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