facing similar challenges.

Explanation:

A perforated septum can arise from various factors, including previous drug use, and can lead to discomfort like a continuous runny nose and recurrent ear infections. The complexity of your case means it’s crucial to seek out an expert specifically skilled in reconstructive surgery for septal repairs. The recommendation from your ENT about consulting a surgeon at specialized institutions like Johns Hopkins is a good starting point.

Actionable Steps:

  1. Research Reconstructive Surgeons:

    • Look for plastic or facial reconstructive surgeons who have experience with nasal surgeries, particularly those who specialize in corrective procedures for septal perforations. Check their credentials and reviews.
    • Consider institutions with a strong reputation for ENT and reconstructive surgeries, such as Johns Hopkins or other regional specialists.
  2. Get a Second Opinion:

    • Don't hesitate to reach out to another ENT or plastic surgeon for a second opinion. This could provide you with more options or different surgical techniques that may be available.
    • Use online resources or medical associations to find qualified surgeons in your area or at specialized centers.
  3. Explore Support Networks:

    • Look for online communities or local support groups for individuals with chronic nasal conditions or those recovering from substance use. Hearing others' experiences may give you additional insight and emotional support.
    • Consider discussing your feelings and concerns with a mental health professional who can provide coping strategies as you navigate this process.
  4. Document Your Symptoms:

    • Keep track of your symptoms, including any changes or new issues that arise. This information will be useful during your consultations with specialists.
  5. Stay Informed About Your Condition:

    • Research trusted medical websites such as the Mayo Clinic, CDC, or specialized medical journals for information on septal perforation, its causes, and treatment options.

Remember, you're taking an important step by seeking help and exploring your options. It’s natural to feel disheartened by the complexity of your case, but there are avenues to pursue that may lead to improved outcomes. Keep advocating for your health, and know that support is available.

Related Questions

Understanding Tuberculosis Exposure Risk

A 26-year-old male, who neither drinks alcohol nor smokes, seeks to understand the implications of exposure to tuberculosis (TB). As an anesthesia technician, I became concerned after I encountered a TB-positive patient about a month ago. I had to enter the patient’s room several times to perform blood gas tests. On my first entry, I mistakenly wore my N95 mask incorrectly due to the hectic nature of attending to multiple rooms. From my research, it appears that TB is quite transmissible; direct exposure can pose a serious risk of infection. Transmission usually requires prolonged contact with an infected individual, particularly in a close or face-to-face setting. In this case, the patient was lying face down and appeared to be sleeping when I entered. I have already undergone testing for TB, but I am eager to deepen my understanding of the risks involved in these situations.

COPDInternal MedicineEndocrinology
Male25-34
4 minutes ago

24M | Unexplained Fainting Incident

**Note:** I previously shared this story, but it was inexplicably removed. I’m a 24-year-old male without any medical diagnosis or prescription medications. While I do consume alcohol occasionally, I hadn’t been drinking before this happened. Around 3 a.m., I got up from bed to use the restroom. As soon as I began to urinate, I suddenly felt a wave of dizziness. The next moment I was aware of was regaining consciousness in the bathtub, startled awake by the sensation of something dripping on me—only to discover it was my own blood. This was my first experience with fainting. When I came to, confusion set in. I was disoriented and couldn’t comprehend why I was being dripped on while in what I thought was my “bed.” Strangely, I also imagined that I was lying on a collection of marbles (which I actually don’t own)—this turned out to be the shattered glass of my shower door lying around me. I’m uncertain whether I lost consciousness first and then fell, or if the fall caused my brief blackout. It took me a few moments to understand why I was in the bathroom at all. I’m not sure how long I was out; I only remember it was around 3 in the morning when I initially got up, and about the same time when I regained consciousness. I dialed 911, and the ambulance arrived promptly. They checked my vitals, performed an EKG and measured my blood sugar, finding nothing unusual. At the emergency room, they repeated the vital checks, conducted a CT scan, drew blood, and took x-rays—yet still no abnormalities were detected. I had several cuts on my face and left arm (curiously, this is the arm that would have been turned away from the door), along with bruising around my ribs. Since the incident, I’ve been suffering from headaches and pain in my ribs. I received stitches on both my face and arm. The nurse suggested I could have stronger pain relief, but I opted for just Toradol. They eventually discharged me, stating, "We’re unsure what caused this, but return if it happens again." What might have triggered such an incident? How can I safeguard against it reoccurring if they remain uncertain about the cause?

Thyroid DisordersCOPDInternal Medicine
Male25-34
34 minutes ago

Swelling Beneath My Chin Near the Jawline

18-Year-Old Male: I'm reaching out to any medical professionals who might provide insights into my situation. I've been using marijuana since I was 14, but now, at 17, I'm making an effort to stop and have been clean for 18 days. Recently, I've discovered an unusual swelling located just beneath my chin, behind my jaw. It causes some discomfort when I move, yet it doesn’t feel painful continuously. I'm somewhat anxious that this could be indicative of a more serious issue, especially considering it's positioned near my chin's lymph nodes. Any advice or information would be greatly appreciated as it might help alleviate my worry.

ArthritisLupusInternal Medicine
Male25-34
1 hour ago

Challenges with Appetite and Discomfort While Eating — Difficulty in Gaining Weight

As an 18-year-old male, I find that I become satisfied after consuming rather minimal amounts of food. This situation presents a considerable challenge, particularly since I only need to have a standard breakfast, lunch, or dinner to feel completely satiated for the remainder of the day. My goal of increasing my weight has made this issue even more complicated. When I limit myself to one meal per day, I often face weight loss or an uncomfortable sensation of fullness that leaves me feeling sluggish. Opting for two meals makes me feel excessively bloated, distracting me from my daily responsibilities. Moreover, I suffer from an unusual issue with my throat, where almost any food I consume causes discomfort, as detailed in the list below. I have contemplated focusing on having just lunch while continuing my weightlifting regimen to maintain my current weight and gradually build muscle. What advice could you offer? Could there be an underlying cause for these symptoms? Lastly, would it be wise for me to consult a healthcare professional? Foods That Cause Discomfort: Bread, flour, pizza, fruits, sugary or starchy items, seed oils, chips, and essentially everything else. Foods That Are Tolerable: Rice, salads, chicken, fish, and vegetables. Overall Symptoms Include: * Quick satiety after normal meals * Challenges in gaining weight * Bloated and lethargic sensations when consuming more than one meal * Persistent throat sensitivity to a wide variety of foods

Thyroid DisordersInternal MedicineEndocrinology
Male25-34
1 hour ago

Seeking Insights: My Journey with Undiagnosed Neurological Symptoms

Hello everyone, I'm a 34-year-old female grappling with neurological symptoms that first appeared in October, and I’m eager to hear from anyone who might have faced similar challenges. My journey began with unexpected migraines, blurred vision, and an ongoing sensation of being off-balance or intoxicated. Gradually, I began experiencing mainly sensory-related symptoms, such as tingling and burning sensations, feelings of extreme heat and cold, sharp pains radiating in my arms and back, as well as discomfort in my hands and toes, alongside intermittent numbness. I also endure varying degrees of weakness and heaviness in my right side, specifically my arm and leg, although I haven’t suffered complete functional loss. The nature of my symptoms is erratic; they fluctuate rather than consistently deteriorate. An MRI revealed mild, scattered lesions in the white matter, which were deemed nonspecific. Further tests from a lumbar puncture returned normal results, showing no markers of inflammation, and the oligoclonal bands were not present. A thorough range of lab tests yielded no significant findings. After evaluating my case, the neurology team suggested a possible diagnosis of MS and administered a three-day course of intravenous steroids. While I noticed a slight improvement in some sensory pain, my symptoms persist and continue to vary day by day. I still experience headaches and pressure in my head along with episodes of blurred vision, but there have been no new deficits since treatment. I am reaching out to connect with others who have had similar experiences. I would like to learn about the insights or diagnoses you encountered and what treatments proved beneficial (such as those related to migraine disorders, dysautonomia, or sensory neuropathy, for example). If you have navigated a similar path, I would greatly appreciate your sharing your story. Thank you!

Multiple SclerosisLupusEndocrinology
Male25-34
1 hour ago