Week 3: PAO Surgery

Welcome back!

*Anything underlined is specific information about the surgery or recovery process.

This surgery, called a periacetabular osteotomy, comes exactly 2 weeks after my arthroscopy surgery for my labrum repair.

Day 14: Second surgery day #2

It was another 9am arrival. I first signed off on my mom and dad being able to make decisions if anything happened to me, which is something strange to do. I was also very dry, skin wise, with no allowance of lotions.

I went into the back, they put in my IV (hand, this time, left) and I met the surgery crew, one by one. It was mostly my anesthesiologists. They were very sweet, humorous personalities, and were great about my skin. Dr. Murphy, the lead anesthesiologists, chatted joyfully with me about medical school and the 12 years it takes to get to her position.

When they rolled me into the surgery room, they made jokes with me. They were also gracious enough to first tell me they were putting oxygen in the mask. When they were going to start the hard stuff, they sent me off with waves and “see you laters”.

I woke up in my recovery room. I was groggy but didn’t feel very nauseous. I was also in a more laying position, though. Throat was scratchy – tubed me again. In addition, they added a second IV on my right hand. It wasn’t attached to anything, but it was there just in case.

My mother said she spoke to the surgeon, Dr. Feldman, and he stated that I gave him a hard time with my bones being super strong. He had to put a bit more muscle in.

Talking winded me, easily. I spoke to both my boyfriend and my father over the phone.

I don’t remember when I tried to pee my first time, but I wasn’t able to move, so they had to put a bed pan underneath me. Not comfortable at all, but I see why it is necessary. Peeing can be an issue for a lot of people because of the anesthesia and the possible epidural I had. I just couldn’t pee.

They gave me a time frame of surgery to 12am — either pee by then or they’d need to give me a catheter to unload my bladder.

My leg pain also started to get worse. I believe she gave me my first oxycodone of 2.5mg late that night.

By 12am, I had tried two more times to use the restroom. It wasn’t happening. Boo.

At 1am, my amazing nurse, Eliany, came in to give me a catheter. She made this new and scary experience as good as it possibly could be. The catheter is highly lubed, and silicone, so once it was in and the juices were flowing, she and I just chit chatted. In the end, I had a whopping 900ml of fluid come out. She was stunned! The woman who took my vital signs was also shocked. 900ml = 30 ounces. I really had to pee!

At 4am, my vitals were taken and I had a fever of 101. 6. The tremendous amount of blankets on me probably didn’t help, so she took some off and gave me this blow toy (can’t remember the name). You have to breath in and out of it. Whatever magic it has, it brought down my temperature to 99.6. She gave me some Tylenol to help keep the fever down.

Then at 4:30am, I had blood work taken.

During all of this, they would give me Toridol every 3 hours as an anti-inflammatory. It goes into your IV and can sting a bit. One nurse told me that they can dilute it so it doesn’t sting as much — the sting could mess up the vein and we’d have to use the other hand.

Speaking of IVs, around 6am, Eliany realized that I had messed up my left hand IV (it was sticking out and crunched), so we had to move my fluids to my other hand. It is extremely hard to move yourself with a complete dead leg on your hands. It’s just a massive anchor, so I had to be more careful with my right hand pushing and pulling myself on the bed.

Day 15: At 8am, my surgeon and his legion of people stepped in. He took a look at my spot. It’s definitely long. My leg and left abdomen are also very swollen — a few different colors in there. I also asked him, before he vanished as quickly as he ambushed my room, if I could get the Covid vaccine at any point. He said for us to do our two week post op appointment first to see how my body is doing. He doesn’t want to overwhelm my system.

The biggest thing of the day was at 10am. My psychical therapist, named Pam, came in. Lord, help me.

It was HARD. I don’t know how people leave home that day right after surgery. I never could have left the hospital that day.

First, she teaches you foot pumps, knee pumps, and glute pumps, at least as best as you can do them. She then went into two passive leg movements my mother had to learn to do. You can not do them by yourself — you MUST have someone do them with you. The first, is moving my left leg into a 90 degree angle, or as much as my leg will allow. It is unbelievably weird to allow someone else to move my leg. There are so many tight feelings. My leg would make little twitches wanting to help but knowing it wasn’t allowed to. The second movement is to abduct the leg 15-30 degrees to the left. We stayed conservative and tried to only do 15-20 degrees. Again, my body wanted to fight back, but I had to Elsa my way through it all. Let it goooooooo.

She then had me sit up, which I hadn’t done. My metrosexual nurse, Sam, showed me I could use this triangle device hanging above my head to sit up, but to not get used to it since I wouldn’t have it at home. I had to push myself up using my horribly bruised ab to slowly rise, plus a right hand that I couldn’t put too much pressure on. I never realized how much a dead weight of a left leg would affect my ability to simply sit up.

Now standing — they wanted me to start with a walker. The dizziness was already setting in, but I tried to rise up putting pressure on the walker and my steady leg. They also stood by to help me if I wobbled.

Now the dizziness was apparent and the nausea was also making an entrance.

“Are you feeling dizzy? Are you going to pass out?” Pam asked.

I don’t know? I had never fainted before and I just told myself this wasn’t the moment to do it. I told her no, so we attempted to walk me to the bathroom, which was about five feet away, with the toilet being about 7 feet away. What she wanted me to do was using a dipping and swinging motion — pushing the walker forward and then, putting my full weight into my arms, using both of my legs to hover above the ground before putting them both down. Only 30lbs (or toe/foot touch down) on the left leg and the rest in the right. I would continue on as such.

Sounds easy. With my dizziness, nausea, and new leg, I was struggling. It was, and still is, a mind game for me to not use any muscles, especially my quad, in order to move my left leg. Plus, all the pain in that leg and muscle aches in my abdomen made it hard for me to distinguish which muscles were the correct ones to use and which were the no-no ones.

And, once I made it to the toilet, it wasn’t exactly a normal toilet. It is a special commode for those needing assistance in sitting. It’s this faux toilet that hovers above the actual seat and had handles to help you sit down.

I could pee on my own! Yea! But my already shocked body was ready to just go lay back down. But, nope.

The next device presented to me while I was sitting on my throne — a wheelchair. I needed to try and sit in it for an hour, however I should try 30 minute increments throughout the day. She said all my exercises should be done 3x a day.

“We need to get her ready for her car ride home.” So there I was, practicing my sitting. Sounds simple. However, I was starting to shake by 30 minutes in, my leg pain becoming too much for me accompanied by the dizziness and nausea. When they took my blood pressure in the wheelchair, it was 96/58. This girl had had enough.

They helped me back into the bed, my leg vibrating from pain. I began to shake and they covered me. Nurse Sam with his perfectly quaffed hair (I actually told him this when I was first waking up from surgery) came in and asked about my pain once I was situated in bed. I told him I was at a 10. He provided me with my first 10mg dose of oxycodone. It worked its magic and lulled me to sleep all bundled in my bed.

Once awake, I ate a few bites of the hospital Salisbury steak and potatoes. Nurse Sam was not excited about my dinner and got me a menu to have for the rest of my stay to see if I wanted anything else. With my low blood pressure and tiredness, I could care less with food. I only ate tiny bits here and there. The only liquids I really enjoyed were the small cranberry, orange, and apple juices they would gift me.

My anxiety grew once my meal was over. I had to get up and use the bathroom and I was scared. We called a helper in. It went badly.

I legitimately struggled to move 7ft in my walker to the toilet. I couldn’t lift my body. The walker felt too low to me and the agony of those 84 inches had me go full white and sweaty as I sat on the toilet. They saw my face and immediately called for Pam to come in. She then saw my face sitting on the toilet and she grew anxious. No one wanted me to faint, especially me. They set up my wheelchair right outside the bathroom door. I muscled my way over to it and sat down. They got some color to come back to my face.

As I sat, Pam obstinately adjusted my walker to be a notch taller. She felt it would be too tall but I was not going to struggle one more second with that infernal object. After my seated torture, I was allowed back into the bed. This was around 4:15pm. I was given more oxy as well. I fell asleep.

I was out for about 2.5 hours which was lovey. Nurse Sam had added more toradol in my IV, as well as an iron drip for my red blood cells.

The biggest win was getting up to pee and not feeling like I was going to keel over. I was happy. I had my mother help me wet wash off my neck and ears that night.

I did a little wheelchair run around in the room and my leg exercises in the bed. It stung my leg, but I had to wait for more medications. You can only take the oxycodone every four hours, max.

My dinner, at 9:15pm (which needed to be heated since it had been sitting since 7pm) was a chicken leg and mac-n-cheese. Not bad. I was given 5mg of oxy at 9:45pm. My mother left around 10:45pm.

Day 16: In the middle of that night, they came at 4am to check in on me (from my memory). I only took the toradol. I should have taken more oxycodone.

At 5:30am someone came to check my blood pressure. It was low again. I asked for a bed pan since I didn’t have the energy to get up and use the bathroom.

What sucked was the ice machine wasn’t really working fast enough on the floor to produce what was needed. I had to wait for ice until 6:30am.

My doctor came in, once again in such an abrupt fashion, around 8:30am and cleared me to leave either that day or the following one depending on how I felt. He took a look at my swelling and said it was absolutely fine. There was a lot but he said it’s because he didn’t want to put a drain in. He didn’t want to chance me needing a blood transfusion. Okayyyy.

He then made fun of my Spiderman pillow that sat next to me in bed. Wonderful bedside manner.

I got up at 9:30am without much dizziness. Peed, but no #2. All these medications were stuffing me up. I was worried about leaving that day with how my stomach was behaving, as well as my pain.

This is where I got a little lax on my notes — I was, and am, generally exhausted. It was hard to concentrate. It’s taking all my might to even write this blog. No wonder no one has really kept a log on their progress, week by week. I am a workaholic and I didn’t open my computer ONCE while in the hospital. This surgery will kick your ass, ,plain and simple. My pain tolerance is pretty high, so if you’re able to awake from this surgery feeling like a million bucks, then go you!

My new PT guy, Justin, came in around 10am. You could tell the girls on the floor liked him. He had a Cali vibe, lax and ‘go with the flow’ attitude. He encouraged me to use my walker for a bit and roll around on my wheelchair. After a good roll around (new on the wheeeeeeels), I came back and to the room, shot up some Toradol, and got back in bed for exercises. Then, I fell asleep for about 30 minutes.

My blood pressure was still around 96/58. Eh. I really didn’t want to leave that day feeling so blah.

My nurse that day was lovely and pretty. Her name was JZ and originally from the Philippines. She was nice to converse with on the down times when she came to check on me and get me medications or ice.

My mother bravely washed my hair in the shower that late afternoon. It took some planning and maneuvering in my reclining wheelchair, but she did it. However, once my long hair was fully brushed, the shivering set it. I immediately needed to be back in bed and covered up before the shaking got too out of control.

You see, there is this thing called muscle spasms and it is HELL if it happens to the left leg. It’s like a bolt of lighting that jolts your leg into firing all those painful nerves. They tell you they don’t want your leg muscles to pick the leg up or move it because it could hurt the healing process. Well, a leg spasm scares me since it not only hurts, but forces the muscles to tense and move my leg. I’ve experienced a handful already and they come whenever they wish.

I slept a little and awoke around 5:30pm. They also took my vitals and my blood pressure was better — 106/61. That gave me some hope. The only thing now was my bathroom issue.

This is where the night went south… very, very south.

I went against my gut intuition. They had already given me Milk of Magnesia and Miralax I believe, but nothing worked. I wanted to do magnesium citrate since I knew it would just come out, no work on my end. With the toilet being so strange and my feet almost dangling, I had no way of doing anything to help a bowel movement. I was stuck with the dead leg and no traction.

But, my new nurse, little, old, Luz, was really adamant I let her use a suppository. I really wanted to do what I was comfortable with and knew would work, but she stated she was known as the “rotor router” at the hospital and to trust her. So, I did.

What came next was excruciating.

“You’ll have to roll on your side,” Luz explains. Excuse me?

My hip pain was not going to tolerate being forced sideways for her to shove something up my ass. But, no, no other explainable way to give me a suppository.

For the first time, between both surgeries, I involuntary started crying as soon as she pushed my body onto my right side. The pain was just overwhelming. This huge, swollen, left side was now pressured down on top of me, and the tears just flowed. It was the worst feeling of torture, for what I felt, was no reason. And then I had to lay there for 30 minutes waiting to see if it would work. It barely did. I had to struggle over to the bathroom and I sat on that toilet for a good 20 minutes I am going to guess, to only produce a small bowel movement. It wasn’t easy and I thought I was going to throw up at one point. NEVER AGAIN. It wasn’t worth it at all.

I sat down in my wheelchair and ate some ice chips. Nurse Luz was thrilled that I went. I secretly wanted to punch her in the face. She was such a nice, older lady, too, but was on my shit list, literally and figuratively.

My mother was scared to leave me even though the policy stated she wasn’t supposed to stay. Nurse Luz, my torturer, gained some points by stating my mother could stay and sleep on one of the chairs in my room that pulled out. I didn’t want to be left alone. I already missed my boyfriend so much and could have gone for a massive embrace from him, so I was grateful I had my mom by my side that whole night in case I had another bathroom incident. Plus, the nurses at night aren’t always quick to respond to a request and I was not going to shit myself. I was humiliated enough that day, along with my crazy skin, that defecating on my bed would have been the straw.

Day 17: No one really bothered me at night. I didn’t get blood taken and my blood pressure was still on the better side. I was ready to leave.

I did a little PT with my mom, peed, brushed my teeth, did a wash down sitting in my wheelchair, and then ate a little breakfast (just eggs). At 9:30am, I was given some meds (aspirin, toradol, something for acid reflux, and stool softener). Then at 10am, 10mg of oxycodone. I wanted to be able to do my exercises and rest while my mom had to leave and go get everything from our hotel room to check out.

The physical therapist came in while my mother was gone to show me how I could try out stepping up and down on a step, but I was already getting sleepy from the meds. He came back later, once my mom was back to show us how to do it. You back up to a step and go up backwards, using your good leg first. When going down, you go forward, putting weight into your waker/hands and swinging the weight down.

Before he had come back to show me how to do the steps, I got up to pee. When I sat on the toilet, I could tell how swollen my left side was. Everything looked lopsided. And because my left side pushed towards my right, some of my skin has been irritated on my inner left thigh, and behind my left leg there is a spot that is really irritated since my leg sweats while seated from the weight and not being able to move. It’s lovely. My skin as well has been very dry. I hate the way I feel throughout the day. I am now dealing with TWO huge issues, a leg and my skin. But it is what it is.

After PT, I was able to sign all my paperwork, get my meds, and grab all of my stuff. My new nurse, Yanet, made sure I was given one more oxy for the road, placed me in my wheelchair, loaded up my walker, and helped us down to the first floor. As my mother grabbed my car, Yanet stood waiting with me, telling me how she wishes to travel soon and find a more permanent residence here in the states (she is from Cuba).

We left around 1:30pm. I was placed into the backseat for what was thought to be a more comfortable ride — slide me backwards into the driver’s side so my left leg was up against the seats. It’s not as great as it sounds. I am 5’5″ and it was tight. No wiggle room once the door closed. I think it would have been better in the front seat.

We almost made it home without a blip, but my mother got pulled over for a stupid reason! They gave her a ticket, which annoyed me. The officer was clearly trying to meet his quota for the end of the month.

My father met us at my apartment and my mother pulled in as far as she could to my door. They each helped me out and settled me into a seat. I was pretty winded, which concerned my father. I could tell he was excited to see me and how I was doing. Even though I was tired, I sat up with him and chatted.

When he left, to go get me his blood pressure machine, I went and used the bathroom before laying down. I just hated seeing so much swelling. Everything is just like jelly.

I rested for a bit. My dad showed me the blood pressure machine while I was in bed. I then did my exercises with my mom before my boyfriend showed up with little gifts from his family and some food for me. I was so happy to see his face. The first thing he thought of when he saw my walker was that we could totally deck it out. He knows me so well and I hadn’t even thought about that with everything else that was on my mind.

We got to visit, then off to bed.

Day 18-20 combined:

I’m exhausted, so this is being condensed to the main event things.

One, sleeping is going to be an on and off thing. First night wasn’t horrible, but you are going to want to get up in the middle of the night to pee. My mom lovingly always helps me. Your leg, for everything, is dead weight. You will need help.

Two, try and cut down on the oxy as soon as you can. I was still taking 5mg every 4-6 hours that first real day home. On the second day home, I stopped. I used Tylenol twice for pain relief and that was it. It just completely blocks your stomach.

Three, any motion, like coughing or sneezing, made my hip have a popping nose. It’s scary, but I cannot help it. While my boyfriend was visiting once for lunch, I got something stuck in my windpipe and having to do a big cough terrified me. You never know what’s going on in that swollen hip.

Four, hip spasms will happen. I had one last night and it sucked. It jolted me up at 12:30am.

Five, I have crazy dreams. I think it was from the oxy and anesthesia still wearing off, so it might happen to you. They were amazingly vivid. The first one was Day 18 night. My boyfriend was happily available at 1:30am for me to talk to him about it. I loved being able to chat with him so late.

Six, use whatever you need for your stomach — stool softeners, fibrous foods, and cutting down of meds. I’ve been eating dates, prunes, raisins, soft foods (like oatmeal and yogurt) and it’s helped.

Seven, I had Naproxen from my first surgery. The PA for my surgeon said it was fine to start taking again, but I started looking at interactions with meds and it didn’t look like a great idea. I tried it for a day, spreading it out from my Tylenol. You can take Naproxen (which is an anti-inflammatory) with aspirin, but you can’t take aspirin, Tylenol, and Naproxen together. Be careful with all your meds. Take as directed.

Eight, stick to your exercises. I do them with my mother three times a day. Pump your feet a lot, too. My foot goes cold a lot and my mother massages them once a day to get some circulation going.

Nine, rest when you need to rest. I take a nap each day. I still get quiet exhausted, both physically and emotionally. I was laying on my bed this morning after taking so long putting my clothes on by myself, and it’s tough. You feel out of touch with the world and doing anything stresses out my body. It takes 3-4x longer to do anything and it messes with your psyche. Going from Ms. Productive to Ms. Dependent isn’t a natural transition. Plus, zero privacy — not used to that at all. Challenges are everywhere.

Ten, I have to tell this hilarious story. My mother had been there for every moment. On Day 18, I took my first shower. It took an hour. She helped sit me down and actually shaved my legs for me — the best, right? She then gave me privacy to wash myself. Once I wrapped my body in towel while still sitting down, she came in and tried helping me sit up. She was behind the chair, her arms underneath my armpits in case I slipped. As our skin touched and I placed pressure on her to stand, our skin made a small farting noise. I immediately heard my mom try to hold in a laugh. Then, another fart noise came from the same spot on our arms. That was it — she died. It hurt me to laugh so I was desperate to get passed the moment, but she apologized and took a second to pull herself together. We sat me back down and everything. I would have laughed hard, too, if I wasn’t in the predicament I was in. Good times.

And to be kind, I am putting the harder to look at pictures for the end, so anyone who wishes to refrain from seeing them, you are good!

Here are some pictures from my surgery area to my skin