Re fractured nose with deviated nasal septum

Dear Ask The Doctor: I have a broken nose, I broke in 4th grade, and on the 25th of Febuary I broke it again, and my septum is now in the middle of my left nostril, and I am in terrible pain, it hurts to move or anything. I am having shooting pains through my face, ears, and head. What can I do? I am tempted to go to the emergency room, but I don't know what they will do. I have an appointment with an ENT April 25th, that was the soonest they could get me in but I am concerned because my doctor told me I need something done asap. So my question is if I go to the ER (Gerber Hospital) will they do anything, or just give pain meds and send me home? I am allergic to most pain meds, so I really don't want any, I want something done to fix the problem. It is very hard to breath.

Dear Deb: If your injury is severe, as you described, and you are in a lot of pain with remarkable swelling you'll need to seek immediate medical attention and won't have time to prepare for your appointment. I strongly recommend you to go to the doctor before the appointment that you mentioned, because a deviated septum is not the only complication of a fractured nose, but these ones too: collection of blood or hematoma that may block one or both nostrils, a septal hematoma requires prompt surgical drainage to prevent cartilage damage. If your fracture is due to a forceful blow, such as from an automobile accident, you may also experience a cartilage fracture. If your injury is severe enough to warrant surgical treatment, the surgeon should address both your bone and cartilage injuries. If the break has displaced the bones and cartilage in your nose, your doctor may be able to manually realign them with a nonsurgical procedure called closed reduction. Closed reduction should be conducted no more than 14 days after the fracture. Severe breaks, multiple breaks or breaks that have gone untreated for more than 14 days may not be candidates for closed reduction. In these cases, surgery to realign the bones and reshape your nose (rhinoplasty) may be necessary. If the break has damaged your nasal septum, causing obstruction or difficulty breathing, reconstructive surgery called septorhinoplasty may be recommended.