When I told my job I needed two weeks off they freaked, cause apparently they think the place can't run without me. Whatever. So I knew I would have to have a damn good reason to be off a month, and since I couldn't think of a good reason I only took two weeks off. That's right. I was back at work, working 12 hour days (because I had been gone for two weeks and needed to catch up), 12 days after surgery. Many people here at Susan's told me I COULD NOT do this, but I did and it was okay, although I don't recommend it unless you absolutely have to. I should mention that I was a 31 year old in virtually perfect health. Before surgery I told my endocrinologist who's well-respected in the trans community about my plans, and she told me it would be difficult but that I would be okay and that she understood why I had to. But to reiterate, don't do this unless you absolutely have to. It was very painful at times, then throw in the stress of dealing with the blood, dilating four times a day, pain, etc. and I was near breakdown a couple of times during the first two weeks. I told work that I was going on a road trip with family for two weeks, so I couldn't even let on that I was in pain.
As far as my passport went, I sent my doctor's letters off for the temporary as I had been told by the State Department, and they went ahead and sent me a permanent 10-year passport with my new gender already on it. No muss, no fuss.