Weeks 21-24 & Screw removal

the acupuncture dr suggested that the sessions will help with my bone health more than the numbness.  he thinks the numbness comes back naturally when the body feels like it.  so i stopped getting acupuncture since i was trying to treat numbness.  that's kinda disappointing news.

i added back box jumps to my gym activities.  i don't think it's so bad as long as impact is absorbed properly when landing on the box. 

SCREW REMOVAL
a few days before screw removal, a pre-op nurse called me to go over health history etc. the business day before screw removal, i called pre-op to get my screw removal day surgery time. it was set for 1:30 and show up 90 min ahead.  i didn't need to go in for xrays or labs.  day surgery is typically scheduled after the more complicated/longer morning cases.  not all dr's take out screws but as a pediatric orthopod, i think Dr Millis prefers to take out hardware.  i find them bothersome and poking out at times and Dr Millis also wants to take more images so it's probably better to have them out.

we flew up to boston the day before screw removal. i ate a late dinner, around 9:30, of vietnamese pork chops on rice with a runny fried egg on top. and an avocado shake.  i had to follow the same NPO guidelines as PAO, so no solids after midnight and no clear liquids 2hr before surgery.  i snack and eat all the time so i was really scared about being hungry all the way until my 1:30pm surgery time.  i got some apple juice to get some calories in the morning.  i asked about coconut water (since it's high in electrolytes) but it was dinged b/c it's not clear.

i had to stop fish oil 2 wks prior to surgery. other preparation i did was bring my no-rinse bathing wipes, my cough pillow and some of the pain and nausea meds from PAO.  luckily it's warmer now so i brought dresses to wear so i wouldn't have to deal with pants around my wound.  and i packed my granny undies again.

the morning of screw removal, i actually went to flour bakery to pick up some pastries. they're famous for their sticky buns and the almond croissants are tasty too.  i didn't eat them, just looked at them fondly.  i got a call from an OR nurse asking me to come in earlier if possible.  i was mostly restricted by my last liquid intake.  this day surgery (hardware removal cpt code 20680) did not require pre-authorization from my insurance carrier.

at day surgery pre-op, check-in was signing some consent forms and producing a urine sample.  a nurse went over my health history and took vitals. Dr Millis and his fellow Dr Novais came in to check on any questions i had, and i signed more consent papers.  my main concern was having my incision scar heal prettier this time around so Dr Millis suggested keeping steri-strips on for 4mo and to really try not to over-stretch that area for a month or so.  he said upper body exercises while seated should be fine, but to really try to lay low for the first 2 wks. we decided not to do general anesthesia and opted for conscious sedation.  i did conscious sedation for my impacted wisdom teeth and remember hearing them wrangling my teeth out.  both dr's said this would be much easier than that.  they take the screws out manually(!) with a screwdriver.  i was afraid if i was "awake", i'd hear power drills going and have bone chips flying in my face.

anesthesiology Dr Sethna and his resident started poking stuff into me. i got woozy then was rolled into the OR. i remember a little more this time around.  they showed me on the TV screen.  i started spotting this AM so i left my panties on and they pull them down in the OR.  i remember hearing lots of voices and then they gave me my screws in a baggy and i was clutching onto them.  when i came to, the first thing i said was "i played golf twice".  very random.

i was pretty alert and felt good in recovery.  i had a huge foam bandage on, from mid-thigh to belly.  not quite like the Millis diaper but still pretty puffy.  good thing i had loose undies and a dress cuz there's no way i could get pants over this roof insulation padding.  Dr Millis checked up on me and the nurses went thru discharge.  had some apple juice and oyster crackers.  the only thing that hurt was the huge IV in my hand.  they gave me crutches again. i think i was wheelchaired out in less than an hour.  Dr Millis suggested i eat light first and might have difficulty being comfortable sitting at a restaurant, so we went straight to pick up peking duck and lobster with ginger&scallion sauce. i ate heartily back at the hotel, including my pastries from this AM, then got sleepy and dozed off.

i woke up from pain after my post-op morphine wore off, even tho i also took 1-2mg of dilaudad.  it felt like a really really bad burn and intense stretching. walking around to the bathroom and standing up straight was also uncomfortable and the whole area feels sore. i didn't bathe the first night but used my no-rinse wipes. luckily i don't have any nausea this time.  i slept with a pillow under my knees b/c lying flat seemed to stretch the incision area. sleeping on the unoperated side caused much discomfort in the incision area.

the following morning i removed the puffy protective bandage and the gauze underneath was pristine (no blood leakage).  i was reminded that the painkillers may cause constipation but didn't have a problem. i showered and was going to visit Dr Millis but since there was no bleeding he said not to go in.  i didn't think i'd need crutches but i'm glad they gave me a new pair cuz it's difficult to stand up straight and it's nice to take pressure off the operated side.  i took the T (boston subway) and got lunch but had to walk really slowly.  i should probably be eating my pain meds more frequently b/c i have much pain but can tolerate it.  i guess i didn't feel any of this during the PAO cuz i was on epidural for 3 days.     

i'm getting a lot of itchiness again, on my belly and upper back. same as after PAO, most likely from the pain meds. plane ride back to NYC was fine.  i still have to crutch slowly b/c i feel like the incision is stretching a lot or something but i didn't opt for the wheelchair.  i don't think i need the cough pillow this time around.  it doesn't hurt to sneeze which is good b/c of allergy season.

i ended up using crutches for 6 days after getting the screws out, 2 crutches for the first 2 days then using 1 or 2 crutches depending on how far i was walking. Dr Millis made the screw removal incision the exact same as my PAO one because i wanted to clean up some blobby scarring. usually i think the screws can be removed with just a ~2in opening (vs the 5in PAO incision). i think scar tissue was cut out which made my skin feel more tight, which is why i think i had trouble standing up straight for a while. it felt like i might split open my incision.    

Weeks 18-20 slow going

i've had 4 acupuncture sessions (1x/wk) for my numb spot and haven't noticed any improvement yet. the needles go in different spots each time and the 3rd&4th sessions, the dr put needles in my non-operated leg, shoulders and scalp too.  my insurance doesn't cover acupuncture. the dr cannot say how many sessions i will need but i'll continue to go until i get my screws removed.

my hip joint is feeling less and less discomfort with different movements at the gym--boxing rotation/pivoting and squats. there's still lots of snapping/clicking/popping that my (new) trainer is "amused" by, but i'm annoyed by them so they better go away.  i'm starting to think that the discomfort i have when i tuck knees to chest (while upside-down) is not due to the bone being blocked, but something more strength or flexibility.  i can squat all the way to the floor without any trouble but it's problematic lifting my knee into chest. hip flexion moves like full sit-ups and keeping the leg straight and lifted off the floor are uncomfortable too.  i started doing leg raises while lying down with ankle weights to help strengthen that. it's not pain-free when i do it.

while sleeping, my bad knee does not bend flat to the side (figure 4) comfortably; the knee will not drop all the way down.  sometimes i try to sleep with my bad side bent in different ways to do sleeping stretches/PT!

the first time i tried to jump rope and did fine on 2 feet.  once i tried to skip rope, my brain turned off and i kept tripping, probably out of fear. i only tried for like 5sec tho b/c my hip area actually did hurt on impact on the operated side. i jump rope regularly now including double-unders but landing on the bad leg alone is still causing pain. double-unders are fine.  i can do stairclimber 2 steps at a time w/o any issues but cardio machines are so boring for me, i only do it for 5mins.  i haven't tried running yet but i can "run" sideways fine, which is a common boxing drill (running around in a circle or ring).

played golf for the first time at 5-mo post.  our club is walking only and kinda hilly so i've been scared to go out but the forecast was mid50s so i gave it a go.  plus i'll be out again for 3-4wks after my screws come out. surprisingly i didn't top or shank any shots and managed to break 90.  i tend to use my upper body more, even before surgery (i have the same problem with boxing), and today i def felt that i was using my lower body even less.  i probably had more winter rust issues with my swing than i can blame on my hip.  it was great to be out again and i look forward to my next round.

What to bring for hospital stay

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.