this is a little out of order chronologically but might be helpful.
i put the outfit i wore to surgery in a paper bag after changing into the johnnie. this is probably all the clothes you need for your whole stay, and you can wear it home upon discharge. wear a loose pair of pants because you will probably be swollen (surgery fluids, trauma) and the incision area will be tender.
if you're not a beauty queen, all you probably need is lip balm. CHB had toothbrush, toothpaste, soap, shampoo, lotion, comb. i probably would have preferred to have my own hairbrush. they also had baby wipes which i used for everything (face, underarms, hands). i have an unhealthy addiction to my nailclipper, so i brought one to snip off hangnails and things.
i probably wouldn't have worn any underwear b/c it's an ordeal to get them off to use the toilet. but i got my period and the hospital gave me these funky gauzey panties and pads. PT was all women, which was the only time i was standing up, so i didn't care much about them seeing my gauze undies. plus i was too drugged out to care. otherwise, some loose-fitting undies might be useful if you don't want to wear the hospital ones.
i had my blackberry with me for emails, phone calls, pictures and taking notes. headsets are good for long calls (like more than 2min long) cuz i was too tired to hold up my phone usually. blackberry charger.
camera, for snapping pix for the memory pages. (make sure battery is charged).
i didn't bring any books or other forms of entertainment. never turned on the TV either. magazines were too heavy to hold and too many words to focus. i was kept plenty busy with nurses, drs, and my own visitors. plus sleeping.
if you have an itch cream you think works for everything, you might want to bring that. otherwise you are in a hospital so they can get anything you need. rubbing alcohol felt great on my super itchy areas.
i didn't wear shoes or slippers, just the grippy socks they gave me.
there are plenty of blankets at the hospital if you get cold.
Sunday, March 27, 2011
Sunday, March 20, 2011
PAO Timeline - Prep & Recovery
here is a rough timeline of my PAO preparation and recovery, per Dr Millis and CHB instructions.
Pre-surgery
*give 2 pints of blood (some patients may require more or less). check with your blood center for how long before surgery, how close to surgery and how far apart you can give blood. CHB would take my blood 6wks before and no later than 1wk prior to surgery. 1 blood giving per 7 days. remember to tell them if you've been sick or if you've eaten any NSAID anti-inflammatories (72-hrs).
*if you have to give blood, follow the iron supplement guidelines and when you should stop taking them pre-surgery (i think they want to make sure you're not constipated prior to surgery)
*Dr Millis's preferred dGEMRIC MRI for checking cartilage health
*stop birth control pills (resume 1mo post) and any blood-thinning supplements (aspirin, fish/flax oil) 2wks prior
*remove nail polish (get toenails trimmed too cuz you won't be able to reach them for a while!)
Hospital stay
Day 1: pain meds (the strong stuff) and Lovenox anti-blood clotting shots (daily). PT ankle pumps, glute squeeze, quad extension.
Day 2: remove wound drainage, cut off Millis diaper (mummy gauze wrapping my whole mid-section), replace Tegaderm over incision steri-strips, start very remedial PT in bed (limb movement with help of PT; adduction/abduction, bend knee and slide foot to butt, pronate knee).
Day 3: turn off epidural, take out catheter, get out of bed and into wheelchair. hang out in sofa recliner. walk parallel bars for PT.
Day 4: first real shower. parallel bars for PT still very difficult since hip flexor does not let my foot advance. learned how to use crutches. 1/6 body weight on bad leg. keep bad leg in front of good leg at all times.
Day 5: did stairs for PT. managed to not fall face down and passed PT on 2nd try tho still very difficult to lift bad leg down steps. discharged.
Week 2
*preferred wheelchair until Day 9, miraculously could do stairs w/crutches without looking crippled
*Dr Millis replaced Tegaderm over steri-strips Day 9
*switched to 650mg Tylenol on Day 13; stopped all pain meds 2-weeks post-op
*calcium, vitamin C, and iron for bone-healing; meat protein for incision to heal
Week 3
*put away commode
*lift leg off couch w/o using hands to aid it
*steri-strips all fallen off incision
Week 4
*cured my torso itchiness finally w/coconut oil (after using sarna, gold bond, curel, benadryl cream)
*energy improving; no more catnaps
One-month post-op
*Dr visit
*no more hip bending restrictions
*40% body weight on bad leg
*can walk with normal gait with 2 crutches
*no more pillow under knee while sleeping, can sleep on side with pillow between knees as support
*PT: butt bridges, ab crunches, quad stretch, theraband leg raises
*gym: bike 0 resistance, gentle swim, upper body and anything that doesn't engage hip movement, calf press, ham curls
*stop lovenox shots, move to 81mg baby aspirin for 60 days
*massage scar with coconut oil to make it heal prettier and reduce keloid formation
Week 6
*able to raise leg while standing and sitting and keep it propped up comfortably
*can vacuum with one crutch
Week 8
*not using crutches while home and walking fine (not sanctioned by Dr Millis) but never leave home w/o them
Week 9
*managed to clip toenails of bad foot with some discomfort since cross-legged sitting hurts at the hip and knee doesn't drop to ground
10-week post-op
*Dr visit
*stress fracture near ischium surgical cut (so be careful cuz i didn't feel any pain!)
*graduate to 1 crutch
*PT: figure-4 hip flexor stretch, hip flexor stretch over edge of table, theraband leg lifts w/stiffer band, balance on left leg, no more L/R weight-bearing restriction
*return wheelchair (tho probably could have returned 1-mo post)
Month 3
*knee continues to feel weak and un-secure; Hip Team says this is due to quad weakening
*starting to notice screws thru my skin
*don't need to be sitting to put on socks and pants anymore as much (had discomfort at hip bend before)
4-months post-op
*Dr visit
*no more crutches
*bone filling in well, fracture healing well but not 100% yet
*can do any physical activities except impact (jumping, running--at least not yet); golf and boxing ok
*cross-legged sitting is 97% discomfort-free
*small triangle wedge below incision has some sensation back but numb spot is still very big (just below groin to knee, whole front half of thigh)
*start acupuncture for numb spot
4.5-months post-op
*jump rope on 2 feet (skip rope is too much impact landing on operated leg alone)
5-months post-op
*played first round of golf
Week 24
*screws out in day surgery
*painkillers for 24hrs
*crutches for 3-5 days as tolerated
*wound should be closed 2wks post
*started light exercises 3 weeks post-screw removal
*went boxing 1-month post-screw removal
Pre-surgery
*give 2 pints of blood (some patients may require more or less). check with your blood center for how long before surgery, how close to surgery and how far apart you can give blood. CHB would take my blood 6wks before and no later than 1wk prior to surgery. 1 blood giving per 7 days. remember to tell them if you've been sick or if you've eaten any NSAID anti-inflammatories (72-hrs).
*if you have to give blood, follow the iron supplement guidelines and when you should stop taking them pre-surgery (i think they want to make sure you're not constipated prior to surgery)
*Dr Millis's preferred dGEMRIC MRI for checking cartilage health
*stop birth control pills (resume 1mo post) and any blood-thinning supplements (aspirin, fish/flax oil) 2wks prior
*remove nail polish (get toenails trimmed too cuz you won't be able to reach them for a while!)
Hospital stay
Day 1: pain meds (the strong stuff) and Lovenox anti-blood clotting shots (daily). PT ankle pumps, glute squeeze, quad extension.
Day 2: remove wound drainage, cut off Millis diaper (mummy gauze wrapping my whole mid-section), replace Tegaderm over incision steri-strips, start very remedial PT in bed (limb movement with help of PT; adduction/abduction, bend knee and slide foot to butt, pronate knee).
Day 3: turn off epidural, take out catheter, get out of bed and into wheelchair. hang out in sofa recliner. walk parallel bars for PT.
Day 4: first real shower. parallel bars for PT still very difficult since hip flexor does not let my foot advance. learned how to use crutches. 1/6 body weight on bad leg. keep bad leg in front of good leg at all times.
Day 5: did stairs for PT. managed to not fall face down and passed PT on 2nd try tho still very difficult to lift bad leg down steps. discharged.
Week 2
*preferred wheelchair until Day 9, miraculously could do stairs w/crutches without looking crippled
*Dr Millis replaced Tegaderm over steri-strips Day 9
*switched to 650mg Tylenol on Day 13; stopped all pain meds 2-weeks post-op
*calcium, vitamin C, and iron for bone-healing; meat protein for incision to heal
Week 3
*put away commode
*lift leg off couch w/o using hands to aid it
*steri-strips all fallen off incision
Week 4
*cured my torso itchiness finally w/coconut oil (after using sarna, gold bond, curel, benadryl cream)
*energy improving; no more catnaps
One-month post-op
*Dr visit
*no more hip bending restrictions
*40% body weight on bad leg
*can walk with normal gait with 2 crutches
*no more pillow under knee while sleeping, can sleep on side with pillow between knees as support
*PT: butt bridges, ab crunches, quad stretch, theraband leg raises
*gym: bike 0 resistance, gentle swim, upper body and anything that doesn't engage hip movement, calf press, ham curls
*stop lovenox shots, move to 81mg baby aspirin for 60 days
*massage scar with coconut oil to make it heal prettier and reduce keloid formation
Week 6
*able to raise leg while standing and sitting and keep it propped up comfortably
*can vacuum with one crutch
Week 8
*not using crutches while home and walking fine (not sanctioned by Dr Millis) but never leave home w/o them
Week 9
*managed to clip toenails of bad foot with some discomfort since cross-legged sitting hurts at the hip and knee doesn't drop to ground
10-week post-op
*Dr visit
*stress fracture near ischium surgical cut (so be careful cuz i didn't feel any pain!)
*graduate to 1 crutch
*PT: figure-4 hip flexor stretch, hip flexor stretch over edge of table, theraband leg lifts w/stiffer band, balance on left leg, no more L/R weight-bearing restriction
*return wheelchair (tho probably could have returned 1-mo post)
Month 3
*knee continues to feel weak and un-secure; Hip Team says this is due to quad weakening
*starting to notice screws thru my skin
*don't need to be sitting to put on socks and pants anymore as much (had discomfort at hip bend before)
4-months post-op
*Dr visit
*no more crutches
*bone filling in well, fracture healing well but not 100% yet
*can do any physical activities except impact (jumping, running--at least not yet); golf and boxing ok
*cross-legged sitting is 97% discomfort-free
*small triangle wedge below incision has some sensation back but numb spot is still very big (just below groin to knee, whole front half of thigh)
*start acupuncture for numb spot
4.5-months post-op
*jump rope on 2 feet (skip rope is too much impact landing on operated leg alone)
5-months post-op
*played first round of golf
Week 24
*screws out in day surgery
*painkillers for 24hrs
*crutches for 3-5 days as tolerated
*wound should be closed 2wks post
*started light exercises 3 weeks post-screw removal
*went boxing 1-month post-screw removal
Friday, March 18, 2011
Week 17, trying to get back to normal
my first day off crutches at the gym, i did some kettlebell swings and snatches with 12kg. the swings were a bit uncomfy on the hips at first with clicking feelings but it went away. 2nd day at the gym i did wall balls with 10lb ball. wow, my legs were so sore, i think i was walking worse after these workouts than after surgery! i almost needed to pull out my commode chair again cuz i couldn't sit. nothing hurt otherwise. lunges surprisingly don't bother me at all. with squats i need to modify how deep i go cuz it doesn't feel stable and i feel myself shifting to my good side.
i started boxing again too and feel some discomfort when pivoting/rotating on the lead leg (my operated left leg). i feel fine the next day however so hopefully my leg just needs to get used to the movement.
practiced my golf swing with a wooden stick. rotation/pivoting felt fine but i wasn't making any impact on the ground. will be interesting to see where the ball goes when i get back out. this is def the longest stretch of time i've gone w/o playing golf.
from month 2 to month 4, i'd say i put on maybe 8lb of unwanted weight. probably a combo of being mobile but not able to do real cardio. plus i sought out maybe 20 different cupcake and pie shops and fried chicken joints for taste tests in that time.
for PT, i continue the figure-4 and hip flexor stretch over the table. i think i might add ankle weight full leg raises (while lying down) to help strengthen the hip area.
after walking for a while, i feel like i start walking funny. it's not really pain. maybe it's being cautious and a little tired. or is my operated leg longer now?
i tried acupuncture for my numb spot. the dr ran electrical pulses thru a few of the needles, including one on the top of my foot. the needle in my numb spot i didn't feel at all. i don't notice any improvement after 1 try and will go again next week.
i've started training again, boxing 2x/week plus a boxing class, and strength 2x/wk. my former trainer has decided not to make me strong anymore but would rather make me chubby and meet for burgers and toasted marshmallow shakes instead. so i met a couple new trainers to see who could rebuild my lower body and bring PAOer back to my hips! we're taking it slow as they're learning about limitations just as much as i am.
my screw removal is set for may as a day surgery at CHB, roughly 6 months post-op.
i started boxing again too and feel some discomfort when pivoting/rotating on the lead leg (my operated left leg). i feel fine the next day however so hopefully my leg just needs to get used to the movement.
practiced my golf swing with a wooden stick. rotation/pivoting felt fine but i wasn't making any impact on the ground. will be interesting to see where the ball goes when i get back out. this is def the longest stretch of time i've gone w/o playing golf.
from month 2 to month 4, i'd say i put on maybe 8lb of unwanted weight. probably a combo of being mobile but not able to do real cardio. plus i sought out maybe 20 different cupcake and pie shops and fried chicken joints for taste tests in that time.
for PT, i continue the figure-4 and hip flexor stretch over the table. i think i might add ankle weight full leg raises (while lying down) to help strengthen the hip area.
after walking for a while, i feel like i start walking funny. it's not really pain. maybe it's being cautious and a little tired. or is my operated leg longer now?
i tried acupuncture for my numb spot. the dr ran electrical pulses thru a few of the needles, including one on the top of my foot. the needle in my numb spot i didn't feel at all. i don't notice any improvement after 1 try and will go again next week.
i've started training again, boxing 2x/week plus a boxing class, and strength 2x/wk. my former trainer has decided not to make me strong anymore but would rather make me chubby and meet for burgers and toasted marshmallow shakes instead. so i met a couple new trainers to see who could rebuild my lower body and bring PAOer back to my hips! we're taking it slow as they're learning about limitations just as much as i am.
my screw removal is set for may as a day surgery at CHB, roughly 6 months post-op.
Wednesday, March 9, 2011
Four-months Post-Op Appt
i have been cured of my crutches! hooray! i had my 4-mo post-op appt and i was prepared to hear that my stress fracture was not healing because i haven't been sitting at home quietly like a good patient. PA erin showed me xrays from today and a month ago and said everything is healing well. the main bone part where all the screws are is healed in fine. the cuts in the bottom part still need some time. i sometimes have a dull ache/bruise feeling in my butt crease. PA erin said this is normal even tho the fracture is healing. i have been cleared for golf and boxing (lots of rotational/pivot motion but ok). i still can't do impact activities, so no jump rope, box jumps, running stairs etc. i can squat with light weight (10lb should be fine) so i might try to do wall balls again (squatting and throwing a medicine ball against the wall).
i will probably get my screws taken out in the next couple of months. i'll need a couple weeks for the incision to heal again before being active so the scar will heal smoothly. Dr Millis suggested i don't need to get general anesthesia, just some sedation and no intubation. it takes maybe half an hour and i'm on my way. i'll try to schedule it so it won't interfere with golf season (which seems so far away in this cold weather). screw removal is done mon/fri, usu after major surgery cases are completed.
PT jamie gave me a pilates move to do. lying down, press lower back into ground and march feet up and down with knees bent. this helps core. she suggested some other hip strengthening exercises. i asked her if i really need to do them since my hip is quite strong as is and i never really did those types of things pre-surgery. she didn't think i'd have to, but if i get bored maybe i will. i will continue with my stretches (pinformis figure-4 and hip flexor off edge of table) b/c i think i'm still tight in these areas.
my cross-legged sitting position is getting more comfortable. i can bring knees to chest (tucking) while upside-down a little easier now too. there will be some limitation there now since the surgery makes my femoral head bump into the acetabular roof more.
a small triangle-shape area below my incision has gained back full sensation in my large numb spot. there is a patch that feels bruised and is a little sore when i walk, around mid-thigh. otherwise my numb spot is still very large, which i'm told is normal. Dr Millis commented that he inserts the screws in such a way that the nerve doesn't need to be fussed with when he removes the screws.
i didn't realize...that may have been the last time i saw my hip team! unless my right side decides to act up.
i will probably get my screws taken out in the next couple of months. i'll need a couple weeks for the incision to heal again before being active so the scar will heal smoothly. Dr Millis suggested i don't need to get general anesthesia, just some sedation and no intubation. it takes maybe half an hour and i'm on my way. i'll try to schedule it so it won't interfere with golf season (which seems so far away in this cold weather). screw removal is done mon/fri, usu after major surgery cases are completed.
PT jamie gave me a pilates move to do. lying down, press lower back into ground and march feet up and down with knees bent. this helps core. she suggested some other hip strengthening exercises. i asked her if i really need to do them since my hip is quite strong as is and i never really did those types of things pre-surgery. she didn't think i'd have to, but if i get bored maybe i will. i will continue with my stretches (pinformis figure-4 and hip flexor off edge of table) b/c i think i'm still tight in these areas.
my cross-legged sitting position is getting more comfortable. i can bring knees to chest (tucking) while upside-down a little easier now too. there will be some limitation there now since the surgery makes my femoral head bump into the acetabular roof more.
a small triangle-shape area below my incision has gained back full sensation in my large numb spot. there is a patch that feels bruised and is a little sore when i walk, around mid-thigh. otherwise my numb spot is still very large, which i'm told is normal. Dr Millis commented that he inserts the screws in such a way that the nerve doesn't need to be fussed with when he removes the screws.
i didn't realize...that may have been the last time i saw my hip team! unless my right side decides to act up.
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